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Sample records for benign gynecological diseases

  1. Association of nursing-documented ambulation with length of stay following total laparoscopic hysterectomy for benign gynecologic disease

    OpenAIRE

    Kim, Kidong; Yoo, Sooyoung; Yang, Eun Joo; No, Jae Hong; Hwang, Hee; Kim, Yong-Beom

    2013-01-01

    Objective The objective was to examine the association of postoperative physical activity with length of stay in patients who received total laparoscopic hysterectomy for benign gynecologic disease. Methods The case group was composed of 70 patients who entered a critical pathway for elective total laparoscopic hysterectomy from 2009 to 2012 and were discharged behind schedule. The control group was selected from patients who were discharged on schedule, and matched to cases using 1:3 ratio p...

  2. The debate over robotics in benign gynecology.

    Science.gov (United States)

    Rardin, Charles R

    2014-05-01

    The debate over the role of the da Vinci surgical robotic platform in benign gynecology is raging with increasing fervor and, as product liability issues arise, greater financial stakes. Although the best currently available science suggests that, in the hands of experts, robotics offers little in surgical advantage over laparoscopy, at increased expense, the observed decrease in laparotomy for hysterectomy is almost certainly, at least in part, attributable to the availability of the robot. In this author's opinion, the issue is not whether the robot has any role but rather to define the role in an institutional environment that also supports the safe use of vaginal and laparoscopic approaches in an integrated minimally invasive surgery program. Programs engaging robotic surgery should have a clear and self-determined regulatory process and should resist pressures in place that may preferentially support robotics over other forms of minimally invasive surgery. Copyright © 2014 Mosby, Inc. All rights reserved.

  3. Review of enhanced recovery programs in benign gynecologic surgery.

    Science.gov (United States)

    Trowbridge, Elisa R; Dreisbach, Caitlin N; Sarosiek, Bethany M; Dunbar, Catherine Page; Evans, Sarah Larkin; Hahn, Lee Anne; Hullfish, Kathie L

    2018-01-01

    Enhanced recovery programs (ERPs) are evidence-based protocols designed to improve functional rehabilitation after surgery. ERPs have gained widespread acceptance in many surgical disciplines, and their use leads to significant improvements in patient outcomes while reducing hospital length of stay (LOS). There remains a paucity of data on the use of ERPs in benign gynecologic surgery. The purpose of this review was to evaluate current literature on the use of ERP concepts in benign gynecologic surgery. A systematic search of PubMed, CINAHL, Web of Science, and the Cochrane databases was conducted, cross-referencing search terms related to gynecologic surgery and ERP concepts. The search was limited to publications available in English. Studies published prior to 2000, and those involving gynecologic oncology, nonadult patients, and outpatient surgery were excluded. Nine studies were included in the analysis. Due to heterogeneity of the included studies, no statistical pooling was possible and comparison between studies was limited to their respective themes. Primary study outcomes included LOS, postoperative nausea and vomiting (PONV), pain management, patient satisfaction, and hospital costs. Five studies investigated ERPs, two evaluated measures to improve PONV, and four focused on unique aspects of pain management. Across the studies, ERPs that focused on the patients' basic symptoms and recovery were found to have equal, if not better, outcomes than standard practice. This integrative review supports the implementation of ERPs in benign gynecologic surgery. The results showed that the use of ERPs decreased LOS, improved pain scores, and reduced hospital costs, without increasing perioperative complications. We suggest additional randomized controlled trials of ERP concepts in benign gynecologic surgery to support their more widespread use and application.

  4. Comparison of Laparoscopic Hysterectomy Morbidity for Gynecologic, Oncologic, and Benign Gynecologic Conditions

    Science.gov (United States)

    Mahdavi, Ali; Peiretti, Michele; Dennis, Sylvia

    2006-01-01

    Objectives: We compared the perioperative morbidity of laparoscopic hysterectomy for gynecologic oncologic (group A) and benign gynecologic (group B) indications at a single institution. Methods: This is a retrospective analysis of 159 consecutive cases of laparoscopic hysterectomy at a tertiary care university hospital. It includes 74 women with gynecologic cancers and 85 women with benign gynecologic conditions. Results: Patients in group A were significantly older and had higher body mass index (P≤0.001). The differences in mean blood loss (A, 201.1 mL; B, 183.6 mL, P=0.504), conversion to laparotomy (2 for each group), and wound infection (none) were not significant in the 2 groups. The mean operating time (253.2 and 188.2 minutes, P<0.001) and the mean length of hospital stay (3.5 days and 2.5 days, P<0.001) were significantly longer in group A. Transfusion was required for 2 patients in group A and 4 in group B. One intraoperative injury to the bladder occurred in group A. Conclusions: In spite of older age and longer operative time in cancer patients, there was no difference in perioperative complications associated with laparoscopic hysterectomy for gynecologic malignancies compared with benign gynecologic conditions. PMID:17575753

  5. Opportunistic bilateral salpingectomy during benign gynecological surgery for ovarian cancer prevention: a survey of Gynecologic Oncology Committee of Japan Society of Obstetrics and Gynecology.

    Science.gov (United States)

    Mikami, Mikio; Nagase, Satoru; Yamagami, Wataru; Ushijma, Kimio; Tashiro, Hironori; Katabuchi, Hidetaka

    2017-07-01

    Recent evidence has supported the concept that epithelial ovarian cancer (EOC) arises from the cells of the fallopian tube or endometrium. This study investigated current practice in Japan with respect to performing opportunistic bilateral salpingectomy (OBS) during gynecological surgery for benign disease for Ovarian Cancer Prevention. We mailed a questionnaire to 767 hospitals and clinics, comprising 628 accredited training institutions of the Japan Society of Obstetrics and Gynecology (JSOG), Japan Society of Gynecologic Oncology (JSGO), or Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy (JSGOE) and 139 private institutions with at least one JSGOE-certified licensed gynecologic laparoscopist. Among the 767 institutions, 444 (57.9%) provided responses, including 91 (20.6%) that were both JSGOE and JSGO accredited, 71 (16.0%) that were only JSGO accredited, 88 (19.8%) that were only JSGOE accredited, and 194 (43.7%) that were unaccredited. It was found that awareness and performance of OBS largely depended on the JSGO and/or JSGOE accreditation status. OBS was only performed at 54.0% of responding institutions and just 6.8% of the institutions were willing to participate in randomized controlled trials to validate this method for reducing the incidence of ovarian cancer. The JSOG Gynecologic Tumor Committee will announce its opinion on salpingectomy for ovarian cancer prevention to all JSOG members and will develop a system for monitoring the number of OBS procedures in Japan. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

  6. Radiotherapy of benign diseases

    International Nuclear Information System (INIS)

    Haase, W.

    1982-01-01

    Still today radiotherapy is of decisive relevance for several benign diseases. The following ones are briefly described in this introductory article: 1. Certain inflammatory and degenerative diseases as furuncles in the face, acute thrombophlebitis, recurrent sudoriparous abscesses, degenerative skeletal diseases, cervical syndrome and others; 2. rheumatic joint diseases; 3. Bechterew's disease; 4. primary presenile osteoporosis; 5. synringomyelia; 6. endocrine ophthalmopathy; 7. hypertrophic processes of the connective tissue; 8. hemangiomas. A detailed discussion and a profit-risk analysis is provided in the individual chapters of the magazine. (MG) [de

  7. Radiation therapy of benign diseases

    International Nuclear Information System (INIS)

    Order, S.E.; Donaldson, S.

    1990-01-01

    This book reports on the evaluation and treatment of benign disease. The text begins with a chapter concerning standards of practice by an eminent malpractice lawyer, thereby clarifying the medical-legal implications of the radiation treatment of benign disease. The text then lists, in alphabetic order, those benign diseases which have been or are currently treated with radiotherapy for each disease entity. A feature is the survey of current radiation practice in the United States

  8. Readmission After Gynecologic Surgery: A Comparison of Procedures for Benign and Malignant Indications.

    Science.gov (United States)

    Cory, Lori; Latif, Nawar; Brensinger, Colleen; Zhang, Xiaochen; Giuntoli, Robert L; Burger, Robert A; Morgan, Mark; Ko, Emily

    2017-08-01

    To compare 30-day postsurgical readmission rates and associated risk factors for readmission among women undergoing gynecologic surgery for benign and malignant conditions. In a retrospective cohort study, we identified patients after surgery for benign and malignant gynecologic conditions in the National Surgical Quality Improvement Program database between January 1, 2011, and December 31, 2012. Data collected included surgical factors, perioperative characteristics, surgical complications, and 30-day readmissions. The primary study outcome was readmission rates after gynecologic surgery for benign and oncologic conditions. Secondary study outcomes were risk factors associated with readmission among gynecologic surgeries performed for benign and oncologic conditions. Approximately 3% (1,444/46,718) compared with 8.2% (623/7,641) of patients who underwent gynecologic surgery for benign and malignant indications, respectively, were readmitted (Pgynecologic cancer surgery included worse preoperative conditions (OR 1.49, 95% CI 1.17-1.90) and major complications (OR 17.84, 95% CI 14.19-22.43). In comparison, independent risk factors for readmission after surgery for benign indications included comorbid conditions (OR 1.36, 95% CI 1.18-1.57), operative time (15-59 minutes: referent; 60 minutes or greater: 1.37, 95% CI 1.14-1.63) and major complications (OR 53.91, 95% CI 46.98-61.85). Among gynecologic surgeries, those performed for oncologic indications were associated with readmission rates 2.8 times that of surgeries performed for benign indications. In adjusted models, worse preoperative conditions and surgical complications remained independent risk factors associated with the higher rate of readmission among patients with gynecologic cancer.

  9. Prevention of diseases in Gynecology

    Directory of Open Access Journals (Sweden)

    Sebija Izetbegovic

    2013-01-01

    Results: There are five primary functions of management as: Anticipate and plan, organize, command, coordinate and control. If we introduce the following definition in the sense of medical science and apply it to the medical practice that would mean way of recognizing, managing and resolving issues of diagnosis and therapy of diseases (in this case gynecology diseases according to certain guidelines and treatment algorithms. Treatment of family doctors is an important aspect in the quality-of-life of women and their reproductive health as well as a significant issue in public, environmental and social problems. Conclusions: It is very important to deal with it on the primary care level and in addition to promote the primary and secondary prevention of diseases, which is sometimes more important than the curative procedures. The primary prevention involves regular gynecological examinations and screening. The doctors have also a duty to educate women about the risk factors for malignant diseases, as well as proposing some of the qualitative preventive measures.

  10. Radical Pancreaticoduodenectomy for Benign Disease

    Directory of Open Access Journals (Sweden)

    D. O. Kavanagh

    2008-01-01

    Full Text Available Whipple's procedure is the treatment of choice for pancreatic and periampullary malignancies. Preoperative histological confirmation of malignancy is frequently unavailable and some patients will subsequently be found to have benign disease. Here, we review our experience with Whipple's procedure for patients ultimately proven to have benign disease. The medical records of all patients who underwent Whipple's procedure during a 15-year period (1987–2002 were reviewed; 112 patients underwent the procedure for suspected malignancy. In eight cases, the final histology was benign (7.1%. One additional patient was known to have benign disease at resection. The mean age was 50 years (range: 30–75. The major presenting features included jaundice (five, pain (two, gastric outlet obstruction (one, and recurrent gastrointestinal haemorrhage (one. Investigations included ultrasound (eight, computerised tomography (eight, endoscopic retrograde cholangiopancreatography (seven; of these, four patients had a stent inserted and three patients had sampling for cytology, and endoscopic ultrasound (two. The pathological diagnosis included benign biliary stricture (two, chronic pancreatitis (two, choledochal cyst (one, inflammatory pseudotumour (one, cystic duodenal wall dysplasia (one, duodenal angiodysplasia (one, and granular cell neoplasm (one. There was no operative mortality. Morbidity included intra-abdominal collection (one, anastomotic leak (one, liver abscess (one, and myocardial infarction (one. All patients remain alive and well at mean follow-up of 41 months. Despite recent advances in diagnostic imaging, 8% of the patients undergoing Whipple'’s procedure had benign disease. A range of unusual pathological entities can mimic malignancy. Accurate preoperative histological diagnosis may have allowed a less radical operation to be performed. Endoscopic ultrasound–guided fine needle aspirate (EUS-FNA may reduce the need for Whipple's operation in

  11. Radical pancreaticoduodenectomy for benign disease.

    LENUS (Irish Health Repository)

    Kavanagh, D O

    2008-01-01

    Whipple\\'s procedure is the treatment of choice for pancreatic and periampullary malignancies. Preoperative histological confirmation of malignancy is frequently unavailable and some patients will subsequently be found to have benign disease. Here, we review our experience with Whipple\\'s procedure for patients ultimately proven to have benign disease. The medical records of all patients who underwent Whipple\\'s procedure during a 15-year period (1987-2002) were reviewed; 112 patients underwent the procedure for suspected malignancy. In eight cases, the final histology was benign (7.1%). One additional patient was known to have benign disease at resection. The mean age was 50 years (range: 30-75). The major presenting features included jaundice (five), pain (two), gastric outlet obstruction (one), and recurrent gastrointestinal haemorrhage (one). Investigations included ultrasound (eight), computerised tomography (eight), endoscopic retrograde cholangiopancreatography (seven; of these, four patients had a stent inserted and three patients had sampling for cytology), and endoscopic ultrasound (two). The pathological diagnosis included benign biliary stricture (two), chronic pancreatitis (two), choledochal cyst (one), inflammatory pseudotumour (one), cystic duodenal wall dysplasia (one), duodenal angiodysplasia (one), and granular cell neoplasm (one). There was no operative mortality. Morbidity included intra-abdominal collection (one), anastomotic leak (one), liver abscess (one), and myocardial infarction (one). All patients remain alive and well at mean follow-up of 41 months. Despite recent advances in diagnostic imaging, 8% of the patients undergoing Whipple\\'s procedure had benign disease. A range of unusual pathological entities can mimic malignancy. Accurate preoperative histological diagnosis may have allowed a less radical operation to be performed. Endoscopic ultrasound-guided fine needle aspirate (EUS-FNA) may reduce the need for Whipple\\'s operation

  12. Spectrum of benign breast diseases

    International Nuclear Information System (INIS)

    Khanzada, T.W.; Samad, A.; Sushel, C.

    2009-01-01

    Objective: To determine the frequencies of various benign breast diseases (BBD) in female patients in three private hospitals of Hyderabad. Methodology: This is a prospective cohort study of all female patients visiting the surgical clinic with breast problems. This study was conducted at Isra University Hospital Hyderabad and two other private hospitals of Hyderabad over a period of about three years starting from March 2004 to February 2007. All female patients visiting the surgical clinic with breast problems were included in the study. Patients with obvious clinical features of malignancy or those who on work up were diagnosed as carcinoma were excluded from the study. Results: A total of 275 patients were included in the study. About 44% (120/275) patients belonged to third decade of life (age between: 21-30 years) followed by 33% from forth decade (age between: 31- 40 years). Fibroadenoma was the most common benign breast disease, seen in 27% (75/275) of patients, followed by fibrocystic disease seen in about 21% (57/275) patients. Conclusion: Benign Breast Diseases (BBD) are common problems in females of reproductive age. Fibroadenoma is the commonest of all benign breast disease in our set up mostly seen in second and third decade of life. Fibrocystic disease of the breast is the next common BBD whose incidence increases with increasing age. (author)

  13. Bemiparin for thromboprophylaxis after benign gynecologic surgery: a randomized clinical trial.

    Science.gov (United States)

    Alalaf, S K; Jawad, A K; Jawad, R K; Ali, M S; Al Tawil, N G

    2015-12-01

    Venous thromboembolism (VTE) is the leading cause of mortality and morbidity in women following gynecologic surgery. To determine the efficacy of a second-generation low molecular weight heparin (bemiparin) for thromboprophylaxis after benign gynecologic surgery. We performed a single-blind randomized controlled trial including women in the moderate-risk, high-risk and highest-risk groups for developing VTE after benign gynecologic surgery. Participants were randomized at a 1 : 1 ratio into parallel groups to receive either seven daily doses of 3500 IU of subcutaneous bemiparin or to a non-intervention group receiving standard rehydration and advice on ambulation. Participants were followed up for 7 days and 30 days postoperatively for symptomatic VTE, which was confirmed by compression Doppler ultrasound, magnetic resonance imaging, or computed tomographic pulmonary angiography, according to the type of VTE. In total, 387 participants were randomized to the bemiparin group and 387 to the non-intervention group. The incidence of symptomatic VTE (deep vein thrombosis and pulmonary embolism) events was lower (0/377) in participants who received bemiparin than in those who received no pharmacologic intervention (12/380, 3.2%; 95% confidence interval [CI] 0.002-0.6). Logistic regression analysis showed significant associations between VTE and immobility (odds ratio [OR] 7.1; 95% CI 1.3-36.2), varicose veins (OR 16.8; 95% CI 3.1-76.2), and thrombophilia (OR 39.3; 95% CI 1.5-1006.7). There were no major bleeding events or side effects related to the use of bemiparin. Bemiparin was an effective thromboprophylactic agent for preventing venous thrombosis after benign gynecologic surgery. © 2015 International Society on Thrombosis and Haemostasis.

  14. Urinary Tract Injury in Gynecologic Laparoscopy for Benign Indication: A Systematic Review.

    Science.gov (United States)

    Wong, Jacqueline M K; Bortoletto, Pietro; Tolentino, Jocelyn; Jung, Michael J; Milad, Magdy P

    2018-01-01

    To perform a comprehensive literature review of the incidence, location, etiology, timing, management, and long-term sequelae of urinary tract injury in gynecologic laparoscopy for benign indication. A systematic review of PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov was conducted. Four hundred thirty-three studies were screened for inclusion with 136 full-text articles reviewed. Ninety studies published between 1975 and 2015 met inclusion criteria, representing 140,444 surgeries. Articles reporting the incidence of urinary tract injury in gynecologic laparoscopy for benign indication were included. Exclusion criteria comprised malignancy, surgery by urogynecologists, research not in English, and insufficient data. A total of 458 lower urinary tract injuries were reported with an incidence of 0.33% (95% CI 0.30-0.36). Bladder injury (0.24%, 95% CI 0.22-0.27) was overall three times more frequent than ureteral injury (0.08%, 95% CI 0.07-0.10). Laparoscopic hysterectomy not otherwise specified (1.8%, 95% CI 1.2-2.6) and laparoscopically assisted vaginal hysterectomy (1.0%, 95% CI 0.9-1.2) had the highest rates of injury. Most ureteral injuries resulted from electrosurgery (33.3%, 95% CI 24.3-45.8), whereas most bladder injuries resulted from lysis of adhesions (23.3%, 95% CI 18.7-29.0). Ureteral injuries were most often recognized postoperatively (60%, 95% CI 47-76) and were repaired by open ureteral anastomosis (47.4%, 95% CI 36.3-61.9). In contrast, bladder injuries were most often recognized intraoperatively (85%, 95% CI 75-95) and were repaired by laparoscopic suturing (34.9%, 95% CI 29.2-41.7). The incidence of lower urinary tract injury in gynecologic laparoscopy for benign indication remains low at 0.33%. Bladder injury was three times more common than ureteral injury, although ureteral injuries were more often unrecognized intraoperatively and underwent open surgical repair. These risk estimates can assist gynecologic surgeons in effectively

  15. Differential Diagnosis of Gynecologic Organ-Related Diseases in Women Presenting with Ascites

    Directory of Open Access Journals (Sweden)

    Ming-Huei Cheng

    2008-12-01

    Full Text Available Ascites is a pathologic accumulation of fluid within the peritoneal cavity, and usually develops as a result of liver disease, congestive heart failure or nephrotic syndrome. Ascites is also a common manifestation of some gynecologic diseases. It is important that health care workers consider gynecologic problems among the potential differential diagnoses in patients presenting with ascites. Various kinds of ovarian diseases, such as epithelial ovarian cancer, benign ovarian fibroma, stromal hyperplasia, ovarian hyperstimulation syndrome, primary peritoneal serous carcinoma, endometriosis and peritoneal tuberculosis, should be kept in mind when women are found to have ascites.

  16. Benign paroxysmal positional vertigo in Parkinson's disease

    NARCIS (Netherlands)

    Wensen, E. van; Leeuwen, R.B. van; Zaag-Loonen, H.J. van der; Masius-Olthof, S.; Bloem, B.R.

    2013-01-01

    BACKGROUND: Dizziness is a frequent complaint of patients with Parkinson's disease (PD), and orthostatic hypotension (OH) is often thought to be the cause. We studied whether benign paroxysmal positional vertigo (BPPV) could also be an explanation. AIM: To assess the prevalence of benign paroxysmal

  17. Patient positioning for robot-assisted laparoscopic benign gynecologic surgery: A review.

    Science.gov (United States)

    Takmaz, Ozguc; Asoglu, Mehmet Resit; Gungor, Mete

    2018-04-01

    Robotic surgical platforms are now in widespread use in the practice of gynecology all over the world. The introduction of robotic surgery has required some modifications of patient positioning when compared to standard laparoscopic surgery. Optimal patient positioning is likely to be the most essential step of robotic surgery as it provides the technical feasibility to have adequate access to the pelvic structures for performing the surgery. It is prudent to pay attention to preventing patient shifting in Trendelenburg position because of tendency of sliding down toward the direction of the head. Inappropriate patient positioning is associated with inadequate exposure of the operative field as well as detrimental complications that may lead to long-term side effects. These issues can be reduced with use of proper or strategic positioning technique. The purpose of this review is to highlight important points to properly position patient for robot-assisted laparoscopic benign gynecologic surgery and protect patient from position-related injuries. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Benign paroxysmal positional vertigo in Parkinson's disease.

    Science.gov (United States)

    van Wensen, E; van Leeuwen, R B; van der Zaag-Loonen, H J; Masius-Olthof, S; Bloem, B R

    2013-12-01

    Dizziness is a frequent complaint of patients with Parkinson's disease (PD), and orthostatic hypotension (OH) is often thought to be the cause. We studied whether benign paroxysmal positional vertigo (BPPV) could also be an explanation. To assess the prevalence of benign paroxysmal positional vertigo in patients with Parkinson's disease, with and without dizziness. 305 consecutive outpatients with PD completed the Movement Disorders Society-sponsored revision of the Unified Parkinsons' Disease Rating Scale-motor score, the Dizziness Handicap Inventory, the Dix-Hallpike maneuver and a test for orthostatic hypotension. When positive for benign paroxysmal positional vertigo, a repositioning maneuver was performed. Patients were followed for three months to determine the clinical response. 305 patients responded (186 men (61%), mean age 70.5 years (Standard Deviation 9.5 years)), of whom 151 (49%) complained of dizziness. 57 (38%) of the dizzy patients appeared to have orthostatic hypotension; 12 patients (8%) had a classical but previously unrecognized benign paroxysmal positional vertigo. A further four patients (3%) had a more atypical presentation of benign paroxysmal positional vertigo. Three months after treatment, 11 (92%) of patients with classical benign paroxysmal positional vertigo were almost or completely without complaints. We found no 'hidden' benign paroxysmal positional vertigo among patients without dizziness. The prevalence of benign paroxysmal positional vertigo among all patients with PD was 5.3%. Among Parkinson patients with symptoms of dizziness, up to 11% may have benign paroxysmal positional vertigo, which can be treated easily and successfully. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  19. The decline of hysterectomy for benign disease.

    LENUS (Irish Health Repository)

    Horgan, R P

    2012-01-31

    Hysterectomy is one of the most common gynaecological surgical procedures performed but there appears to be a decline in the performance of this procedure in Ireland in recent times. We set out to establish the extent of the decline of hysterectomy and to explore possible explanations. Data for hysterectomy for benign disease from Ireland was obtained from the Hospital In-Patient Enquiry Scheme (HIPE) section of the Economic and Social Research Institute for the years 1999 to 2006. The total number of hysterectomies performed for benign disease showed a consistent decline during this time. There was a 36% reduction in the number of abdominal hysterectomy procedures performed.

  20. Imaging malignant and apparent malignant transformation of benign gynaecological disease

    Energy Technology Data Exchange (ETDEWEB)

    Lee, A.Y.; Poder, L.; Qayyum, A.; Wang, Z.J.; Yeh, B.M. [Department of Radiology, University of California San Francisco, San Francisco, CA (United States); Coakley, F.V., E-mail: Fergus.Coakley@radiology.ucsf.ed [Department of Radiology, University of California San Francisco, San Francisco, CA (United States)

    2010-12-15

    Common benign gynaecological diseases, such as leiomyoma, adenomyosis, endometriosis, and mature teratoma, rarely undergo malignant transformation. Benign transformations that may mimic malignancy include benign metastasizing leiomyoma, massive ovarian oedema, decidualization of endometrioma, and rupture of mature teratoma. The aim of this review is to provide a contemporary overview of imaging findings in malignant and apparent malignant transformation of benign gynaecological disease.

  1. Impact of radiation therapy for benign diseases

    International Nuclear Information System (INIS)

    Kantor, G.; Van Houtte, P.; Beauvois, S.; Roelandts, M.

    1997-01-01

    Radiation therapy of benign diseases represent a wide panel of indications. Some indications are clearly identified as treatment of arteriovenous malformations (AVM), hyperthyroid ophthalmopathy, postoperative heterotopic bone formations or keloid scars. Some indications are under evaluation as complications induced by neo-vessels of age-related macular degeneration or coronary restenosis after angioplasty. Some indications remain controversial with poor evidence of efficiency as treatment of bursitis, tendinitis or Dupuytren's disease. Some indications are now obsolete such as warts, or contra-indicated as treatment of infant and children. (authors)

  2. Surgery versus pharmacotherapy of benign thyroid diseases

    International Nuclear Information System (INIS)

    Younes, Nidal A.; Albousal, Abla M.

    2003-01-01

    Surgical management of thyroid diseases (BTDs) has been a topic of interest and confusion for many years. Almost 80% of thyroidectomies at an average endocrine surgical unit are carried out for BTDs.Resistance to surgical intervention in BTDs has been based on the belief that increased complication rate is inherent in its use, this is despite thepotential advatages in terms of confirming the benign nature of the lesion, controlling the disease, and relieving of local symptoms of large neck mass. Benign thyroid diseases are more likely to occur in middle-aged woman living in iodine deficient areas, or have a family history of goiter, or in patients taking iodine-containig drugs, like amoidarone, or in patients with previous history of x-ray exposure. However, the physician must be carefull in making the diagnosis of BTDsin patients of extremes of age or in presence of positive history of radiation, or in patients with family history of thyroid or colon cancer . In this atricle we will review the etiology,epidemiology , diagonastic methodologiesand the recent trends in the sugical and medical mangement of BTDs. (author)

  3. CT and MR imaging of gynecological emergency disease

    International Nuclear Information System (INIS)

    Fujii, Shinya; Kinoshita, Toshibumi; Tahara, Takatoshi; Matsusue, Eiji; Ogawa, Toshihide

    2004-01-01

    We describe the CT and MRI findings of gynecologic emergency diseases: pelvic inflammatory disease, ectopic pregnancy, ovarian hemorrhage, ovarian torsion, rupture of ovarian tumor, eclampsia, and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. Diagnostic keys to these diseases are presented in this review. CT and MRI play a complementary role to sonography in accurately diagnosing these diseases. In situations that require an exact, immediate diagnosis, radiologists should be familiar with the key imaging findings. (author)

  4. The radiation therapy of benign diseases

    International Nuclear Information System (INIS)

    Hess, F.

    1980-01-01

    X-ray should only be applied when other forms of treatment of good-natured diseases do not provide equally good results. One should note that somatic lesion should be completely avoided and genetic lesion avoided to the greatest probability. One can distinguish according to ones aims between inflammation irradiation, pain irradiation, stimulation therapy and functional therapy. An indication for inflammation irradiation can be post-operative parotitis, furuncle in the face, mastitis puerperalis, panaritium ossale, recurrent sudoriparouns abscesses and repelling reactions after transplanting organs. Pain irradiation is indicated with degenerative diseases of the skeleton system. A further possible application is radiotherapy of hypotrophic processes and benign tumours. Functional radiotherapy is indicated with hyperendocrinism, neurovegetative disorders and allergies. (MG) [de

  5. Radiotherapy of benign diseases in Berlin (West)

    International Nuclear Information System (INIS)

    1. In Berlin (West), X-ray therapy was applied during the year 1973 in 18 hospitals and by 33 practicing physicians. The 3rd quarter of the year 1973 was taken as basis for the frequency of therapeutic X-ray application. From a total of 15912 patients, 9432 were X-rayed on account of malignant diseases, 6480 because of benigne diseases. This number definitely surpasses the number of cases treated in Munich by X-ray therapy. In Berlin, this might be connected to the age structure. 2. Utilizing the quotations and calculations put down in the report about the effect of atomic radiation by the Scientific Committee of the United Nations, and the values quoted for gonadal doses in the literature, a total-GSD-value of 0.82 +- 0.2 mrem/a was calculated for hospitals and practicing physicians in Berlin. In spite of higher frequencies, this value is approximately of the same order of magnitude as the values calculated for Munich for the year 1971 by I. and H.P. Schmelz. 3. The total-GSD-value for the population of the Federal Republic of Germany resulting from artificial radiation exposure during 1976 is reported to be approximately 60 mrem. Thus, the GSD-value for the X-ray therapy of benign diseases lies approximately at 1.3% and should be of minor significance for radiation-hygienic reflections. 4. Of primary concern is still the radiation exposure to individual patients. Because of possible secondary effects, X-ray therapy for keloids and hemangiomas in infancy and youth are of particular significance. For this reason, its proportion to GSD is also in Berlin relatively large. (orig.) [de

  6. CT application in diagnosing benign diseases of breast

    International Nuclear Information System (INIS)

    Ge Jingfang; Chen Qi; He Guoxiang

    2000-01-01

    Objective: To evaluate the value of CT for diagnosing benign diseases of breast. Methods: The breast CT scan and mammography were performed on 44 patients (78 focus). The accuracy of determining the position and nature of breast diseases was compared between the two mentioned diagnostic methods. All cases were confirmed as breast benign disease by pathology. Results: CT played a remarkable role in the diagnosis of breast fibroadenoma and cyst, and is superior to mammography in demonstrating deep breast lesion, multiple-focus and multiple-patterns benign diseases of breast. The accuracy of CT and mammography in determining the position and nature of benign diseases of breast were 85% and 54% (x 2 = 12.58, P 2 = 8.29, P < 0.01) respectively. Conclusion: CT has a higher accuracy than mammography in determining the position and nature of breast benign disease

  7. The ABC of benign breast disease | Ndhluni | Continuing Medical ...

    African Journals Online (AJOL)

    Benign breast disease is common, although the incidence is sparsely documented in the literature and is probably quite underestimated. The main reason is that it is regarded as unimportant, with far more attention being focused on breast cancer. However, benign breast disease is far more common than breast cancer.

  8. Modern role and issues of radiation therapy for benign diseases

    International Nuclear Information System (INIS)

    Miyashita, Tsuguhiro; Tateno, Atsushi; Kumazaki, Tatsuo

    1999-01-01

    Cases of radiation therapy for benign diseases have diminished in number because of recent alternative methods and knowledge about radiation carcinogenesis. In contrast to this tendency, our cases of benign diseases have recently increased. The facts made us reconsider today's radiation therapy of benign diseases. We reviewed 349 patients who were diagnosed as having benign tumors or non-neoplastic conditions and treated by radiation therapy in the past sixteen years. Analyzed items were the annual transition of treatment number, sorts of diseases, patients' age and sex, and the goal of therapy. Of all radiation therapy patients, benign diseases account for 9.26%. The annual percentages were 0.5%, 6.0%, 11.2% and 13.7% at intervals of five years since 1982. The majority was 246 post-operative irradiation for keloids (71%) and 41 pituitary adenomas (12%). Compared with malignant tumors, benign disease patients were statistically younger and female-dominant. Applications of radiation therapy in keloids and pituitary adenomas had definite goals, but were unclear in other rare diseases. Benign diseases should be treated by radiation therapy as the second or third option, provided the patients have serious symptoms and their diseases do not respond to other modalities. It seems to be widely accepted that favorite cases such as keloids and pituitary adenomas are treated by radiation therapy. But, optimal radiation therapies for other rare benign diseases have not been established. Therefore, the building of databases on radiation therapy on benign diseases should be pursued. Since benign disease patients were young and female-dominant and had many remaining years, their carcinogenicity potential should be considered. (author)

  9. CT diagnosis of pelvic hemoperitoneum in obstetric and gynecologic diseases

    International Nuclear Information System (INIS)

    Iwasaki, Yoshie; Nakayama, Fumie; Ohnishi, Takeshi; Sakuyama, Keiko; Ishikawa, Tohru

    1996-01-01

    We reviewed CT findings of 10 cases with ovarian hemorrhage and 8 cases with ruptured ectopic pregnancy. Pelvic hematomas were surgically proven in 8 of 10 patients with ovarian hemorrhage and 8 of 8 patients with ruptured ectopic pregnancy. All cases showed high density hematomas (mean attenuation: 73.4) in the pelvic space. CT has high predictive value for pelvic hemoperitoneum in obstetric and gynecologic diseases. (author)

  10. Smoking habit and benign breast disease

    International Nuclear Information System (INIS)

    Dziewulska-Bokiniec, A.

    1995-01-01

    The possible association between cigarette smoking and the risk of benign breast disease (BBD) was assessed in a case-control study conducted in Gdansk, Poland, between 1990 and 1994. The study compared 160 women with newly diagnosed BBD admitted to the Gdansk Cancer Outpatients Clinic and 160 controls, women from outpatients clinics at the Medical University of Gdansk. There was no convincing evidence of an association, either positive or negative, between various indicators of smoking habit (smoking status, number of cigarettes smoked per day, duration of smoking) and the risk of BBD. Slightly lower relative risk (RRs) of BBD in ex-smokers of 10 or more cigarettes per day (RR = 0.9; 95% confidence interval, CI: 0.4-2.2), and with duration of smoking >= (RR = 0.1-3.4), were also observed in current smokers (RR = 0.8; 95% CI: 0.4-1.5), and (RR = 0.8; 95% CI: 0.1-3.4), but these findings were not statistically significant. (author)

  11. Clinical application of pelvic MR angiography for gynecologic diseases

    International Nuclear Information System (INIS)

    Ohnishi, Takeshi

    1996-01-01

    Magnetic resonance (MR) imaging is the second most important method next to the ultrasound for the diagnosis of gynecological disorders. MR angiography provides a new noninvasive method for evaluating vascular occlusive disease of the lower extremities and the branches of abdominal aorta. To our knowledge, no determinant of efficacy of MR angiography and images of gynecological diseases have yet been made. Maximum intensity projection image was obtained from the data set by the three dimensional contrast enhanced MR angiography (3D-CE MRA) with newly designed fat suppression method. MR angiogram reveals well visualization of lower abdominal aorta and its branches. Furthermore, uterine arteries were identified in 49.3% of the cases, branching from the internal iliac artery. Leiomyoma of the uterus showed an enhanced uterus in 53.7% of the eases. All cases of endometriosis demonstrated a homogeneous, high signal intensity being a specific finding. In conclusion, maximum intensity projection image of pelvis showed a good visualization of the lower abdominal aorta and its branches. Uterine artery and, in a few cases, ovarian artery can be demonstrated on MR angiography. All cases of endometriosis showed a significant, high signal intensity. This technique is noninvasive and be a supplementary method for diagnosis and follow up of vasculature of gynecological disorders. (author)

  12. Sclerotherapy for Benign Cystic Diseases in the Neck

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hoon; Sohn, Chul Ho; Choi, Seung Hong; Yun, Tae Jin [Dept. of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2012-08-15

    Surgery has been the classic treatment of choice for benign cystic diseases, including lymphatic malformation, ranula, branchial cleft cyst, thyroglossal duct cyst, thyroid cyst, parathyroid cyst, and lymphocele. However, surgery is associated with a tendency toward recurrence and may be accompanied by various complications, such as nerve injuries, vascular injuries, and scar formation. Therefore, sclerotherapy using various agents has been applied successfully to treatment of benign cystic diseases in the neck. This editorial reviews the use of various sclerotic agents and application of sclerotherapy to benign cystic diseases in the neck.

  13. The ABC of benign breast disease

    African Journals Online (AJOL)

    reassurance of its benign nature may be all that is necessary, along with firm brassiere support and, possibly, the use of mild analgesics. Underlying precipitating factors, such as marijuana or other drug use, should be eliminated. Some patients benefit from avoidance of methylxanthines (i.e. caffeine in cola, tea, and coffee), ...

  14. Insights from radiation treatment for benign disease

    Energy Technology Data Exchange (ETDEWEB)

    Bleehen, N.M.

    1987-08-29

    This note compares mortality figures for patients treated with low dose ionizing radiation for benign conditions between the 1920's and 1950's with figures available from the Japanese A-bomb survivors. X radiation for ringworm, ankylosing spondylitis and post-partum mastitis are considered. Figures for leukemia are roughly comparable between radiotherapy groups and A-bomb survivors. Figures for the increased relative risk of breast cancer in spondylitis patients were in marked contrast to bomb survivors who received comparable doses, but compatible with the increase among women given x-rays for acute post-partum mastitis in the 1940's and 1950's. This study also suggests the possibility of different time patterns of risk between different cancers. (U.K.).

  15. Bowel Obstruction Caused by Colorectal Cancer Masquerading as Extrinsic Compression of Benign Gynecologic Tumors: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Wen-Chiung Hsu

    2004-03-01

    Conclusion: Although a lower abdominal tumor with bowel obstruction can be considered to be a result of a gynecologic tumor by physical examination and sonography, colorectal cancer should be included in the differential diagnosis.

  16. Developmental competence of immature oocytes aspirated from antral follicles in patients with gynecological diseases

    Directory of Open Access Journals (Sweden)

    Fereshteh Safian

    2015-08-01

    Full Text Available Background: In vitro maturation (IVM of immature oocytes collected from ovary has been proposed for fertility preservation. In addition, quality of oocytes post IVM is one of the factors determining its developmental competence. By using the non-invasive Polscope system, both meiotic spindle (MS and zona pellucida (ZP can be assessed in living oocytes. Objective: The aim was to investigate the developmental potential of immature oocytes retrieved from ovarian tissue after IVM, as a method for fertility preservation, in patients with gynecological diseases. Materials and Methods: The ovarian cortex from 26 patients with malignant and benign diseases (21-45 years old, were obtained directly from collaborating hospitals, and transported to the IVF center on ice. In total 61 immature oocytes were aspirated, of which 18 (29.5% were degenerated and discarded. The remaining 43 (70.5% healthy oocytes were cultured in IVM culture media for 48 hr. The rate of maturity was assessed, and the ZP birefringence and MS were imaged with Polscope technology. Results: Overall 43 immature oocytes underwent IVM technology, of which 30.2% reached viable metaphase II (MII oocytes. The ovarian tissues of 9 (34.6% women were lacking oocytes at any stage. During polarized light microscopy examination, MS could be visualized only in one of the MII oocytes, but high ZP birefringence’s were observed in the majority of the oocytes post IVM (61.5%. Conclusion: Oocytes maturation post IVM from unstimulated ovaries showed a good developmental competence in gynecologic patients. Further studies should be performed to advance the oocyte maturation program, such as co-culture system, for fertility preservation.

  17. Impact of radiation therapy for benign diseases; Role de la radiotherapie dans les affections benignes

    Energy Technology Data Exchange (ETDEWEB)

    Kantor, G. [Institut National de la Sante et de la Recherche Medicale (INSERM), Fondation Bergonie, 33 - Bordeaux (France); Van Houtte, P.; Beauvois, S.; Roelandts, M. [Institut Bordet, Brussels (Belgium)

    1997-12-31

    Radiation therapy of benign diseases represent a wide panel of indications. Some indications are clearly identified as treatment of arteriovenous malformations (AVM), hyperthyroid ophthalmopathy, postoperative heterotopic bone formations or keloid scars. Some indications are under evaluation as complications induced by neo-vessels of age-related macular degeneration or coronary restenosis after angioplasty. Some indications remain controversial with poor evidence of efficiency as treatment of bursitis, tendinitis or Dupuytren`s disease. Some indications are now obsolete such as warts, or contra-indicated as treatment of infant and children. (authors)

  18. Robotic surgery in complicated gynecologic diseases: Experience of Tri-Service General Hospital in Taiwan

    Directory of Open Access Journals (Sweden)

    Shun-Jen Tan

    2012-03-01

    Conclusion: The present analyses include various complicated gynecologic conditions, which make the estimation of the effectiveness of robotic surgery in each situation individually not appropriate. However, our experiences do show that robotic surgery is feasible and safe for patients with complicated gynecologic diseases.

  19. [Benign multicystic peritoneal mesothelioma in a patient with Crohn disease].

    Science.gov (United States)

    Fluxá, Daniela; Kronberg, Udo; Lubascher, Jaime; O'Brien, Andrés; Las Heras, Facundo; Ibáñez, Patricio; Quera, Rodrigo

    2016-12-01

    Benign multicystic peritoneal mesothelioma is an uncommon lesion arising from the peritoneal mesothelium. It is asymptomatic or presents with unspecific symptoms. Imaging techniques may reveal it, however the final diagnosis can only be made by histopathology. Surgery is the only effective treatment considering its high recurrence rate. We report a 19 years old male with Crohn’s disease. Due to persistent abdominal pain, an abdominal magnetic resonance imaging was performed, showing a complex cystic mass in the lower abdomen. The patient underwent surgery and the lesion was completely resected. The pathological study reported a benign multicystic peritoneal mesothelioma.

  20. Histerectomia e as doenças ginecológicas benignas: o que está sendo praticado na Residência Médica no Brasil? Hysterectomy and benign gynecological diseases: what has been performed in Medical Residency in Brazil?

    Directory of Open Access Journals (Sweden)

    Helena Lúcia Zydan Sória

    2007-02-01

    Full Text Available OBJETIVO: avaliar o ensino e a prática da histerectomia no Brasil nas diferentes regiões do país e compará-las com dados da literatura mundial. MÉTODOS: foram enviados questionários aos 132 Serviços de Residência Médica de Ginecologia e Obstetrícia do Brasil cadastrados pelo Ministério da Educação e Cultura em 2003. O mesmo continha nove questões sobre indicações em casos de doenças benignas, procedimentos operatórios, uso de antibioticoprofilaxia, fios para sutura da cúpula vaginal e complicações. Para a análise dos resultados, foram aplicados os testes de Friedman, Kruskal-Wallis e chi2, conforme a natureza das variáveis. RESULTADOS: nos 48,5% de questionários respondidos ou justificados (não-respostas, houve predomínio da região Sudeste (62%. A via operatória preferencial foi a abdominal, variando de 60 a 100% em média (pPURPOSE: to evaluate the teaching and the practice of hysterectomy in the Brazilian regions and to compare them with data of international literature. METHODS: questionnaires about nine issues on benign hysterectomy indications, surgical procedures, use of antibiotic prophylaxis, suture of the vaginal vault and complications were sent to the 132 Gynecological and Obstetrics Residency Services of Brazil, registered by the Ministry of the Education and Culture in 2003. Data were computed and statically analyzed, with the use of the Friedman's, Kruskal-Wallis's and chi2 tests, according to the characteristics of the variables. RESULTS: 48.5% of the questionnaires were answered or justified when there were no answers, mainly in the Southeastern region (62%. The main surgical hysterectomy procedure was the abdominal, varying from 60 to 100% (p<0.001, followed by the vaginal (10 to 40% and the laparoscopy (6%. In 94% of the cases, laparoscopy was not employed. The main indication for hysterectomy was myomatosis (60.4%; p<0.001, followed by adenomiosis (8.3% and abnormal uterine bleeding (7.5%. First

  1. GYNECOLOGICAL STATUS OF PATIENTS WITH COLORECTAL CANCER

    Directory of Open Access Journals (Sweden)

    V. A. Solodky

    2015-01-01

    Full Text Available The purpose of the study was to identify risk factors for colorectal cancer on the basis of retrospective analysis of gynecological history and status of 183 patients with colon adenocarcinoma treated at the Russian X-Ray Radiology Research Center between 1996 and 2011. Evaluation of gynecological status was based on findings  of gynecological, transvaginal and ultrasound examinations of the genitals, as well as on cytological cervical screening and colposcopy. Hysteroscopy and separate diagnostic curettage were performed if necessary. Gynecological status of patients with colorectal cancer was characterized by ovarian hypofunction and high incidence of benign non-inflammatory (78.1 % and inflammatory (88.0 % disorders of genital tract. In most cases (63.9 % polyneoplasia in patients with colorectal cancer combined with breast, endometrial and ovarian cancers. Considering younger age of the onset of benign disease of the genital tract, this group of patients should be followed up carefully for the development of colon cancer.

  2. Nuclear medicine for diagnosis in benign diseases of the skeleton. Nuklearmedizinische Knochendiagnostik benigner Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Feine, U. (Tuebingen Univ. (Germany). Abt. fuer Nuklearmedizin)

    1992-12-01

    In summary, the lecture presents today's state of nuclear medical diganostics in benign bone disease, the radiopharmaceuticals, and the methods used. Besides the [sup 99]m-Tc-labeled diphosphonates a couple of additional radioactive labeled substances play an important part in bone scintigraphic imaging especially in scanning inflammatory bone disease and the bone marrow. There are several substances available to label leucocytes and human immunoglobulins. Concerning the methods the performance of the 3-phase bone scanning and the application of SPECT becomes increasingly important. In detail discussed are among other methods the inflammation-scanning in osteomyelitis, the scintigraphic imaging in benign bone tumors and tumor like lesions, in circulation disorders of the bone with necroses and hyperperfusion (reflex sympathetic dystrophy, transient hip osteoporosis), and in bone lesions following trauma or stress, for example also in battered child syndrome. The indication to the different imaging procedures as X-ray, computed tomography, nuclear magnetic resonance, and scintigraphic imaging are discussed, whereby the scintiscanning urges its place, mainly due to good specifity, in documenting the different functional states of the bone such as inflammation, perfusion, necrosis, tumor and/or bone marrow infiltration. (orig.).

  3. The effect of peritoneal gas drain on postoperative pain in benign gynecologic laparoscopic surgery: a double-blinded randomized controlled trial controlled trial

    Directory of Open Access Journals (Sweden)

    Tharanon C

    2016-08-01

    Full Text Available Chantip Tharanon, Kovit Khampitak Department of Obstetrics and Gynecology, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand Objectives: To compare the effect of peritoneal gas drain on postoperative pain in benign gynecologic laparoscopic surgery and the amount of postoperative analgesic dosage.Methods: The trial included 45 females who had undergone operations during the period December 2014 to October 2015. The patients were block randomized based on operating time (<2 and ≥2 hours. The intervention group (n=23 was treated with postoperative intraperitoneal gas drain and the control group (n=22 was not. The mean difference in scores for shoulder, epigastric, suprapubic, and overall pain at 6, 24, 48 hours postoperatively were statistically evaluated using mixed-effect restricted maximum likelihood regression. The differences in the analgesic drug usage between the groups were also analyzed using a Student’s t-test. The data were divided and analyzed to two subgroups based on operating time (<2 hours, n=20; and ≥2 hours, n=25.Results: The intervention had significantly lower overall pain than the control group, with a mean difference and 95% confidence interval at 6, 24, and 48 hours of 2.59 (1.49–3.69, 2.23 (1.13–3.34, and 1.48 (0.3–2.58, respectively. Correspondingly, analgesic drug dosage was significantly lower in the intervention group (3.52±1.47 mg vs 5.72±2.43 mg, P<0.001. The three largest mean differences in patients with operating times of ≥2 hours were in overall pain, suprapubic pain at 6 hours, and shoulder pain at 24 hours at 3.27 (1.14–5.39, 3.20 (1.11–5.26, and 3.13 (1.00–5.24, respectively. These were greater than the three largest mean differences in the group with operating times of <2 hours, which were 2.81 (1.31–4.29, 2.63 (0.51–4.73, and 2.02 (0.68–3.36. The greatest analgesic drug requirement was in the control group with a longer operative time.Conclusion: The use of

  4. A modified three-port “hidden scars” surgical approach in gynecology: A surgeon's experience of an initial 72 cases

    OpenAIRE

    Wong, Felix Wu Shun; Lee, Eric Tat Choi

    2014-01-01

    Objective: The study objectives were to determine the surgical outcomes of a personal series of gynecological patients treated with a modified three-port “hidden scars” surgical approach (HS surgical approach) for the treatment of benign gynecological diseases. Study design: This was a retrospective series performed by one of the study authors FW to analyze 72 women treated with a modified three-port HS approach for the treatment of benign gynecological diseases from January 2013 to August...

  5. Venous thromboembolic events in minimally invasive gynecologic surgery

    Science.gov (United States)

    Ramirez, Pedro T.; Nick, Alpa M.; Frumovitz, Michael; Schmeler, Kathleen M.

    2015-01-01

    The rate of venous thromboembolic events (VTE) including deep venous thrombosis (DVT) and pulmonary embolism (PE) among women undergoing gynecologic surgery is high, particularly for women with a gynecologic malignancy. Current guidelines recommend VTE thrombopropylaxis in the immediate postoperative period for patients undergoing open surgery. However, the VTE prophylaxis recommendations for women undergoing minimally invasive gynecologic surgery are not as well established. The risk of VTE in patients undergoing minimally invasive surgery appears to be low based on retrospective analyses. To date, there are no established guidelines that specifically provide a standard of care for patients undergoing minimally invasive gynecologic surgery for benign or malignant disease. PMID:23850360

  6. Radiation for not-so-benign coronary artery disease

    International Nuclear Information System (INIS)

    Massullo, Vincent

    1996-01-01

    The role of radiation therapy in the treatment of malignant disease has long been accepted. More limited application of radiation in the treatment of benign conditions has been proven but generally not pursued. On the centennial anniversary of radiation therapy, a promising, but as yet unproved, application of radiation for treatment of benign vascular disease has become an exciting field of research, speculation, and controversy. This panel presentation will discuss the rationales and dilemmas of applying radiation in the prevention of arterial restenosis after therapeutic intervention. Coronary artery bypass grafting and more recently coronary angioplasty have become accepted, effective therapies to reverse significant coronary stenosis, and thereby benefit the majority of patients with coronary artery disease. However, a large proportion of patients will suffer restenosis in spite of optimal conventional therapy. The search for a means to prevent such restenosis has been partially successful by therapies, and even engineering intravascular devices. In spite of these efforts, a significant number of patients will fail today's conventional therapy and suffer arterial restenosis. Fibroblast myointimal proliferation is felt to be a major element in this restenosis process. Clinical experience shows that radiation inhibits other similar benign fibroblast proliferative processes such as keloid scar formation and heterotopic ossification. Radiation is now being considered as a means to inhibit myointimal fibroblast proliferation and hopefully prevent attendant arterial restenosis as well. This has catalyzed various animal model investigations that have shown significant arteries. Promising results in the animal model and in very early human institutional trials. These trials are designed to determine if radiation is truly effective and can be safely delivered to prevent restenosis in diseased human arteries. This panel discussion will provide a firm basic science and

  7. Nuclear medicine for diagnosis in benign diseases of the skeleton

    International Nuclear Information System (INIS)

    Feine, U.

    1992-01-01

    In summary, the lecture presents today's state of nuclear medical diganostics in benign bone disease, the radiopharmaceuticals, and the methods used. Besides the 99 m-Tc-labeled diphosphonates a couple of additional radioactive labeled substances play an important part in bone scintigraphic imaging especially in scanning inflammatory bone disease and the bone marrow. There are several substances available to label leucocytes and human immunoglobulins. Concerning the methods the performance of the 3-phase bone scanning and the application of SPECT becomes increasingly important. In detail discussed are among other methods the inflammation-scanning in osteomyelitis, the scintigraphic imaging in benign bone tumors and tumor like lesions, in circulation disorders of the bone with necroses and hyperperfusion (reflex sympathetic dystrophy, transient hip osteoporosis), and in bone lesions following trauma or stress, for example also in battered child syndrome. The indication to the different imaging procedures as X-ray, computed tomography, nuclear magnetic resonance, and scintigraphic imaging are discussed, whereby the scintiscanning urges its place, mainly due to good specifity, in documenting the different functional states of the bone such as inflammation, perfusion, necrosis, tumor and/or bone marrow infiltration. (orig.) [de

  8. Basics of Radiation Biology When Treating Hyperproliferative Benign Diseases

    Directory of Open Access Journals (Sweden)

    Franz Rödel

    2017-05-01

    Full Text Available For decades, low- and moderate-dose radiation therapy (RT has been shown to exert a beneficial therapeutic effect in a multitude of non-malignant conditions including painful degenerative muscoloskeletal and hyperproliferative disorders. Dupuytren and Ledderhose diseases are benign fibroproliferative diseases of the hand/foot with fibrotic nodules and fascial cords, which determine debilitating contractures and deformities of fingers/toes, while keloids are exuberant scar formations following burn damage, surgery, and trauma. Although RT has become an established and effective option in the management of these diseases, experimental studies to illustrate cellular composites and factors involved remain to be elucidated. More recent findings, however, indicate the involvement of radiation-sensitive targets like mitotic fibroblasts/myofibroblasts as well as inflammatory cells. Radiation-related molecular mechanisms affecting these target cells include the production of free radicals to hamper proliferative activity and interference with growth factors and cytokines. Moreover, an impairment of activated immune cells involved in both myofibroblast proliferative and inflammatory processes may further contribute to the clinical effects. We here aim at briefly describing mechanisms contributing to a modulation of proliferative and inflammatory processes and to summarize current concepts of treating hyperproliferative diseases by low and moderate doses of ionizing radiation.

  9. [Coeliac disease as a possible cause of some gynecological and obstetric abnormalities].

    Science.gov (United States)

    Fiolková, K; Biringer, K; Hrtánková, M; Fiolka, R; Danko, J

    To bring a review of available literature sources on the prevalence of coeliac disease and its possible impact on gynecological and obstetric disorders. Review article. Gynecology and Obstetrics Clinic, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia. Analysis of literary sources. Coeliac disease is an autoimmune enteropathy caused by abnormal immune system response to gluten. Over the last decade when the prevalence of the disease increases rapidly confirming the relationship between coeliac disease and a range of reproductive disorders. Problems in this area are mostly confirmed in untreated women. Among the atypical symptoms of coeliac disease also include infertility such as delayed onset of menstruation, early menopause, secondary amenorrhea, infertility and pregnancy complications, such as recurrent abortions, intrauterine fetal growth restriction, small fetus for gestational age, low birth weight and premature birth.

  10. The Pattern of Benign Breast Diseases in Rural Hospital in India ...

    African Journals Online (AJOL)

    ... benign breast diseases, right sided breast involvement was more common constituting 181 (47.63%) cases while left breast involvement was less common constituting 151 (39.73%) of the patients. Bilateral involvement was seen in only 48 (12.63%) of patients. The pattern of benign breast disease, fibroadenoma was the ...

  11. Chronic Subdural Hematoma in Elderly Patients: Is This Disease Benign?

    Science.gov (United States)

    Uno, Masaaki; Toi, Hiroyuki; Hirai, Satoshi

    2017-08-15

    As the world population becomes progressively older, the overall incidence of chronic subdural hematoma (CSDH) is increasing. Peak age of onset for CSDH has also increased, and recently the 80-year-old level has a peak. Many patients with CSDH have had prior treatment with anticoagulants and antiplatelet drugs, which have an accompanying risk of CSDH. In elderly patients with CSDH, symptoms of cognitive change (memory disturbance, urinary incontinence, and decreased activity) and disturbance of consciousness at admission were more frequent compared to younger patients with CSDH. The literature actually offers conflicting advice regarding CSDH treatment; however, burr hole surgery with drainage under local anesthesia is the most common surgical procedure, even in elderly patients. The recurrence rate of CSDH has not decreased over recent decades, and it has ranged from 0.36-33.3%. Outcomes in patients over 75 years old was significantly worse than for those younger than 75. Moreover, long-term outcomes for elderly patients with CSDH are poor. CSDH in the elderly is no longer a benign disease. In the future, it will be important for us to understand the mechanisms of onset and recurrence of CSDH and to develop more effective medical treatments and noninvasive surgical techniques for elderly patients.

  12. Recent advancement of therapeutic endoscopy in the esophageal benign diseases

    Science.gov (United States)

    Bechara, Robert; Inoue, Haruhiro

    2015-01-01

    Over the past 30 years, the field of endoscopy has witnessed several advances. With the advent of endoscopic mucosal resection, removal of large mucosal lesions have become possible. Thereafter, endoscopic submucosal resection was refined, permitting en bloc removal of large superficial neoplasms. Such techniques have facilitated the development of antireflux mucosectomy, a promising novel treatment for gastroesophageal reflux. The introduction and use of over the scope clips has allowed for endoscopic closure of defects in the gastrointestinal tract, which were traditionally treated with surgical intervention. With the development of per-oral endoscopic myotomy (POEM), the treatment of achalasia and spastic disorders of the esophagus have been revolutionized. From the submucosal tunnelling technique developed for POEM, Per oral endoscopic tumor resection of subepithelial tumors was made possible. Simultaneously, advances in biotechnology have expanded esophageal stenting capabilities with the introduction of fully covered metal and plastic stents, as well as biodegradable stents. Once deemed a primarily diagnostic tool, endoscopy has quickly transcended to a minimally invasive intervention and therapeutic tool. These techniques are reviewed with regards to their application to benign disease of the esophagus. PMID:25992187

  13. Guideline for radioiodine therapy for benign thyroid diseases (version 3)

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. zu Koeln (Germany); Dressler, J. [Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany); Gruenwald, F. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Frankfurt (Germany); Leisner, B. [Abt. fuer Nuklearmedizin des Allg. Krankenhauses St. Georg, Hamburg (Germany); Moser, E. [Abt. fuer Nuklearmedizin der Radiologischen Universitaetsklinik Freiburg (Germany); Reiners, C.; Schneider, P. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Wuerzburg (Germany); Schober, O. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Muenster (Germany)

    2004-12-01

    The version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves' disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves' disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient's preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients' preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3{sup rd} version. (orig.) [German] Die Version 3 der Leitlinie zur Radioiodtherapie (RIT) bei benignen Schilddruesenerkrankungen stellt im Wesentlichen eine redaktionelle Ueberarbeitung der Version 2 dar. Im Kapitel Indikation und Empfehlungen fuer eine Radioiodtherapie, eine Operation oder eine thyreostatische Therapie bei gutartigen Schilddruesenerkrankungen basiert die Leitlinie auf einem interdisziplinaer abgestimmten Konzept. Die Entscheidungskriterien sind multifaktoriell und beruecksichtigen die Art der Schilddruesenerkrankung (Autonomie, Morbus Basedow, Struma, Rezidivstruma

  14. Benign breast diseases. Radiology, pathology, risk assessment. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Chinyama, Catherine N. [Princess Elizabeth Hospital, Le Vauquiedor, St. Martin' s Guernsey, Channel Islands (United Kingdom); Brighton and Sussex Medical School, Brighton (United Kingdom)

    2014-04-01

    Radiological and pathological correlation of the full range of benign breast lesions, with emphasis on screen-detected lesions. Detailed discussion of risk assessment. Revised and updated edition, with a new chapter on gynaecomastia. Ideal aid to the management of patients with benign or indeterminate breast lesions in a multidisciplinary setting. The second edition of this book has been extensively revised and updated. There have been numerous scientific advances in the radiology, pathology and risk assessment of benign breast lesions since the publication of the first edition. The first edition concentrated on screen-detected lesions, which has since been rectified; new symptomatic and screen-detected lesions are discussed in the second edition and include: mastitis and breast abscesses, idiopathic granulomatous mastitis, diabetic mastopathy, phyllodes tumours, gynaecomastia and pseudoangiomatous stromal hyperplasia. The chapters on columnar cell lesions and mucocele-like lesions have been extensively updated. Where applicable, genetic analysis of the benign lesions, which is becoming part of personalised medicine in the field of breast cancer, has been included. The book also presents detailed analyses of the main models, such as the Gail Model, used to assess the subsequent risk of breast cancer in individuals. The current trend in the management of all cancers is preventative. Screening mammography detects early curable cancers as well as indeterminate lesions, the latter of which are invariably pathologically benign. The author has collated important benign lesions and, based on peer-reviewed publications, has documented the relative risk of subsequent cancer to allow the patient and the clinician to implement preventative measures where possible. This book will therefore serve as an essential component of multidisciplinary management of patients with symptomatic and screen-detected benign breast lesions.

  15. Port site infiltration of local anesthetic after laparoendoscopic single site surgery for benign adnexal disease.

    Science.gov (United States)

    Kim, Jung Eun; Shim, Seung-Hyuk; Dong, Meari; Lee, Hyojin; Hwang, Han Sung; Kwon, Han Sung; Lee, Sun Joo; Lee, Ji Young; Sohn, In Sook; Kim, Soo-Nyung; Kang, Soon-Beom

    2017-09-01

    To determine whether local bupivacaine injection into the incision site after gynecologic laparoendoscopic single site surgery (LESS) improves postoperative pain. This prospective cohort study included consecutive 158 patients who had LESS for benign adnexal disease from March 2013 to December 2015. Chronologically, 82 patients (March 2013 to August 2014) received no bupivacaine (group 1) and 76 (August 2014 to December 2015) received a bupivacaine block (group 2). For group 2, 10 mL 0.25% bupivacaine was injected into the 20 mm-incision site through all preperitoneal layers after LESS completion. Primary outcome is postoperative pain score using the visual analog scale (VAS). There was no difference in clinicopathological characteristics between the groups. Operating time (expressed as median [range], 92 [55-222] vs. 100 [50-185] minutes, P =0.137) and estimated blood loss (50 [30-1,500] vs. 125 [30-1,000] mL, P =0.482) were similar between the groups. Post-surgical VAS pain scores after 3 hours (3.5 [2-6] vs. 3.5 [2-5], P =0.478), 6 to 8 hours (3.5 [2-6] vs. 3 [1-8], P =0.478), and 16 to 24 hours (3 [2-4] vs. 3 [1-7], P =0.664) did not differ between groups. Bupivacaine injection into the trocar site did not improve postoperative pain after LESS. Randomized trials are needed to evaluate the benefits of local bupivacaine anesthetic for postoperative pain reduction.

  16. Radiation therapy of benign diseases. A clinical guide. 2. rev. ed.

    International Nuclear Information System (INIS)

    Order, S.E.; Donaldson, S.S.

    1998-01-01

    This volume, which expands and updates the first edition, is designed as a practical text to aid the radiation oncologist in the evaluation and treatment of benign diseases. An introductory chapter by an eminent malpractice lawyer clarifies the medical-legal implications of the radiation treatment of such diseases. Thereafter the various benign conditions are considered in alphabetical order; in each case a brief resume is followed by citations of pertinent literature in both explanatory tables and reference lists. A special feature is the survey of current radiation practice in the United States. This complete update will be recognized as the standard text on radiation therapy for benign diseases. (orig.)

  17. Radiation therapy of benign diseases. A clinical guide; 2. rev. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Order, S.E. [Camden Univ., NJ (United States). Medical Center; Donaldson, S.S. [Stanford Univ., CA (United States). Medical Center

    1998-07-01

    This volume, which expands and updates the first edition, is designed as a practical text to aid the radiation oncologist in the evaluation and treatment of benign diseases. An introductory chapter by an eminent malpractice lawyer clarifies the medical-legal implications of the radiation treatment of such diseases. Thereafter the various benign conditions are considered in alphabetical order; in each case a brief resume is followed by citations of pertinent literature in both explanatory tables and reference lists. A special feature is the survey of current radiation practice in the United States. This complete update will be recognized as the standard text on radiation therapy for benign diseases. (orig.)

  18. [Gynecological and obstetrical management of rheumatic diseases in reproductive age].

    Science.gov (United States)

    Pepe, Franco; Stracquadanio, Mariagrazia; Privitera, Agata; Ciotta, Lilliana; DE Luca, Francesco

    2018-04-01

    The gynecologist's role in the management of rheumatic patients is complex: it includes the prevention of damage caused by drugs, the counseling about contraception to avoid pregnancy while taking teratogen drugs, the scheduling of pregnancy during the quiescent phase of the specific disease, the replacement of teratogen drugs and a competent management of the pregnancy. The task is carried out as part of a multidisciplinary team with a focus on the differential diagnosis between specific complications of pregnancy and the complications of the rheumatic disease. This is the right way to allow a conscious reproduction, with reduced risks and acceptable maternal-fetal outcomes, to this kind of patients considered at high risk.

  19. Dosimetry prior to I-131-therapy of benign thyroid disease

    International Nuclear Information System (INIS)

    Haenscheid, Heribert; Lassmann, Michael; Reiners, Christoph

    2011-01-01

    The activity to be administered in I-131 therapy of benign thyroid disease is determined by the radiation absorbed dose necessary to cure the disease, the target mass, and the residence time of the I-131 in the target volume. Data from 73 patients with complete sets of uptake measurements 2, 6, 24, 48, and 96 (n = 53) or 120 (n = 20) hours after oral administration of 1 MBq I-131 were used to deduce residence times from subsets of 3, 2, or only 1 measurement for each individual. The values were compared to those obtained with the reference method, i.e. a fit of an uptake function based on a 2-compartment model to all 5 measurements, to quantify the errors introduced by the less demanding assessments. Deviations are less than 10% if the 2- compartment uptake function is fitted to only 3 values measured after 6, 24, and 96-120 h. Use of 2, 24, and 96-120 h data results in errors > 20% in individual patients. The effective half-lives as determined from 2 measurements after 24 and 96-120 h correlate well with those deduced from the reference method with larger deviations in individuals with slow iodine kinetics and late maximal uptake. Residence times determined from the 24 h uptake, assuming linear increase during the first day, and the effective half-life limited to maximum 8 days underestimate the actual values systematically in patients with long and short half-lives. These errors can be eliminated by a modification of the calculation method resulting in deviations less than 14% in all but one individual for this procedure. The accuracy of methods based on only one retention value increases with the time of measurement after the administration of I-131. While systematic errors up to a factor of two occur if the 24 h uptake is used for the estimate, deviations are less than 18% for measurements after 120 h. The results suggest that only one late uptake assessment warrants residence time estimates with an acceptable error. Given the high inherent uncertainties in the

  20. Gallium scanning in differentiating malignant from benign asbestos-related pleural disease

    International Nuclear Information System (INIS)

    Teirstein, A.S.; Chahinian, P.; Goldsmith, S.J.; Sorek, M.

    1986-01-01

    In order to assess the utility of 67gallium citrate in delineating malignant pleural mesothelioma from benign asbestos-related pleural disease, 49 patients with malignant mesothelioma and 16 with benign asbestos-related pleural disease were studied. Seven patients with malignant mesothelioma had no history of asbestos exposure, while the remaining 58 patients were exposed. Forty-three of the 49 patients (88%) with malignant mesothelioma had a positive 67gallium scan including 36 of the 42 (86%) patients with asbestos exposure and all 7 patients without a history of asbestos exposure. Three of 16 patients (19%) with benign asbestos-related pleural disease had a positive scan. 67Gallium radionuclide imaging is nonspecific but may be valuable in noninvasive monitoring of asbestos-exposed populations, which have a high risk for the late development of benign and/or malignant pleural disease

  1. Evaluation of Helicobacter pylori infection and other risk factors in patients with benign peptic ulcer disease

    OpenAIRE

    Depender Kumar Timshina; Pankaja SS; Himagirish K Rao; Vikram Kate

    2011-01-01

    Objective: To assess and compare the risk factors in patients with benign gastric and duodenal ulcers and to correlate the prevalence of Helicobacter pylori (H. pylori) infection in benign peptic ulcer disease. Methods: A total of 30 consecutive patients with peptic ulcer disease were included in this study after upper gastrointestinal endoscopy. Their clinical profile and endoscopic findings were noted. Antral biopsies were subjected to histopathological examination and urease...

  2. Comparison of Na+/I- symporter expression rate in malignant and benign thyroid diseases: immunohistochemical study

    International Nuclear Information System (INIS)

    Kang, Do Young; Jeong, Young Jin; Lee, Kyung Eun; Park, Heon Soo; Yoo, Young Hyun; Roh, Mee Sook

    2006-01-01

    Previous studies have not showed consistent results for the level of expression of sodium/iodide symporter (NIS) in thyroid diseases, especially malignant tumor. We undertook this study to evaluate the distribution of NIS expression in malignant thyroid diseases and compare with that in benign thyoid disease. Total patients were 119 cases (Men 15, 48±13 yrs). Total number of samples were 205 pieces. In malignant thyroid disease, there were 153 samples: 90 in papillary carcinoma, 4 in follicular carcinoma, 2 in medullary carcinoma and 57 in metastatic lymph node. In benign thyroid disease, there were 52 samples: 36 in goiter/cyst, 11 in thyroiditis and 5 in follicular adenoma. Using immunohistochemical methods, we probed 205 samples with monoclonal anti-NIS Ab. Grading of staining was scored as 0 (negative or absent), 1 (weakly positive), 2 (moderately positive) or 3 (strongly positive). Expression rate (ER) of NIS positivity in individual disease entity was expressed as percentage of total number divided by number in 2 plus 3 grade. ERs of malignant thyroid diseases were 63% in papillary carcinoma, 81% in metastatic lymph node, 71% in follicular carcinoma and 100% in medullary carcinoma. ERs of benign thyroid disease were 53% in goiter/cyst, 64% in thyroiditis and 40% in follicular adenoma. ER of benign thyroid deceases was higher than benign thyroid diseases (71% vs 54%). Grading of NIS expression in papillary carcinoma or goiter/cyst was heterogeneously distributed in considerable cases. Normal tissue also showed heterogeneous distribution or NIS expression, which was not correlated with that of primary lesion. In papillary thyroid carcinoma, distribution of NIS expression was heterogeneous and increased, and not different compared with that of benign thyroid disease

  3. Benign diseases of the mandible in MRI; Benigne Erkrankungen des Unterkiefers im MRT

    Energy Technology Data Exchange (ETDEWEB)

    Kress, B.; Sartor, K. [Universitaetsklinikum Heidelberg (Germany). Abt. Neuroradiologie; Gottschalk, A. [Bundeswehrkrankenhaus, Ulm (Germany). Abt. fuer Radiologie; Schmitter, M. [Universitaetsklinikum Heidelberg (Germany). Abt. fuer Zahnaerztliche Prothetik

    2004-04-01

    Diseases of the mandible affect the soft tissues aside from the osseous manifestation. This can be shown clearly and in great detail by magnetic resonance imaging (MRI). MRI is the gold standard in the diagnostic evaluation of any internal derangement of the temporomandibular joint. Dental MRI requires high resolution techniques and in some cases also intravenous administration of contrast material. These techniques allow delineation of the neurovascular bundle. In the past few years new indications were formulated, for example, the evaluation of the integrity of the inferior alveolar nerve in trauma and in radicular cysts. New quantitative methods now enable insights into the pathophysiology. The objective of this review is to communicate accepted indications for MRI of the mandible and to present innovative applications. (orig.) [German] Mandibulaere Erkrankungen beteiligen neben dem Knochen Weichteilstrukturen, die sich mit der MRT klar und detailreich darstellen lassen. In der bildgebenden Diagnostik der Binnenstoerung des Kiefergelenks (internal derangement) gilt die MRT als Goldstandard. Die MR-Tomographie des Unterkiefers erfordert hochaufloesende Techniken und bei besonderen Indikationen die intravenoese Kontrastmittelgabe. Diese Techniken erlauben es, das neurovaskulaere Buendel des Unterkiefers darzustellen. In den letzten Jahren sind neue Indikationsgebiete hinzugekommen, darunter solche, die die Unversehrtheit des N.alveolaris inferior bei Frakturen oder Raumforderungen des Unterkiefers ueberpruefen. Neue quantitative Verfahren geben mittlerweile Einblicke in Pathophysiologie. Ziel dieser Uebersichtsarbeit soll es sein, klassische Indikationen der Unterkiefer-MRT darzustellen und innovative Anwendungsmoeglichkeiten aufzuzeigen. (orig.)

  4. Benign Atrophic Papulosis (Degos Disease) With Lymphocytic Vasculitis and Lichen Sclerosus-Like Features.

    Science.gov (United States)

    Kim, Esther; Motaparthi, Kiran

    2018-04-01

    Degos disease manifests as 2 distinct clinical variants, malignant atrophic papulosis and benign atrophic papulosis, which are distinguished by the presence or absence of systemic disease. Both forms feature cutaneous involvement typified by erythematous papules with scar-like centers, and the classic histologic picture is described as wedge-shaped dermal necrosis overlying thrombotic vasculopathy. However, the histopathology of early lesions is distinct and more variable. A case of benign atrophic papulosis with lymphocytic vasculitis and lichen sclerosus-like features is described, and the spectrum of histologic findings in Degos disease is reviewed.

  5. Global N-acetylaspartate concentration in benign and non-benign multiple sclerosis patients of long disease duration

    Energy Technology Data Exchange (ETDEWEB)

    Achtnichts, Lutz [Departments of Neurology and Neuroradiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel (Switzerland); Gonen, Oded, E-mail: oded.gonen@nyumc.org [Department of Radiology, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY 10016 (United States); Rigotti, Daniel J.; Babb, James S. [Department of Radiology, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY 10016 (United States); Naegelin, Yvonne [Departments of Neurology and Neuroradiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel (Switzerland); Penner, Iris-Katharina; Bendfeldt, Kerstin [Department of Cognitive Psychology and Methodology, University of Basel, Missionsstrasse 60/62, 4055 Basel (Switzerland); Hirsch, Jochen; Amann, Michael; Kappos, Ludwig [Departments of Neurology and Neuroradiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel (Switzerland); Gass, Achim [Departments of Neurology and Neuroradiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel (Switzerland); Dept. of Neurology, Universitaetsmedizin Mannheim, University of Heidelberg (Germany)

    2013-12-01

    Background and objective: To examine whether clinically benign multiple sclerosis patients (BMS) show similar losses of their global N-acetylaspartate (NAA) neuronal marker relative to more clinically disabled patients of similar disease duration. Methods: The whole-brain NAA concentration (WBNAA) was acquired with whole-head non-localizing proton MR spectroscopy. Fractional brain parenchymal volume (fBPV), T{sub 2} and T{sub 1} lesion loads, were obtained from the MRI in: (i) 24 BMS patients: 23.1 ± 7.2 years disease duration, median Expanded Disability Status Scale (EDSS) score of 2.0 (range: 0–3); (ii) 26 non-benign MS patients (non-BMS), 24.5 ± 7.4 years disease duration, median EDSS of 4.0 (range: 3.5–6.5); (iii) 15 healthy controls. Results: Controls’ 12.4 ± 2.3 mM WBNAA was significantly higher than the BMS's and non-BMS's 10.5 ± 2.4 and 9.9 ± 2.1 mM (both p < 0.02), but the difference between the patients’ groups was not (p > 0.4). Likewise, the controls’ 81.2 ± 4.5% fBPV exceeded the BMS and non-BMS's 77.0 ± 5.8% and 76.3 ± 8.6% (p < 0.03), which were also not different from one another (p > 0.7). BMS patients’ T{sub 1}-hypointense lesion load, 2.1 ± 2.2 cm{sup 3}, was not significantly different than the non-BMS's 4.1 ± 5.4 cm{sup 3} (p > 0.08) and T{sub 2}-hyperintense loads: 6.0 ± 5.7 cm{sup 3} and 8.7 ± 7.8 cm{sup 3}, were also not different (p > 0.1). Conclusions: WBNAA differentiates normal controls from MS patients but does not distinguish BMS from more disabled MS patients of similar disease duration. Nevertheless, all MS patients who remain RR for 15+ years suffered WBNAA loss similar to the average RR MS population at fourfold shorter disease duration suggesting relative global neuronal sparing or leveling-off of the neurodegeneration rate.

  6. Global N-acetylaspartate concentration in benign and non-benign multiple sclerosis patients of long disease duration

    International Nuclear Information System (INIS)

    Achtnichts, Lutz; Gonen, Oded; Rigotti, Daniel J.; Babb, James S.; Naegelin, Yvonne; Penner, Iris-Katharina; Bendfeldt, Kerstin; Hirsch, Jochen; Amann, Michael; Kappos, Ludwig; Gass, Achim

    2013-01-01

    Background and objective: To examine whether clinically benign multiple sclerosis patients (BMS) show similar losses of their global N-acetylaspartate (NAA) neuronal marker relative to more clinically disabled patients of similar disease duration. Methods: The whole-brain NAA concentration (WBNAA) was acquired with whole-head non-localizing proton MR spectroscopy. Fractional brain parenchymal volume (fBPV), T 2 and T 1 lesion loads, were obtained from the MRI in: (i) 24 BMS patients: 23.1 ± 7.2 years disease duration, median Expanded Disability Status Scale (EDSS) score of 2.0 (range: 0–3); (ii) 26 non-benign MS patients (non-BMS), 24.5 ± 7.4 years disease duration, median EDSS of 4.0 (range: 3.5–6.5); (iii) 15 healthy controls. Results: Controls’ 12.4 ± 2.3 mM WBNAA was significantly higher than the BMS's and non-BMS's 10.5 ± 2.4 and 9.9 ± 2.1 mM (both p < 0.02), but the difference between the patients’ groups was not (p > 0.4). Likewise, the controls’ 81.2 ± 4.5% fBPV exceeded the BMS and non-BMS's 77.0 ± 5.8% and 76.3 ± 8.6% (p < 0.03), which were also not different from one another (p > 0.7). BMS patients’ T 1 -hypointense lesion load, 2.1 ± 2.2 cm 3 , was not significantly different than the non-BMS's 4.1 ± 5.4 cm 3 (p > 0.08) and T 2 -hyperintense loads: 6.0 ± 5.7 cm 3 and 8.7 ± 7.8 cm 3 , were also not different (p > 0.1). Conclusions: WBNAA differentiates normal controls from MS patients but does not distinguish BMS from more disabled MS patients of similar disease duration. Nevertheless, all MS patients who remain RR for 15+ years suffered WBNAA loss similar to the average RR MS population at fourfold shorter disease duration suggesting relative global neuronal sparing or leveling-off of the neurodegeneration rate

  7. German Association of Endocrine Surgeons practice guidelines for the surgical treatment of benign thyroid disease.

    Science.gov (United States)

    Musholt, Thomas J; Clerici, Thomas; Dralle, Henning; Frilling, Andreja; Goretzki, Peter E; Hermann, Michael M; Kussmann, Jochen; Lorenz, Kerstin; Nies, Christoph; Schabram, Jochen; Schabram, Peter; Scheuba, Christian; Simon, Dietmar; Steinmüller, Thomas; Trupka, Arnold W; Wahl, Robert A; Zielke, Andreas; Bockisch, Andreas; Karges, Wolfram; Luster, Markus; Schmid, Kurt W

    2011-06-01

    Benign thyroid disorders are among the most common diseases in Germany, affecting around 15 million people and leading to more than 100,000 thyroid surgeries per year. Since the first German guidelines for the surgical treatment of benign goiter were published in 1998, abundant new information has become available, significantly shifting surgical strategy towards more radical interventions. Additionally, minimally invasive techniques have been developed and gained wide usage. These circumstances demanded a revision of the guidelines. Based on a review of relevant recent guidelines from other groups and additional literature, unpublished data, and clinical experience, the German Association of Endocrine Surgeons formulated new recommendations on the surgical treatment of benign thyroid diseases. These guidelines were developed through a formal expert consensus process and in collaboration with the German societies of Nuclear Medicine, Endocrinology, Pathology, and Phoniatrics & Pedaudiology as well as two patient organizations. Consensus was achieved through several moderated conferences of surgical experts and representatives of the collaborating medical societies and patient organizations. The revised guidelines for the surgical treatment of benign thyroid diseases include recommendations regarding the preoperative assessment necessary to determine when surgery is indicated. Recommendations regarding the extent of resection, surgical techniques, and perioperative management are also given in order to optimize patient outcomes. Evidence-based recommendations for the surgical treatment of benign thyroid diseases have been created to aid the surgeon and to support optimal patient care, based on current knowledge. These recommendations comply with the Association of the Scientific Medical Societies in Germany requirements for S2k guidelines.

  8. [Epigenetic background of the most common non-oncologic gynecological diseases].

    Science.gov (United States)

    Joó, József Gábor; Csatlós, Eva; Brubel, Réka; Bokor, Attila; Karabélyos, Csaba; Rigó, János

    2014-03-30

    Epigenetic effects influence the function of genes regulating the main physiological mechanisms. Some of these environmental factors may reduce or inhibit the function of these genes. The environmental effects on gene function may result in a change of the DNA structure leading to non-heritable phenotype changes. Epigenetic factors play an important etiological role in the development of numerous diseases in obstetrics and gynecology. Uterine fibroids probably have a complex etiological background including epigenetic mechanisms. The multifactorial aetiology of endometriosis suggests key roles for immunological and hormonal factors in the development of the diseases. These mechanisms are influenced by epigenetic factors, which may serve as therapeutic targets in the future. The possible in utero origin of polycystic ovary syndrome determines the main directions of research concerning epigenetic factors in the etiological background, with the hope of eventual prevention and/or treatment in the preconceptional period as well as during pregnancy care.

  9. Saphenous vein thrombophlebitis (SVT): a deceptively benign disease.

    Science.gov (United States)

    Hanson, J N; Ascher, E; DePippo, P; Lorensen, E; Scheinman, M; Yorkovich, W; Hingorani, A

    1998-04-01

    The association between deep vein thrombosis (DVT) and the hypercoagulable state is a well-established entity. However, the association between saphenous vein thrombophlebitis and coagulation abnormalities has not been investigated. Although thrombosis of varicose veins typically runs a benign course, phlebitis of the saphenous system may propagate to the deep system or saphenofemoral junction that requires more aggressive therapy. Given the potential similarity in clinical outcome between saphenous vein thrombophlebitis (SVT) and DVT, we have investigated the coagulation profile of patients presenting with isolated SVT. Seventeen consecutive patients who presented to our vascular laboratory with isolated SVT had a coagulation profile performed that included antithrombin III (AT III), protein C (PC), protein S (PS) antigen and activity levels, activated protein C (APC) resistance, factor V DNA mutation, and coagulation factors II and X. All patients had duplex scans performed on both the superficial and deep venous systems. Patients with SVT only were treated with nonsteroidal antiinflammatory drugs (NSAIDs) and warm soaks as outpatients, whereas those patients found to have DVT or a clot at the saphenofemoral junction were fully anticoagulated with heparin and coumadin therapy. All 17 patients had at least one repeat coagulation profile performed up to 5 months after their SVT occurrence to ensure that the results of hypercoagulability were not transient. Ten (59%) of the 17 patients with SVT had abnormal coagulation profiles on initial presentation. All 10 patients who were hypercoagulable had repeat tests and 6 (35%) remained abnormal. Four patients who had abnormal results converted to normal values. Seven patients with normal coagulation profiles on initial presentation had repeat tests and all remained normal. The incidence of the hypercoagulable state in patients with SVT is high. Thirty-five percent of patients with isolated SVT had consistently abnormal

  10. Identifying Two Common Types of Breast Benign Diseases Based on Multiphoton Microscopy

    Directory of Open Access Journals (Sweden)

    Yan Wu

    2018-01-01

    Full Text Available Multiphoton microscopy has attracted increasing attention and investigations in the field of breast cancer, based on two-photon excited fluorescence (TPEF and second-harmonic generation (SHG. However, the incidence of breast benign diseases is about 5 to 10 times higher than breast cancer; up to 30% of women suffer from breast benign diseases and require treatment at some time in their lives. Thus, in this study, MPM was applied to image fibroadenoma and fibrocystic lesion, which are two of the most common breast benign diseases. The results show that MPM has the capability to identify the microstructure of lobule and stroma in normal breast tissue, the interaction of compressed ducts with surrounding collagen fiber in fibroadenoma, and the architecture of cysts filled with cystic fluid in fibrocystic disease. These findings indicate that, with integration of MPM into currently accepted clinical imaging system, it has the potential to make a real-time diagnosis of breast benign diseases in vivo, as well as breast cancer.

  11. Differentiation of malignant and degenerative benign bone disease using 99mTc-citrate scintigraphy

    International Nuclear Information System (INIS)

    Guo Rui; Jin Jianhua; Li Sijin; Li Xianfeng; Zhang Xiaojuan; Ren Yuan

    2008-01-01

    Objective: To differentiate malignant and degenerative benign bone disease using 99m Tc- citrate scintigraphy. Methods: Thirty-nine patients (92 lesions) with confirmed malignant bone disease or degenerative benign bone disease were studied, for which the results of 99m Te-methylene diphosphonate( 99m Tc- MDP) scintigraphy were positive. 99m Tc-citrate scintigraphy was performed within a time interval of 2-7 days after 99m Tc-MDP scintigraphy. Visual analysis and semiquantitative analysis were applied. Each lesion was scored as malignant or benign, which was independently verified, using conventional techniques (histopathology, X-ray, CT, MRI and clinical follow up). Results: In visual analysis of 99m Tc-citrate imaging, most malignant lesions (35/48, 72.92%) clearly showed high radioactivity accumulation, while most benign lesions (39/44, 88.64%) had not obviously visible uptake of 99m Tc-citrate. In semiquantitative analysis of 99m Tc- citrate image, malignant lesions demonstrated a higher lesion-to-background radioisotope uptake ratio (RUR) than that of benign degenerative lesions (1.47 ± 0.42 vs. 1.09 ± 0.38, t=2.887, P 99m Tc-MDP in the two groups is of the same (1.96 ± 0.25 vs. 1.87 ± 0.21, t=1.178, P>0.20). Conclusion: 99m Tc- citrate scintigraphy is a promising method to differentiate malignant from benign degenerative lesions seen as areas of increased activity on 99m Tc-MDP bone scintigraphy. (authors)

  12. Health care utilization one year following the diagnosis benign breast disease or breast cancer

    NARCIS (Netherlands)

    Keyzer-Dekker, Claudia M. G.; van Esch, Lotje; Schreurs, Wilhelmina H.; van Berlo, Charles L. H.; Roukema, Jan A.; de Vries, Jolanda; van der Steeg, Alida F. W.

    2012-01-01

    Purpose: We analyzed health care utilization (HCU) and its predictors in the first year after the diagnostic process for breast cancer (BC) or benign breast disease (BBD) using questionnaires. The impact of trait anxiety on HCU was examined. Results: In total 591 women were analyzed, 440 with BBD

  13. Technical Aspects of Laparoscopic Distal Pancreatectomy for Benign and Malignant Disease: Review of the Literature

    NARCIS (Netherlands)

    de Rooij, T.; Sitarz, R.; Busch, O. R.; Besselink, M. G.; Abu Hilal, M.

    2015-01-01

    Distal pancreatectomy is the standard curative treatment for symptomatic benign, premalignant, and malignant disease of the pancreatic body and tail. The most obvious benefits of a laparoscopic approach to distal pancreatectomy include earlier recovery and shorter hospital stay. Spleen-preserving

  14. Urinary β-HCG in Benign and Malignant Urinary Tract Diseases

    Directory of Open Access Journals (Sweden)

    A.-B. Halim

    1994-01-01

    Full Text Available Detectable leve ls of HCG have been reported in conditions other th an normal pregnancy, including threatened abortion, ectopic pregnancy, trophoblastic tumors, carcinomas of the stomach, liver, pancreas and breast as well as multiple myeloma and melanoma. The present study was conducted to estimate urinary β-HCG in bladder cancer and benign urinary tract disorders. 163 individuals were included, 68 with bladder cancer (60 males and 8 females, 64 with benign urinary tract diseases (55 males and 9 females and 31 normal healthy controls (26 males and 5 females. Urinary β-HCG was estimated by the ELISA technique using the reagents supplied by DRG International Inc., Germany. Results of th e study revealed an overexpression of β-HCG in mali gnant and benign urinary tract diseases. 60.3% of the cancer patients and 29.7% of patients with benign diseases showed urinary β-HCG values above the upper limit of the control group (2mIU/ml .

  15. Helicobacter species are associated with possible increase in risk of biliary lithiasis and benign biliary diseases

    Directory of Open Access Journals (Sweden)

    Pandey Manoj

    2007-08-01

    Full Text Available Abstract Background Hepato-biliary tract lithiasis is common and present either as pain or as asymptomatic on abdominal ultrasonography for other causes. Although the DNA of Helicobacter species are identified in the gallbladder bile, tissue or stones analyzed from these cases, still a causal relationship could not be established due to different results from different geographical parts. Methods A detailed search of pubmed and pubmedcentral was carried out with key words Helicobacter and gallbladder, gallstones, hepaticolithiasis, cholelithiasis and choledocholithiasis, benign biliary diseases, liver diseases. The data was entered in a data base and meta analysis was carried out. The analysis was carried out using odds ratio and a fixed effect model, 95% confidence intervals for odds ratio was calculated. Chi square test for heterogeneity was employed. The overall effect was calculated using Z test. Results A total of 12 articles were identified. One study used IgG for diagnosis while others used the PCR for Ure A gene, 16 S RNA or Cag A genes. A couple of studies used culture or histopathology besides the PCR. The cumulative results show a higher association of Helicobacter with chronic liver diseases (30.48%, and stone diseases (42.96%(OR 1.77 95% CI 1.2–2.58; Z = 2.94, p = 0.003, the effect of each could not be identified as it was difficult to isolate the effect of helicobacter due to mixing of cases in each study. Conclusion The results of present meta analysis shows that there is a slight higher risk of cholelithiasis and benign liver disease (OR 1.77, however due to inherent inability to isolate the effect of stone disease from that of other benign lesions it is not possible to say for sure that Helicobacter has a casual relationship with benign biliary disease or stone disease or both.

  16. Helicobacter species are associated with possible increase in risk of biliary lithiasis and benign biliary diseases

    Science.gov (United States)

    Pandey, Manoj

    2007-01-01

    Background Hepato-biliary tract lithiasis is common and present either as pain or as asymptomatic on abdominal ultrasonography for other causes. Although the DNA of Helicobacter species are identified in the gallbladder bile, tissue or stones analyzed from these cases, still a causal relationship could not be established due to different results from different geographical parts. Methods A detailed search of pubmed and pubmedcentral was carried out with key words Helicobacter and gallbladder, gallstones, hepaticolithiasis, cholelithiasis and choledocholithiasis, benign biliary diseases, liver diseases. The data was entered in a data base and meta analysis was carried out. The analysis was carried out using odds ratio and a fixed effect model, 95% confidence intervals for odds ratio was calculated. Chi square test for heterogeneity was employed. The overall effect was calculated using Z test. Results A total of 12 articles were identified. One study used IgG for diagnosis while others used the PCR for Ure A gene, 16 S RNA or Cag A genes. A couple of studies used culture or histopathology besides the PCR. The cumulative results show a higher association of Helicobacter with chronic liver diseases (30.48%), and stone diseases (42.96%)(OR 1.77 95% CI 1.2–2.58; Z = 2.94, p = 0.003), the effect of each could not be identified as it was difficult to isolate the effect of helicobacter due to mixing of cases in each study. Conclusion The results of present meta analysis shows that there is a slight higher risk of cholelithiasis and benign liver disease (OR 1.77), however due to inherent inability to isolate the effect of stone disease from that of other benign lesions it is not possible to say for sure that Helicobacter has a casual relationship with benign biliary disease or stone disease or both. PMID:17708763

  17. Helicobacter species are associated with possible increase in risk of biliary lithiasis and benign biliary diseases.

    Science.gov (United States)

    Pandey, Manoj

    2007-08-20

    Hepato-biliary tract lithiasis is common and present either as pain or as asymptomatic on abdominal ultrasonography for other causes. Although the DNA of Helicobacter species are identified in the gallbladder bile, tissue or stones analyzed from these cases, still a causal relationship could not be established due to different results from different geographical parts. A detailed search of pubmed and pubmedcentral was carried out with key words Helicobacter and gallbladder, gallstones, hepaticolithiasis, cholelithiasis and choledocholithiasis, benign biliary diseases, liver diseases. The data was entered in a data base and meta analysis was carried out. The analysis was carried out using odds ratio and a fixed effect model, 95% confidence intervals for odds ratio was calculated. Chi square test for heterogeneity was employed. The overall effect was calculated using Z test. A total of 12 articles were identified. One study used IgG for diagnosis while others used the PCR for Ure A gene, 16 S RNA or Cag A genes. A couple of studies used culture or histopathology besides the PCR. The cumulative results show a higher association of Helicobacter with chronic liver diseases (30.48%), and stone diseases (42.96%)(OR 1.77 95% CI 1.2-2.58; Z = 2.94, p = 0.003), the effect of each could not be identified as it was difficult to isolate the effect of helicobacter due to mixing of cases in each study. The results of present meta analysis shows that there is a slight higher risk of cholelithiasis and benign liver disease (OR 1.77), however due to inherent inability to isolate the effect of stone disease from that of other benign lesions it is not possible to say for sure that Helicobacter has a casual relationship with benign biliary disease or stone disease or both.

  18. Alcohol, smoking and benign hepato-biliary disease

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel Mønsted; Novovic, Srdan

    2017-01-01

    through effects on bile cholesterol metabolism, the enterohepatic circulation, and gallbladder function. The impact of smoking on gallstone formation seems minor. Both alcohol intake and smoking do not alter the clinical course of gallstone disease carriers. Cholecystectomy is the preferred treatment...... for symptomatic gallstone disease. Studies about the impact of alcohol and smoking on the post-cholecystectomy state are few and future studies should be performed. Pancreatitis is associated with both excessive alcohol intake and smoking in observational studies. Interpretation of associations with pancreatitis...... is hampered by an incomplete understanding of underlying mechanisms and by the co-existence of excessive alcohol intake and smoking. Smoking cessation and alcohol abstinence is recommended in the treatment of pancreatitis, but higher-level evidence is needed....

  19. Gynecologic Oncologist as surgical consultant: intraoperative consultations during general gynecologic surgery as an important focus of gynecologic oncology training.

    Science.gov (United States)

    Aviki, Emeline M; Rauh-Hain, J Alejandro; Clark, Rachel M; Hall, Tracilyn R; Berkowitz, Lori R; Boruta, David M; Growdon, Whitfield B; Schorge, John O; Goodman, Annekathryn

    2015-04-01

    The aim of this study is to explore the previously unexamined role of the Gynecologic Oncologist as an intraoperative consultant during general gynecologic surgery. Demographic and clinical data were collected on 98 major gynecologic surgeries that included both a general Gynecologist and a Gynecologic Oncologist between October 2010 and August 2014. Data were analyzed using XLSTAT-Prov2014.2.02. Of 794 major gynecologic surgeries, 98 (12.3%) cases that involved an intraoperative consultation were identified. There were 36 (37%) planned consults and 62 (63%) unplanned consults. Significantly more planned consults were during laparoscopy (100% v 58%; pGynecologic Oncologists play a pivotal role in the support of generalist colleagues during pelvic surgery. In this series, Gynecologic Oncologists were consulted frequently for complex major benign surgeries. It is important to incorporate the skills required of an intraoperative consultant into Gynecologic Oncology fellowship training. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Disparities in Mangement of Patients with Benign Colorectal Disease: Impact of Urbanization and Specialized Care.

    Science.gov (United States)

    Pandit, Viraj; Khalil, Mazhar; Joseph, Bellal; Jandova, Jana; Jokar, Tahereh Orouji; Haider, Ansab Abbas; Zangbar, Bardiya; Asim, Asad; Hassan, Ahmed; Nfonsam, Valentine

    2016-11-01

    Disparities in the management of patients with various medical conditions are well established. Colorectal diseases continue to remain one of the most common causes for surgical intervention. The aim of this study was to assess disparities (rural versus urban) in the surgical management of patients with noncancerous benign colorectal diseases. We hypothesized that there is no difference among rural versus urban centers (UC) in the surgical management for noncancerous benign colorectal diseases. The national estimates of surgical procedures for benign colorectal diseases from the National Inpatient Sample database 2011 representing 20 per cent of all in-patient admissions were abstracted. Patients undergoing procedures (abscess drainage, hemmoroidectomy, fistulectomy, and bowel resections) were included. Patients with colon cancer and those who underwent emergency surgery were excluded. The population was divided into two groups: urban and rural, based on the location of treatment. Outcome measures were in-hospital complications, mortality, and hospital costs. Subanalysis of UC was preformed: centers with colorectal surgeons and centers without colorectal surgeons. Regression analysis was performed. A total of 20,617 patients who underwent surgical intervention for benign colorectal diseases across 496 (urban: 342, rural: 154) centers, were included. Of the UC, 38.3 per cent centers had colorectal surgeons. Patients managed in UC had lower complication rate (7.6% vs 10.2%, P diseases managed surgically in urban versus rural centers. Specialized care with colorectal surgeons at UC helps reduce adverse patient outcomes. Steps to provide effective and safe surgical care in a cost-effective manner across rural as well as UC are warranted. Level III, retrospective cohort analysis.

  1. Oxidative stress induced damage in benign and malignant breast diseases: histopathological and biochemical aspects

    Directory of Open Access Journals (Sweden)

    Seema Khanna

    2012-04-01

    Full Text Available Increasing evidences indicate involvement of free radicals in the pathogenesis of benign and malignant breast diseases. Free radicals are highly reactive molecules and react with non–radicals in chain reaction leading to formation of new free radicals. If the defense mechanism of body fails to combat them, these free radicals pose a threat of injuring tissues by reacting with cell lipids. Lipids in the cell membrane undergo degradation to form hydroperoxides, which decompose to form a variety of products including malondialdehyde (MDA. MDA therefore was used as a marker to assess oxidative damage of cells and tissues. The aim of the present study was to assess the status of oxidative stress in the patients of benign and malignant breast diseases. Study has been made on the blood samples of 25 cases of benign breast disease and on an equal number of breast carcinoma patients. 20 healthy subjects were taken as the control cases.Mean MDA levels were significantly raised with depletion of antioxidant activity in all the patients in comparison to their control group suggesting the role of oxidative damage in the aetiopathogenesis of disease.

  2. PPARγ: A Molecular Link between systemic metabolic disease and benign prostate hyperplasia

    Science.gov (United States)

    Jiang, Ming; Strand, Douglas W.; Franco, Omar E.; Clark, Peter E.; Hayward, Simon W.

    2011-01-01

    The emergent epidemic of metabolic syndrome and its complex list of sequelae mandate a more thorough understanding of benign prostatic hyperplasia and lower urinary tract symptoms (BPH/LUTS) in the context of systemic metabolic disease. Here we discuss the nature and origins of BPH, examine its role as a component of LUTS and review retrospective clinical studies that have drawn associations between BPH/LUTS and type II diabetes, inflammation and dyslipidemia. PPARγ signaling, which sits at the nexus of systemic metabolic disease and BPH/LUTS through its regulation of inflammation and insulin resistance is proposed as a candidate for molecular manipulation in regard to BPH/LUTS. Finally, we introduce new cell and animal models that are being used to study the consequences of obesity, diabetes and inflammation on benign prostatic growth. PMID:21645960

  3. Robotic surgery in gynecology.

    Science.gov (United States)

    Alkatout, Ibrahim; Mettler, Liselotte; Maass, Nicolai; Ackermann, Johannes

    2016-01-01

    Robotic surgery is the most dynamic development in the sector of minimally invasive operations currently. It should not be viewed as an alternative to laparoscopy, but as the next step in a process of technological evolution. The advancement of robotic surgery, in terms of the introduction of the Da Vinci Xi, permits the variable use of optical devices in all four trocars. Due to the new geometry of the "patient cart," an operation can be performed in all spatial directions without re-docking. Longer instruments and the markedly narrower mechanical elements of the "patient cart" provide greater flexibility as well as access similar to those of traditional laparoscopy. Currently, robotic surgery is used for a variety of indications in the treatment of benign gynecological diseases as well as malignant ones. Interdisciplinary cooperation and cooperation over large geographical distances have been rendered possible by telemedicine, and will ensure comprehensive patient care in the future by highly specialized surgery teams. In addition, the second operation console and the operation simulator constitute a new dimension in advanced surgical training. The disadvantages of robotic surgery remain the high costs of acquisition and maintenance as well as the laborious training of medical personnel before they are confident with using the technology.

  4. Benign tremulous Parkinsonism: a unique entity or another facet of Parkinson?s disease?

    OpenAIRE

    Deeb, Wissam; Hu, Wei; Almeida, Leonardo; Patterson, Addie; Martinez-Ramirez, Daniel; Wagle Shukla, Aparna

    2016-01-01

    Benign tremulous parkinsonism (BTP) is characterized by a prominent tremor that occurs both at rest and with action in conjunction with other mild features of parkinsonism. The progression of symptoms is typically slow and there is often a positive family history. Although BTP is included within the phenotypic spectrum of Parkinsonism its exact relationship with idiopathic Parkinson?s disease remains unclear. Treatment of BTP is challenging especially considering the poor response to levodopa...

  5. Influencing factors on the serum carcinoembryonic antigen (CEA) in benign liver diseases

    International Nuclear Information System (INIS)

    Pompecki, R.; Mehl, H.; Fehr, R.; Braun, H. von

    1982-01-01

    Carcinoembryonic antigen (CEA) was determined in the sera of 452 patients with benign liver diseases by radioimmunoassay (CEA-RIA Kit, Abbott). The CEA-level exceeded 2.5 ng/ml in 39 percent and 5.0 ng/ml in 9 percent of the cases. Independent influences of age, nicotin, and alcohol consumption and connective tissue proliferation of the liver on the CEA level were demonstrated and quantified by two- and higher-dimensional contingency table analysis. Toxic liver diseases were combined with elevated serum CEA values more often than inflammatory diseases. This aspect could not be investigated independently since there were only a few cases of toxic liver diseases without alcohol consumption. Sex and relative body weight do not seem to affect the CEA level. Additional diseases of the gastrointestinal tract or the cardiovascular system did not influence the serum CEA level in liver diseases. Therefore, in patients with benign liver diseases, an elevated serum CEA level indicates increased proliferation of the connective tissue. Age, nicotin, and alcohol consumption have to be considered independently in the clinical judgement of elevated serum CEA levels, irrespective of the underlying disease. (orig.) [de

  6. Prophylactic salpingectomy in women undergoing hysterectomy for benign gynaecological disease - a new Danish recommendation

    DEFF Research Database (Denmark)

    Sloth, Sigurd Beier; Gimbel, Helga; Jørgensen, Annemette

    Background In May 2015 we published a national clinical guideline on hysterectomy for benign gynaecological conditions in cooperation with the Danish Health and Medicines Authority. One of nine investigated areas of interest was whether or not to remove the fallopian tubes in women undergoing...... hysterectomy for benign gynaecological disease. Methods A guideline panel of gynaecologists predefined critical and important outcomes for the assessment. The critical outcomes were defined as reoperation, operations on salpinx, fallopian tube cancer, ovarian cancer and post-operative levels of Anti......-Müllerian Hormone (AMH). The important outcomes were defined as post-operative infections. A search specialist conducted a systematic literature search for publications from 2004 to 2014 in English, Danish, Norwegian and Swedish. In our first search we looked for existing guidelines in the Guidelines International...

  7. Basic concepts in the kidney and bladder: The granulomatous diseases and the benign processes

    International Nuclear Information System (INIS)

    Goldman, S.M.

    1987-01-01

    This course considers the group of bladder and kidney diseases that poses great difficulty in preoperative diagnosis. Transitional cell and hypernephroma look-alikes are the true ''great imitators'' of diseases of the urinary system. The first half of the course examines the pathologic-physiologic underpinnings of granulomatous diseases of the urinary tract. With an understanding of these basic processes, the myriad radiologic manifestations of this group of diseases (tuberculosis, xanthogranulomatous pyelonephritis, malakoplakia, schistosomiasis, and so forth) will become more obvious. The second part of the course examines the radiologic and pathologic manifestations of certain common forms of cystitis (cystitis cystica, cystitis glandularis, Cytoxan cystitis, cystitis emphysematosa) and other benign processes (pheochromocytomas, neurofibromas, fibrous polyps, duplications) that may be confused with their malignant counterparts by the unsuspecting radiologists. Knowledge of these two large groups of disease should allow a more intelligent approach to these often misdiagnosed urinary tract diseases

  8. Gynecological cancers.

    Science.gov (United States)

    Avril, Norbert; Gourtsoyianni, Sofia; Reznek, Rodney

    2011-01-01

    The clinical problems raised in patients presenting with all forms of gynecological malignancy are currently addressed using conventional cross-sectional imaging, usually MRI. In general, F-18 FDG PET-CT has not been shown to have a clinical role in any of these cancers at presentation, although studies are under way to use this form of metabolic imaging to predict prognosis and the response to treatment. Although F-18 FDG PET-CT is superior to conventional imaging techniques, it is only moderately sensitive in demonstrating lymph node metastasis preoperatively, and is inadequate for local staging of patients with endometrial cancer. In ovarian cancer, F-18 FDG PET-CT provides an accurate assessment of the extent of disease, particularly in areas difficult to assess for metastases by CT and MRI such as the abdomen and pelvis, mediastinum, and supraclavicular region. F-18 FDG PET-CT is a sensitive method of detecting pelvic and para-aortic lymph nodal disease in cervical cancer, and appears to be superior to MRI and CT despite the limitations in identifying small foci of disease. In the main, as elsewhere in patients with cancer, the value of PET-CT is in identifying and defining the extent of recurrent disease, in distinguishing between posttreatment fibrosis and recurrence, and possibly in monitoring response to therapy.

  9. A novel serum microRNA panel to discriminate benign from malignant ovarian disease.

    LENUS (Irish Health Repository)

    Langhe, Ream

    2015-01-28

    Ovarian cancer is the seventh most common cancer in women and the most frequent cause of gynaecological malignancy-related mortality in women. Currently, no standardized reliable screening test exists. MicroRNA profiling has allowed the identification of signatures associated with diagnosis, prognosis and response to treatment of human tumours. The aim of this study was to determine if a microRNA signature could distinguish between malignant and benign ovarian disease. A training set of 5 serous ovarian carcinomas and 5 benign serous cystadenomas were selected for the initial experiments. The validation set included 20 serous ovarian carcinomas and 20 benign serous cystadenomas. The serum\\/plasma focus microRNA Exiqon panel was used for the training set. For the validation set a pick and mix Exiqon panel, which focuses on microRNAs of interest was used. A panel of 4 microRNAs (let-7i-5p, miR-122, miR-152-5p and miR-25-3p) was significantly down regulated in cancer patients. These microRNAs target WNT signalling, AKT\\/mTOR and TLR-4\\/MyD88, which have previously been found to play a role in ovarian carcinogenesis and chemoresistance. let-7i-5p, miR-122, miR-152-5p and miR-25-3p could act as diagnostic biomarkers in ovarian cancer.

  10. Disparity Expression of Notch1 in Benign and Malignant Colorectal Diseases

    Science.gov (United States)

    Huang, Rui; Tang, Qingchao; You, Qi; Liu, Zheng; Wang, Guiyu; Chen, Yinggang; Sun, Yuwen; Muhammad, Shan; Wang, Xishan

    2013-01-01

    Background and Objectives Although there was growing evidence supporting the hypothesis that Notch1 was one of the few candidate genes linked with colorectal cancer (CRC) susceptibility, the precise level of Notch1 protein expression in benign and malignant colorectal diseases was still unknown. Our study has investigated the Notch1 expression in benign and malignant colorectal diseases as well as to investigate the role and clinicopathological significance of aberrant expression of Notch1 in CRC. Methods The protein expression of Notch1 was examined by immunohistochemistry in 901 clinical specimens with colorectal diseases, including 220 patients with ulcerative colitis, 232 patients with colorectal adenoma and 449 patients with colorectal cancer. Associations between the expression of Notch1 and various clinicopathological features, as well as survival status, were studied. Results Cytoplasmic Notch1 was expressed in 7.7% of patients with ulcerative colitis, 14.7% of patients with colorectal adenoma and 58.0% of patients with colorectal cancer, respectively. Colorectal cancer patients with high expression levels of Notch1 showed lower overall survival (OS) and disease-free survival (DFS) rates than those patients with low Notch1 expression. Conclusions Expression level of Notch1 was gradually increased from precancerous lesions to cancer. It might play as an oncogene in the CRC development, and might be potentially used as a biomarker for prognosis of CRCs. PMID:24312514

  11. Benign tremulous Parkinsonism: a unique entity or another facet of Parkinson's disease?

    Science.gov (United States)

    Deeb, Wissam; Hu, Wei; Almeida, Leonardo; Patterson, Addie; Martinez-Ramirez, Daniel; Wagle Shukla, Aparna

    2016-01-01

    Benign tremulous parkinsonism (BTP) is characterized by a prominent tremor that occurs both at rest and with action in conjunction with other mild features of parkinsonism. The progression of symptoms is typically slow and there is often a positive family history. Although BTP is included within the phenotypic spectrum of Parkinsonism its exact relationship with idiopathic Parkinson's disease remains unclear. Treatment of BTP is challenging especially considering the poor response to levodopa, therefore surgical therapies such as deep brain stimulation surgery are sought for treatment of these tremors. In this review, we will summarize the clinical features, diagnosis, neuropathology and treatment for BTP.

  12. Radiation therapy for benign diseases: patterns of care study in Germany

    International Nuclear Information System (INIS)

    Seegenschmiedt, M. Heinrich; Katalinic, Alexander; Makoski, Hans-Bruno; Haase, Wulf; Gademann, Guenther; Hassenstein, Eckhard

    2000-01-01

    Background: Radiotherapy of benign diseases is controversial and rarely applied in Anglo-American countries, whereas in other parts of the world it is commonly practiced for several benign disorders. Similar to a European survey, a pattern of care study was conducted in Germany. Method: Using a mailed questionnaire, radiation equipment, treatment indication, number of patients, and treatment concepts were assessed in 1994, 1995, and 1996 in 134 of 152 German institutions (88%): 22 in East and 112 in West Germany; 30 in university hospitals and 104 in community hospitals. Average numbers of each institution and of all institutions were analyzed for frequencies and ratios between regions and among institutions. Radiation treatment concepts were analyzed. Results: A mean of 2 (range 1-7) megavoltage and 1.4 (range 0-4) orthovoltage units were available per institution; 32 institutions (24%) had no orthovoltage equipment. A mean of 20,082 patients were treated annually: 456 (2%) for inflammatory diseases (221 hidradenitis, 78 local infection, 23 parotitis; 134 not specified) 12,600 (63%) for degenerative diseases (2711 peritendinitis humeroscapularis, 1555 epicondylitis humeri; 1382 plantar/dorsal heel spur; 2434 degenerative osteoarthritis; 4518 not specified); 927 (5%) for hyperproliferative diseases (146 Dupuytren's contracture, 382 keloids; 155 Peyronie's disease; 244 not specified); 1210 (6%) for functional disorders (853 Graves' orbitopathy; 357 not specified); and 4889 (24%) for other disorders (e.g., 3680 heterotopic ossification prophylaxis). In univariate analysis, there were geographic (West vs. East Germany) differences in using radiation therapy (RT) for inflammatory and degenerative disorders, and institutional differences (university versus community hospitals) in using RT for hyperproliferative and functional disorders (p < 0.05). The prescribed dose concepts were mostly in the low dose range, <10 Gy but varied widely and inconsistently within

  13. Stenting of the Cystic Duct in Benign Disease: A Definitive Treatment for the Elderly and Unwell

    Energy Technology Data Exchange (ETDEWEB)

    Hersey, N., E-mail: naomi.hersey@sth.nhs.uk [Sheffield Teaching Hospitals NHS Trust, Department of Radiology, Northern General Hospital (United Kingdom); Goode, S. D., E-mail: s.goode@sheffield.sc.uk [Sheffield Teaching Hospitals NHS Trust, Sheffield Vascular Institute (United Kingdom); Peck, R. J., E-mail: robert.peck@sth.nhs.uk; Lee, F., E-mail: fred.lee@sth.nhs.uk [Sheffield Teaching Hospitals NHS Trust, Department of Radiology, Northern General Hospital (United Kingdom)

    2015-08-15

    PurposeThere have been few case reports describing cystic duct stent insertion in the management of acute cholecystitis secondary to benign disease with no case series published to date. We present our series demonstrating the role of cystic duct stents in managing benign gallbladder disease in those patients unfit for surgery.Materials and MethodsThirty three patients unfit for surgery in our institution underwent cystic duct stent insertion for the management of acute cholecystitis in the period June 2008 to June 2013. Patients underwent a mixture of transperitoneal and transhepatic gallbladder puncture. The cystic duct was cannulated with a hydrophilic guidewire which was subsequently passed through the common bile duct and into the duodenum. An 8Fr 12-cm double-pigtail stent was placed with the distal end lying within the duodenum and the proximal end within the gallbladder.ResultsTen patients presented with gallbladder perforation, 21 patients with acute cholecystitis, 1 with acute cholangitis and 1 with necrotising pancreatitis. The technical success rate was 91 %. We experienced a 13 % complication rate with 3 % mortality rate at 30 days.ConclusionCystic duct stent insertion can be successfully used to manage acute cholecystitis, gallbladder empyema or gallbladder perforations in those unfit for surgery and should be considered alongside external gallbladder drainage as a definitive mid-term treatment option.

  14. Technical Aspects of Laparoscopic Distal Pancreatectomy for Benign and Malignant Disease: Review of the Literature

    Science.gov (United States)

    de Rooij, T.; Sitarz, R.; Busch, O. R.; Besselink, M. G.; Abu Hilal, M.

    2015-01-01

    Distal pancreatectomy is the standard curative treatment for symptomatic benign, premalignant, and malignant disease of the pancreatic body and tail. The most obvious benefits of a laparoscopic approach to distal pancreatectomy include earlier recovery and shorter hospital stay. Spleen-preserving distal pancreatectomy should be attempted in case of benign disease. Spleen preservation can be achieved preferably by preserving the splenic vessels (Kimura technique), but also by resecting the splenic vessels and maintaining vascularity through the short gastric vessels and left gastroepiploic artery (Warshaw technique). Several studies have suggested a higher rate of spleen preservation with laparoscopy. The radical antegrade modular pancreatosplenectomy has become mainstay for treating pancreatic cancer and can be performed laparoscopically as well. Evidence on the feasibility and safety of laparoscopic distal pancreatectomy for cancer is scarce. Despite the obvious advantages of laparoscopic surgery, postoperative morbidity remains relatively high, mainly because of the high incidence of pancreatic fistula. For decades, surgeons have tried to prevent these fistulas but to date no strategy has been confirmed to be effective in 2 consecutive randomized studies. Pragmatic multicenter studies focusing on technical aspects of laparoscopic distal pancreatectomy are lacking and should be encouraged. PMID:26240565

  15. Technical Aspects of Laparoscopic Distal Pancreatectomy for Benign and Malignant Disease: Review of the Literature

    Directory of Open Access Journals (Sweden)

    T. de Rooij

    2015-01-01

    Full Text Available Distal pancreatectomy is the standard curative treatment for symptomatic benign, premalignant, and malignant disease of the pancreatic body and tail. The most obvious benefits of a laparoscopic approach to distal pancreatectomy include earlier recovery and shorter hospital stay. Spleen-preserving distal pancreatectomy should be attempted in case of benign disease. Spleen preservation can be achieved preferably by preserving the splenic vessels (Kimura technique, but also by resecting the splenic vessels and maintaining vascularity through the short gastric vessels and left gastroepiploic artery (Warshaw technique. Several studies have suggested a higher rate of spleen preservation with laparoscopy. The radical antegrade modular pancreatosplenectomy has become mainstay for treating pancreatic cancer and can be performed laparoscopically as well. Evidence on the feasibility and safety of laparoscopic distal pancreatectomy for cancer is scarce. Despite the obvious advantages of laparoscopic surgery, postoperative morbidity remains relatively high, mainly because of the high incidence of pancreatic fistula. For decades, surgeons have tried to prevent these fistulas but to date no strategy has been confirmed to be effective in 2 consecutive randomized studies. Pragmatic multicenter studies focusing on technical aspects of laparoscopic distal pancreatectomy are lacking and should be encouraged.

  16. Evaluation of Helicobacter pylori infection and other risk factors in patients with benign peptic ulcer disease

    Directory of Open Access Journals (Sweden)

    Depender Kumar Timshina

    2011-03-01

    Full Text Available Objective: To assess and compare the risk factors in patients with benign gastric and duodenal ulcers and to correlate the prevalence of Helicobacter pylori (H. pylori infection in benign peptic ulcer disease. Methods: A total of 30 consecutive patients with peptic ulcer disease were included in this study after upper gastrointestinal endoscopy. Their clinical profile and endoscopic findings were noted. Antral biopsies were subjected to histopathological examination and urease test for detection of H. pylori. Results were correlated. The study was cleared by the Institute Research Council and the Ethics committee. Results: The male: female ratio was 11:4. Overall, H. pylori infection was prevalent in 93.3% of the patients. Patients who took spicy food had a significantly higher rate of H. pylori positivity (P=0.04. Smoking, alcohol intake and NSAIDs did not affect H. pylori status in patients. There was no significant association between the site of the ulcer and H. pylori infection. Conclusions: Based on our observations we conclude that prevalence of H. pylori infection is similar in duodenal and gastric ulcers and intake of spicy food is a significant risk factor.

  17. Stenting of the Cystic Duct in Benign Disease: A Definitive Treatment for the Elderly and Unwell

    International Nuclear Information System (INIS)

    Hersey, N.; Goode, S. D.; Peck, R. J.; Lee, F.

    2015-01-01

    PurposeThere have been few case reports describing cystic duct stent insertion in the management of acute cholecystitis secondary to benign disease with no case series published to date. We present our series demonstrating the role of cystic duct stents in managing benign gallbladder disease in those patients unfit for surgery.Materials and MethodsThirty three patients unfit for surgery in our institution underwent cystic duct stent insertion for the management of acute cholecystitis in the period June 2008 to June 2013. Patients underwent a mixture of transperitoneal and transhepatic gallbladder puncture. The cystic duct was cannulated with a hydrophilic guidewire which was subsequently passed through the common bile duct and into the duodenum. An 8Fr 12-cm double-pigtail stent was placed with the distal end lying within the duodenum and the proximal end within the gallbladder.ResultsTen patients presented with gallbladder perforation, 21 patients with acute cholecystitis, 1 with acute cholangitis and 1 with necrotising pancreatitis. The technical success rate was 91 %. We experienced a 13 % complication rate with 3 % mortality rate at 30 days.ConclusionCystic duct stent insertion can be successfully used to manage acute cholecystitis, gallbladder empyema or gallbladder perforations in those unfit for surgery and should be considered alongside external gallbladder drainage as a definitive mid-term treatment option

  18. Side effects and risks of radioiodine treatment of benign thyroid diseases

    International Nuclear Information System (INIS)

    Becker, W.; Hohenberger, W.; Wolf, F.; Erlangen-Nuernberg Univ., Erlangen

    1990-01-01

    Radioiodine treatment is considered to be the treatment of choice in benign thyroid diseases because of its very low side effects. Real and hypothetic risks and side effects have to be differentiated. Both may occur early and late after the treatment. Radioiodinethyroiditis in small volumes at high doses is very rare. Exacerbation of a thyroid storm (0.34%) as well as local compressions accompanied with reactive edema of the thyroid are early real side effects of radioiodine treatment. Late real side effects are failure of treatment (7-30% of thyrotoxicosis) and induction of hypothyroidism (4-20% of functional autonomy and increasing frequency in Graves' diseases with time). Late hypothetic risks are somatic (1-9/10000 bis 1-9/100000) or genetic (1-9/100000). An early risk might be the misdiagnosis of an additional thyroid carcinoma. (orig.) [de

  19. Dose concepts and dosimetry for radioiodine therapy of benign thyroid diseases

    International Nuclear Information System (INIS)

    Bockisch, A.; Brandt-Mainz, K.; Goerges, R.

    1997-01-01

    Dose planning prior to radioiodine therapy of benign thyroidal disease is usually based on macrodosimetry. The paper shows that this assumption is acceptable. The common concepts for dose planning are given. The following target doses are nowadays widely accepted: 150 Gy for euthyroid goiter, 400 Gy for toxic adenoma, 150 Gy for disserminated autonomy, 200 Gy for hyperthyroid Grave's disease if posttherapeutic euthyroidism is intended, and 250 (to 300) Gy if the risk of recurrency is to be minimized ('ablative' concept). Finally, a surveyfis given concerning the precision in which the parameters relevant for the dose calcultion can be determined. For realistic favourable conditions, the dose can be determined with an accuracy of better than ±25%. (orig.) [de

  20. Coloanal anastomosis in the management of benign and malignant rectal disease

    Energy Technology Data Exchange (ETDEWEB)

    Drake, D.B.; Pemberton, J.H.; Beart, R.W. Jr.; Dozois, R.R.; Wolff, B.G.

    1987-11-01

    The aim was to determine the efficacy, safety, and long-term clinical and functional results of coloanal anastomosis in patients with complicated benign and malignant rectal disease. Twenty-nine patients underwent coloanal or colopouch-anal anastomosis for either carcinoma of the rectum not technically amenable to conventional low anterior resection, severe radiation injury, large benign lower third tumors, or complications of previous operations. The mean age of the patients was 61 years and 82% were men. A diverting colostomy was constructed in 55% of the patients. The mean (+/- SEM) length of follow-up was 20 +/- 3 months. There was no operative mortality. Transient urinary retention, however, occurred in 40%, anastomotic stricture in 28%, and anastomotic leakage in 3.4%. Four patients (14%) could not have intestinal continuity restored and therefore were considered failures. The stool frequency for all remaining patients (N = 25) was 3 +/- 1 per day (mean +/- SEM) and did not vary with age, sex, or indication for operation. Complete continence was achieved by 84% of patients, but no patient was incapacitated by poor bowel function. In patients in whom a conventional colorectostomy is impractical or unwise, coloanal anastomosis is a safe and efficacious alternative operation that preserves anal continence.

  1. Coloanal anastomosis in the management of benign and malignant rectal disease

    International Nuclear Information System (INIS)

    Drake, D.B.; Pemberton, J.H.; Beart, R.W. Jr.; Dozois, R.R.; Wolff, B.G.

    1987-01-01

    The aim was to determine the efficacy, safety, and long-term clinical and functional results of coloanal anastomosis in patients with complicated benign and malignant rectal disease. Twenty-nine patients underwent coloanal or colopouch-anal anastomosis for either carcinoma of the rectum not technically amenable to conventional low anterior resection, severe radiation injury, large benign lower third tumors, or complications of previous operations. The mean age of the patients was 61 years and 82% were men. A diverting colostomy was constructed in 55% of the patients. The mean (+/- SEM) length of follow-up was 20 +/- 3 months. There was no operative mortality. Transient urinary retention, however, occurred in 40%, anastomotic stricture in 28%, and anastomotic leakage in 3.4%. Four patients (14%) could not have intestinal continuity restored and therefore were considered failures. The stool frequency for all remaining patients (N = 25) was 3 +/- 1 per day (mean +/- SEM) and did not vary with age, sex, or indication for operation. Complete continence was achieved by 84% of patients, but no patient was incapacitated by poor bowel function. In patients in whom a conventional colorectostomy is impractical or unwise, coloanal anastomosis is a safe and efficacious alternative operation that preserves anal continence

  2. Laparoscopic heminephrectomy for benign and malignant diseases of the horseshoe kidney

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    Altug Tuncel

    2016-12-01

    Full Text Available Objectives: In the current study, we present our pure laparoscopic heminephrectomy experience in 13 patients with horseshoe kidney (HK. Material and Methods: A total of 13 patients with HK underwent pure laparoscopic heminephrectomy (Transperitoneal= 7, Retroperitoneal = 6 due to benign and malign renal conditions (non-functional hydronephrotic and/or infected kidney = 12, kidney mass = 1. Results: The mean age of the patients was 45.8 years. The mean operating time was 140 minutes, and estimated blood loss was 131 ml. The mean hospital stay was 2.3 days. Division of istmus was performed with stapler in 5 patients, ultrasonic scalpel in 3, 15 mm Hem-o-lok clip in 3, 10 mm LigaSure vessel seal system in one and endoscopic suture by 0 polyglactin in one patient without bleeding. Twelve patients underwent pure laparoscopic heminephrectomy due to nonfunctional hydronephrotic and or infected kidney. One patient underwent transperitoneal laparoscopic right heminephrectomy due to kidney mass. According to modifies Clavien classification, Grade I complication (wound infection occurred in one patient (7.7% who underwent heminephrectomy due to non-functional kidney. Conclusions: Laparoscopic heminephrectomy seems to be technically feasible and safe for benign and malignant diseases in patients with HK.

  3. Topical PDT in the Treatment of Benign Skin Diseases: Principles and New Applications

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    Miri Kim

    2015-09-01

    Full Text Available Photodynamic therapy (PDT uses a photosensitizer, light energy, and molecular oxygen to cause cell damage. Cells exposed to the photosensitizer are susceptible to destruction upon light absorption because excitation of the photosensitizing agents leads to the production of reactive oxygen species and, subsequently, direct cytotoxicity. Using the intrinsic cellular heme biosynthetic pathway, topical PDT selectively targets abnormal cells, while preserving normal surrounding tissues. This selective cytotoxic effect is the basis for the use of PDT in antitumor treatment. Clinically, PDT is a widely used therapeutic regimen for oncologic skin conditions such as actinic keratosis, squamous cell carcinoma in situ, and basal cell carcinoma. PDT has been shown, under certain circumstances, to stimulate the immune system and produce antibacterial, and/or regenerative effects while protecting cell viability. Thus, it may be useful for treating benign skin conditions. An increasing number of studies support the idea that PDT may be effective for treating acne vulgaris and several other inflammatory/infective skin diseases, including psoriasis, rosacea, viral warts, and aging-related changes. This review provides an overview of the clinical investigations of PDT and discusses each of the essential aspects of the sequence: its mechanism of action, common photosensitizers, light sources, and clinical applications in dermatology. Of the numerous clinical trials of PDT in dermatology, this review focuses on those studies that have reported remarkable therapeutic benefits following topical PDT for benign skin conditions such as acne vulgaris, viral warts, and photorejuvenation without causing severe side effects.

  4. Topical PDT in the Treatment of Benign Skin Diseases: Principles and New Applications

    Science.gov (United States)

    Kim, Miri; Jung, Haw Young; Park, Hyun Jeong

    2015-01-01

    Photodynamic therapy (PDT) uses a photosensitizer, light energy, and molecular oxygen to cause cell damage. Cells exposed to the photosensitizer are susceptible to destruction upon light absorption because excitation of the photosensitizing agents leads to the production of reactive oxygen species and, subsequently, direct cytotoxicity. Using the intrinsic cellular heme biosynthetic pathway, topical PDT selectively targets abnormal cells, while preserving normal surrounding tissues. This selective cytotoxic effect is the basis for the use of PDT in antitumor treatment. Clinically, PDT is a widely used therapeutic regimen for oncologic skin conditions such as actinic keratosis, squamous cell carcinoma in situ, and basal cell carcinoma. PDT has been shown, under certain circumstances, to stimulate the immune system and produce antibacterial, and/or regenerative effects while protecting cell viability. Thus, it may be useful for treating benign skin conditions. An increasing number of studies support the idea that PDT may be effective for treating acne vulgaris and several other inflammatory/infective skin diseases, including psoriasis, rosacea, viral warts, and aging-related changes. This review provides an overview of the clinical investigations of PDT and discusses each of the essential aspects of the sequence: its mechanism of action, common photosensitizers, light sources, and clinical applications in dermatology. Of the numerous clinical trials of PDT in dermatology, this review focuses on those studies that have reported remarkable therapeutic benefits following topical PDT for benign skin conditions such as acne vulgaris, viral warts, and photorejuvenation without causing severe side effects. PMID:26404243

  5. Sexual function, anxiety and depression in women with benign breast disease. A case-control study

    Directory of Open Access Journals (Sweden)

    Flávia Fairbanks

    Full Text Available Summary Introduction: Sexual dysfunction is highly prevalent, affecting 40% of the female population. The incidence of such dysfunction is known to be higher among women with malignant breast disease and in patients with depression or anxiety. However, there are few data regarding the prevalence of sexual dysfunction among women with benign breast disease (BBD. Objective: To evaluate the incidence of sexual dysfunction, depression and anxiety among women with BBD, in comparison with that observed for healthy women. Method: We evaluated the incidence of sexual dysfunction in 60 patients with benign breast disease (fibroadenomas, breast cysts, breast pain and phyllodes tumor and 69 healthy women (control group. Participants completed the Sexual Quotient Questionnaire for Females (SQQ-F, the Beck Depression Inventory and the Beck Anxiety Inventory. Statistical analysis revealed that depression and anxiety were comparable between BBD and control groups (10.3 vs. 20.3% and 38.7 vs. 34.3%, respectively, p>0.05. The mean SQQ-F score (65.6±22.7 vs. 70.1±16.8; p>0.05 and sexual dysfunction (33.3 vs. 25.4%; p=0.324 were similar between BBD and control groups. Conclusion: We found no differences between women with BBD and healthy women in terms of the incidence of sexual dysfunction, anxiety and depression. Nevertheless, given the high prevalence of this condition, it is important to assess sexual quality of life, as well as overall quality of life, in women with BBD.

  6. Differential diagnosis of metastatic bone disease and benign bone disease on spine SPECT in patients with low back pain

    International Nuclear Information System (INIS)

    Lee, Seung Hun; Choi, Yun Young; Cho, Suk Shin

    2001-01-01

    One or more abnormal vertebrae detected on bone scintigraphy is a common finding in clinical practice, and it could pose a diagnostic dilemma especially in cancer patients, as either metastasis or benign disease may cause scintigraphic abnormality. The purpose of this study was to determine whether additional spine SPECT has a role in differentiating malignant from benign lesions in patients with back pain. We reviewed spine SPECT studies obtained over a three-year period in 108 patients. Among them, forty-five patients with abnormal SPECT and clinically followed records were evaluated (20 cancer patients were included). Uptake patterns were classified as follows: 1. Body: diffusely increased uptake, linear increased uptake of end plate, segmental increased uptake, and cold defect, 2 Posterior element; posterior to body (pedicle), posterior to intervertebral disc space (facet joint), and spinous process. Lesions were correlated with radiological findings and with final diagnosis. Sixty-nine bone lesions were detected on SPECT images, including 18 metastases, 28 degenerative diseases and 21 compression fractures. Cold defect (6) and segmental increased uptake (5) were dominant findings in metastasis: linear increased uptake (12), and facet joint uptake (15) were in degenerative change; and diffuse increased uptake (9), and linear increased uptake (9) were in compression fracture. Cold defect and segmental increased uptake of body were characteristic findings of metastasis, but care should be taken because compression fracture also shows segmental increased uptake in some cases. Degenerative disease was easily diagnosed because of the typical finding of linear increased uptake of end plate and facet joint. Therefore, additional bone SPECT after planar bone scan would be helpful for differentiating metastasis from benign condition in cancer patients

  7. A classification tree for the prediction of benign versus malignant disease in patients with small renal masses.

    Science.gov (United States)

    Rendon, Ricardo A; Mason, Ross J; Kirkland, Susan; Lawen, Joseph G; Abdolell, Mohamed

    2014-08-01

    To develop a classification tree for the preoperative prediction of benign versus malignant disease in patients with small renal masses. This is a retrospective study including 395 consecutive patients who underwent surgical treatment for a renal mass classification tree to predict the risk of having a benign renal mass preoperatively was developed using recursive partitioning analysis for repeated measures outcomes. Age, sex, volume on preoperative imaging, tumor location (central/peripheral), degree of endophytic component (1%-100%), and tumor axis position were used as potential predictors to develop the model. Forty-five patients (11.4%) were found to have a benign mass postoperatively. A classification tree has been developed which can predict the risk of benign disease with an accuracy of 88.9% (95% CI: 85.3 to 91.8). The significant prognostic factors in the classification tree are tumor volume, degree of endophytic component and symptoms at diagnosis. As an example of its utilization, a renal mass with a volume of classification tree to predict the risk of benign disease in small renal masses has been developed to aid the clinician when deciding on treatment strategies for small renal masses.

  8. The ultrasound screening of the benign breast diseases and breast cancer

    Directory of Open Access Journals (Sweden)

    N. A. Zakharova

    2014-01-01

    Full Text Available Оbjective: the main goal of the study is to evaluate the current results for the ultrasound screening of the benign breast disease and breast cancer performed in the Khanty-Mansi Autonomous Area – Ugra. The screening covers women under 40 years old. During 2007–2012 181 428women were undergo the breast ultrasound, among them there are 93 965 (51 % women were screened. Approximately 10 % of screenedwomen were referred for further assessment. The average cancer detection rate was 0.46 per 1000 screened women. Additionally, has been proved the importance of breast ultrasound as a method for further assessment at mammographic screening among women over 40 years old.

  9. Clinical performance of LOCI™-based tumor marker assays for tumor markers CA 15-3, CA 125, CEA, CA 19-9 and AFP in gynecological cancers.

    Science.gov (United States)

    Dolscheid-Pommerich, Ramona C; Keyver-Paik, Mignon; Hecking, Thomas; Kuhn, Walther; Hartmann, Gunther; Stoffel-Wagner, Birgit; Holdenrieder, Stefan

    2017-10-01

    Evidence is sparse regarding the clinical performance of luminescent oxygen channeling immunoassays-based tumor marker assays in gynecological cancer. Analyzing serum samples of 336 patients with Dimension™Vista1500, we investigated the diagnostic power of carbohydrate antigen 15-3, carbohydrate antigen 125, carcinoembryonic antigen, carbohydrate antigen 19-9, and alpha-fetoprotein in patients suffering from different types of gynecological cancer and precancerous gynecological diseases and compared findings to appropriate control groups. The cohort comprised 177 female patients with gynecological cancers (73 breast, 22 cervical, 16 endometrial, 17 vulva, and 49 ovarian cancers), 26 patients with precancerous gynecological diseases (11 vulva, 4 cervical, and 10 breast), 109 patients with benign gynecological diseases, and 24 healthy controls. Discriminative power was assessed by areas under the curve in receiver operating characteristic curves, and sensitivities were determined at a fixed specificity of 95%. Levels of biomarkers in healthy controls were in the expected ranges and a discriminative power between gynecological cancers and healthy controls was observed for several tumor markers. Established tumor type-associated markers were elevated in specific gynecological cancers and benign controls as well as within precancerous gynecological diseases and healthy control group. In ovarian cancer, carbohydrate antigen 125 and carbohydrate antigen 15-3 were significantly elevated compared to the respective benign diseases. Carbohydrate antigen 125 was the most conclusive marker (area under the curve = 0.86% and 77.6% sensitivity at 95% specificity). In breast cancer, carcinoembryonic antigen and carbohydrate antigen 15-3 were significantly higher than in the respective benign diseases. Carcinoembryonic antigen achieved the most conclusive area under the curve (0.65) with 31.5% sensitivity at 95% specificity. None of the investigated markers was found to be of

  10. Impact of preventive therapy on the risk of breast cancer among women with benign breast disease.

    Science.gov (United States)

    Cuzick, Jack; Sestak, Ivana; Thorat, Mangesh A

    2015-11-01

    There are three main ways in which women can be identified as being at high risk of breast cancer i) family history of breast and/or ovarian cancer, which includes genetic factors ii) mammographically identified high breast density, and iii) certain types of benign breast disease. The last category is the least common, but in some ways the easiest one for which treatment can be offered, because these women have already entered into the treatment system. The highest risk is seen in women with lobular carcinoma in situ (LCIS), but this is very rare. More common is atypical hyperplasia (AH), which carries a 4-5-fold risk of breast cancer as compared to general population. Even more common is hyperplasia of the usual type and carries a roughly two-fold increased risk. Women with aspirated cysts are also at increased risk of subsequent breast cancer. Tamoxifen has been shown to be particularly effective in preventing subsequent breast cancer in women with AH, with a more than 70% reduction in the P1 trial and a 60% reduction in IBIS-I. The aromatase inhibitors (AIs) also are highly effective for AH and LCIS. There are no published data on the effectiveness of tamoxifen or the AIs for breast cancer prevention in women with hyperplasia of the usual type, or for women with aspirated cysts. Improving diagnostic consistency, breast cancer risk prediction and education of physicians and patients regarding therapeutic prevention in women with benign breast disease may strengthen breast cancer prevention efforts. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Two-port cholecystectomy maintains safety and feasibility in benign gallbladder diseases: a comparative study.

    Science.gov (United States)

    Lee, Sang Chul; Choi, Byeong-Jo; Kim, Say-June

    2014-01-01

    In an effort to overcome the limitations of single-port laparoscopic cholecystectomy (LC) while preserving the cosmetic benefits of reduced ports cholecystectomy, we have developed a 2-port LC that allows for the full, unrestricted use of 4 laparoscopic instruments. We retrospectively analyzed data of patients who had undergone either 4-port LC or 2-port LC for benign gallbladder diseases between March 2007 and March 2013. Two incisions of 2-port LC were composed of an umbilical incision as the manner of single-port laparoscopic surgery and a 5-mm epigastric incision. These two incisions were utilized for comfortable bimanual manipulation under the liver-elevated vision provided by a liver retractor. During the study period, 766 patients underwent LC; 263 (34.3%) started with 4-port LC, and 503 (65.7%) started with 2-port LC. Of patients started with 2-port LC, 486 patients (96.6%) was ended up with 2-port without open conversion or addition of port(s). The two groups had similar operative time, open conversion rate, incidence of complications, analgesic requirement, and length of postoperative hospital stay. Multivariate analyses revealed that the independent factors related to prolonged operative time (≥ 90 th percentile) in 2-port LC were the presence of cholecystitis (odds ratio [OR] 2.412, 95% CI 1.246-4.668, p = 0.009) and admission through the emergency department (OR 2.132, 95% CI 1.135-4.004, p = 0.019). This study suggests that 2-port LC for benign gallbladder diseases is as safe and feasible as 4-port LC when it is performed by surgeons trained in conventional laparoscopic techniques. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  12. Gynecologic cancer

    International Nuclear Information System (INIS)

    Uehara, Takashi; Katsumata, Noriyuki

    2008-01-01

    Surgery and radiation therapy have been the main types of treatment for gynecologic cancer. However, chemotherapy in gynecologic oncology has recently made dramatic progress and presently is becoming the most widespread treatment. After the discovery of cisplatin in the field of chemotherapy for epithelial ovarian cancer, it has now become the leading treatment modality. According to the result of several important phase III randomized control trials (RCTs), the platinum-taxane combined therapy has now become the standard treatment regimen. Regarding endometrial cancer, Cisplatin-Adriamycin-Cyclophosphamide (CAP) therapy has been used as an effective adjuvant chemotherapy in Japan. The adjuvant chemotherapy (Adriamycin-Cisplatin therapy) for the endometrial cancer has now been recognized worldwide as the standard therapy based on the findings of a phase III RCT. Concurrent chemoradiotherapy for cervical cancer has also been recommended as the standard therapy in Japan since 1999 based on the successful results of numerous RCTs which proved its efficacy. The chemotherapy for gynecologic cancers has been investigated and standardized based on the results of numerous clinical trials. These trials have been conducted by many clinical trial groups, such as the Gynecologic Oncology Group (GOG), Southwest Oncology Group (SWOG), and the European Organization for Research and Treatment of Cancer (EORTC) throughout the world, in addition to the Japan Clinical Oncology Group (JCOG) and the Japanese Gynecologic Oncology Group (JGOG) in Japan. The valuable contributions of these clinical trials are helping in the development of new drug therapies, thus leading to such treatment regimens playing increasingly important and wider roles in the field of gynecologic oncology treatment in the future. (author)

  13. [Investigation of the relationship between chronic diseases and residual symptoms of benign paroxysmal positional vertigo].

    Science.gov (United States)

    Zhou, Fengjie; Fu, Min; Zhang, Nan; Xu, Ye; Ge, Ying

    2015-09-01

    To investigate the prognosis-related influence factors of the residual symptoms after the canalith repositioning procedure (CRP) for the benign paroxysmal positional vertigo (BPPV) in the second affiliated hospital of dalian medical university. Among patients who were diagnosed with BPPV and treated by CRP, the one that still show residual symptoms were enrolled in our study, then make a follow-up irregularly about the tendency of their residual symptoms' self-healing,and respectively record in their gender, age and chronic diseases and so on. Single-factor analysis and multi-factors analysis was utilized to investigate the residual symptoms' related influencing factors. In this study, 149 cases of patients were in record, for the residual symptoms, 71 patients can go to self-healing, 78 patients can not; age is 23-88, 30 cases in the young group, 46 cases in the middle aged group, 47 cases in the young elderly group, 26 cases in the elderly group; patients suffering from high blood pressure are 76 cases, 76 cases had diabetes, 47 cases had hyperlipidemia, 110 cases had heart disease, 43 cases had ischemic encephalopathy. The residual symptoms in the elderly females patients and patients suffering from the hypertension, diabetes, heart disease patients and ischemic encephalopathy are not easy to heal by itself, in which, the older and the fact suffering from the hypertension and diabetes are the risk factors influencing the prognosis of the residual symptoms.

  14. Perioperative management of benign hepatic tumors in patients with glycogen storage disease type Ia.

    Science.gov (United States)

    Oshita, Akihiko; Itamoto, Toshiyuki; Amano, Hironobu; Ohdan, Hideki; Tashiro, Hirotaka; Asahara, Toshimasa

    2008-01-01

    Glycogen storage disease type Ia (GSD-Ia; von Gierke disease) is an inherited disorder caused by glucose-6-phosphatase deficiency, and there have been some reports of hepatic tumors in patients with this disease. We report two patients with benign hepatic tumors with GSD-Ia. One is a 19-year-old man who underwent segmentectomy 4 for a focal nodular hyperplasia, and the other is a 31-year-old woman who underwent segmentectomies 3, 5, and 6 for hepatic adenomas. Two significant perioperative complications, resulting from the carbohydrate metabolic disorders, hypoglycemia and metabolic acidosis, occurred in both patients. We managed the metabolic complications successfully by administering a sufficient volume of glucose intravenously. Close perioperative monitoring of blood glucose and lactate concentrations is essential in the perioperative management of patients with GSD-Ia. The intravenous administration of glucose, starting with a smaller dose and then increasing the dose, is adequate management for lactic acidosis with or without hypoglycemia during the perioperative period.

  15. Large differences in proportions of harmful and benign amino acid substitutions between proteins and diseases.

    Science.gov (United States)

    Schaafsma, Gerard C P; Vihinen, Mauno

    2017-07-01

    Genes and proteins are known to have differences in their sensitivity to alterations. Despite numerous sequencing studies, proportions of harmful and harmless substitutions are not known for proteins and groups of proteins. To address this question, we predicted the outcome for all possible single amino acid substitutions (AASs) in nine representative protein groups by using the PON-P2 method. The effects on 996 proteins were studied and vast differences were noticed. Proteins in the cancer group harbor the largest proportion of harmful variants (42.1%), whereas the non-disease group of proteins not known to have a disease association and not involved in the housekeeping functions had the lowest number of harmful variants (4.2%). Differences in the proportions of the harmful and benign variants are wide within each group, but they still show clear differences between the groups. Frequently appearing protein domains show a wide spectrum of variant frequencies, whereas no major protein structural class-specific differences were noticed. AAS types in the original and variant residues showed distinctive patterns, which are shared by all the protein groups. The observations are relevant for understanding genetic bases of diseases, variation interpretation, and for the development of methods for that purpose. © 2017 Wiley Periodicals, Inc.

  16. Endometriose intestinal: uma doença benigna? Bowel endometriosis: a benign disease?

    Directory of Open Access Journals (Sweden)

    Marco Antonio Bassi

    2009-01-01

    Full Text Available A despeito do caráter benigno da endometriose, estima-se que 1% dos casos esteja relacionado com câncer, especialmente quando ambas as condições ocorrem nos ovários. Lesões extra-ovarianas encontradas no septo retovaginal, cólon, bexiga, vagina e peritônio da região pélvica também já foram associadas com neoplasias malignas. Várias características do tecido endometrial ectópico o aproximam do fenótipo neoplásico, e a própria endometriose possui comportamento tipicamente neoplásico com capacidade de invasão do estroma adjacente e associação com lesões à distância. Esta revisão atualiza conhecimentos diagnósticos, clínicos e terapêuticos dos implantes intestinais de tecido endometriótico, bem como sua relação com processos neoplásicos para melhor compreensão de seu caráter benigno ou de seu eventual potencial para malignidade.Endometriosis is generally assumed to be a benign disease, but it is estimated that 1% of cases are associated with cancer, especially when both conditions are present in the ovary. Extra-ovarian lesions in the rectovaginal septum, colon, bladder, vagina and peritoneum were already associated with malign neoplasia. Several characteristics of endometrial tissue are very similar to the neoplasia phenotype. Endometriosis itself typically behaves as a neoplasia process, spreading over adjacent stroma and being associated with distant lesions. This is an update on the diagnostic, clinical, and therapeutic knowledge of, management of bowel implants of endometrial tissue, as well as the relation with neoplastic processes to better understand its benign nature or eventual potential for malignancy.

  17. Transfusion rate and prevalence of unexpected red blood cell alloantibodies in women undergoing hysterectomy for benign disease

    DEFF Research Database (Denmark)

    Thoestesen, Lisbeth M; Rasmussen, Kjeld L; Lauszus, Finn F

    2011-01-01

    To determine transfusion rates, risk factors for transfusion and the prevalence of unexpected red blood cell alloantibodies in women undergoing hysterectomy for benign disease. In addition, we aimed to evaluate the necessity of the pretransfusion testing for red blood cell alloantibodies....

  18. Organization of health care for the patients with benign diseases: the problem of one-day hospitalization

    Directory of Open Access Journals (Sweden)

    L. V. Kochorova

    2013-01-01

    Full Text Available The article analises the volume of medical care to the citizens of St. Petersburg, suffering with benign diseases and hospitalized for one day. It is shown,that the level of one-day hospitalization is a marker of not approved hospitalization and unreasonable spending of funds in the state system of obligatory insurance.

  19. What is the benefit of preoperative sperm preservation for patients who undergo restorative proctocolectomy for benign diseases?

    NARCIS (Netherlands)

    van Duijvendijk, P.; Slors, J. F.; Taat, C. W.; van Lochem, L. T.; Bonsel, G. J.; de Vries, J. W.; Obertop, H.

    2000-01-01

    In patients with benign colorectal diseases undergoing a restorative proctocolectomy with an ileal pouch-anal anastomosis, semen cryopreservation seems rational to enable the possibility of procreation in case surgery leads to sexual disorders or impotence. The aim of this study was to determine the

  20. The clinical significance of perioperative serum IL-10 level changes in patients with benign and malignant pulmonary diseases

    International Nuclear Information System (INIS)

    Qi Falian; Xu Jun; Du Xiumin; Lu Zhaotong; Fu Qiang

    2003-01-01

    Objective: To study the clinical significance of perioperative changes of serum IL-10 level in patients with benign and malignant pulmonary diseases. Methods: Serum IL-10 levels in patients with benign (n=17) and malignant (n=25) pulmonary diseases were measured before and 1, 3, 7, 14 days after operation with RIA. Values in 82 controls were also taken. Results: The preoperative levels of serum IL-10 in patients with lung cancer were significantly higher than those in other groups (p 0.05); The levels of serum IL-10 in 36.4% of all the patients with lung cancer on day 14 were higher than the upper limit of the normal value. In patients with benign lung diseases, perioperative changes were slight and non-significant. Conclusion: Serum IL-10 level is a reliable parameter for distinguishing benign lung disease from malignant ones. Defining preoperative and postoperative changes of serum IL-10 levels might be of prognostic value in patients with lung cancer

  1. [The peculiar features of the clinical course of Meniere's disease associated with benign paroxysmal positional vertigo].

    Science.gov (United States)

    Pal'chun, V T; Mel'nikov, O A; Levina, Yu V; Guseva, A L

    2018-01-01

    The objective of the present study was to evaluate the frequency of occurrence and clinical features of vertigo spells in the patients presenting with Ménière's disease (MD) associated with benign paroxysmal positional vertigo (BPPV). A total of 104 patients with MD were available for the observation. All of them underwent the comprehensive examination that included the audiological study and vestibular tests, such as the Dix-Hallpike test and the roll-test for BPPV diagnostics. A structured questionnaire was used to calculate the average number of vertigo spells per month during the period of 6 months and the mean duration of the vertigo spells; the presence or the absence of changes in hearing ability during the spells as well as the severity of vertigo were determined with the use of the 10-point visual analogue scale. The patients suffering from BPPV associated with Meniere's disease presented with the following clinical features which distinguished them from the patients with idiopathic BPPV (pvertigo spells in the patients having MD associated with BPPV occurred with an enhanced frequency; their mean duration was relatively short due to the presence of both long and short positional vertigo attacks characterized by the absence of hearing changes during the spells and the equal severity of vertigo (p < 0,05).

  2. Benign Prostatic Hyperplasia, Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease: Is Metaflammation the Link?

    Science.gov (United States)

    Russo, Giorgio Ivan; Cimino, Sebastiano; Castelli, Tommaso; Favilla, Vincenzo; Gacci, Mauro; Carini, Marco; Condorelli, Rosita A; La Vignera, Sandro; Calogero, Aldo E; Motta, Fabio; Puzzo, Lidia; Caltabiano, Rosario; Morgia, Giuseppe

    2016-12-01

    The prevalence of prostatic inflammation (PI) is very frequent in patients affected by benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). To investigate the relationship between prostatic inflammation (PI) and the presence of MetS and non-alcoholic fatty liver disease (NAFLD) in a cohort of patients affected by BPH/LUTS. We conducted a prospective study from January 2012 to June 2014 on 264 consecutive patients, who underwent transurethral resection of the prostate for bladder outlet obstruction. Metabolic syndrome (MetS) has been defined according to the International Diabetes Federation (IDF). Prior to surgery, each patient has been evaluated for the presence of MetS and NAFLD. All surgical specimens were investigated for the presence of an inflammatory infiltrate, according to the Irani score. The prevalence of patients affected by MetS alone was 13.8% (32/232), 13.8% (32/232) by NAFLD alone, and 42.7% (99/232) by both diseases. The rate of subjects affected by MetS + NAFLD and severe PI was significantly greater than those with only one metabolic alteration (75.8% vs. 24.2%, P prostate gland by increasing severity of inflammation. Prostate 76:1528-1535, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. The relationship between serum PSA, six sex hormones and the benign or malignant prostate diseases

    International Nuclear Information System (INIS)

    Xu Yancun

    2008-01-01

    In order to study clinical significance of serum prostate-specific antigen (PSA), free prostate specific antigen (PSA), f/tPSA and six sex hormones in prostate diseases, the serum levels of PSA, fPSA, f/tPSA, T, P, E 2 , PRL, LH and FSH in 72 cases of hyperplasia of prostate patients and 40 patients with prostate cancer were determined by RIA. The results showed that the serum levels of T, E 2 , PRL, LH, FSH in the BPH Group were significantly lower than those of in Pca group, the serum level of P in Pca group were significantly lower than those in BPH group; the levels of fPSA and f/tPSA ratio in BPH Group were significantly higher than those in Pca group. The results suggest that benign and malignant prostate disease (BPH and Pca) was related with the hormone imbalance. The serum total PSA and fPSA can be regarded as important indicators in the diagnosis of BPH and Pea. The combined determination of PSA, fPSA and f/tPSA may improve the diagnostic accuracy of Pca. (authors)

  4. Differentiation of malignant and degenerative benign bone disease using Tc-99m Citrate and Tc-99m MDP scintigraphy

    International Nuclear Information System (INIS)

    Jin, J.; Guo, R.; Li, S.-J.; Ren, Y.; Zhang, C.; Zhang, X.

    2007-01-01

    Full text: For the evaluation of bone metastases in patients (pts) with cancer, 99mTcMDP bone scintigraphy is an important tool, but some limitations exist. One of these is the differential diagnosis of malignant and degenerative benign bone disease. The aim of this study was to differentiate them using 99mTcCitrate and 99mTcMDP scintigraphy. Methods: 39 pts (92 lesions) with known malignant or degenerative benign bone disease were studied. 23 pts had malignant bone disease (48 lesions, group 1), the other 16 pts had degenerative benign bone disease (44 lesions, group2), for which the results of 99mTcMDP scintigraphy were positive. In both groups, 99mTcCitrate scintigraphy was performed within a time interval of 2-7 days after 99mTcMDP scintigraphy (555∼740MBq. static, 3hr, planar or SPECT i m a g e s w h e n r e q u i r e d ) . The 99mTccitrate/99mTcMDP lesion-to-background radioisotope uptake ratio (RUR) was calculated for each lesion. Conventional techniques (histopathology, X-ray, CT, MRI and clinical follow up) were considered to be proof of the presence of bone metastases and degenerative benign bone disease. Results: Uptake of 99mTcMDP in the two groups is the same (1.96±0.25 vs. 1.87±0.21; t=1.178, P>0.20), while in 99mTcCitrate image, malignant lesions demonstrated a higher uptake of lesion activity than that of benign degenerative lesions (1.47±0.42 vs. 1.09±0.38; t=2.887, P<0.01). The mean 99mTccitrate/99mTcMDP RUR in the malignant group was significantly higher than the mean in the benign group (0.78±0.21 vs. 0.54±0.19; t=3.646, P<0.001). Conclusions: The preliminary results of the study confirm the usefulness and feasibility of 99mTcCitrate scintigraphy for differentiating malignant from benign degenerative lesions seen as areas of increased activity on 99mTcMDP bone scintigraphy. (author)

  5. Complex Fibroadenoma and Breast Cancer Risk: A Mayo Clinic Benign Breast Disease Cohort Studya

    Science.gov (United States)

    Nassar, Aziza; Visscher, Daniel W.; Degnim, Amy C.; Frank, Ryan D.; Vierkant, Robert A.; Frost, Marlene; Radisky, Derek C.; Vachon, Celine M.; Kraft, Ruth A.; Hartmann, Lynn C.; Ghosh, Karthik

    2015-01-01

    Purpose To examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. Methods The study included women aged 18 to 85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed vs expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression (nonproliferative disease, proliferative disease without atypia [PDWA], or atypical hyperplasia). Results Fibroadenoma was identified in 2,136 women (noncomplex, 1,835 [85.9%]; complex, 301 [14.1%]). SIR for noncomplex fibroadenoma was 1.49 (95% CI, 1.26–1.74); for complex fibroadenoma, it was 2.27 (95% CI, 1.63–3.10) (test for heterogeneity in SIR, P=.02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (eg, incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Conclusions Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics. PMID:26264469

  6. Complex fibroadenoma and breast cancer risk: a Mayo Clinic Benign Breast Disease Cohort Study.

    Science.gov (United States)

    Nassar, Aziza; Visscher, Daniel W; Degnim, Amy C; Frank, Ryan D; Vierkant, Robert A; Frost, Marlene; Radisky, Derek C; Vachon, Celine M; Kraft, Ruth A; Hartmann, Lynn C; Ghosh, Karthik

    2015-09-01

    The purpose of this study is to examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. The study included women aged 18-85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed versus expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression [nonproliferative disease, proliferative disease without atypia (PDWA), or atypical hyperplasia]. Fibroadenoma was identified in 2136 women [noncomplex, 1835 (85.9%); complex, 301 (14.1%)]. SIR for noncomplex fibroadenoma was 1.49 (95% CI 1.26-1.74); for complex fibroadenoma, it was 2.27 (95% CI 1.63-3.10) (test for heterogeneity in SIR, P = .02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (e.g., incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics.

  7. Impact of Premedication on Preoperative Anxiety in Females with Gynecological Diseases

    Directory of Open Access Journals (Sweden)

    I. G. Bobrinskaya

    2007-01-01

    Full Text Available Objective: to study preoperative psychoemotional, autonomic, and hematodynamic responses in patients to develop criteria for evaluating the efficiency of premedication.Subjects and methods. Sixty gynecological patients (mean age 38.5±1.1 years, who were being prepared for elective surgery, were examined. According to the results of an integrative anxiety test, the patients were divided into 3 groups in relation to the level of personality anxiety. The three-stage study was conducted to evaluate systemic circulation by the results of impedance rheography and by the state of the autonom-ic nervous system, as evidenced by variational pulsometry.Results. Preoperatively, the patients showed varying personality anxiety that further formed the psychoemotional features of their response to an impending operation. Situational anxiety components, such as a phobic element and emotional discomfort, should be also regarded as an informative criterion for the adequacy of premedication. Psychoemotional and autonomic changes were more pronounced in Group 3 patients who were prone to the development of decompensation of adaptive mechanisms due to their personality typological traits.Conclusion. Premedication involving only narcotic analgesics and antihistamines does not limit the overac-tivation of the sympathetic part of the autonomic nervous system on the eve of the forthcoming operation. 

  8. Digital rectal fecal occult blood screening during gynecologic examination.

    Science.gov (United States)

    Willis, Farinna L; Fanning, James

    2004-05-01

    The purpose of this study was to test the feasibility of digital rectal fecal occult blood screening during pelvic examination. We reviewed the data for 232 consecutive women who underwent digital rectal fecal occult blood screening during routine pelvic examination and who had had at least 1-year of follow-up visits: 59% of the women were followed for gynecologic cancer, and 41% of the women were followed for benign gynecologic disease. The median age was 62 years. Patients with positive digital rectal fecal occult blood screening were sent for gastroenterologic examination. Sixteen of 232 patients (7%) had a positive digital rectal fecal occult blood screening result. On gastroenterologic examination, 5 of the 16 patients (31%) were found to have disease (2 polyps, 1 diverticular disease, 2 radiation proctitis). At 1-year follow-up, no patient had colon cancer. Until better compliance can be obtained with home stool sample fecal occult blood testing, we recommend a larger study of digital rectal fecal occult blood screening during gynecologic examination to verify our results.

  9. Analysis of Dose Response for Circulatory Disease After Radiotherapy for Benign Disease

    Energy Technology Data Exchange (ETDEWEB)

    Little, Mark P., E-mail: mark.little@nih.gov [Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza South, Rockville, Maryland (United States); Kleinerman, Ruth A. [Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza South, Rockville, Maryland (United States); Stovall, Marilyn; Smith, Susan A. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Mabuchi, Kiyohiko [Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza South, Rockville, Maryland (United States)

    2012-12-01

    Purpose: To assess the shape of the dose-response for various circulatory disease endpoints, and modifiers by age and time since exposure. Methods and Materials: This was an analysis of the US peptic ulcer data testing for heterogeneity of radiogenic risk by circulatory disease endpoint (ischemic heart, cerebrovascular, other circulatory disease). Results: There were significant excess risks for all circulatory disease, with an excess relative risk Gy{sup -1} of 0.082 (95% CI 0.031-0.140), and ischemic heart disease, with an excess relative risk Gy{sup -1} of 0.102 (95% CI 0.039-0.174) (both p = 0.01), and indications of excess risk for stroke. There were no statistically significant (p > 0.2) differences between risks by endpoint, and few indications of curvature in the dose-response. There were significant (p < 0.001) modifications of relative risk by time since exposure, the magnitude of which did not vary between endpoints (p > 0.2). Risk modifications were similar if analysis was restricted to patients receiving radiation, although the relative risks were slightly larger and the risk of stroke failed to be significant. The slopes of the dose-response were generally consistent with those observed in the Japanese atomic bomb survivors and in occupationally and medically exposed groups. Conclusions: There were excess risks for a variety of circulatory diseases in this dataset, with significant modification of risk by time since exposure. The consistency of the dose-response slopes with those observed in radiotherapeutically treated groups at much higher dose, as well as in lower dose-exposed cohorts such as the Japanese atomic bomb survivors and nuclear workers, implies that there may be little sparing effect of fractionation of dose or low-dose-rate exposure.

  10. Evaluation of a potential parathyroid dysfunction under treatment with radioactive iodine of benign thyroid diseases

    International Nuclear Information System (INIS)

    Schumacher, Serena Christine

    2011-01-01

    The intention of the present thesis was the evaluation of a potential parathyroid dysfunction under treatment with radioactive iodine of benign thyroid diseases. It was to be examined whether a change in the parathyroid function would arise within the first week on treatment. So far there are some minor studies existing describing significant changes in the parathyroid hormone serum level within the first months after radioactive iodine therapy of benign and malignant thyroid diseases. Moreover, it is a fact that external beam-radiotherapy can induce neoplasia and that the risk for the subsequent development of primary hyperparathyroidism doubles or triples after external beam-radiotherapy of the head and neck. Up to now, however, an increased incidence for primary hyperparathyroidism following treatment with radioactive iodine ( 131 I) could not be proved. At the department of nuclear medicine of the university hospital Giessen-Marburg GmbH, location Marburg, a prospective cohort study was executed on radioactive iodine therapy of benign thyroid diseases with 105 probands (75 women / 30 men, mean age 60.62 ± 14.3 years). According to their thyroid diseases these 105 probands were classified into following subgroups: thyroid adenoma with 23 patients, multifocal thyroid autonomy with 8 patients, disseminated thyroid autonomy with 37 patients as well as the subgroup Graves' hyperthyroidism (without Graves' ophtalmopathy) and accordingly Graves' disease (with Graves' ophtalmopathy) with 37 patients. The serum level of the intact parathyroid hormone was determined directly before starting the radioactive iodine therapy on the admission day and on day 1, 3 and 5 of the radioactive iodine therapy as well as at the ambulant follow-up examination one month after the start of the therapy. In case of 99 of 105 probands the serum level of parathyroid hormone declined on treatment with 131 I with its nadir on day 3 of therapy (decline by 15.71 ng/l or 27

  11. Adolescent dietary vitamin D and sun exposure in relation to benign breast disease.

    Science.gov (United States)

    Boeke, Caroline E; Tamimi, Rulla M; Berkey, Catherine S; Colditz, Graham A; Giovannucci, Edward; Malspeis, Susan; Willett, Walter C; Frazier, A Lindsay

    2015-08-01

    Vitamin D may reduce cell proliferation and tumor growth in breast tissue, and exposure may be most important during adolescence when breast tissue is developing. In the Nurses' Health Study II, higher recalled adolescent vitamin D intake was associated with a lower risk of benign breast disease (BBD). Our study aimed to assess adolescent vitamin D exposure in relation to BBD in young women. Vitamin D was assessed in 6,593 adolescent girls (9-15 years of age at baseline) in the prospective Growing Up Today Study cohort using the mean energy-adjusted intakes from food frequency questionnaires in 1996, 1997, and 1998. In 1999, 5,286 girls reported skin color, sunscreen use, tanning bed use, and number of sunburns in the past year, and we used state of residence to assess low versus high ultraviolet index. Biopsy-confirmed BBD was reported on questionnaires in 2005, 2007, and 2010 (n = 122). Dietary vitamin D, tanning behaviors, and other sun exposure variables were not significantly associated with BBD in logistic regression models adjusted for age, family history of breast cancer or BBD, age at menarche, nulliparity, alcohol intake, body mass index, and physical activity. The relative risk for the top (>467 IU/day) versus bottom (intake was 0.76 (95 % CI 0.47, 1.23). Sun exposure was not significantly associated with BBD in this prospective cohort. However, a suggestive inverse association between dietary vitamin D and BBD was observed that merits further study.

  12. Nationwide trends in surgery and radioiodine treatment for benign thyroid disease during iodization of salt

    DEFF Research Database (Denmark)

    Cerqueira, C.; Knudsen, N.; Ovesen, L.

    2010-01-01

    Objective: Iodization of salt was introduced in Denmark in 1998 because of mild-to-moderate iodine deficiency (ID). The aim of this study was to analyze the utilization rate of surgery and radioiodine therapy for benign thyroid disorders before and after the introduction of iodization, and to study...... a possible association between the changes and the raised iodine intake. Design: A nationwide register study. Methods: Information on operations and radioiodine treatments for benign thyroid disorders was extracted from nationwide registers in the years 1990 to 2007. Treatment rates are presented for surgery...

  13. Patient management in radioiodine therapy of benign thyroid disease; Radiojodtherapie gutartiger Schilddruesenerkrankungen: Ambulante Vorbereitung und Nachsorge

    Energy Technology Data Exchange (ETDEWEB)

    Dressler, J. [Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany)

    1997-08-01

    Benign thyroid disease ranks by far as the most frequent therapy in nuclear medicine. In Germany approximately 25 000 cases of hyperthyreosis are being treated in association with autonomy or Graves` disease, but also for the reduction of goiters or the correction of latent functional disturbances. In such indications radiotherapy is virtually free of risk as opposed to surgery and ranks more favorable in regard to costs and curative effects versus pharmacological long term treatment. Still regional varying therapeutical concepts and intentions are being pursued and trials of improvements described. There is consent in therapy that quality of treatment is closely linked to a specialized out-door platient preparation, individual hospital activity dosage and lifelong follow up including continued evaluation of therapeutical results. In this paper minimal requirements of outpatient measures before and after therapy are summarized which in Germany is only permitted on an inhospital patient basis. Considering basics of radioactive preventive law, scientific evidence of available results of therapeutical studies and a survey of German therapeutic centers, suggestions for a quality maintaining management in view of the most effective utilization for the limited available number of beds is presented for discussion. (orig.) [Deutsch] Die mit Abstand haeufigste nuklearmedizinische Therapie betrifft die gutartigen Schilddruesenerkrankungen. In Deutschland werden jaehrlich etwa 25 000 Hyperthyreosen bei Autonomie oder Morbus Basedow, aber auch Strumen zur Verkleinerung oder Beseitigung einer latenten Funktionsstoerung behandelt. Die Radiojodtherapie ist bei den genannten Indikationen gegenueber der Operation praktisch risikofrei, gegenueber einer medikamentoesen Langzeitbehandlung kurativ und kostenguenstiger. Nach wie vor werden regional variierende Behandlungskonzepte und -ziele verfolgt und Optimierungsversuche beschrieben. Einigkeit besteht bei den Therapeuten, dass die

  14. Evaluation of a potential parathyroid dysfunction under treatment with radioactive iodine of benign thyroid diseases; Pruefung einer potentiellen strahleninduzierten Nebenschilddruesenfunktionsstoerung waehrend einer Radioiodtherapie benigner Schilddruesenerkrankung

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, Serena Christine

    2011-09-28

    The intention of the present thesis was the evaluation of a potential parathyroid dysfunction under treatment with radioactive iodine of benign thyroid diseases. It was to be examined whether a change in the parathyroid function would arise within the first week on treatment. So far there are some minor studies existing describing significant changes in the parathyroid hormone serum level within the first months after radioactive iodine therapy of benign and malignant thyroid diseases. Moreover, it is a fact that external beam-radiotherapy can induce neoplasia and that the risk for the subsequent development of primary hyperparathyroidism doubles or triples after external beam-radiotherapy of the head and neck. Up to now, however, an increased incidence for primary hyperparathyroidism following treatment with radioactive iodine ({sup 131}I) could not be proved. At the department of nuclear medicine of the university hospital Giessen-Marburg GmbH, location Marburg, a prospective cohort study was executed on radioactive iodine therapy of benign thyroid diseases with 105 probands (75 women / 30 men, mean age 60.62 ± 14.3 years). According to their thyroid diseases these 105 probands were classified into following subgroups: thyroid adenoma with 23 patients, multifocal thyroid autonomy with 8 patients, disseminated thyroid autonomy with 37 patients as well as the subgroup Graves' hyperthyroidism (without Graves' ophtalmopathy) and accordingly Graves' disease (with Graves' ophtalmopathy) with 37 patients. The serum level of the intact parathyroid hormone was determined directly before starting the radioactive iodine therapy on the admission day and on day 1, 3 and 5 of the radioactive iodine therapy as well as at the ambulant follow-up examination one month after the start of the therapy. In case of 99 of 105 probands the serum level of parathyroid hormone declined on treatment with {sup 131}I with its nadir on day 3 of therapy (decline by 15.71 ng

  15. Roentgenodiagnosis in obsterics and gynecology

    International Nuclear Information System (INIS)

    Demidkin, P.N.; Shnirel'man, A.I.

    1980-01-01

    A whole range of problems of roentgenologic diagnosis in gynecology and obstetrics is considered. The basic techniques currently used are described; their characteristic is given, as well as the analysis of the data obtained. The problems of diagnosing the course and versions of normal pregnancy, all types of obstetric pathology, sterility, development defects, functional derangements of genitals, uterine alterations due to abdominohysterotomy, inflammatory processes and endometriosis, are considered. The x-ray characteristic of small pelvis shape and pelvimetry are considered in detail. A special importance is attached to the oncological problems, such as X-ray diagnosis of benign and malignant tumors of the uterus and uterine appendages and their differential diagnosis, methods of diagnosing the proliferation of malignant neoplasms, possibilities of controlling radiation and surgical treatment. The results of analyzing the diagnostic and prognostic importance of X-ray investigations in obstetrics and gynecology, recommendations for applying certain techniques and their combinations, are given [ru

  16. Modeling the absorbed dose to the common carotid arteries following radioiodine treatment of benign thyroid disease

    DEFF Research Database (Denmark)

    la Cour, Jeppe Lerche; Hedemann-Jensen, Per; Søgaard-Hansen, Jens

    2013-01-01

    in the western countries are treated each year with RAI for benign thyroid disorders (about 140,000 a year in the EU), stressing that it is of clinical importance to be aware of even rare radiation-induced side effects. In order to induce or accelerate atherosclerosis, the dose to the carotid arteries has...

  17. Therapeutic application of new holmium-166 chitosan complex in malignant and benign diseases

    International Nuclear Information System (INIS)

    Park, K.B.; Kim, Y.M.; Shin, B.C.; Kim, J.R.; Ryu, J.M.; Lim, S.M.

    1998-01-01

    -articular administration to male rabbits. Biodistribution of 166 Ho-CHICO 48 hours after intraperitoneal administration to male mice showed most of the radioactivities were evenly distributed at the inner wall of the peritoneal cavity. The ease with which the 166 Ho-CHICO can be prepared as a kit form and its high in-vitro and in-vivo stability make it an attractive agent for radionuclide therapy in malignant and benign diseases. (author)

  18. Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program.

    Science.gov (United States)

    Castells, Xavier; Domingo, Laia; Corominas, Josep María; Torá-Rocamora, Isabel; Quintana, María Jesús; Baré, Marisa; Vidal, Carmen; Natal, Carmen; Sánchez, Mar; Saladié, Francina; Ferrer, Joana; Vernet, Mar; Servitja, Sonia; Rodríguez-Arana, Ana; Roman, Marta; Espinàs, Josep Alfons; Sala, María

    2015-01-01

    Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.

  19. Circulating Prostate Cells Found in Men with Benign Prostate Disease Are P504S Negative: Clinical Implications

    Directory of Open Access Journals (Sweden)

    Nigel P. Murray

    2013-01-01

    Full Text Available Introduction. Developments in immunological and quantitative real-time PCR-based analysis have enabled the detection, enumeration, and characterization of circulating tumor cells (CTCs. It is assumed that the detection of CTCs is associated with cancer, based on the finding that CTCs can be detected in all major cancer and not in healthy subjects or those with benign disease. Methods and Patients. Consecutive men, with suspicion of prostate cancer, had blood samples taken before prostate biopsy; mononuclear cells were obtained using differential gel centrifugation and CPCs detecting using anti-PSA immunocytochemistry. Positive samples underwent further classification with anti-P504S. Results. 329 men underwent prostate biopsy; of these men 83 underwent a second biopsy and 44 a third one. Of those with a biopsy negative for cancer, 19/226 (8.4% had CPCs PSA (+ P504S (− detected at first biopsy, 6/74 (8.1% at second biopsy, and 5/33 (15.2% at third biopsy. Men with cancer-positive biopsies did not have PSA (+ P504S (− CPCs detected. These benign cells were associated with chronic prostatitis. Conclusions. Patients with chronic prostatitis may have circulating prostate cells detected in blood, which do not express the enzyme P504S and should be thought of as benign in nature.

  20. Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases; Stellenwert des Serum-Thyreoglobulinspiegels bei der Diagnostik benigner und maligner Schilddruesenerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Rink, T.; Schroth, H.J. [Abt. fuer Nuklearmedizin, Staedtisches Klinikum, Hanau (Germany); Dembowski, W.; Klinger, K. [Medizinische Klinik, St. Vinzenz Krankenhaus, Hanau (Germany)

    2000-08-01

    concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases. (orig.) [German] Ziel dieser Studie ist es, neue und bislang zum Teil kontrovers diskutierte Indikationen zur Bestimmung des Thyreoglobulins (Tg) bei unterschiedlichen Schilddruesenerkrankungen in der klinischen Routine zu ueberpruefen. Methoden: Die Studie umfasst folgende Kollektive: 250 gesunde Probanden, 50 Patienten mit euthyreoter Struma diffusa, 161 Patienten mit euthyreoter Knotenstruma (davon 108 operierte Faelle, wobei sich 17 Karzinome fanden), 60 hyperthyreote Patienten mit autonomer Knotenstruma, 150 Patienten mit Thyreoiditis Hashimoto und 30 hyperthyreote Patienten mit M. Basedow. Ergebnisse: Die Grenze des Referenzbereichs errechnete sich zu 30 ng Tg/ml. Die Analyse der diffusen Strumen zeigte eine lineare Abhaengigkeit des Tg-Spiegels von der Schilddruesengroesse, wobei der Erwartungswert in etwa dem Organvolumen in ml entsprach. Knotige Veraenderungen fuehrten zu einem ueberproportionalen Tg-Anstieg, der allerdings einer grossen Varianz unterlag und daher im Einzelfall nur schwer abzuschaetzen war. Von den 17 Patienten mit Schilddruesenkarzinom lag der Tg-Spiegel in 10 Faellen unterhalb des Erwartungswertes, 2 Patienten zeigten einen Tg-Wert von >1000 ng/ml. Bei Autonomien fand sich bezogen auf eine durch Substitution extrem supprimierte Vergleichsgruppe ein signifikant hoeherer mittlerer Tg-Spiegel. Aufgrund der hohen Varianz der Tg-Werte beider Kollektive war die Diagnose der Autonomie anhand der Tg-Bestimmung jedoch kaum moeglich. In der Gruppe mit Thyreoiditis Hashimoto zeigte sich im Vergleich zum Normalkollektiv ein erniedrigter Tg-Spiegel. Bei M. Basedow war die mittlere Tg-Konzentration signifikant hoeher als in der Vergleichsgruppe mit Struma diffusa, dennoch lagen 47% aller Werte noch im Referenzbereich. Schlussfolgerung: Hohe Tg-Werte fuehren bei Verdacht auf Malignitaet, Autonomie oder M. Basedow zu einer hoeheren

  1. Robotic-assisted laparoscopic hysterectomy versus conventional laparoscopic hysterectomy for benign gynaecological disease

    DEFF Research Database (Denmark)

    Sloth, Sigurd Beier; Rudnicki, Martin; Gimbel, Helga

    Background: In May 2015 the Danish Health and Medicines Authority is publishing a national clinical guideline on hysterectomy for benign gynaecological conditions. One of the key issues assessed in the guideline is the effectiveness of robotic-assisted laparoscopic hysterectomy (RALH) versus...... was associated with a longer operating time than LH. Based on the available evidence and patient values and preferences the Danish Health and Medicines Authority gives a weak/conditional recommendation against RALH in the treatment of benign gynaecological conditions........ For the important outcomes evidence of low quality showed a longer operating time for RALH compared with LH. There were no differences in the other predefined important outcomes. Conclusions: Evidence of low quality did not support a better outcome or fewer complications after RALH when compared with LH. RALH...

  2. Changes in Local Immunity Factors in Women with Pre-Existing Cervical Disease and Benign Ovarian Tumors

    Directory of Open Access Journals (Sweden)

    Nazar Matviykiv

    2017-10-01

    Full Text Available The objective of the research was to study the indices of local immunity in relation to the hormonal state of the body in women with benign ovarian tumors and pre-existing cervical diseases. Materials and methods. The concentration of major gonadotropic and steroid hormones during the female ovarian and menstrual cycle, as well as individual local immunity factors of proinflammatory cytokines and secretory immunoglobulin A was studied in 40 patients with benign ovarian tumors and pre-existing cervical diseases. Results and discussion. In the second phase of the ovarian and menstrual cycle, a significant reduction (by 3.0 times in the concentration of progesterone and relative hypoestrogenism (by 1.5 times as compared to the control data were found. Anovulation was observed in 40.00% of cases and corpus luteum deficiency syndrome was diagnosed in 62.5% of women. The assessment of secretory immunoglobulin A concentration allowed us to note (along with the hypersecretion of proinflammatory cytokines an increase in this marker in half of the examined women in the presence of chronic cervicitis and vaginitis, candidiasis and viral lesion - along with the activation of proinflammatory cytokine depression of secretory immunoglobulin A synthesis as compared to the control data. Conclusions. Local immunity changes in women with benign ovarian tumors and pre-existing cervical diseases are accompanied by abnormalities of the hormonal profile and the association of maladaptive changes in the system of local immunity manifested by fluctuations in the level of secretory immunoglobulin A during the secretory phase of the menstrual cycle and an increase in proinflammatory cytokine synthesis. The results of the conducted study allowed us to note a significant increase in the concentration of secretory immunoglobulin A along with the activation of proinflammatory cytokine synthesis in most women with benign ovarian tumors and pre-existing cervical diseases which

  3. Contrast-Enhanced Ultrasound for Evaluation of High-Intensity Focused Ultrasound Treatment of Benign Uterine Diseases

    Science.gov (United States)

    Cheng, Chong-Qing; Zhang, Rui-Tao; Xiong, Yu; Chen, Li; Wang, Jian; Huang, Guo-Hua; Li, Ke-Quan; Zhang, Lian; Bai, Jin

    2015-01-01

    Abstract As a noninvasive treatment technique, ultrasound-guided high-intensity focused ultrasound (HIFU) has been considered as a routine treatment for uterine fibroids and adenomyosis in China. Contrast-enhanced ultrasound (CEUS) has been proposed as another option to assess the treatment efficacy during HIFU treatment. The aim of this investigation is to evaluate the adverse effects of HIFU ablation for benign uterine diseases in a group of patients studied with ultrasound contrast agent (UCA), in comparison with a group of patients not exposed to UCA. From November 2010 to December 2013, 2604 patients with benign uterine diseases were treated with HIFU. Among them, 1300 patients were exposed to an UCA, whereas 1304 patients were not. During HIFU procedure, the incidences of leg pain, sacral/buttock pain, groin pain, treatment area pain, and the discomfort “hot” sensation on skin were higher in the patients who were exposed to SonoVue (Bracco, Milan, Italy) than those who were not (20.5% vs 11.7%, 52.5% vs 42.3%, 6.5% vs 4.5%, 68.9% vs 55.4%, and 48.1% vs 42.9%, respectively). Among the postoperative adverse effects, the incidence of lower abdominal pain was significantly higher in patients who were exposed to an UCA than those who were not (51.2% vs 39.9%, P < 0.05). Two patients who were exposed to an UCA had acute renal function failure. In conclusion, UCA may increase the incidences of some common HIFU-related adverse effects during HIFU treatment for benign uterine diseases, but most of which were acceptable and self-limited. After HIFU treatment, renal function should be monitored in patients with a history of hypertension or taking nonsteroidal anti-inflammatory drugs. PMID:25906100

  4. Danazol treatment of benign breast disease: a survey of U.S.A. multi-centre studies.

    Science.gov (United States)

    Brookshaw, J D

    1979-01-01

    514 patients with benign breast disease provided records from multicentre studies in the U.S.A. Results showed that a high proportion responded with either decrease or elimination of symptoms, response usually being apparent 15 to 45 days after commencing treatment. Dosage schedules varied between 50 and 400 mg danazol daily and length of treatment between 15 and 196 days. There was a tendency for patients with more severe symptoms to respond better to the higher dosages, and for the elimination rate for all grades of severity to improve with time. Side effects were not severe, and of the expected type including weight gain, oiliness of skin and hair, and acne.

  5. Modeling the absorbed dose to the common carotid arteries following radioiodine treatment of benign thyroid disease

    International Nuclear Information System (INIS)

    La Cour, Jeppe Lerche; Jensen, Lars Thorbjorn; Hedemann-Jensen, Per; Sogaard-Hansen, Jens; Nygaard, Birte

    2013-01-01

    External fractionated radiotherapy of cancer increases the risk of cardio- and cerebrovascular events, but less attention has been paid to the potential side effects on the arteries following internal radiotherapy with radioactive iodine (RAI), i.e. 131-iodine. About 279 per million citizens in the western countries are treated each year with RAI for benign thyroid disorders (about 140,000 a year in the EU), stressing that it is of clinical importance to be aware of even rare radiation-induced side effects. In order to induce or accelerate atherosclerosis, the dose to the carotid arteries has to exceed 2 Gy which is the known lower limit of ionizing radiation to affect the endothelial cells and thereby to induce atherosclerosis. To estimate the radiation dose to the carotid arteries following RAI therapy of benign thyroid disorders. Assuming that the lobes of the thyroid gland are ellipsoid, that the carotid artery runs through a part of the lobes, that there is a homogeneous distribution of RAI in the lobes, and that the 24 h RAI uptake in the thyroid is 35% of the 131 I orally administrated, we used integrated modules for bioassay analysis and Monte Carlo simulations to calculate the dose in Gy/GBq of administrated RAI. The average radiation dose along the arteries is 4-55 Gy/GBq of the 131 I orally administrated with a maximum dose of approximately 25-85 Gy/GBq. The maximum absorbed dose rate to the artery is 4.2 Gy/day per GBq 131 I orally administrated. The calculated radiation dose to the carotid arteries after RAI therapy of benign thyroid disorder clearly exceeds the 2 Gy known to affect the endothelial cells and properly induce atherosclerosis. This simulation indicates a relation between the deposited dose in the arteries following RAI treatment and an increased risk of atherosclerosis and subsequent cerebrovascular events such as stroke. (author)

  6. A comparison of quality outcome measures in patients having a hysterectomy for benign disease: robotic vs. non-robotic approaches.

    Science.gov (United States)

    Martino, Martin A; Berger, Elizabeth A; McFetridge, Jeffrey T; Shubella, Jocelyn; Gosciniak, Gabrielle; Wejkszner, Taylor; Kainz, Gregory F; Patriarco, Jeremy; Thomas, M Bijoy; Boulay, Richard

    2014-01-01

    To measure procedure-related hospital readmissions within 30 days after discharge for patients who have a hysterectomy for benign disease. Secondary outcome quality measures evaluated were cost, estimated blood loss, length of stay and sum of costs associated with readmissions. Retrospective cohort study (Canadian Task Force classification II-2). Academic community hospital. Patients who underwent hysterectomy to treat benign disease from January 2008 to December 2012. Patients were grouped according to route of hysterectomy: robotic-assisted laparoscopic hysterectomy (robotic), laparoscopic hysterectomy (laparoscopic), abdominal hysterectomy (open via laparotomy), and vaginal hysterectomy (vaginal). Inclusion criteria were met by 2554 patients: 601 in the robotic group, 427 in the laparoscopic group, 1194 in the abdominal group, and 332 in the vaginal group. Readmission rates in the robotic cohort were significantly less (probotic cohorts: Robotic (1%), laparoscopic (2.5%), open (3.5%), vaginal (2.4%). Estimated blood loss, length of stay, and sum of readmission costs were also significantly less in the robotic cohort (probotic-assisted laparoscopic hysterectomy have a significantly lower chance of readmission robotics cohort also experienced a shorter length of stay, less estimated blood loss, and a cost savings associated with readmissions when compared to non-robotic approaches. Prospective registries describing quality outcomes, total sum of costs including 30 days follow-up, as well as patient-related quality of life benefits are recommended to confirm these findings and determine which surgical route offers the highest patient and societal value. Copyright © 2014. Published by Elsevier Inc.

  7. Supracervical versus total hysterectomy in women undergoing hysterectomy for benign gynaecological disease - a new danish recommendation

    DEFF Research Database (Denmark)

    Sloth, Sigurd Beier; Jørgensen, Annemette; Schroll, Jeppe Bennekou

    reviewed the literature. A methodologist performed a metaanalysis based on the available evidence. The quality of evidence was rated according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results The literature search produced 269 hits for existing guidelines, 407 hits......Background In May 2015 we published a national clinical guideline on hysterectomy for benign gynaecological conditions in cooperation with the Danish Health and Medicines Authority. One of nine investigated areas of interest was whether to perform total or supracervical hysterectomy in women....... The important outcomes were defined as quality of life, cyclic vaginal bleeding, operating time, intraoperative bleeding and post-operative infections. A search specialist conducted a systematic literature search for publications from 2004 to 2014 in English, Danish, Norwegian and Swedish. In our first search...

  8. A 3D benign paroxysmal positional vertigo model for study of otolith disease

    Directory of Open Access Journals (Sweden)

    Michael Teixido

    2016-03-01

    Full Text Available Objective: To develop a three-dimensional study tool of the membranous labyrinth in order to study the pathophysiology, diagnostic workup and treatment of benign paroxysmal positional vertigo (BPPV. BPPV is the most common cause of peripheral vertigo. Its diagnosis and treatment depend on an understanding of the anatomy of the vestibular labyrinth and its position relative to the head. To date, many illustrations have been made to explain principals of diagnosis and treatment of BPPV, but few have been based on anatomical studies of the membranous labyrinth. Methods: A cadaveric human membranous labyrinth was axially sectioned at 20 μm resolution, stained and segmented to create a high-resolution digital model. The model was cloned to create an enantiomeric pair of labyrinths. These were associated a 3D model of a human skull, segmented from MRI data, and were oriented according to established anatomic norms. Canal markers representing otoliths were created to mark canalith position during movement of the model within the 3D environment. Results: The model allows visualization of true membranous labyrinth anatomy in both ears simultaneously. The dependent portion of each semicircular duct and of the utricle can easily be visualized in any head position. Moveable markers can mark the expected progress of otolith debris with changes in head position and images can be captured to document simulations. The model can be used to simulate pathology as well as diagnostic maneuvers and treatment procedures used for BPPV. The model has great potential as a teaching tool. Conclusion: A simple model based on human anatomy has been created to allow careful study of BPPV pathophysiology and treatment. Going forward, this tool could offer insights that may lead to more accurate diagnosis and treatment of BPPV. Keywords: Benign paroxysmal positional vertigo, Modeling, Anatomy, Histology, Model, 3D

  9. Berek & Novak's gynecology

    National Research Council Canada - National Science Library

    Berek, Jonathan S; Novak, Emil

    2012-01-01

    .... The third section is on preventive and primary care for women, and the remaining five sections are directed at methods of diagnosis and management in general gynecology, operative general gynecology, urogynecology and pelvic reconstructive surgery, reproductive endocrinology, and gynecologic oncology"--Provided by publisher.

  10. Monocyte/macrophage and T-cell infiltrates in peritoneum of patients with ovarian cancer or benign pelvic disease

    Directory of Open Access Journals (Sweden)

    Ma Qing

    2006-07-01

    Full Text Available Abstract Background We previously showed that tumor-free peritoneum of patients with epithelial ovarian cancer (EOC exhibited enhanced expression of several inflammatory response genes compared to peritoneum of benign disease. Here, we examined peritoneal inflammatory cell patterns to determine their concordance with selected enhanced genes. Methods Expression patterns of selected inflammatory genes were mined from our previously published data base. Bilateral pelvic peritoneal and subjacent stromal specimens were obtained from 20 women with EOC and 7 women with benign pelvic conditions. Sections were first stained by indirect immunoperoxidase and numbers of monocytes/macrophages (MO/MA, T cells, B cells, and NK cells counted. Proportions of CD68+ cells and CD3+ cells that coexpressed MO/MA differentiation factors (CD163, CCR1, CXCR8, VCAM1, and phosphorylated cytosolic phospholipase A2 [pcPLA2], which had demonstrated expression in EOC peritoneal samples, were determined by multicolor immunofluorescence. Results MO/MA were present on both sides of the pelvic peritoneum in EOC patients, with infiltration of the subjacent stroma and mesothelium. CD68+ MO/MA, the most commonly represented population, and CD3+ T cells were present more often in EOC than in benign pelvic tumors. NK cells, B cells, and granulocytes were rare. CXCL8 (IL-8 and the chemokine receptor CCR1 were coexpressed more frequently on MO/MA than on CD3+ cells contrasting with CD68+/CD163+ cells that coexpressed CXCL8 less often. An important activated enzyme in the eicosanoid pathway, pcPLA2, was highly expressed on both CD68+ and CD163+ cells. The adherence molecule Vascular Cell Adhesion Molecule-1 (VCAM1 was expressed on CD31+ endothelial cells and on a proportion of CD68+ MO/MA but rarely on CD3+ cells. Conclusion The pelvic peritoneum in EOC exhibits a general pattern of chronic inflammation, represented primarily by differentiated MO/MA, and distinct from that in benign

  11. The Usefulness of Ultrasound Imaging in Gynecologic Oncology.

    Science.gov (United States)

    Woodfield, Courtney A

    2018-04-01

    Pelvic ultrasound examination is the primary imaging modality for evaluating a wide range of female pelvic symptomatology, and is often the first imaging test to detect a gynecologic malignancy. Ultrasound imaging is particularly useful for evaluating the thickness and appearance of the endometrium in patients with abnormal bleeding, and in detecting and characterizing ovarian lesions. This article reviews the ultrasound appearance of gynecologic neoplasms grouped by anatomic site of origin, the ultrasound appearance of select benign pelvic pathology not to be misinterpreted as malignancy, as well as available ultrasound imaging-based guidelines for managing potential gynecologic neoplasms. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Spontaneous activity in electromyography may differentiate certain benign lower motor neuron disease forms from amyotrophic lateral sclerosis.

    Science.gov (United States)

    Jokela, Manu E; Jääskeläinen, Satu K; Sandell, Satu; Palmio, Johanna; Penttilä, Sini; Saukkonen, Annamaija; Soikkeli, Raija; Udd, Bjarne

    2015-08-15

    There is limited data on electromyography (EMG) findings in other motor neuron disorders than amyotrophic lateral sclerosis (ALS). We assessed whether the distribution of active denervation detected by EMG, i.e. fibrillations and fasciculations, differs between ALS and slowly progressive motor neuron disorders. We compared the initial EMG findings of 43 clinically confirmed, consecutive ALS patients with those of 41 genetically confirmed Late-onset Spinal Motor Neuronopathy and 14 Spinal and Bulbar Muscular Atrophy patients. Spontaneous activity was more frequently detected in the first dorsal interosseus and deltoid muscles of ALS patients than in patients with the slowly progressive motor neuron diseases. The most important observation was that absent fibrillations in the first dorsal interosseus muscle identified the benign forms with sensitivities of 66%-77% and a specificity of 93%. The distribution of active denervation may help to separate ALS from mimicking disorders at an early stage. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Application of Digital Diagnosis and Treatment Technique in Benign Mandibular Diseases.

    Science.gov (United States)

    Ju, Rui; Zeng, Wei; Lian, Xiaotian; Chen, Gang; Yin, Huaqiang; Tang, Wei

    2018-02-06

    To explore the feasibility of preoperative planning for treatment of benign mandibular lesions (BML) using digital technologies such as three-dimensional (3D) reconstruction, measurement, visualization as well as image contrast and design of neural positioning protection template (NPPT) in combination with 3D printing technology in the BML diagnosis and treatment. The 3D models of BML and inferior alveolar nerves (IAN) of 10 BML patients were reconstructed based on their digital imaging and communications in medicine (DICOM) data using MIMICS16.0 software. The models were used to visualize lesions and nerve contrast measurement and guide design of personalized NPPT and osteotomy after operation modality was determined in order to achieve accurate, minimally invasive operation with shortened intraoperative time. Intraoperative NPPT application could accurately locate lesions and their scope and assist osteotomy. The measurement results were consistent with those of preoperative reconstruction and measurement. The BML were curetted completely without damage IAN. The 10 BML patients had no numbness and other discomforts in the lower lip and mandibular teeth after operation. The digital diagnosis and treatment technology is an effective method for functional treatment of BML patients and its application could achieve personalized, minimally invasive and precise treatment and save intraoperation time.

  14. OCT in Gynecology

    Science.gov (United States)

    Kuznetsova, Irina A.; Gladkova, Natalia D.; Gelikonov, Valentin M.; Belinson, Jerome L.; Shakhova, Natalia M.; Feldchtein, Felix I.

    Timely and efficient diagnosis of diseases of the female reproductivesystem is very important from the social viewpoint [1, 2]. Diagnosticefficacy of the existing techniques still needs improvement sincemalignant neoplasms of the female reproductive system organs are stableleaders among causes of death (over 35.9 %) [3]. Each year, 851.9 thousand genital cancer cases are recorded worldwide [1, 2]. However, the diagnostic efficacy of the visual examination with biopsy is limited. Correct interpretation of colposcopic features requires high skills and long-term clinical experience, which makes colposcopy very subjective and limits interobserver agreement [8-10]. OCT is known to visualize in vivo and noninvasively tissue microstructure with spatial resolution approaching the histologic level and therefore can be expected to guide biopsies and to provide real-time tissue structure information when biopsies are contraindicated or impractical. Although thorough clinical studies are required to determine if OCT can be suitable for this purpose in gynecology in general and for cervical cancer in particular, the early results look encouraging. In this chapter, we present a wide spectrum of the OCT studies of different partsof the female reproductive system and demonstrate the potential of the clinical use of this new visualization method in gynecological practice.

  15. Is bisphosphonate therapy for benign bone disease associated with impaired dental healing? A case-controlled study

    Science.gov (United States)

    2011-01-01

    Background Bisphosphonates are common first line medications used for the management of benign bone disease. One of the most devastating complications associated with bisphosphonate use is osteonecrosis of the jaws which may be related to duration of exposure and hence cumulative dose, dental interventions, medical co-morbidities or in some circumstances with no identifiable aggravating factor. While jaw osteonecrosis is a devastating outcome which is currently difficult to manage, various forms of delayed dental healing may be a less dramatic and, therefore, poorly-recognised complications of bisphosphonate use for the treatment of osteoporosis. It is hypothesised that long-term (more than 1 year's duration) bisphosphonate use for the treatment of post-menopausal osteoporosis or other benign bone disease is associated with impaired dental healing. Methods/Design A case-control study has been chosen to test the hypothesis as the outcome event rate is likely to be very low. A total of 54 cases will be recruited into the study following review of all dental files from oral and maxillofacial surgeons and special needs dentists in Victoria where potential cases of delayed dental healing will be identified. Potential cases will be presented to an independent case adjudication panel to determine if they are definitive delayed dental healing cases. Two hundred and fifteen controls (1:4 cases:controls), matched for age and visit window period, will be selected from those who have attended local community based referring dental practices. The primary outcome will be the incidence of delayed dental healing that occurs either spontaneously or following dental treatment such as extractions, implant placement, or denture use. Discussion This study is the largest case-controlled study assessing the link between bisphosphonate use and delayed dental healing in Australia. It will provide invaluable data on the potential link between bisphosphonate use and osteonecrosis of the jaws

  16. Is bisphosphonate therapy for benign bone disease associated with impaired dental healing? A case-controlled study

    Directory of Open Access Journals (Sweden)

    Thomson Wendy

    2011-04-01

    Full Text Available Abstract Background Bisphosphonates are common first line medications used for the management of benign bone disease. One of the most devastating complications associated with bisphosphonate use is osteonecrosis of the jaws which may be related to duration of exposure and hence cumulative dose, dental interventions, medical co-morbidities or in some circumstances with no identifiable aggravating factor. While jaw osteonecrosis is a devastating outcome which is currently difficult to manage, various forms of delayed dental healing may be a less dramatic and, therefore, poorly-recognised complications of bisphosphonate use for the treatment of osteoporosis. It is hypothesised that long-term (more than 1 year's duration bisphosphonate use for the treatment of post-menopausal osteoporosis or other benign bone disease is associated with impaired dental healing. Methods/Design A case-control study has been chosen to test the hypothesis as the outcome event rate is likely to be very low. A total of 54 cases will be recruited into the study following review of all dental files from oral and maxillofacial surgeons and special needs dentists in Victoria where potential cases of delayed dental healing will be identified. Potential cases will be presented to an independent case adjudication panel to determine if they are definitive delayed dental healing cases. Two hundred and fifteen controls (1:4 cases:controls, matched for age and visit window period, will be selected from those who have attended local community based referring dental practices. The primary outcome will be the incidence of delayed dental healing that occurs either spontaneously or following dental treatment such as extractions, implant placement, or denture use. Discussion This study is the largest case-controlled study assessing the link between bisphosphonate use and delayed dental healing in Australia. It will provide invaluable data on the potential link between bisphosphonate use

  17. Leg pain and gynecologic malignancy.

    Science.gov (United States)

    Singh, Lilly; Stevens, Erin E

    2013-09-01

    Gynecologic malignancies affect more than 83 000 women in the United States, each year. Because the disease involves the pelvis, many patients have side effects distal to this area in their lower extremities. The differential diagnosis of leg pain can be divided into vascular, neurologic, and musculoskeletal causes. In this review article, we address numerous etiologies of leg pain, reviewing the prevalence of disease, physical examination findings, diagnostic as well as treatment modalities.

  18. Subtypes of Benign Breast Disease as a Risk Factor for Breast Cancer: A Systematic Review and Meta-Analysis Protocol

    Directory of Open Access Journals (Sweden)

    Manoosh Zendehdel

    2018-01-01

    Full Text Available Breast cancer is a multifactorial disease. Benign breast disease (BBD is one of the most important risk factors for breast cancer. The etiology of BBD is unknown. It is divided into nonproliferative and proliferative diseases. The selection of studies will be based on titles, abstract screening, inclusion and exclusion criteria, and quality assessment. Previous studies have shown that all types of BBD increase the risk of breast cancer, but the risk degree is different for each one. Accurate risk estimation of breast cancer in each category can be very important for proper clinical management. This systematic review and meta-analysis will be conducted on observational studies (traditional case control, nested case control, case cohort, and cohort published in the Web of Science (ISI, PubMed (MEDLINE, Scopus, Google Scholar, and the key journals of this field such as Breast Cancer Research and Treatment and Cancer Research from January 2000 to June 2015. Reference lists and gray literature will be reviewed too. All the initial retrievals will be performed by 2 researchers independently. The data extraction form will consist of general information concerning the studies, study eligibility, method, risk of bias assessment, and results—including odds ratios, risk ratios, rate ratios, and hazard ratios. The PRISMA and MOOSE guidelines will be used to report our findings. Registration Details: PROSPERO-42016035243

  19. Malignant and benign diseases of the breast in 41 male patients: mammography, sonography and pathological correlations; Maligne und benigne Erkrankungen der Brust bei 41 maennlichen Patienten: Mammographie und Sonographie mit histopathologischer Korrelation

    Energy Technology Data Exchange (ETDEWEB)

    Partik, B.; Mallek, R.; Pokieser, P.; Wunderbaldinger, P.; Helbich, T.H. [Vienna Univ. (Austria). Klinik fuer Radiodiagnostik; Rudas, M. [Vienna Univ. (Austria). Inst. fuer Klinische Pathologie

    2001-11-01

    Aim: The goal of our study was to evaluate findings in mammography and sonography in male patients with pathohistologically proven diseases of the breast. Material and Methods: Mammographies and sonographies, which were obtained in 41 male patients in a 6-year period, were retrospectively evaluated in accordance with the BI-RADS trademark classification. Results: Histologically 13 carcinomas, 21 gynecomastias, 3 pseudogynecomastias, 2 epithelial inclusion cysts and 2 other benign lesions were diagnosed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of mammography in differentiation of benign versus malignant disease were 92%, 89%, 80%, 96% and 90%, respectively. Additional sonography did not change these results. However, sonography increased diagnostic confidence in 18.2% (2/11) of suspicious lesions. Conclusion: In our study the invasive ductal carcinoma of male patients was a predominantly lobulated, ill-defined lesion in mammography and sonography. The differentiation of carcinoma to pseudogynecomastia and diffuse or dendritic gynecomastia was securely feasible. However, we could not reliably distinguish between carcinoma and some benign mass lesions. In cases of mammographically diagnosed masses or unclear mammography, additional sonography should be performed to increase the diagnostic confidence. (orig.) [German] Ziel: Die Befunde von Mammographie und Sonographie bei histologisch gesicherten malignen und benignen Mammaerkrankungen maennlicher Patienten zu evaluieren. Material und Methode: Retrospektiv wurden die in einem Zeitraum von 6 Jahren durchgefuehrten Mammographien und Sonographien bei 41 maennlichen Patienten in Anlehnung an die BI-RADS trademark Klassifikation ausgewertet. Resultate: Es wurden 13 Karzinome, 21 Gynaekomastien, 3 Pseudogynaekomastien, 2 Atherome und 2 weitere benigne Laesionen histologisch diagnostiziert. Die Mammographie zeigte in der Differenzierung maligne versus benigne Laesion

  20. Palliative care in gynecologic oncology.

    Science.gov (United States)

    Karlin, Daniel; Phung, Peter; Pietras, Christopher

    2018-02-01

    Patients with gynecologic malignancies face many difficult issues in the course of their diseases, ranging from physical symptoms to advance care planning in light of a poor prognosis. This review examines the evidence supporting integration of palliative care early in the course of disease and symptom management, and provides a framework for difficult conversations. Palliative care has been demonstrated to improve quality of life and promote survival if integrated early in the course of disease. An evidence-based approach should guide symptom management, such as pain and nausea. Advance care planning and goals of care discussions are enhanced by a framework guiding discussion and the incorporation of empathetic responses. Palliative care is a diverse multidisciplinary field that can provide significant benefit for patients with gynecologic malignancies.

  1. Benign positional vertigo

    Science.gov (United States)

    Vertigo - positional; Benign paroxysmal positional vertigo; BPPV: dizziness- positional ... Benign positional vertigo is also called benign paroxysmal ... ear has fluid-filled tubes called semicircular canals. When you ...

  2. Development of quality of care interventions for adult patients on home parenteral nutrition (HPN) with a benign underlying disease using a two-round Delphi approach

    NARCIS (Netherlands)

    Dreesen, M.; Foulon, V.; Vanhaecht, K.; Hiele, M.; De Pourcq, L.; Pironi, L; Gossum, A. van; Wanten, G.J.A.; Baxter, J.P.; Joly, F.; Cuerda, C.; Willems, L.

    2013-01-01

    BACKGROUND & AIMS: HPN patients with benign diseases deserve professional care as they have to deal with complex techniques and risk potentially dangerous complications. The aim was to highlight main outcome quality indicators and to develop a set of key interventions to direct multidisciplinary

  3. Uraemia from Benign Hypertension

    African Journals Online (AJOL)

    tance,' and the criteria for the recognition of malignant hypertension have become so well established that there is no dispute about the diagnosis when this condition ends in uraemia. By contrast, benign hypertension mani- fests itself mainly as cardiac or cerebrovascular disease,"" and although the occurrence of renal ...

  4. Management of gynecologic oncology emergencies

    International Nuclear Information System (INIS)

    Harwood-Nuss, A.L.; Benrubi, G.I.; Nuss, R.C.

    1987-01-01

    Gynecologic malignancies are the third most common cancer among women in the United States. Because of often subtle early findings, the diagnosis may not be made before the widespread dissemination of the disease. The Emergency Department physician will commonly encounter a woman with vaginal bleeding, pelvic pain, or a symptomatic abdominal mass. In this article, we have described the epidemiology, recognized patterns of spread, and associated findings of gynecologic tumors. The proper Emergency Department evaluation and management of these problems is emphasized with guidelines for the timing of referrals and consultation with the gynecologic oncologist. The treatment of gynecologic malignancies is often complicated and responsible for Emergency Department visits. The various modalities are addressed according to the organ systems affected and include sections on postoperative problems, gastrointestinal complaints, urologic complications of therapy, radiation therapy and its complications, with an emphasis on the most serious complications necessitating either careful outpatient management or hospital admission. As cost-containment pressure grows, we have included sections on chemotherapy and total parenteral nutrition, both of which are becoming common outpatient events for the cancer patient. 28 references

  5. Investigating the role of Sirt1-modulated oxidative stress in relation to benign paroxysmal positional vertigo and Parkinson's disease.

    Science.gov (United States)

    Tsai, Kun-Ling; Cheng, Yuan-Yang; Leu, Hsin-Bang; Lee, Yi-Yen; Chen, Tzeng-Ji; Liu, Ding-Hao; Kao, Chung-Lan

    2015-09-01

    Benign paroxysmal positional vertigo (BPPV) is one of the most frequently encountered primary complaints in dizziness clinics. The incidence of BPPV has been proven to increase with age. The relationship between BPPV and another neurodegenerative disease, Parkinson's disease (PD), has not been previously discussed. This study aimed to investigate the relationship of BPPV and PD with oxidative stress. A total of 30,811 subjects participated in our cohort study. The study cohort comprised 5057 BPPV patients and a comparison cohort of 25,754 nonBPPV patients. SIRT1 axis gene expression was investigated in BPPV patient blood samples and a PD cell model of 6-hydroxydopamine (6-OHDA)-treated PC-12 cells to elucidate the potential in vitro and in vivo mechanisms of degeneration in PD and BPPV. Our data suggest that BPPV patients with histories of head injuries show a significantly higher hazard to develop subsequent PD (hazard ratio, 3.942; confidence interval, 1.523-10.205, p = 0.005). We also observed that oxidative status is increased in blood samples from patients with BPPV. Our in vitro study suggests that SIRT1 function is inhibited by oxidative stress, which thereby promotes 6-hydroxydopamine-induced cell death. We conclude that BPPV is independently associated with an increased risk of PD. This finding may be attributed to oxidative stress-mediated inhibition of SIRT1 expression levels. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Therapeutic consequences of oesophageal function studies in patients with benign oesophageal disease

    DEFF Research Database (Denmark)

    Jakobsen, Erik; Kruse-Andersen, S; Wallin, Lene

    1988-01-01

    making the final decision for therapy. Eleven percent of the patients referred with a diagnosis of hiatal hernia or reflux had achalasia or oesophageal spasm. Nine percent of the patients referred for motility disorders had reflux-related disease. The referral diagnosis was changed to a diagnosis...

  7. Gynecologic ultrasonography: recent advances and research in various technical modalities

    Directory of Open Access Journals (Sweden)

    Juraj Drobný

    2010-10-01

    Full Text Available Juraj DrobnýFirst Department of Obstetrics and Gynaecology, St. Cyril and Method University Hospital, Bratislava, Slovak RepublicAbstract: This paper reviews clinical research in gynecologic sonography, focussing on uterine cavity lesions, endometrial abnormalities and adnexal masses (including endometriosis, and ectopic pregnancy. For each topic, detection of sonographic pathologic features and sonographic mode are discussed, as well as the latest applications of sonodiagnostic methods, and relevant topics in clinical research. A new approach to evaluation of sonographic structures can be seen, including for borderline mucinous and serous ovarian tumors, in mean gray value, evaluation of grade of tissue echogenicity, evaluation of intact endometrial midline echo in ectopic pregnancy, and application of gel instillation sonography. Novel sonographic three-dimensional modalities, such as virtual navigation through three orthogonal planes, multislice tomosonography, volumetry by a virtual organ computer-aided analysis system, three-dimensional power Doppler, and space reconstruction of structures enable gynecologic diagnoses to be made more exactly. Clinical research investigates different sonographic features in benign and malignant gynecologic pathology. For studies of typical signs of benign uterine fibroids, endometrial volume, and vascularization of malignant endometrial tumors, as well as typical benign adnexal structures, the ovarian crescent sign were performed. At this time, no exact sonographic features for distinguishing between benign and malignant gynecologic tumors are available.Keywords: sonography, uterine cavity lesions, endometrial abnormalities, adnexal masses

  8. Radiation therapy of benign diseases: patterns of care study in Germany

    International Nuclear Information System (INIS)

    Seegenschmiedt, M.H.; Katalinic, A.; Makoski, H.B.; Haase, W.; Gademann, G.; Hassenstein, E.

    1999-01-01

    A questionnaire was mailed in 3 years (1994, 1995, 1996) to all radiation facilities in Germany, which assessed equipment, indications, number of patients and treatment concepts. A total of 134 (88%) institutions returned all requested data: 22 in East and 112 in West Germany; 30 in university and 104 in community/private hospitals. The average data of each institution and of all institutions were analyzed for frequencies and ratios between different regions and institutions. A mean of 2 (range 1 to 7) megavoltage (Linac/Cobalt 60) and 1.4 (range 0 to 4) orthovoltage units were available per institution; 32 (24%) institutions had no orthovoltage equipment. A mean of 20,082 patients were treated per year: 456 (2%) for inflammatory diseases (221 hidradenitis, 78 nail bed infection, 23 parotitis, 134 not specified), 12,600 (63%) for degenerative diseases (2,711 peritendinitis humeroscapularis, 1,555 epicondylitis humeri, 1,382 heel spur, 2,434 degenerative osteoarthritis, 4,518 not specified), 927 (5%) for hypertrophic diseases (146 Dupuytren's contracture, 382 keloids, 155 Peyronie's disease, 244 not specified), 1,210 (6%) for functional disorders (853 Graves' orbitopathy, 357 not specified), and 4,889 (24%) for other disorders (e.g. 3,680 heterotopic ossification prophylaxis). In univariate analysis, there were significant geographical (West vs East Germany) differences in the use of radiotherapy for inflammatory and degenerative disorders and institutional differences (university vs community/private hospitals) in the use of radiotherapy for hypertrophic and functional disorders (p [de

  9. Benign gastric filling defect

    Energy Technology Data Exchange (ETDEWEB)

    Oh, K. K.; Lee, Y. H.; Cho, O. K.; Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

  10. Benign gastric filling defect

    International Nuclear Information System (INIS)

    Oh, K. K.; Lee, Y. H.; Cho, O. K.; Park, C. Y.

    1979-01-01

    The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

  11. Breast cancer screening: updated recommendations of the Brazilian College of Radiology and Diagnostic Imaging, Brazilian Breast Disease Society, and Brazilian Federation of Gynecological and Obstetrical Associations

    Directory of Open Access Journals (Sweden)

    Linei Augusta Brolini Dellê Urban

    Full Text Available Abstract Objective: To present the current recommendations for breast cancer screening in Brazil, as devised by the Brazilian College of Radiology and Diagnostic Imaging, the Brazilian Breast Disease Society, and the Brazilian Federation of Gynecological and Obstetrical Associations. Materials and methods: We analyzed scientific studies available in the Medline and Lilacs databases. In the absence of evidence, the recommendations reflected the consensus of a panel of experts. Recommendations: Annual mammography screening is recommended for women 40-74 years of age. Among women ≥ 75 years of age, annual mammography screening should be reserved for those with an expected survival > 7 years. Complementary ultrasound should be considered for women with dense breasts. Complementary magnetic resonance imaging is recommended for women at high risk. When available, an advanced form of mammography known as tomosynthesis can be considered as a means of screening for breast cancer.

  12. Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases

    International Nuclear Information System (INIS)

    Rink, T.; Schroth, H.J.; Dembowski, W.; Klinger, K.

    2000-01-01

    Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto's thyroiditis and 30 hyperthyroid patients with Graves' disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto's thyroiditis showed slightly decreased Tg levels. In Graves' disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range ( [de

  13. [Pitfalls in diagnostic imaging and assessment of benign asbestos-related thoracic diseases].

    Science.gov (United States)

    Rehbock, B; Hofmann-Preiß, K; Kraus, T

    2012-05-01

    The recognition of asbestos-related diseases of the lung and/or pleura as an occupational disease is of psychosocial, medical and legal importance to the insured person. Radiological imaging is an essential part of the assessment and requires an increasingly high level of competence in the field of radiological diagnosis of pneumoconiosis in interdisciplinary collaboration with occupational medicine and pneumonology. The chest radiogram remains an integral part of basic diagnostic procedures in asbestos-related diseases of the lungs and/or pleura. Its importance lies in the detection of extended pleural changes as well as substantial fibrosis. The inherent low sensitivity and specificity of projection radiography is taken into account by the increasing use of multi-slice high resolution (HR) CT (in low dose technique). Radiological pitfalls in pleural plaque assessment with respect to plain chest X-ray concern all structures that superimpose on the pleural circumference, particularly the anatomical layers of the chest wall (extra-pleural fatty tissue, muscles, thoracic skeleton) as well as other pulmonary findings that can only be reliably assigned using CT. Even if state-of the-art CT is applied, asymmetries and abnormal expression of anatomical structures and variants (e. g. muscles and blood vessels) can lead to false-positive findings. The interstitial fibrosis of asbestosis, manifested as usual interstitial pneumonia (UIP) is non-pathognomonic for asbestosis. Therefore, parietal pleural thickening as a coincident finding to UIP is considered as being the main feature and a highly suggestive indicator of asbestosis in patients with a history of asbestos exposure. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Benign Prostatic Hyperplasia: A New Metabolic Disease of the Aging Male and Its Correlation with Sexual Dysfunctions

    Science.gov (United States)

    Corona, Giovanni; Vignozzi, Linda; Lotti, Francesco; Cipriani, Sarah

    2014-01-01

    Metabolic syndrome (MetS) is a well-recognized cluster of cardiovascular (CV) risk factors including obesity, hypertension, dyslipidemia, and hyperglycaemia, closely associated with an increased risk of forthcoming cardiovascular disease and type 2 diabetes mellitus. Emerging evidence indicates that benign prostate hyperplasia (BPH) and its related lower urinary tract symptoms (LUTS) represent other clinical conditions frequently observed in subjects with MetS. Several modifiable factors involved in MetS determinism, such as inadequate diet, lack of physical exercise, and smoking and drinking behaviours are emerging as main contributors to the development of BPH. The pathogenetic mechanisms underlying the connection between MetS and BPH have not been completely clarified. MetS and its components, hypogonadism, and prostate inflammation probably play an important role in inducing BPH/LUTS. Although historically considered as a “normal” consequence of the aging process, BPH/LUTS should now be faced proactively, as a preventable disorder of the elderly. Type of diet and level of physical activity are now considered important factors affecting prostate health in the aging male. However, whether physical exercise, weight loss, and modifications of dietary habit can really alter the natural history of BPH/LUTS remains to be determined. Further research is advisable to better clarify these points. PMID:24688539

  15. Urinary Polyamine Biomarker Panels with Machine-Learning Differentiated Colorectal Cancers, Benign Disease, and Healthy Controls.

    Science.gov (United States)

    Nakajima, Tetsushi; Katsumata, Kenji; Kuwabara, Hiroshi; Soya, Ryoko; Enomoto, Masanobu; Ishizaki, Tetsuo; Tsuchida, Akihiko; Mori, Masayo; Hiwatari, Kana; Soga, Tomoyoshi; Tomita, Masaru; Sugimoto, Masahiro

    2018-03-07

    Colorectal cancer (CRC) is one of the most daunting diseases due to its increasing worldwide prevalence, which requires imperative development of minimally or non-invasive screening tests. Urinary polyamines have been reported as potential markers to detect CRC, and an accurate pattern recognition to differentiate CRC with early stage cases from healthy controls are needed. Here, we utilized liquid chromatography triple quadrupole mass spectrometry to profile seven kinds of polyamines, such as spermine and spermidine with their acetylated forms. Urinary samples from 201 CRCs and 31 non-CRCs revealed the N ₁, N 12 -diacetylspermine showing the highest area under the receiver operating characteristic curve (AUC), 0.794 (the 95% confidence interval (CI): 0.704-0.885, p machine learning method using combinations of polyamines showed a higher AUC value of 0.961 (95% CI: 0.937-0.984, p machine-learning method showed potential as a screening tool of CRC.

  16. Robot-assisted oesophageal and gastric surgery for benign disease: antireflux operations and Heller's myotomy.

    Science.gov (United States)

    Falkenback, Dan; Lehane, Christopher W; Lord, Reginald V N

    2015-03-01

    Robot-assisted general surgery operations are being performed more frequently. This review investigates whether robotic assistance results in significant advantages or disadvantages for the operative treatment of gastro-oesophageal reflux disease and achalasia. The electronic databases (Medline, Embase, PubMed) were searched for original English language publications for antireflux surgery and Heller's myotomy between January 1990 and December 2013. Thirty-three publications included antireflux operations and 20 included Heller's myotomy. The publications indicate that the safety and effectiveness of robotic surgery is similar to that of conventional minimally invasive surgery for both operations. The six randomized trials of robot-assisted versus laparoscopic antireflux surgery showed no significant advantages but significantly higher costs for the robotic method. Gastric perforation during non-redo robotic fundoplication occurred in four trials. No consistent advantage for robot-assisted antireflux surgery has been demonstrated, and there is an increased cost with current robotic technology. A reported advantage for robotic in reducing the perforation rate during Heller's myotomy for achalasia remains unproven. Gastric perforation during robotic fundoplication may be due to the lack of haptic feedback combined with the superhuman strength of the robot. © 2014 Royal Australasian College of Surgeons.

  17. Radiotherapy of splenomegaly. A palliative treatment option for a benign phenomenon in malignant diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kriz, Jan; Mueller, Rolf-Peter; Eich, Hans Theodor [Koeln Univ. (Germany). Dept. of Radiation Oncology; Micke, Oliver [St. Franziskus Hospital, Bielefeld (Germany). Dept. of Radiation Oncology; Bruns, Frank [Medical School Hannover (Germany). Dept. of Radiation Oncology; Haverkamp, Uwe [Clemens Hospital, Muenster (Germany). Dept. of Radiation and Radiation Oncology; Muecke, Ralph; Schaefer, Ulrich [Hospital Lippe (Germany). Dept. of Radiation Oncology; Seegenschmiedt, Heinrich [Center of Radiotherapy, Hamburg (Germany)

    2011-04-15

    Purpose: Since the 20{sup th} century, radiotherapy (RT) has been used for treatment of symptomatic splenomegaly (SM). SM occurs in association with hematologic disorders. The purpose of this analysis was to determine the indication, treatment concepts, and efficiency of RT. Material and Methods: Clinical features, treatment concepts, and outcome data during the past 20 years were analyzed. Endpoints were pain relief, symptomatic and hematological response, and treatment-related side effects. Results: From 1989-2009, a total of 122 patients received 246 RT courses because of symptomatic SM. Overall 31 patients had chronic myelogenous leukemia (CML), 37 had chronic lymphocytic leukemia (CLL), 23 had osteomyelofibrosis (OMF), 17 had polycythemia vera (PV), 5 had acute myelogenous leukemia, 4 had idiopathic thrombocytopenic purpura (ITP), 3 had non-Hodgkin lymphoma (NHL), and 2 had multiple myeloma (MM). Patients were treated with {sup 60}Co gamma rays or 5-15MV photons. The fraction size ranged from 10-200 cGy and the total dose per treatment course from 30-1600 cGy. Significant pain relief was achieved for 74.8% of the RT courses given for splenic pain. At least 50% regression was attained for 77% of the RT courses given for SM. 36 patients died within 2 months due to the terminal nature of their disease. Of the RT courses applied for cytopenia, 73.6% achieved a significant improvement of hematological parameters and reduction of transfusion need. Notable hematologic toxicities were reported < EORTC/RTOG II . Conclusion: The present analysis documents the efficacy of RT. In addition, RT as a palliative treatment option for symptomatic SM should not be forgotten. (orig.)

  18. Non-progressive juvenile spinal muscular atrophy of the distal upper limb (Hirayama's disease: a clinical variant of the benign monomelic amyotrophy

    Directory of Open Access Journals (Sweden)

    NASCIMENTO OSVALDO J. M.

    2000-01-01

    Full Text Available Hirayama's disease (HD is frequently found in Asia, and is rarely referred among westerners. It affects young people with higher incidence in males. It is a focal distal amyotrophy with unilateral or asymmetric bilateral involvement of C7, C8 and T1 innervated muscles. HD appears sporadically and has a benign evolution with clinical stabilization in around one year. We report four young male patients with clinical and electrophysiological alterations described in HD, which were followed-up during 5 years. Electromyographic findings were indicative of lower motor neuron involvement. We analyzed cervical MRI aiming at understanding if a questionable spinal cord compression could be implicated in the pathogenesis, but no abnormality was verified. In view of its clinical, and EMG characteristics, HD is no more than a benign monomelic amyotrophy (BMA clinical variant, and not a specific disease. This eponym could be considered only for the distal upper limb variant (Hirayama's variant of the BMA.

  19. Benign bone tumors

    International Nuclear Information System (INIS)

    Gilday, D.L.; Ash, J.M.

    1976-01-01

    There is little information in the literature concerning the role of bone scanning in benign bone neoplasms except for sporadic reports. Since the advent of /sup 99m/Tc-polyphosphate, bone imaging has proven feasible and useful in locating the cause of bone pain, such as in osteoid osteomas, which are not always radiologically apparent, and in evaluating whether or not a radiologic lesion is indeed benign and solitary. Blood-pool images are particularly important in neoplastic disease, since the absence of hyperemia in the immediate postinjection period favors the diagnosis of a benign neoplasm, as does low-grade uptake on the delayed study. The scan, including pinhole magnification images, is especially valuable in diagnosing lesions in the spine and pelvis, which are poorly seen radiologically. We have studied various types of benign bone tumors, including simple and aneurysmal bone cysts, fibrous cortical defects, and nonossifying fibromas, all of which had minimal or no increased uptake of the radiopharmaceutical, unless traumatized. Although osteochondromas and enchondromas showed varied accumulation of activity, the scan was useful in differentiating these from sarcomatous lesions. All osteoid osteomas demonstrated marked activity, and could be accurately located preoperatively, as could the extent of fibrous dysplasia. The bone scan in the reticuloses also showed abnormal accumulation of activity, and aided in arriving at the prognosis and treatment of histiocytic bone lesions

  20. Endovascular Stent Treatment for Symptomatic Benign Iliofemoral Venous Occlusive Disease: Long-Term Results 1987–2009

    International Nuclear Information System (INIS)

    Gutzeit, A.; Zollikofer, Ch. L.; Dettling-Pizzolato, M.; Graf, N.; Largiadèr, J.; Binkert, C. A.

    2011-01-01

    Venous stenting has been shown to effectively treat iliofemoral venous obstruction with good short- and mid-term results. The aim of this study was to investigate long-term clinical outcome and stent patency. Twenty patients were treated with venous stenting for benign disease at our institution between 1987 and 2005. Fifteen of 20 patients (15 female, mean age at time of stent implantation 38 years [range 18–66]) returned for a clinical visit, a plain X-ray of the stent, and a Duplex ultrasound. Four patients were lost to follow-up, and one patient died 277 months after stent placement although a good clinical result was documented 267 months after stent placement. Mean follow-up after stent placement was 167.8 months (13.9 years) (range 71 (6 years) to 267 months [22 years]). No patient needed an additional venous intervention after stent implantation. No significant difference between the circumference of the thigh on the stented side (mean 55.1 cm [range 47.0–70.0]) compared with the contralateral thigh (mean 54.9 cm [range 47.0–70.0]) (p = 0.684) was seen. There was a nonsignificant trend toward higher flow velocities within the stent (mean 30.8 cm/s [range 10.0–48.0]) and the corresponding vein segment on the contralateral side (mean 25.2 cm/s [range 12.0–47.0]) (p = 0.065). Stent integrity was confirmed in 14 of 15 cases. Only one stent showed a fracture, as documented on x-ray, without any impairment of flow. Venous stenting using Wallstents showed excellent long-term clinical outcome and primary patency rate.

  1. Optimal carbon dioxide insufflation pressure during robot-assisted thyroidectomy in patients with various benign and malignant thyroid diseases

    Directory of Open Access Journals (Sweden)

    Kim Hoon

    2012-09-01

    Full Text Available Abstract Background Currently, data are not available concerning a safe insufflation pressure that provides a proper view of the surgical field without adverse metabolic and hemodynamic changes in humans undergoing the robot-assisted thyroidectomy bilateral axillo-breast approach (BABA using the da Vinci robotic surgical system. The purpose of this study was to determine the optimal carbon dioxide (CO2 insufflation pressure in patients with various benign and malignant thyroid diseases when using the da Vinci robotic surgical system. Methods A total of 32 patients underwent thyroid surgery at 6 (n = 15, 9 (n = 15, and 12 (n = 2 mmHg. The partial pressure of carbon dioxide (PaCO2, pH, cardiac output, heart rate, and mean arterial pressure were measured at baseline, 30 min and 1, 1.5, and 2 hours after CO2 insufflation, and 30 min after desufflation. Results CO2 insufflation of 12 mmHg caused severe facial subcutaneous emphysema, hypercarbia, and acidosis during robot-assisted thyroidectomy with BABA. The study was stopped before completion for the patients’ safety in accordance with the study protocol. Applying 6- or 9- mmHg of CO2 insufflation pressure caused increases in PaCO2 and decreases in arterial pH. However, vital signs were stable and pH and PaCO2 were within the physiologic range during the surgery in the 6- and 9-mmHg groups. Conclusions We propose that a CO2 insufflation pressure under 10 mmHg in robot-assisted thyroidectomy with BABA is the optimal insufflation pressure for patient safety.

  2. Flame-broiled food, NAT2 acetylator phenotype, and breast cancer risk among women with benign breast disease.

    Science.gov (United States)

    Gallicchio, Lisa; McSorley, Meghan A; Newschaffer, Craig J; Thuita, Lucy W; Argani, Pedram; Hoffman, Sandra C; Helzlsouer, Kathy J

    2006-09-01

    The objective of this study was to examine the association between flame-broiled food consumption, a source of heterocyclic amine exposure, and the development of breast cancer among cohort of women with benign breast disease (BBD). The variation of the association by acetylation phenotype, as determined by the genotypes of selected N-acetyltransferase 2 (NAT2) enzymes, was also examined. Among participants in an ongoing cohort study, 1187 women reported having a breast biopsy for BBD and completed a food frequency questionnaire. NAT2 G857A, NAT2 T341C, and NAT2 G590A genotypes were determined using DNA extracted from blood specimens collected in 1989. Incident cases of breast cancer were identified through linkage of the cohort participants with the Washington County Cancer Registry and the Maryland State Cancer Registry. Follow-up for the BBD cohort began at study entry in 1989 and ended on April 28, 2003. Of the women in this study, 77 subsequently developed breast cancer. Results showed that, among rapid acetylators, flame-broiled food intake was associated with a statistically significant increase in the risk of breast cancer (odds ratio (OR) 2.62; 95% confidence interval (CI) 1.06, 6.46). No association was observed between flame-broiled food intake and breast cancer among slow acetylators (OR 0.75; 95% CI 0.39, 1.43). These findings suggest that flame-broiled food may be a modifiable risk factor for the progression of BBD to invasive breast cancer among women who have genotypes consistent with rapid acetylation.

  3. MR imaging in gynecology and obstetrics

    International Nuclear Information System (INIS)

    Bauer, M.; Tontsch, P.; Schulz-Wendtland, R.

    2000-01-01

    The toolbook covers the full range of indications for MRI in obstetrics and gynecology. It is the joint work of radiologists and obstetrician-gynecologists and supplies state-of-the-art information needed by doctors in the private practice or a hospital department. Examples from the Table of Contents: Physical principles of MRI, applications and performance aspects. Systematic presentation of diagnostic findings for comparative analysis and assessment. Biological effects and risks. Benign and malignant neoplasms of the mammary glands and the female genital organs. MRI for prenatal care and diagnostic evaluation. New method: MR spectroscopy. (orig./CB) [de

  4. Robotic gynecologic surgery: past, present, and future.

    Science.gov (United States)

    Chen, Chi Chiung Grace; Falcone, Tommaso

    2009-09-01

    Robotic techniques are increasingly being used to perform gynecologic surgical procedures including hysterectomies, performed for benign and malignant indications, myomectomies, tubal reanastomoses, and sacrocolpopexies. Robotic procedures seem to confer the same benefits as laparoscopic surgery without additional complications. It is unclear, however, whether robotic surgery imparts any additional benefits such as decreased operative times when compared with open or conventional laparoscopic techniques. The advantages to robotic surgery include improved visualization of the operative field with increased dexterity allowing more precise movements. Disadvantages include the learning curve associated with learning a new surgical technique and the equipment and operating costs of the robot and of using the robot.

  5. Epidemiology of gynecologic cancers in China.

    Science.gov (United States)

    Jiang, Xiyi; Tang, Huijuan; Chen, Tianhui

    2018-01-01

    Cancer has become a major disease burden across the globe. It was estimated that 4.29 million new incident cases and 2.81 million death cases of cancer would occur in 2015 in China, with the age-standardized incidence rate (ASIR) of 201.1 per 100,000 and age-standardized mortality rate (ASMR) of 126.9 per 100,000, respectively. For females, 2 of the top 10 most common types of cancer would be gynecologic cancers, with breast cancer being the most prevalent (268.6 thousand new incident cases) and cervical cancer being the 7th most common cancer (98.9 thousand new incident cases). The incidence and mortality of gynecologic cancers have been constantly increasing in China over last 2 decades, which become a major health concern for women. Survival rates of gynecologic cancers are generally not satisfactory and decrease along with advancing stage, though national data on survival are still not available. It is of great importance to overview on the epidemiology of gynecologic cancers, which may provide scientific clues for strategy-making of prevention and control, and eventually lowering the incidence and mortality rate as well as improving the survival rate in the future. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

  6. Disparities in Gynecological Malignancies

    Directory of Open Access Journals (Sweden)

    Sudeshna eChatterjee

    2016-02-01

    Full Text Available Objectives: Health disparities and inequalities in access to care among different socioeconomic, ethnic, and racial groups have been well documented in the U.S. healthcare system. In this review, we aimed to provide an overview of barriers to care contributing to health disparities in gynecological oncology management and to describe site-specific disparities in gynecologic care for endometrial, ovarian, and cervical cancer. Methods: We performed a literature review of peer-reviewed academic and governmental publications focusing on disparities in gynecological care in the United States by searching PubMed and Google Scholar electronic databases. Results: There are multiple important underlying issues that may contribute to the disparities in gynecological oncology management in the United States, namely geographic access and hospital based-discrepancies, research-based discrepancies, influence of socioeconomic and health insurance status, and finally the influence of race and biological factors. Despite the reduction in overall cancer-related deaths since the 1990s, the 5-year survival for Black women is significantly lower than for White women for each gynecologic cancer type and each stage of diagnosis. For ovarian and endometrial cancer, black patients are less likely to receive treatment consistent with evidence-based guidelines and have worse survival outcomes even after accounting for stage and comorbidities. For cervical and endometrial cancer, the mortality rate for black women remains twice that of White women. Conclusions: Health care disparities in the incidence and outcome of gynecologic cancers are complex and involve biologic factors as well as racial, socioeconomic and geographic barriers that influence treatment and survival. These barriers must be addressed to provide optimal care to women in the U.S. with gynecologic cancer.

  7. Preoperative screening of thromboembolism using plasma D-dimer test and proximal vein compression ultrasonography in Japanese gynecologic patients.

    Science.gov (United States)

    Shigemi, Daisuke; Matsuhashi, Tomohiko; Yamada, Takashi; Kamoi, Seiryu; Takeshita, Toshiyuki

    2017-03-01

    Venous thromboembolism (VTE) is a serious complication of surgery, including gynecologic surgery. The plasma D-dimer test and proximal/distal vein compression ultrasonography are frequently used as an easy, preoperative VTE screening method. However, targeted patients for these two examinations have not been established. We retrospectively reviewed 380 gynecologic surgical patients who underwent preoperative VTE screening including the plasma D-dimer test and proximal/distal vein compression ultrasonography from March 2014 to February 2015. All patients underwent laparotomy or laparoscopy. In patients with a high risk of pulmonary thromboembolism, compression ultrasonography was substituted by or combined with contrast-enhanced computed tomography. With regard to D-dimer level, patients were divided to three groups: D-dimer level ≤0.5 μg/mL (group A), D-dimer level between 0.6 and 0.9 μg/mL (group B), and D-dimer level ≥ 1.0 μg/mL (group C). Twenty-seven cases had preoperatively detected VTE. Three patients in group B with benign disease were diagnosed with VTE before surgery. Among benign patients in group B, there was a significant difference in preoperative VTE occurrence between patients without risk factors (0/68 cases) and those with risk factors (3/54 cases). All 11 patients with benign disease having preoperative VTE had one or more risk factors. Even in benign cases with low preoperative D-dimer levels (0.6-0.9 μg/mL), an imaging test should be added when the patient has one or more VTE risk factors.

  8. Prospective study of growth and development in older girls and risk of benign breast disease in young women.

    Science.gov (United States)

    Berkey, Catherine S; Willett, Walter C; Frazier, A Lindsay; Rosner, Bernard; Tamimi, Rulla M; Colditz, Graham A

    2011-04-15

    In adult women with retrospective data, childhood adiposity, pubertal growth and development were associated with benign breast disease (BBD) and/or breast cancer. The authors prospectively evaluated these childhood/adolescent characteristics and BBD risk. The Growing Up Today Study (GUTS) included females, aged 9-15 years in 1996, who completed annual questionnaires through 2001, then 2003, 2005, and 2007. Participants annually/biennially provided information on menarche, height, and weight, from which the authors derived body mass index (BMI in kg/m(2) ). Peak height growth velocity (PHV in cm/year) was estimated from longitudinal data. On 2005-2007 surveys, 6899 females (18-27 years of age) reported whether a healthcare provider ever diagnosed BBD (n = 147), and whether it was confirmed by biopsy (n = 67). Logistic models investigated risk factors adjusted for age, alcohol, pregnancy, and maternal history. More childhood adiposity (odds ratio [OR], 0.91/[kg/m(2) ]; P = .04) and shorter adult height (OR, 0.93/inch shorter; P = .07) were associated with lower risk of biopsy-confirmed BBD. Girls with most rapid height growth were at increased risk (OR, 2.12; P = .09) relative to those with the slowest growth. Age at menarche was not associated (OR, 1.11/year; P = .32) nor was adult BMI (adjusted for childhood BMI: OR, 1.01/[kg/m(2) ]; P = .98); larger BMI increases (childhood to adulthood) were not protective (OR + 1.04/[kg/m(2) ]; P = .37). Among girls with maternal breast cancer, those with more rapid growth had higher risk (OR, 1.47/[cm/year]; P = .02). All estimates were age-adjusted. Increased BBD risk (likely evolving to elevated breast cancer risk) was observed in thinner girls, girls with the most rapid growth, and taller women. Contrary to expectations, later menarche age was not protective against BBD, consistent with studies that found BBD patients are not protected against breast cancer by later menarche. Copyright © 2011 American Cancer Society.

  9. Global epidemiology of hysterectomy: possible impact on gynecological cancer rates

    DEFF Research Database (Denmark)

    Hammer, Anne; Rositch, Anne; Kahlert, Johnny Abildgaard

    2015-01-01

    Despite the fact that hysterectomy is the most common surgical procedure worldwide in gynecology, national reporting of the incidence rate of gynecological cancers rarely removes the proportion no longer at risk of the disease from the population-at-risk-denominator (ie. women who have had a hyst...

  10. The possible role of tumor antigen CA 15-3, CEA and ferritin in malignant and benign disease

    OpenAIRE

    Nafija Serdarević; Samira Mehanović

    2012-01-01

    Introduction: Serum CA15-3 has been one of the most reliable tumor markers used in monitoring of breast cancer patients. To increase its sensitivity, the combined measurement of other tumor markers (CEA and ferritin) with CA15-3 was investigated. The aim of this study was determination of CA 15-3, CEA and ferritin in female patients with breast cancer, lung cancer and mastitisMethods: 300 patients with carcinoma, hospitalized at Department of Gynecologic Oncology and Department for Oncology a...

  11. No gynecologist in town: the gynecological care of women in rural Taiwan

    Directory of Open Access Journals (Sweden)

    Lai LJ

    2015-07-01

    likely to consult for gynecological diseases (23.8% versus 35.4%; P<0.001 and visit gynecologists (18.7% versus 30.4%; P<0.001 than women in towns with a gynecologist. The disparity existed in each age group. Among 5,189 adult women living in towns without a gynecologist and having gynecological diseases, 78.5% (number [n]=4,074 visited gynecologists out of town, especially for infertility, benign disorders of the uterus and ovaries, gynecological examinations, and contraceptive problems, and by contrast 23.3% (n=1,209 visited nongynecologists in town, most commonly for menopausal disorders, endometriosis and pelvic pain, menstrual disorders and hormonal dysfunction, and genital dysplasia.Conclusion: Gynecological care of rural women was adversely affected by the shortage of gynecologists. The consequences of accessibility in underserved areas deserve further investigation. Keywords: gynecological care, urban–rural health service, women’s health

  12. Antioxidant effect of aqueous extract of four plants with therapeutic potential on gynecological diseases; Semen persicae, Leonurus cardiaca, Hedyotis diffusa, and Curcuma zedoaria.

    Science.gov (United States)

    Ji, Shaojian; Fattahi, Amir; Raffel, Nathalie; Hoffmann, Inge; Beckmann, Matthias W; Dittrich, Ralf; Schrauder, Michael

    2017-11-25

    Little information is available concerning antioxidant effects of plant teas (water boiled) which are used more commonly in traditional Chinese medicine than other extracts. Thus, we addressed this issue by evaluating the ability of teas from four different plants with therapeutic potential on gynecological diseases. The aqueous extracts of Semen persicae, Leonurus cardiaca, Hedyotis diffusa, and Curcuma zedoaria rhizome were prepared and then their effects on copper-induced low-density lipoprotein cholesterol (LDL-C) oxidation were evaluated by spectrophotometric method. Density gradient ultracentrifugation method was recruited to isolate LDL-C from healthy individuals. Our results showed that adding 10, 20, and 30 µl S. persicae could increase the lag phase duration of LDL-C oxidation compared with control reaction 12, 21, and 33%, respectively. The most effective delay (87%) was observed when 30 µl H. diffusa was added to the reaction. In cases of L. cardiaca and C. zedoaria, we found no significant influence on the lag phase duration (p > 0.05). Moreover, our findings about starting point of the decomposition phase were almost in parallel with the lag phase results, as 30 µl of S. persicae or H. diffusa teas could significantly increase the initiation time of decomposition (p < 0.05). In conclusion our results showed that both S. persicae and H. diffusa teas and not L. cardiaca and C. zedoaria could have medicinal therapeutic effects partly through direct oxidation prevention.

  13. [Initial experience in the laparoscopic treatment of benign and malignant gynaecological diseases in the Hospital Regional de Alta Especialidad in Oaxaca].

    Science.gov (United States)

    Vásquez-Ciriaco, Sergio; Isla-Ortiz, David; Palomeque-Lopez, Antonio; García-Espinoza, Jaime Aron; Jarquín-Arremilla, Arturo; Lechuga-García, Néstor Alonso

    The history of laparoscopic surgery in gynaecological diseases progressed with the advances of Semm, as well as with the development of tools, equipment, and energy that led to its development in all surgical areas, including oncology. To present the initial experience in the laparoscopic treatment of benign and malignant gynaecological disease in the Hospital Regional de Alta Especialidad in Oaxaca. An analysis was performed on a total of 44 cases, distributed into: type III radical hysterectomy for invasive cervical cancer, hysterectomy type I cervical cancer in situ, extrafascial hysterectomy for benign disease, routine endometrium, ovary and routine salpingo-oophorectomy. The variables included age, BMI, surgical time, bleeding, intraoperative and postoperative complications, conversion, hospital stay, and pathology report. Hysterectomy type III; age 40.2 years, BMI 25.8kg/m 2 , 238ml bleeding, operative time 228min, 2.6-day hospital stay, intraoperative or postoperative complications, tumour size 1.1cm, 14 lymph nodes dissected, vaginal and negative parametrical edge. Type I hysterectomy cervical cancer in situ: 51 years, BMI 23.8kg/m 2 , 80ml bleeding, operative time 127minutes, uterus of 9cm, length of stay of 2 days, a conversion by external iliac artery injury, with bleeding of 1500ml. Routine endometrium: 50.3 years, BMI 30.3kg/m 2 , 83ml bleeding, operative time 180minutes, uterus 12.6cm, length of stay 2.3 days, no complications. The management of benign and malignant pelvic diseases using laparoscopy is feasible and safe, with shorter hospital stays and a prompt recovery to daily activities. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  14. Danish Gynecological Cancer Database

    DEFF Research Database (Denmark)

    Sørensen, Sarah Mejer; Bjørn, Signe Frahm; Jochumsen, Kirsten Marie

    2016-01-01

    AIM OF DATABASE: The Danish Gynecological Cancer Database (DGCD) is a nationwide clinical cancer database and its aim is to monitor the treatment quality of Danish gynecological cancer patients, and to generate data for scientific purposes. DGCD also records detailed data on the diagnostic measures...... for gynecological cancer. STUDY POPULATION: DGCD was initiated January 1, 2005, and includes all patients treated at Danish hospitals for cancer of the ovaries, peritoneum, fallopian tubes, cervix, vulva, vagina, and uterus, including rare histological types. MAIN VARIABLES: DGCD data are organized within separate...... is the registration of oncological treatment data, which is incomplete for a large number of patients. CONCLUSION: The very complete collection of available data from more registries form one of the unique strengths of DGCD compared to many other clinical databases, and provides unique possibilities for validation...

  15. Obstetric and gynecologic imaging

    International Nuclear Information System (INIS)

    Wicks, J.D.

    1987-01-01

    Obstetric and gynecologic imaging has undergone marked changes in the past 10 years, primarily because of the influence of new imaging modalities. The single modality that has most significantly changed the diagnostic approach to obstetric and gynecologic problems is diagnostic ultrasound. The remarkable ability of this technique to display the anatomy of the gravid and nongravid female pelvis without the use of ionizing radiation motivated the development of techniques and instrumentation that have supplanted but not totally replaced many x-ray based examinations. The use of diagnostic ultrasound for the evaluation of obstetric and gynecologic problems is the dominant theme of this chapter. Areas of patient diagnosis and management in which additional imaging techniques, x-rays, or magnetic resonance are used are presented where appropriate

  16. Gynecological cancer alarm symptoms:

    DEFF Research Database (Denmark)

    Balasubramaniam, Kirubakaran; Ravn, Pernille; dePont Christensen, René

    2016-01-01

    INTRODUCTION: To determine the proportion of patients who were referred to specialist care after reporting gynecological cancer alarm symptoms to their general practitioner. To investigate whether contact with specialist care was associated with lifestyle factors or socioeconomic status. MATERIAL...... and odds ratios (ORs) for associations between specialist care contact, lifestyle factors and socioeconomic status. RESULTS: The study included 25 866 non-pregnant women; 2957 reported the onset of at least one gynecological cancer alarm symptom, and 683 of these (23.1%) reported symptoms to their general......: Educational level influence contact with specialist care among patients with gynecological cancer alarm symptoms. Future studies should investigate inequalities in access to the secondary healthcare system. This article is protected by copyright. All rights reserved....

  17. Radiation Therapy for Gynecologic Cancers

    Science.gov (United States)

    ... with some form of gynecologic cancer this year. Cancers of the uterus and cervix are most common gynecologic cancers treated ... detected or removed by surgery. Radiation therapy kills ... of the uterus and cervix, called a hysterectomy. The surgeon may ...

  18. Evaluation of thyroid antibodies and benign disease prevalence among young adults exposed to 131I more than 25 years after the accident at the Chernobyl Nuclear Power Plant

    Directory of Open Access Journals (Sweden)

    Yuko Kimura

    2016-03-01

    Full Text Available Background. The Chernobyl Nuclear Power Plant (CNPP accident exposed a large number of inhabitants to internal 131I radiation. The associations between internal 131I exposure and thyroid autoimmunity and benign thyroid diseases remain controversial in the population living in the contaminated area around the CNNP. In this study, we evaluate the association of 131I with benign thyroid diseases. Methods. We compared the prevalence of Anti-Thyroid Autoantibodies (ATAs, thyroid function, and prevalence of thyroid ultrasound finding outcomes in 300 residents of the contaminated area of Ukraine who were 0–5 years of age at the time of the CNPP accident (group 1 and 300 sex-matched residents who were born after the accident (group 2. Results. We did not find any differences of the prevalence of Antithyroglobulin Antibodies (TGAb positive, Antithyroid Peroxidase Antibodies (TPOAb positive, and TGAb and/or TPOAb positive between the study groups. (11.7% vs 10.3%; p = 0.602, 17.3% vs 13.0%; p = 0.136, 21.0% vs 17.3%; p = 0.254, respectively; after adjusting for age and sex, the prevalence was not associated with the 131I exposure status in the study groups. The prevalence of subclinical and overt hypothyroidism cases was not significantly different (p = 0.093 and p = 0.320 in the two groups, nor was the prevalence of goiter (p = 0.482. On the other hand, the prevalence of nodules was significantly higher in group 1 (p = 0.003, though not significantly so after adjustment for age and sex. Discussion. Working 26–27 years after the CNNP accident, we found no increased prevalence of ATAs or benign thyroid diseases in young adults exposed to 131I fallout during early childhood in the contaminated area of Ukraine. Long-term follow-up is needed to clarify the effects of radiation exposure on autoimmunity reaction in the thyroid.

  19. Acute gynecologic disorders in adolescents: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Tong [Soonchunhyang Univ. Cheonan Hospital/Soonchunhyang Univ. College of Medicine, Cheonan (Korea, Republic of)

    2012-09-15

    Gynecologic disorders that cause pelvic pain in adolescents include hemorrhagic ovarian cysts, rupture or torsion of ovarian cyst or tumors, hematocolpos caused by vaginal obstruction, endometriosis, cystic uterine adenomyosis, pelvic inflammatory diseases, and pelvic inclusion cyst. The use of CT for the evaluation of pelvic pain is increasing, and CT is useful if ultrasound findings are not decisive and the lesion is extensive.

  20. Acute gynecologic disorders in adolescents: CT findings

    International Nuclear Information System (INIS)

    Kim, Young Tong

    2012-01-01

    Gynecologic disorders that cause pelvic pain in adolescents include hemorrhagic ovarian cysts, rupture or torsion of ovarian cyst or tumors, hematocolpos caused by vaginal obstruction, endometriosis, cystic uterine adenomyosis, pelvic inflammatory diseases, and pelvic inclusion cyst. The use of CT for the evaluation of pelvic pain is increasing, and CT is useful if ultrasound findings are not decisive and the lesion is extensive

  1. Utility of PET in gynecological cancer

    International Nuclear Information System (INIS)

    Choi, Chang Woon

    2002-01-01

    Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studies performed with 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG). Although many cancers can be detected by FDG-PET, there has been limited clinical experience with FDG-PET for the detection of gynecological cancers including malignancies in uterus and ovary. FDG-PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can aid in the characterization of indeterminate soft-tissue masses. Most gynecological cancers need to surgical management. FDG-PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG-PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. In this review, I discuss the clinical feasibility and imitations of this imaging modality in patients with gynecological cancers

  2. Proof of concept of the WOMED model of benign thyroid disease: Restitution of thyroid morphology after correction of physical and psychological stressors and magnesium supplementation.

    Science.gov (United States)

    Moncayo, Roy; Moncayo, Helga

    2015-06-01

    The aim of this study was to investigate the influence of a combined supplementation with magnesium, selenium and coenzyme Q10 on the morphology of the thyroid in patients with benign diseases. The clinical examination and treatment approach aims additionally at treating musculoskeletal and psychological stress. A group of 8 patients (5 with hyperthyroidism, 3 with hypothyroidism) who initially attended a public institution received additional treatment at our private institution. The basic pharmacological treatment, i.e. substitution or thyreostatic, was kept unchanged. The inclusion of patients required good quality ultrasound images to be available. Initially the changes of the musculoskeletal system were corrected. Following this, stress components were also treated. After a period of 2-4 years of supplementation we observed a normalization of thyroid morphology as evidenced on ultrasound while at the same time there was a reduction of perfusion intensity. Thyroid antibody titers decreased in the majority of cases. Failure of the treatment was seen in 2 cases of chronic thyroiditis that was present for more than 10 years. The ultrasound images of these patients suggest a possible fibrosis. In spite of the limitation due to the small number of cases, our observational study has delivered proof of concept for our examination and treatment model for benign thyroid disease. Our results challenge validity of the prevailing dogma of a destructive unstoppable "autoimmune" destructive process of the gland. At the same time it shows new therapeutic options for patients with thyroid disease.

  3. The IAEA Activities on Supporting the Use of Unsealed Radioisotopes for the Treatment of Malignant and Benign Diseases

    International Nuclear Information System (INIS)

    Zaknun, J.J.; Pillai, M.R.A.; Palm, S.; Dondi, M.

    2009-01-01

    The Nuclear Medicine Section of the IAEA has a long tradition in supporting the implementation of effective therapeutic application for the management of cancer and benign conditions. This obligation resides in Article II of the IAEA Statutes. The specific mission is to foster the application of nuclear medicine techniques in those diseases that may successfully be managed using radioisotopic applications. In addition to documents related to therapeutic application of unsealed radioisotopes, the IAEA was successful in managing a multicentre Coordinated Research Projects (CRPs) for the treatment of Hepato Cellular Carcinoma published recently in a special edition of the Seminars. Other CRPSs were aimed at improving quality of life of patients suffering from rheumatoid arthritis and haemophilic arthropathy and the palliation of disseminated metastatic bone pain. In addition, to disseminate knowledge, high level experts are invited to consultancy panels to assist in producing relevant documents in the field of Nuclear Medicine, including publications, manuals and educational material all of which are accessible on-line. The Department of Nuclear Sciences and Application (NA) has identified the need to enhance the availability and accessibility of Member States to medical radioisotopes potentially attractive for clinical use, one of these being Lutetium-177. To achieve this objective a world-wide network of cooperation was established. Since several countries operating nuclear reactors at a low to medium-neutron flux are capable of producing sufficient amounts of Lu-177 for the labelling of bone seeking radiopharmaceuticals, Lu-177 ethylenediamine tetra(methylene phosphonic acid) ( 177 Lu-EDTMP) has been identified for its clinical potential as a safe, sustainable and cost-effective radiopharmaceutical for the management of bone pain caused by metastatic prostate and breast cancer. To fulfil the highest standards of international legal requirements, animal studies and

  4. Single-site robotic surgery in gynecologic cancer: a pilot study

    OpenAIRE

    Yoo, Ha-Na; Kim, Tae-Joong; Lee, Yoo-Young; Choi, Chel Hun; Lee, Jeong-Won; Bae, Duk-Soo; Kim, Byoung-Gie

    2015-01-01

    Objective To discuss the feasibility of single-site robotic surgery for benign gynecologic tumors and early stage gynecologic cancers. Methods In this single institution, prospective analysis, we analyzed six patients who had undergone single-site robotic surgery between December 2013 and August 2014. Surgery was performed using the da Vinci Si Surgical System. Patient characteristics and surgical outcomes were analyzed. Results Single-site robotic surgery was performed successfully in all si...

  5. STATISTICS OF GYNECOLOGICAL MALIGNANCIES

    Directory of Open Access Journals (Sweden)

    Ye. M. Aksel

    2009-01-01

    Full Text Available The paper analyzes data on the state-of-the-art of oncological care given to patients with gynecological cancer, considers differences in morbidity rates between individual population groups and regions, and compares the maximum and minimum cancer morbidity rates among different populations.

  6. STATISTICS OF GYNECOLOGICAL MALIGNANCIES

    OpenAIRE

    Ye. M. Aksel

    2009-01-01

    The paper analyzes data on the state-of-the-art of oncological care given to patients with gynecological cancer, considers differences in morbidity rates between individual population groups and regions, and compares the maximum and minimum cancer morbidity rates among different populations.

  7. Robotics in gynecologic surgery.

    Science.gov (United States)

    Frick, A C; Falcone, T

    2009-06-01

    Robotic surgery has evolved from an investigational surgical approach to a clinically useful adjunct in multiple surgical specialties over the past decade. Advocates of robotic-assisted gynecologic surgery revere the system's wristed instrumentation, ergonomic positioning, and three-dimensional high-definition vision system as significant improvements over laparoscopic equipment's four degrees of freedom and two-dimensional laparoscope that demand the surgeon stand throughout a procedure. The cost, lack of haptic feedback, and the bulky size of the equipment make robotics less attractive to others. Studies evaluating outcomes in robotic-assisted gynecologic surgery are limited. Multiple small retrospective studies demonstrate the safety and feasibility of robotic hysterectomy. With increased surgeon experience, operative times are similar to, or shorter than, laparoscopic cases. Robotic assistance can facilitate suturing in laparoscopic myomectomies, and is associated with decreased blood loss and a shorter hospital stay, although may require longer operative times. Robotic assistance has also been applied to multiple procedures in the subspecialties of infertility, urogynecology and gynecologic oncology with good success and relatively low morbidity. However, further research is warranted to better evaluate the relative benefits and costs of robotic assisted gynecologic surgery.

  8. Measurement properties of ThyPRO short-form (ThyPRO-39) for use in Chinese patients with benign thyroid diseases.

    Science.gov (United States)

    Wong, Carlos K H; Choi, Edmond P H; Woo, Y C; Lang, Brian H H

    2018-04-18

    To evaluate the validity and reliability of a newly-translated Thyroid-specific Patient-Reported Outcome short-form (ThyPRO-39) instrument for ethnic-Chinese patients suffering from benign thyroid diseases. The translation and cross-cultural adaptation of the English ThyPRO-39 were performed using the double forward translation, reconciliation, single backward translation, and cognitive debriefing, followed by a panel review. Cross-sectional data of 308 patients with benign thyroid diseases were utilized for this psychometric evaluation of ThyPRO-39 instrument. Convergent validity between similar construct in the ThyPRO-39, SF-6D, and SF-12v2 was assessed using Spearman correlations. The internal construct validity was assessed by corrected item-total correlations. Sensitivity of the ThyPRO-39 domain scores was determined by performing known group comparisons by independent t test. The internal consistency reliability was assessed by Cronbach's alpha coefficient. Significant floor effects were observed in 9 out of 13 domains of the ThyPRO-39. The hypothesized correlations between similar constructs in the ThyPRO-39 and the SF-12v2 and SF-6D were generally observed, supporting convergent validity. The internal construct validity was supported in most items, except eight items in six scales. Scale score of hyperthyroid symptoms of the ThyPRO-39 was significantly higher in the group with Graves' disease or hyperthyroid disease than the group without Graves' disease nor hyperthyroid disease. Scale scores of eye symptoms and impaired daily life were significantly higher in the incidental group than the non-incidental group. For six domains (hyperthyroid symptoms, hypothyroid symptoms, eye symptoms, tiredness, depressivity, and emotional susceptibility), Cronbach's alpha did not reach the recommended standard of 0.7. This was the first psychometric study to translate and adapt the ThyPRO-39 instrument for non-Caucasian patients, and report its validity and reliability

  9. One-third of vertiginous episodes during the follow-up period are caused by benign paroxysmal positional vertigo in patients with Meniere's disease.

    Science.gov (United States)

    Taura, Akiko; Funabiki, Kazuo; Ohgita, Hideaki; Ogino, Eriko; Torii, Hiroko; Matsunaga, Mami; Ito, Juichi

    2014-11-01

    In the present study, about one-third of patients with Meniere's disease developed benign paroxysmal positional vertigo (BPPV)-like attacks. Additionally, more than one-third of all vertigo attacks were BPPV-like attacks. Thus, vertigo attacks in patients with Meniere's disease must be carefully treated because the therapy for such vertigo attacks is totally different from the therapy for BPPV. Physicians sometimes encounter patients with previously diagnosed Meniere's disease who develop BPPV attacks during the course of clinical follow-up. In this study, we explored the frequency with which BPPV was involved in all vertiginous episodes among patients with Meniere's disease. This retrospective study involved 296 patients with Meniere's disease who visited Kyoto University Hospital. The diagnosis of Meniere's disease was based on the guidelines for the diagnosis of Meniere's disease proposed by the Committee on Hearing and Equilibrium. We judged the cause of vertigo as one of the following five types: (1) definite Meniere's disease attack, (2) suspicious Meniere's disease attack, (3) definite BPPV attack, (4) suspicious BPPV attack, or (5) unknown. In all, 96 patients (32.8%) developed BPPV-like attacks, and 187 vertiginous episodes (37.9%) were caused by BPPV. The lateral semicircular canal was the most frequently involved canal.

  10. Investigation of psychosomatic aspects of gynecological and andrological diseases and infertility: a review of contemporary international researches

    Directory of Open Access Journals (Sweden)

    Lantsburg M.E.

    2016-06-01

    Full Text Available In recent decades, the increasing worldwide problems in the reproductive sphere of people, the problem of preserving reproductive health of the population has become very topical, it requires joint medical and psychological efforts. This article presents a review of more than 70 modern English-language scientific publications devoted to the study of psychological and psychosomatic peculiarities of men, women and couples with reproductive disorders and psychological predictors and consequences of these problems. The best known and the least explored psychological aspects of reproductive disorders are highlighted, the results of research are described, also R. Linder’s psychotherapeutic method of preventing premature births is outlined. The article has two parts: the first part presents the research of psychosomatic aspects of male and female reproductive diseases, including infertility; the second one is devoted to psychological and psychosomatic disorders of women during pregnancy and childbirth.

  11. Assessment of mothers’ satisfaction with the care of maternal care in Specialized Educational-Medical Centers in obstetrics and gynecological disease in Northwest, Iran

    Directory of Open Access Journals (Sweden)

    Simin Taghavi

    2015-06-01

    Full Text Available Introduction: Patients satisfaction includes the assessment of healthcare which she/he received. This study aims at assessment of mothers’ satisfaction with the care of maternal care in Specialized Educational-Medical Centers in obstetrics and gynecological disease in Northwest, Iran. Methods: In an analytic-descriptive cross-sectional study, 1000 female patients who admitted in educational-medical centers of Northwest were studied during a 2 years period (2010-2012. They asked to fill a 34-item closed-answer questionnaire (ranking from very unsatisfied to very satisfied responses following their discharge. Validity of the questionnaire was improved by gynecologist’s experts comments, and reliability of the questionnaire were assessed by test-retest methods (α = 0.946. Results: The satisfaction score (satisfied or very satisfied responses were 61.2, 55.8, 61.8 and 59.5 percent for admitting process, primary care services, treatments and therapeutic interventions and overall, respectively. The satisfaction score for access to doctors was highest in the morning and lowest at the night shifts. The satisfaction score about the personnel’s behavior was lowest during the night shifts. The satisfaction score about the residents’ behavior was highest for the morning shifts. There was no significant difference between the three working shifts regarding psychological feelings, humanitarian respect, and issues like nutrition and private and public hygiene. There was a significant direct correlation between the mean score of satisfaction and patients’ age (Spearman’s rho = 0.117, P < 0.001. Conclusion: The satisfaction level of patients hospitalized in Northwest of Iran's Hospitals was intermediate. Planning new strategies in this regard with emphasis on the main limitations may improve the satisfaction rate in the future.

  12. Epidemiological profile and postoperative complications of women undergoing gynecological surgery in a reference center in the northern brazilian legal amazon

    Directory of Open Access Journals (Sweden)

    Sônia Maria Coelho

    Full Text Available Objective: To evaluate the epidemiological profile and the operative complications of patients undergoing gynecological operations for benign diseases in a tertiary public hospital in the state of Roraima, Brazil. Methods: We conducted a retrospective survey through the analysis of 518 records of patients submitted to gynecological operations between January and June 2012. We included the three major operations during this period (n = 175: hysterectomy, colpoperineoplasty and suburethral sling placement. We excluded 236 cases of tubal ligation and 25 cases where it was not possible to access to medical records. Results: The mean age was 47.6 years; the education level of most patients was completed junior high (36.6%; 77% were from the State capital, 47.4% were in stable relationships and 26.3% were housewives. The majority of patients had given birth three or more times (86.6%, with previous vaginal delivery in 50.2%, and cesarean delivery, 21%. The main diagnostic indications for surgical treatment were uterine myoma (46.3%, urinary incontinence (27.4% and genital dystopias (17.7%. We found three cases (1.7% of high-grade intraepithelial lesions on Pap smear. The most common procedure was total hysterectomy (19.8%, 15.5% vaginally. The most common complication was wound infection (2.2%. Conclusion: Women undergoing gynecological operations due to benign disease had a mean age of 47 years, most had levels of basic education, came from the capital, were in stable relationships, predominantly housewives, multiparous and showed low operative complication rates.

  13. Clinical significance of determination of pre-and post-operative changes of serum cortisol, PRL and GH levels in patients with benign abdominal diseases

    International Nuclear Information System (INIS)

    Chen Huifen

    2008-01-01

    Objective: To investigate the clinical significance of Pre- and post-operative changes of serum Cortisol, PRL and GH Levels in patients with benign abdominal diseases. Methods: Serum contents of Cortisol, PRL levels were measured with chemiluminescence immunoassay and serum GH levels with radioimmunoassay both before and after operation in 32 patients with benign abdominal diseases as well as in 35 controls. Results: The serum levels of these three hormones in the patients 24h before operation were slightly but not significantly higher than those in the controls (P>0.05), right before anaesthesia the levels all increased more and were significantly higher than those in controls (P<0.05). Post-operatively the serum levels of the hormones increased farther and by 24h, were very significantly higher than those in the controls (P<0.01). Conclusion: Stress reaction was quite evident in these patients undergoing operation with significantly higher serum contents of cortisol, PRL and GH. The stress reaction, if excessive, should be properly dealt with. (authors)

  14. Development of quality of care interventions for adult patients on home parenteral nutrition (HPN) with a benign underlying disease using a two-round Delphi approach.

    Science.gov (United States)

    Dreesen, Mira; Foulon, Veerle; Vanhaecht, Kris; Hiele, Martin; De Pourcq, Lutgart; Pironi, Loris; Van Gossum, Andre; Wanten, Geert; Baxter, Janet P; Joly, Francisca; Cuerda, Cristina; Willems, Ludo

    2013-02-01

    HPN patients with benign diseases deserve professional care as they have to deal with complex techniques and risk potentially dangerous complications. The aim was to highlight main outcome quality indicators and to develop a set of key interventions to direct multidisciplinary teams in providing qualitative care. A two-round Delphi approach was used to build consensus on the most important outcome indicators and on 59 interventions identified in existing guidelines on HPN. Comments and interventions newly identified in the first round were co-evaluated in the second round. 29 experts from 9 countries completed the two-round Delphi approach. The outcome indicators rated as the most important are 1) incidence of catheter-related infections, 2) incidence of readmission and quality of life (shared second place) and 3) incidence of dehydration. Sixty eight of a total of 89 interventions were considered as important for the quality of care, of which 46 are based on published guidelines and 22 were newly suggested by the Delphi panel. Using a two-round Delphi approach, consensus was reached for the majority of interventions concerning HPN patients with benign diseases. This set of 68 interventions could be of use as a starting point for quality-improvement programs. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  15. Use of high-intensity focused ultrasound in the treatment of both benign and malignant prostatic disease

    Science.gov (United States)

    Kernen, Kenneth M.; Miles, Brian J.

    2000-05-01

    Prostate cancer, the most common malignancy in men in the United States, accounts for more than 29% of all male cancers diagnosed and 13% of all cancer deaths. This translates into approximately 200,000 men diagnosed and 37,000 men who will die from the disease this year in this country. A significant number of patients ultimately choose external beam radiation or interstitial radioactive implants (brachytherapy) combined with external beam radiotherapy as their primary treatment. Approximately 25 - 35% of external beam irradiation patients and 20 - 30% of interstitial implants combined with external beam radiotherapy will fail within 10 years. The treatment options for patients with localized radiorecurrent disease include watchful waiting, endocrine therapy, salvage radiotherapy, and salvage radical prostatectomy, cryotherapy and now high intensity focused ultrasound therapy (HIFU). Although some studies regarding watchful waiting demonstrated comparable results to formal treatment for early prostate cancer, other studies have shown metastatic and mortality rates that are significantly higher, and that radiorecurrent patients would have even greater rates of metastasis and progression to death. Prostate cancer cure by means of endocrine therapy is highly unlikely and its role is still one of palliation with a side effect profile which includes hot flashes, osteoporosis, fatigue, loss of muscle mass, anemia, loss of libido and potency. The role of salvage radiotherapy may offer local control, however long term efficacy has yet to be determined. In a recent series, only 50% of the patients were controlled for a mean of four years with salvage radiotherapy. Salvage prostatectomy has the advantage of providing excellent local control and even a cure if the cancer is confined to the prostate or within the surrounding periprostatic tissue. Historically, salvage prostatectomy is technically demanding and fraught with higher complications. In one large series

  16. The role of selenium, vitamin C, and zinc in benign thyroid diseases and of selenium in malignant thyroid diseases: Low selenium levels are found in subacute and silent thyroiditis and in papillary and follicular carcinoma

    Directory of Open Access Journals (Sweden)

    Starzinger Matthias

    2008-01-01

    Full Text Available Abstract Background Thyroid physiology is closely related to oxidative changes. The aim of this controlled study was to evaluate the levels of nutritional anti-oxidants such as vitamin C, zinc (Zn and selenium (Se, and to investigate any association of them with parameters of thyroid function and pathology including benign and malignant thyroid diseases. Methods This controlled evaluation of Se included a total of 1401 subjects (1186 adults and 215 children distributed as follows: control group (n = 687, benign thyroid disease (85 children and 465 adults; malignant thyroid disease (2 children and 79 adults. Clinical evaluation of patients with benign thyroid disease included sonography, scintigraphy, as well as the determination of fT3, fT4, TSH, thyroid antibodies levels, Se, Zn, and vitamin C. Besides the routine oncological parameters (TG, TSH, fT4, ultrasound Se was also determined in the cases of malignant disease. The local control groups for the evaluation of Se levels were taken from a general practice (WOMED as well as from healthy active athletes. Blood samples were collected between 8:00 and 10:30 a.m. All patients lived in Innsbruck. Statistical analysis was done using SPSS 14.0. The Ho stated that there should be no differences in the levels of antioxidants between controls and thyroid disease patients. Results Among the thyroid disease patients neither vitamin C, nor Zn nor Se correlated with any of the following parameters: age, sex, BMI, body weight, thyroid scintigraphy, ultrasound pattern, thyroid function, or thyroid antibodies. The proportion of patients with benign thyroid diseases having analyte concentrations below external reference cut off levels were 8.7% of cases for vitamin C; 7.8% for Zn, and 20.3% for Se. Low Se levels in the control group were found in 12%. Se levels were significantly decreased in cases of sub-acute and silent thyroiditis (66.4 ± 23.1 μg/l and 59.3 ± 20.1 μg/l, respectively as well as in

  17. CT and MR Imaging of Gynecologic Emergencies.

    Science.gov (United States)

    Iraha, Yuko; Okada, Masahiro; Iraha, Rin; Azama, Kimei; Yamashiro, Tsuneo; Tsubakimoto, Maho; Aoki, Yoichi; Murayama, Sadayuki

    2017-01-01

    Gynecologic emergencies include various diseases that result from adnexal and uterine disorders. Adnexal disorders may be classified into the following three categories: (a) disorders that cause hemorrhage (hemorrhagic ovarian cysts and ectopic pregnancies); (b) disorders related to adnexal tumors (adnexal torsion and rupture of ovarian tumors); and (c) disorders related to pelvic inflammatory disease, such as tubo-ovarian abscesses. Unusual adnexal torsion, such as massive ovarian edema, isolated fallopian tube torsion, and paraovarian cyst torsion, has also been described. Uterine disorders in gynecologic emergencies may be classified into two categories: (a) acute fibroid complications, including red degeneration of a uterine leiomyoma, torsion of subserosal myomas, and torsion of the uterus; and (b) causes of acute uterine bleeding, including retained products of conception and uterine arteriovenous malformations. Some gynecologic diseases are self-limited, while others cause infertility or life-threatening infection or bleeding if left untreated. Therefore, prompt and accurate diagnosis is important for appropriate life-saving treatment and for the preservation of fertility. The imaging findings are important when evaluating acute gynecologic diseases because the symptoms and physical examination findings are often nonspecific and limited. Ultrasonography is the first-line imaging modality; however, when a definitive diagnosis cannot be established, computed tomography (CT) and magnetic resonance (MR) imaging may narrow the differential diagnosis. Appropriate management requires radiologists to be familiar with the CT and MR imaging features of gynecologic emergencies. With respect to rare conditions, radiologists should take into account the representative findings presented in this article to increase diagnostic accuracy. © RSNA, 2017.

  18. Combination of ultrasound-guided percutaneous microwave ablation and radioiodine therapy in benign thyroid disease. A 3-month follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Korkusuz, H.; Happel, C.; Koch, D.A.; Gruenwald, F. [Frankfurt University Hospital (Germany). Dept. of Nuclear Medicine

    2016-01-15

    Pilot studies of combined therapies treating benign nodular goiters reported promising results. The aim of this study was to investigate the effectiveness of combined microwave ablation (MWA) and radioiodine therapy (RIT) with a special focus on thyroid function at the 3-month follow-up. 15 patients (median age: 55 years) with a large goiter and benign thyroid nodules or Graves' disease were treated with the combined therapy. Serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobuline (Tg) and, additionally, antibody levels against thyroglobulin (TgAb), thyrotropin receptors (TRAb) and thyroid peroxidase (TPOAb) were measured at enrollment, post MWA and at the 3-month follow-up (3MFU). Furthermore, the goiter volume, I-131 dose and hospitalization time were analyzed to evaluate effectiveness. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928 MHz. TSH, T4, T3 and Tg did not change at 3MFU, except for in two patients in whom the initial TSH levels improved to normal thyroid functioning levels at follow-up. One of the patients developed a high TRAb-level that receded back into the normal range. At 3MFU, the combined therapy showed a mean thyroid volume reduction of 26.4 ml ± 7.9 ml (30.5 % ± 4.6 % (p < 0.05)). By utilizing the combined therapy, administered activity could be reduced by 26.6 % ± 4.8 % (p < 0.05) and hospitalization time by 30.9 % ± 19.9 % (p < 0.05). The data confirmed the effectiveness of the combination of MWA with RIT. The combined therapy is an innovative and conservative approach and could become a safe alternative to surgery for the treatment of very large benign nodular goiters. Due to the short follow-up and the limited number of patients, further studies will be necessary.

  19. Benign breast lesions in Kano

    African Journals Online (AJOL)

    malignant breast diseases. But the prevalence of breast cancer is increasing especially in communities that hitherto reported low incidence; a recent report from Ibadan cancer registry, showed that ... Table Relative frequency of breast lesions in Kano. Histological No. % of breast % of benign breast diagnosis lesions lesions.

  20. Benign fibroosseous lesions

    Directory of Open Access Journals (Sweden)

    Cansu Köseoğlu Seçgin

    2016-05-01

    Full Text Available Benign fibroosseous lesions represent a group of lesions that share the same basic evolutive mechanism and are characterized by replacement of normal bone with a fibrous connective tissue that gradually undergoes mineralization. These lesions are presented by a variety of diseases including developmental, reactive-dysplastic processes and neoplasms. Depending on the nature and amount of calcified tissue, they can be observed as radiolucent, mixed or radiopaque. Their radiographic features could be well-defined or indistinguishable from the surrounding bone tissue. They can be asymptomatic as in osseous dysplasias and can be detected incidentally on radiographs, or they can lead to expansion in the affected bone as in ossifying fibroma. All fibroosseous lesions seen in the jaws and face are variations of the same histological pattern. Therefore, detailed clinical and radiographic evaluation in differential diagnosis is important. In this review, fibroosseous benign lesions are classified as osseous dysplasia, fibrous dysplasia and fibroosseous tumors; and radiographic features and differential diagnosis of these lesions are reviewed taking into account this classification.

  1. The preponderance and dye-tissue receptive variability analyses of malignant and benign lesions of the female genitalia

    Directory of Open Access Journals (Sweden)

    F.M. Onyije

    2017-04-01

    Conclusion: Our study reported the preponderance of benign lesions than malignant lesions in the sample population. Comparatively, MT exhibited the best dye-tissue receptivity in both benign and malignant lesions than the baseline dye (H&E and remains a valuable tool for the diagnosis of gynecological lesions.

  2. Radiation therapy of gynecological cancer

    International Nuclear Information System (INIS)

    Nori, D.; Hilaris, B.S.

    1987-01-01

    This book consists of three parts: General Principles; Clinical Applications; and Special Topics. Some of the papers are: Introduction to Basic Radiobiology; Staging and Work-up Procedures for Patients with Gynecological Cancers; Radiation Therapy in the Treatment of Cancer of the Cervix; Role of Interstitial Implantation in Gynecological Cancer; Role of Radiocolloids in Gynecological Cancer; Radiosensitizers and Protectors; and Management of Lymphoma Associated with Pregnancy

  3. Dermatoglyphic patterns on fingers and gynecological cancers.

    Science.gov (United States)

    Abbasi, Sakineh; Rasouli, Mina

    2018-03-01

    Fingerprints have so far been used for determining the basis of certain malignant diseases, with positive outcomes. Considering the high rates of cancer-related mortality in Iran, this study was conducted for the purpose of examining the dermatoglyphic pattern of fingers in patients with gynecological cancers as compared to healthy people. The present study was conducted on 151 women with gynecological cancers as the case group and 152 healthy women with no history of such cancers as control group. The dematographic details of participants from both control and case groups were collected using a checklist, and the pattern of their fingerprints was prepared and examined. The data were analyzed for their significance using chi-square test and t- test. Odds ratio with 95% confidence intervals were calculated. Dermatoglyphic analysis showed that arch and loop patterns significantly changed in cases group as compared to control. However, the odds ratio suggested that loop pattern in 6 or more fingers might be a risk factor for developing gynecological cancers. Our results showed that there is an association between fingerprint patterns and gynecological cancers and so, dermatoglyphic analysis may aid in the early diagnosis of these cancers. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Diagnostic and interventional radiology in gynecologic neoplasms

    International Nuclear Information System (INIS)

    Thorvinger, B.

    1990-05-01

    The role and clinical value of the modern radiologic methods for evaluation of gynecologic tumors is not finally settled. The aims of our investigation were therefore to compare clinical examination with CT in patients with possible recurrence of cervical carcinoma; to evaluate the usefulness of CT in patients with fistulas following gynecologic tumors or their treatment; to evaluate the ability of transabdominal US and MR imaging in intrauterine staging including myometrial invasion on patients with endometrial carcinoma; to evaluate CT in the capacity of monitoring therapy response, probable recurrence or clinical remission in patients with ovarian carcinoma; and to evaluate the effect of intraarterial occlusion in facilitating surgery and in evaluating the role of the intraarterial infusion in gynecologic tumors otherwise refractory to all therapy given. CT was more accurate (91%) than clinical pelvic examination (78%) in revealing extensive disease after radiation and/ or surgical treatment. CT was also a most valuable tool in demonstrating genital fistulas following gynecologic malignancy or its treatment. Transabdominal US did not improve staging in early endometrila carcinoma while MR had potential for delineating intrauterine tumor growth (accuracy for myometrial invasion 95%). CT was most valuable in the evaluation of therapeutic response of ovarian malignancy. For possible recurrence or in clinical remission, only positive CT was of clinical significance. The potentials of transcatheter intraarterial management in order to facilitate operability are also discussed. (92 refs.)

  5. The clinical impact of gynecologic MRI.

    Science.gov (United States)

    Ratner, Elena S; Staib, Lawrence H; Cross, Sarah N; Raji, Rhoda; Schwartz, Peter E; McCarthy, Shirley M

    2015-03-01

    OBJECTIVE. This study assessed the clinical impact of pelvic MRI performed after the diagnosis of an indeterminate pelvic mass on ultrasound or CT. MATERIALS AND METHODS. The radiologic records of 567 patients who underwent pelvic MRI at our hospital from 2004 to 2006 were reviewed. Of these patients, 214 patients underwent pelvic MRI for evaluation of a gynecologic mass detected on a preceding ultrasound or CT examination; this group of patients constituted the basis of our study. The imaging and clinical records from the database were used for our analysis. The medical records were reviewed for the impact of the radiologic findings on patient treatment, and the results were tabulated for the findings of the first modality, whether the first modality provided a diagnosis, what management plan would be made according to the first modality, and what management plan would be made as a result of the MRI. The adequacy of the imaging study was assessed on the basis of either obtaining an accurate exact diagnosis or ascertaining at the minimum whether the mass was benign or malignant. Further endpoints included specificity and sensitivity of the individual modalities in the diagnosis of a specific gynecologic mass and whether clinical management was altered. Exact binomial CIs were computed for individual proportions. RESULTS. The clinical management of the patient was altered as a result of MRI in 77% of the cases (CI = 0.70-0.82). Surgery was avoided in 36% (CI = 0.29-0.43), and surgery was changed to a more appropriate method (laparoscopy vs laparotomy, involvement or not of a gynecologic oncologist) in an additional 17% (CI = 0.12-0.23). CONCLUSION. Without having undergone MRI, many of the women and girls in this study would have undergone unnecessary surgery; a more costly type of surgery; or long-term follow-up with the associated financial costs, personal and physical costs, and mental costs from the resultant anxiety of an unresolved indeterminate mass.

  6. First-degree AV block-an entirely benign finding or a potentially curable cause of cardiac disease?

    Science.gov (United States)

    Holmqvist, Fredrik; Daubert, James P

    2013-05-01

    First-degree atrioventricular (AV) block is a delay within the AV conduction system and is defined as a prolongation of the PR interval beyond the upper limit of what is considered normal (generally 0.20 s). Up until recently, first-degree AV block was considered an entirely benign condition. In fact, some complain that it is a misnomer since there is only delay and no actual block in the AV conduction system (usually within the AV node). However, it has long been acknowledged that extreme forms of first-degree AV block (typically a PR interval exceeding 0.30 s) can cause symptoms due to inadequate timing of atrial and ventricular contractions, similar to the so-called pacemaker syndrome. Consequently, the current guidelines state that permanent pacemaker implantation is reasonable for first-degree AV block with symptoms similar to those of pacemaker syndrome or with hemodynamic compromise, but also stresses that there is little evidence to suggest that pacemakers improve survival in patients with isolated first-degree AV block. Recent reports suggest that it may be time to revisit the impact of first-degree AV block. Also, several findings in post hoc analyses of randomized device trials give important insights in possible treatment options. The present review aims to provide an update on the current knowledge concerning the impact of first-degree AV block and also to address the issue of pacing in patients with this condition. ©2013, Wiley Periodicals, Inc.

  7. The possible role of tumor antigen CA 15-3, CEA and ferritin in malignant and benign disease

    Directory of Open Access Journals (Sweden)

    Nafija Serdarević

    2012-09-01

    Full Text Available Introduction: Serum CA15-3 has been one of the most reliable tumor markers used in monitoring of breast cancer patients. To increase its sensitivity, the combined measurement of other tumor markers (CEA and ferritin with CA15-3 was investigated. The aim of this study was determination of CA 15-3, CEA and ferritin in female patients with breast cancer, lung cancer and mastitisMethods: 300 patients with carcinoma, hospitalized at Department of Gynecologic Oncology and Department for Oncology at the University Clinics Center of Sarajevo and 200 healthy subjects were compared.Results: In patients with breast cancer the mean value of tumor markers were CEA 155.61 ng/mL, CA 15-3 106.38 U/mL and ferritin 197.03 ng/mL. In patients with lung cancer CEA was 58.97 ng/ml, CA 15-3 40.62 U/mL and ferritin 544.16 ng/mL. Patients with mastitis had CEA 5.17 ng/mL, CA 15-3 112.67 U/mL and ferritin 174.92 ng/mL. The control group had values of tumor markers CEA 1.62 ng/mL, CA 15-3 11.72 U/mL and ferritin 85.35 ng/mL. We found good correlation between CA 15-3 and CEA correlation coeffi cient was r = 0.750. There was a low correlation between CA 15-3 and ferritin with correlation coeffi cient r = 0.274.Conclusions: The CA 15-3 and CEA are useful markers in patients with confi rmed diagnosis of breast and lung cancers. The ferritin concentration has not increased in patients with breast cancer but it increased inlung patients. The future study has to make investigations of tumor markers and ferritin in different stage of breast cancer.

  8. Lipomatosis simétrica benigna de la lengua en la enfermedad de Madelung Benign symmetric lipomatosis of the tongue in Madelung’s disease

    Directory of Open Access Journals (Sweden)

    A. López Ceres

    2006-04-01

    Full Text Available La enfermedad de Madelung, o lipomatosis simétrica benigna es una enfermedad rara caracterizada por acúmulos grasos no encapsulados localizados de forma simétrica alrededor de cuello y hombros. Esta enfermedad, afecta predominantemente a hombres en edades comprendidas entre los 30 y 60 años, con una relación hombre:mujer de 15:1. Existe una gran relación con el abuso del alcohol. Las personas no alcohólicas y las mujeres también pueden verse afectadas, aunque de forma más rara. Presentamos el caso de una mujer diagnosticada de Enfermedad de Madelung refiriendo engrosamiento progresivo de la lengua. Presentaba dificultad para tragar, disartria y disnea con el decúbito.Madelung´s disease, or benign symmetric lipomatosis, is an uncommon disease characterized by non-encapsulated accumulations of fat in a symmetric manner around the neck and shoulders. This uncommon disease predominantly affects men between the ages of 30 and 60 and it has a 15:1 ratio. There is a strong correlation with alcohol abuse. Nonalcoholics and women can also be affected although this is rare. We report the case of a woman diagnosed with Madelung’s disease, who described a gradual swelling of the tongue. She had difficulty swallowing, dysarthria and dyspnea while sleeping.

  9. The diagnostic value of transvaginal color Doppler ultrasound in obstetrical and gynecological emergency

    International Nuclear Information System (INIS)

    Mai Caitian; Su Xiaowei; Lin Meifang

    2007-01-01

    Objective: To investigate the diagnostic value of transvaginal color Doppler ultrasound in obstetrical and gynecological emergency. Methods: Cases of all kinds of obstetrical and gynecological emergency diseases diagnosed and managed in out hospital from 2003 to 2005 were included. Transvaginal color Doppler sonogr aphic findings, clinical treatments, pathologic results were followed up and analyzed. Results: Accurate diagnosis was made in 194 of 201 cases (96.5%), False diagnostic rate is 3.5%. Conclusion: Transvaginal color Doppler ultrasound may give precise diagnosis for the obstetrical and gynecological emergency diseases. It is the preferred auxiliary method for the diagnosis of gynecological emergency diseases. (authors)

  10. The principles and practice of ultrasonography in obstetrics and gynecology

    International Nuclear Information System (INIS)

    Sanders, R.C.; James, A.E.

    1985-01-01

    This is the latest edition of a reference on diagnostic ultrasound in obstetrics and gynecology. Chapters have been added on infertility, legal aspects of ultrasound, and interventional techniques. Descriptions of instrumentation, physics and bioeffects, measurement data and normal anatomy in the fetus are given. There is a section on fetal anomalies and the investigation and management of various obstetrical problems, such as multiple pregnancy and hydatidiform mole. Coverage of gynecological ultrasound includes normal pelvic anatomy, pelvic masses, pelvic inflammatory disease, and breast evaluation

  11. Vacuum-assisted breast biopsy: A comparison of 11-gauge and 8-gauge needles in benign breast disease

    Directory of Open Access Journals (Sweden)

    Kraemer Bernhard

    2008-05-01

    Full Text Available Abstract Background Minimal invasive breast biopsy is standard care for the diagnosis of suspicious breast lesions. There are different vacuum biopsy (VB systems in use. The aim of the study was to determine the differences between the 8-gauge and the 11-gauge needle with respect to a diagnostic reliability, b complication rate and c subjective perception of pain when used for vacuum-assisted breast biopsy. Methods Between 01/2000 and 09/2004, 923 patients at St. Josefs-Hospital Wiesbaden underwent VB using the Mammotome® (Ethicon Endosurgery, Hamburg. Depending on preoperative detection, the procedure was performed under sonographic or mammographic guidance under local anaesthesia. All patients included in the study were followed up both clinically and using imaging techniques one week after the VB and a second time after a median of 41 months. Excisional biopsy on the ipsilateral breast was an exclusion criteria. Subjective pain scores were recorded on a scale of 0 – 10 (0 = no pain, 10 = unbearable pain. The mean age of the patients was 53 years (30 – 88. Results 123 patients were included in the study in total. 48 patients were biopsied with the 8-gauge needle and 75 with the 11-gauge needle. The use of the 8-gauge needle did not show any significant differences to the 11-gauge needle with regard to diagnostic reliability, complication rate and subjective perception of pain. Conclusion Our data show that there are no relevant differences between the 8-gauge and 11-gauge needle when used for VB. Under sonographic guidance, the use of the 8-gauge needle is recommended for firm breast tissue due to its sharp scalpel point and especially for complete removal of benign lesions. We did not find any advantages in the use of the larger 8-gauge needle compared to the 11-gauge needle in the mammography setting. The utilisation costs of the 8-gauge needle are somewhat higher.

  12. Vacuum-assisted breast biopsy: A comparison of 11-gauge and 8-gauge needles in benign breast disease

    Science.gov (United States)

    Hahn, Markus; Okamgba, Stella; Scheler, Peter; Freidel, Klaus; Hoffmann, Gerald; Kraemer, Bernhard; Wallwiener, Diethelm; Krainick-Strobel, Ute

    2008-01-01

    Background Minimal invasive breast biopsy is standard care for the diagnosis of suspicious breast lesions. There are different vacuum biopsy (VB) systems in use. The aim of the study was to determine the differences between the 8-gauge and the 11-gauge needle with respect to a) diagnostic reliability, b) complication rate and c) subjective perception of pain when used for vacuum-assisted breast biopsy. Methods Between 01/2000 and 09/2004, 923 patients at St. Josefs-Hospital Wiesbaden underwent VB using the Mammotome® (Ethicon Endosurgery, Hamburg). Depending on preoperative detection, the procedure was performed under sonographic or mammographic guidance under local anaesthesia. All patients included in the study were followed up both clinically and using imaging techniques one week after the VB and a second time after a median of 41 months. Excisional biopsy on the ipsilateral breast was an exclusion criteria. Subjective pain scores were recorded on a scale of 0 – 10 (0 = no pain, 10 = unbearable pain). The mean age of the patients was 53 years (30 – 88). Results 123 patients were included in the study in total. 48 patients were biopsied with the 8-gauge needle and 75 with the 11-gauge needle. The use of the 8-gauge needle did not show any significant differences to the 11-gauge needle with regard to diagnostic reliability, complication rate and subjective perception of pain. Conclusion Our data show that there are no relevant differences between the 8-gauge and 11-gauge needle when used for VB. Under sonographic guidance, the use of the 8-gauge needle is recommended for firm breast tissue due to its sharp scalpel point and especially for complete removal of benign lesions. We did not find any advantages in the use of the larger 8-gauge needle compared to the 11-gauge needle in the mammography setting. The utilisation costs of the 8-gauge needle are somewhat higher. PMID:18489771

  13. Diagnostic Ultrasound in Gynecologic Diagnosis

    OpenAIRE

    Coates, C. F.

    1983-01-01

    Diagnostic ultrasound is helpful in the assessment of many common gynecological conditions from early teens to the late postmenopause. Female pelvic anatomy and pathology are readily imaged through a distended urinary bladder. In gynecologic cancer, examination of peritoneal cavity, kidneys and liver can suggest metastatic spread, which aids tumor staging.

  14. Incidental Gynecologic Tract Neoplasms in Women Undergoing Anterior Pelvic Exenteration for Urothelial Carcinoma.

    Science.gov (United States)

    Tran, Lily; Antic, Tatjana; Lastra, Ricardo R

    2017-12-18

    Urothelial carcinoma (UC) invasive into the muscularis propria or tumors unresponsive to treatment are indications for cystectomy. In females, with the goal of achieving complete cancer eradication and for concerns of UC extension into the adjacent pelvic organs, this may also warrant resection of the gynecologic organs. This study is aimed to assess the prevalence of unanticipated gynecologic neoplasms in anterior pelvic exenteration specimens. A retrospective review of pathology reports to identify women undergoing anterior pelvic exenteration for UC was performed (N=221), and incidentally discovered gynecologic tract neoplasms were recorded. Concomitant malignant or premalignant lesions of the gynecologic tract were identified in 8 patients (3.6%). These included endometrial adenocarcinoma [endometrioid type, International Federation of Gynecology and Obstetrics grade 1 (n=2, 0.9%)], cervical high-grade squamous intraepithelial lesion (n=2, 0.9%), Sertoli-Leydig cell tumor of intermediate differentiation (n=1, 0.5%), endometrioid adenocarcinoma of the ovary (n=1, 0.5%), and high-grade serous carcinoma of the ovary (n=1, 0.5%) and fallopian tube (n=1, 0.5%). Benign uterine neoplasms included leiomyomas (n=81, 37%), adenomyoma (n=3, 1.4%), and adenomatoid tumors (n=2, 0.9%). Benign ovarian neoplasms included serous cystadenoma (n=7, 3%), serous cystadenofibroma (n=4, 2%), benign Brenner tumor (n=5, 2.3%), mature teratoma (n=4, 2%), stromal luteoma (n=2, 0.9%), mucinous cystadenoma (n=1, 0.5%), thecoma (n=1, 0.5%), and endometrioid cystadenoma (n=1, 0.5%). Involvement of the gynecologic tract by UC was identified in 11 patients (5%). Spread of UC to the reproductive organs is rare in anterior pelvic exenteration specimens. Coexisting neoplasms of the gynecologic tract are occasionally identified, therefore careful evaluation of these organs is necessary.

  15. Doppler ultrasound in obstetrics and gynecology. 2. rev. and enl. ed.

    International Nuclear Information System (INIS)

    Maulik, D.

    2005-01-01

    The second edition of Doppler Ultrasound in Obstetrics and Gynecology has been expanded and comprehensively updated to present the current standards of practice in Doppler ultrasound and the most recent developments in the technology. Doppler Ultrasound in Obstetrics and Gynecology encompasses the full spectrum of clinical applications of Doppler ultrasound for the practicing obstetrician-gynecologist, including the latest advances in 3D and color Doppler and the newest techniques in 4D fetal echocardiography. Written by preeminent experts in the field, the book covers the basic and physical principles of Doppler ultrasound; the use of Doppler for fetal examination, including fetal cerebral circulation; Doppler echocardiography of the fetal heart; and the use of Doppler for postdated pregnancy and in cases of multiple gestation. Chapters on the use of Doppler for gynecologic investigation include ultrasound in ectopic pregnancy, for infertility, for benign disorders and for gynecologic malignancies. (orig.)

  16. Doppler ultrasound in obstetrics and gynecology. 2. rev. and enl. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Maulik, D. [Winthrop Univ. Hospital, Mineola, NY (United States). Dept. of Obstetrics and Gynecology; Zalud, I. (eds.) [Kapiolani Medical Center for Women and Children, Honolulu, HI (United States)

    2005-07-01

    The second edition of Doppler Ultrasound in Obstetrics and Gynecology has been expanded and comprehensively updated to present the current standards of practice in Doppler ultrasound and the most recent developments in the technology. Doppler Ultrasound in Obstetrics and Gynecology encompasses the full spectrum of clinical applications of Doppler ultrasound for the practicing obstetrician-gynecologist, including the latest advances in 3D and color Doppler and the newest techniques in 4D fetal echocardiography. Written by preeminent experts in the field, the book covers the basic and physical principles of Doppler ultrasound; the use of Doppler for fetal examination, including fetal cerebral circulation; Doppler echocardiography of the fetal heart; and the use of Doppler for postdated pregnancy and in cases of multiple gestation. Chapters on the use of Doppler for gynecologic investigation include ultrasound in ectopic pregnancy, for infertility, for benign disorders and for gynecologic malignancies. (orig.)

  17. [The assessment of the dependence between antigen CA 125 and nicotinism in patients with benign ovarian tumors including endometrial cysts].

    Science.gov (United States)

    Posadzka, Ewa; Jach, Robert; Babczyk, Dorota; Knafel, Anna; Pityński, Kazimierz

    2014-01-01

    Cancer antigen CA-125 is a marker that is primarily used to differentiate benign from malignant tumors as well as to monitor response to ovarian cancer treatment. Taken as a separate marker, it displays low sensitivity and specificity in ovarian cancer diagnosis; however, in combination with other markers it may be successfully applied especially in postmenopausal women. Elevated CA-125 levels in blood serum indicate cancerous as well as non-cancerous diseases. Research aiming to determine environmental factors that may have influence on antigen CA-125 level, and thus on the assessment of this marker's application in gynecological and oncological diseases continues. the aim of the present research is an attempt to estimate the influence of nicotinism on antigen CA-125 in blood serum in patients with diagnosed benign ovarian tumors including endometrial cysts. 174 women aged 16-85 years with diagnosed benign ovarian tumor were qualified for the study. In all patients level of antigen CA-125 in blood serum was assessed preoperatively and nicotinism history was taken. Also transvaginal ultrasound was performed to obtain preliminary diagnosis. Smoking and non-smoking patients were classified into two groups, namely of those with histopathologically confirmed cysts of endometrial type and those with non-endometrial benign ovarian tumors. statistical analysis did not prove any dependence between the CS-125 antigen level and nicotinism in any of these groups. Also additional analysis with division into premenopausal and postmenopausal patients did not determine any statistically significant dependence. Nicotinism does not significantly influence the CA-125 antigen level in patients with benign However, the connection between the addiction severity and its influence on antigen CA-125 in blood serum cannot be excluded. ovarian tumors or endometrial cysts.

  18. Intention to Seek Care for Symptoms Associated With Gynecologic Cancers, HealthStyles Survey, 2008

    OpenAIRE

    Trivers, Katrina F.; Rodriguez, Juan L.; Hawkins, Nikki A.; Polonec, Lindsey; Gelb, Cynthia A.; Purvis Cooper, Crystale

    2011-01-01

    Introduction Women with ovarian cancer typically experience symptoms before diagnosis; such symptoms for other gynecologic cancers have not been systematically studied. We investigated which symptoms of gynecologic cancers prompt intention to seek care among women and whether demographic differences in intention exist. This study was undertaken, in part, to inform development of the Centers for Disease Control and Prevention's campaign, Inside Knowledge: Get the Facts About Gynecologic Cancer...

  19. Endosonography of benign myometrium cysts and cyst-like lesions.

    Science.gov (United States)

    Youssef, Ashraf Talaat

    2015-09-01

    Many pathological causes are responsible for the sonographic presentation of myometrium cysts and cyst-like lesions, where the distinction between these etiologies is required. The current work is aimed at discerning between different etiologies of myometrium cysts and cyst-like lesions for an optimum management. In the course of daily practice of gynecological transvaginal ultrasound, 66 cases of myometrium cysts and cyst-like lesions have been discerned, where all were examined with endovaginal ultrasound using a multifrequency endocavitary probe having color Doppler capability. Adenomyosis uteri detected in 15 cases, invasive mole in 4 cases, congested arcuate veins in 20 cases, incidental cysts in 4 cases, cystic degeneration of myoma in 3 cases, C-section scar cysts and cyst-like lesions in 13 cases, interstitial ectopic pregnancy in 2 cases, incomplete abortion with congested myometrium vessels in 4 cases, and arteriovenous malformation in 1 case. The number of cases with cervical nabothian cysts was not considered since they were too frequent. Endosonography is an important tool in differentiating between the various diseases that are responsible for benign myometrium cysts and cyst-like lesions, which are all important since some of them are visualized as serious clinical situations and others turn out to be of little clinical significance.

  20. Robotic Surgery in Gynecologic Oncology

    Science.gov (United States)

    DeBernardo, Robert; Starks, David; Barker, Nichole; Armstrong, Amy; Kunos, Charles A.

    2011-01-01

    Robotic surgery for the management of gynecologic cancers allows for minimally invasive surgical removal of cancer-bearing organs and tissues using sophisticated surgeon-manipulated, robotic surgical instrumentation. Early on, gynecologic oncologists recognized that minimally invasive surgery was associated with less surgical morbidity and that it shortened postoperative recovery. Now, robotic surgery represents an effective alternative to conventional laparotomy. Since its widespread adoption, minimally invasive surgery has become an option not only for the morbidly obese but for women with gynecologic malignancy where conventional laparotomy has been associated with significant morbidity. As such, this paper considers indications for robotic surgery, reflects on outcomes from initial robotic surgical outcomes data, reviews cost efficacy and implications in surgical training, and discusses new roles for robotic surgery in gynecologic cancer management. PMID:22190946

  1. Inner Ear Disease and Benign Paroxysmal Positional Vertigo: A Critical Review of Incidence, Clinical Characteristics, and Management

    Directory of Open Access Journals (Sweden)

    M. Riga

    2011-01-01

    Full Text Available Background. This study is a review of the incidence, clinical characteristics, and management of secondary BPPV. The different subtypes of secondary BPPV are compared to each other, as well as idiopathic BPPV. Furthermore, the study highlights the coexistence of BPPV with other inner ear pathologies. Methods. A comprehensive search for articles including in the abstract information on incidence, clinical characteristics, and management of secondary BPPV was conducted within the PubMed library. Results. Different referral patterns, different diagnostic criteria used for inner ear diseases, and different patient populations have led to greatly variable incidence results. The differences regarding clinical characteristics and treatment outcomes may support the hypothesis that idiopathic BPPV and the various subtypes of secondary BPPV do not share the exact same pathophysiological mechanisms. Conclusions. Secondary BPPV is often under-diagnosed, because dizziness may be atypical and attributed to the primary inner ear pathology. Reversely, a limited number of BPPV patients may not be subjected to a full examination and characterized as idiopathic, while other inner ear diseases are underdiagnosed. A higher suspicion index for the coexistence of BPPV with other inner ear pathologies, may lead to a more integrated diagnosis and consequently to a more efficient treatment of these patients.

  2. Geographic access to gynecologic cancer care in the United States.

    Science.gov (United States)

    Shalowitz, David I; Vinograd, Alexandra M; Giuntoli, Robert L

    2015-07-01

    Women who live distant from the closest subspecialty treatment center are at risk of failing to utilize high-quality care for gynecologic cancers. There has not yet been a comprehensive, national investigation of populations affected by geographic barriers to gynecologic cancer care. Geographic Information Systems (GIS) were used to identify United States counties farther than 50miles from the closest gynecologic oncologist, and hospital referral regions (HRRs) that do not contain the primary professional address of at least one gynecologic oncologist. US Census data were used to analyze counties' demographic characteristics. County-level cancer incidence was estimated using the Centers for Disease Control and Prevention's State Cancer Profiles. Thirty-six percent (1125/3143) of counties are further than 50miles from the nearest gynecologic oncologist. A total of 14.8 million women live in low-access counties (LACs). Annually, approximately 7663 women with gynecologic cancers may experience geography-related disparities in access. Residents of LACs have lower median household income, are more likely to be White and/or Hispanic, and less likely to be Black. Forty percent (123/306) of HRRs do not contain the primary address of a gynecologic oncologist. Approximately 9% of the female population of the United States may experience geographic barriers to access high-quality care for gynecologic malignancies. Future investigations should assess whether residents of low-access counties utilize high-quality care less often, and whether there is a disparity in clinical outcomes. Disparities might be addressed by ensuring subspecialty care in low-access regions, and/or adjusting system structures to minimize the burdens of traveling long distances for cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. A modified three-port “hidden scars” surgical approach in gynecology: A surgeon's experience of an initial 72 cases

    Directory of Open Access Journals (Sweden)

    Felix Wu Shun Wong

    2014-05-01

    Conclusion: The HS approach in gynecological surgery is feasible, safe, and reproducible when applied in women with gynecological diseases. The operation time, length of stay, and outcome would be comparable to conventional laparoscopic surgery.

  4. Detection of serous precursor lesions in resected fallopian tubes from patients with benign diseases and a relatively low risk for ovarian cancer.

    Science.gov (United States)

    Nishida, Naoyo; Murakami, Fumihiro; Higaki, Koichi

    2016-06-01

    The frequency of ovarian cancers in Japan has increased; however, doubts have been raised concerning the mechanism by which high-grade serous adenocarcinomas (HGSCs) arise. Conventionally, HGSC is thought to originate from the ovarian surface epithelium or epithelial inclusion cyst. However, recent data indicate that HGSCs may in fact develop from precursor lesions in the fallopian tube, including epithelia with a p53 signature, serous tubal intraepithelial carcinomas (STICs), secretory cell outgrowths (SCOUTs), and tubal intraepithelial lesions in transition (TILT). Here, we determined the frequency of these fallopian tube precursors in surgically excised samples from 123 patients with benign pelvic diseases. We identified 12 cases with a p53 signature (9.7%), 26 with observable SCOUTs (21.1%), and 4 with TILT (3.2%), but no STIC cases. Although the lifetime risk for developing ovarian cancer is only around 1.4% for women without germ-line mutations, it is important to evaluate the presence of precursor lesions to understand HGSC pathogenesis better. Taken together, salpingectomy appears to be an option for women who are past their childbearing age and plan to undergo elective pelvic surgery. To our knowledge, this is the first study to investigate the presence of these specific precursors post-salpingectomy in low-risk patients. © 2016 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.

  5. Peculiarities of systemic violations in patients with genital endometriosis in combination with benign diseases of genitalia and syndrome of chronic pelvic pain

    Directory of Open Access Journals (Sweden)

    Grek L.P.

    2017-12-01

    Full Text Available The aim of the work is determination of intercommunication of cytokines ІL-10, ІL-6 levels, TNF-α with subjective estimation of pain, processes of the nervous system desadaptation in patients with genital endometriosis in combination with benign hormonal pathology of the genitalia followed by chronic pelvic pain (CPP. There were 120 women in research divided into several groups, depending on visual analogue scale (VAS and durations of disease: 1st group (n=44, VAS was 7-10 points; 2-d group (n=41 VAS – 4-6 points; 3-d group (n=35 VAS – 0-3 points. Along with progress of CPP there was marked decline of cytokines ІL-10, and increase of ІL-6, TNF -α comparatively with 3-d group (р<0,05; this correlated with the higher points of intensity of pain syndrome in the 1st group, with pain anamnesis duration and increased level of anxiety and depression. Imbalance of cytokines towards the proinflammatory link in definite clinical provoking factors of pain can be considered as a predictor of CPP.

  6. Analysis of Patients with Myelopathy due to Benign Intradural Spinal Tumors with Concomitant Lumbar Degenerative Diseases Misdiagnosed and Erroneously Treated with Lumbar Surgery.

    Science.gov (United States)

    Lu, Kang; Wang, Hao-Kuang; Liliang, Po-Chou; Yang, Chih-Hui; Yen, Cheng-Yo; Tsai, Yu-Duan; Chen, Po-Yuan; Chye, Cien-Leong; Wang, Kuo-Wei; Liang, Cheng-Loong; Chen, Han-Jung

    2017-09-01

    When a cervical or thoracic benign intradural spinal tumor (BIST) coexists with lumbar degenerative diseases (LDD), diagnosis can be difficult. Symptoms of BIST-myelopathy can be mistaken as being related to LDD. Worse, an unnecessary lumbar surgery could be performed. This study was conducted to analyze cases in which an erroneous lumbar surgery was undertaken in the wake of failure to identify BIST-associated myelopathy. Cases were found in a hospital database. Patients who underwent surgery for LDD first and then another surgery for BIST removal within a short interval were studied. Issues investigated included why the BISTs were missed, how they were found later, and how the patients reacted to the unnecessary lumbar procedures. Over 10 years, 167 patients received both surgeries for LDD and a cervical or thoracic BIST. In 7 patients, lumbar surgery preceded tumor removal by a short interval. Mistakes shared by the physicians included failure to detect myelopathy and a BIST, and a hasty decision for lumbar surgery, which soon turned out to be futile. Although the BISTs were subsequently found and removed, 5 patients believed that the lumbar surgery was unnecessary, with 4 patients expressing regrets and 1 patient threatening to take legal action against the initial surgeon. Concomitant symptomatic LDD and BIST-associated myelopathy pose a diagnostic challenge. Spine specialists should refrain from reflexively linking leg symptoms and impaired ability to walk to LDD. Comprehensive patient evaluation is fundamental to avoid misdiagnosis and wrong lumbar surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Evaluation of quality of life pre- and post-vestibular rehabilitation in patients with benign paroxysmal positional vertigo associated with Meniere's disease

    Directory of Open Access Journals (Sweden)

    Azzi, Viviane Jacintha Bolfe

    2012-01-01

    Full Text Available Introduction: Vertigo is a symptom that impacts the patients' quality of life and may force them to cease performing activities of daily living. Here, we discuss benign paroxysmal positional vertigo (BPPV and Meniere's disease (MD, which show exacerbated symptoms when they appear in association. Vestibular rehabilitation (VR is an effective treatment in reducing vertigo, especially in conjunction with other therapies. Aim: To evaluate the quality of life of patients with BPPV and MD before and after VR. Method: We conducted a descriptive observational qualitative and quantitative case study with 12 patients aged 35 to 86 years. All patients diagnosed with BPPV and MD received treatment in the ENT clinic. The Brazilian DHI questionnaire, which assesses the quality of life with a focus on physical, emotional, and functional aspects, was used for data collection, and was completed by patients before the first session and after the fifth session of VR. Data were tested using the Shapiro-Wilk normality test, followed by Wilcoxon, Friedman, and Spearman correlation tests (p < 0.05. Results: There were significant improvements in scores for all aspects, with median changes ranging from 12 to 0 in the physical, 6 to 1 in the emotional, and 11 to 1 in the functional aspect. There were no correlations between the scores and sample characteristics. Conclusion: VR was an effective method for the treatment of patients with BPPV and MD; it improves quality of life and shows the maximal influence on physical aspect scores, regardless of age or gender.

  8. Radiation therapy of benign diseases: patterns of care study in Germany; Strahlentherapie von gutartigen Erkrankungen: eine Bestandsaufnahme fuer Deutschland

    Energy Technology Data Exchange (ETDEWEB)

    Seegenschmiedt, M.H. [Alfried Krupp Krankenhaus Essen (Germany). Klinik fuer Radioonkologie, Strahlentherapie und Nuklearmedizin; Katalinic, A. [Erlangen-Nuernberg Univ., Erlangen (Germany). Inst. fuer Medizinische Statistik und Dokumentation; Makoski, H.B. [Staedtische Kliniken Duisburg (Germany). Strahlenklinik; Haase, W. [St. Vincentius Krankenhaus Karlsruhe (Germany). Klinik fuer Radioonkologie und Strahlentherapie; Gademann, G. [Magdeburg Univ. (Germany). Klinik fuer Strahlentherapie; Hassenstein, E. [Krankenhaus Nordwest, Frankfurt am Main (Germany). Radioonkologische Klinik

    1999-11-01

    A questionnaire was mailed in 3 years (1994, 1995, 1996) to all radiation facilities in Germany, which assessed equipment, indications, number of patients and treatment concepts. A total of 134 (88%) institutions returned all requested data: 22 in East and 112 in West Germany; 30 in university and 104 in community/private hospitals. The average data of each institution and of all institutions were analyzed for frequencies and ratios between different regions and institutions. A mean of 2 (range 1 to 7) megavoltage (Linac/Cobalt 60) and 1.4 (range 0 to 4) orthovoltage units were available per institution; 32 (24%) institutions had no orthovoltage equipment. A mean of 20,082 patients were treated per year: 456 (2%) for inflammatory diseases (221 hidradenitis, 78 nail bed infection, 23 parotitis, 134 not specified), 12,600 (63%) for degenerative diseases (2,711 peritendinitis humeroscapularis, 1,555 epicondylitis humeri, 1,382 heel spur, 2,434 degenerative osteoarthritis, 4,518 not specified), 927 (5%) for hypertrophic diseases (146 Dupuytren's contracture, 382 keloids, 155 Peyronie's disease, 244 not specified), 1,210 (6%) for functional disorders (853 Graves' orbitopathy, 357 not specified), and 4,889 (24%) for other disorders (e.g. 3,680 heterotopic ossification prophylaxis). In univariate analysis, there were significant geographical (West vs East Germany) differences in the use of radiotherapy for inflammatory and degenerative disorders and institutional differences (university vs community/private hospitals) in the use of radiotherapy for hypertrophic and functional disorders (p<0.05). The prescribed dose concepts were mostly in the low dose range (<10 Gy), but varied widely and inconsistently within geographic regions and institution types. (orig./MG) [German] 1994, 1995 und 1996 wurde an alle strahlentherapeutischen Institutionen in Deutschland ein Fragebogen verschickt, mit dem technische Ausstattung, Indikationsspektrum, Patientenzahl und

  9. Benign prostate hyperplasia (BPH) - resources

    Science.gov (United States)

    Resources - benign prostatic hyperplasia (BPH); Prostate enlargement resources; BPH resources ... The following organizations provide information on benign prostatic hyperplasia ( prostate enlargement ... Urology Care Foundation -- www. ...

  10. Gynecologic electrical impedance tomograph

    Science.gov (United States)

    Korjenevsky, A.; Cherepenin, V.; Trokhanova, O.; Tuykin, T.

    2010-04-01

    Electrical impedance tomography extends to the new and new areas of the medical diagnostics: lungs, breast, prostate, etc. The feedback from the doctors who use our breast EIT diagnostic system has induced us to develop the 3D electrical impedance imaging device for diagnostics of the cervix of the uterus - gynecologic impedance tomograph (GIT). The device uses the same measuring approach as the breast imaging system: 2D flat array of the electrodes arranged on the probe with handle is placed against the body. Each of the 32 electrodes of the array is connected in turn to the current source while the rest electrodes acquire the potentials on the surface. The current flows through the electrode of the array and returns through the remote electrode placed on the patient's limb. The voltages are measured relative to another remote electrode. The 3D backprojection along equipotential surfaces is used to reconstruct conductivity distribution up to approximately 1 cm in depth. Small number of electrodes enables us to implement real time imaging with a few frames per sec. rate. The device is under initial testing and evaluation of the imaging capabilities and suitability of usage.

  11. Enhanced discrimination of malignant from benign pancreatic disease by measuring the CA 19-9 antigen on specific protein carriers.

    Directory of Open Access Journals (Sweden)

    Tingting Yue

    Full Text Available The CA 19-9 assay detects a carbohydrate antigen on multiple protein carriers, some of which may be preferential carriers of the antigen in cancer. We tested the hypothesis that the measurement of the CA 19-9 antigen on individual proteins could improve performance over the standard CA 19-9 assay. We used antibody arrays to measure the levels of the CA 19-9 antigen on multiple proteins in serum or plasma samples from patients with pancreatic adenocarcinoma or pancreatitis. Sample sets from three different institutions were examined, comprising 531 individual samples. The measurement of the CA 19-9 antigen on any individual protein did not improve upon the performance of the standard CA 19-9 assay (82% sensitivity at 75% specificity for early-stage cancer, owing to diversity among patients in their CA 19-9 protein carriers. However, a subset of cancer patients with no elevation in the standard CA 19-9 assay showed elevations of the CA 19-9 antigen specifically on the proteins MUC5AC or MUC16 in all sample sets. By combining measurements of the standard CA 19-9 assay with detection of CA 19-9 on MUC5AC and MUC16, the sensitivity of cancer detection was improved relative to CA 19-9 alone in each sample set, achieving 67-80% sensitivity at 98% specificity. This finding demonstrates the value of measuring glycans on specific proteins for improving biomarker performance. Diagnostic tests with improved sensitivity for detecting pancreatic cancer could have important applications for improving the treatment and management of patients suffering from this disease.

  12. Operative outcomes of robot-assisted transaxillary thyroid surgery for benign thyroid disease: early experience in 50 patients.

    Science.gov (United States)

    Axente, Dan Damian; Silaghi, Horatiu; Silaghi, Cristina Alina; Major, Zsigmond Zoltán; Micu, Carmen Maria; Constantea, Nicolae Augustin

    2013-08-01

    The main benefits of robot-assisted transaxillary thyroid surgery are to overcome the technical limitations of other endoscopic procedures for this surgical pathology and to avoid any cervical skin incision. This article describes the first experience of a Romanian team with the endoscopic robot-assisted thyroid surgery. We used the da Vinci SI intuitive surgical system to carry out 50 thyroid operations: 33 unilateral total lobectomies with isthmectomy (TL), 8 unilateral total lobectomies, with contralateral subtotal lobectomy, and 9 total thyroidectomies. Preoperatively, the patients were diagnosed with nodular goiter in 42 cases, nodular autoimmune thyroiditis in 3 cases, Basedow disease in 2 cases, toxic thyroid adenoma in 2 cases, and diffuse goiter in 1 case. We analyzed the clinical characteristics, size and location of the nodules, surgery duration, postoperative complications, pain medication, histopathological findings and postoperative cosmetic results. All surgical procedures were carried out without major incidents. One case required conversion to open approach. The mean length of surgery was 159 ± 38.2 min and the average console time was 68 ± 39.9 min; postoperatively, we recorded one case of transient brachial plexus neurapraxia, one transient vocal cord paresis, one transient hypocalcemia, and four postoperative wound complications. The final histopathological examination revealed two cases of well-differentiated carcinoma. This paper reports the largest series to date in Southeast Europe about robot-assisted transaxillary thyroidectomy. On a group of selected Caucasian patients, postoperative results were similar to open cervicotomy in terms of postoperative complications. The major cosmetic advantage is the absence of scar in the anterior cervical region.

  13. Benign Liver Tumors

    Science.gov (United States)

    ... Legacy Society Make Gifts of Stock Donate Your Car Personal Fundraising Partnership & Support Share Your Story Spread the Word Give While You Shop Contact Us Donate Now Benign Liver Tumors Back ...

  14. Metronomic therapy for gynecologic cancers

    Directory of Open Access Journals (Sweden)

    Wen-Hsiang Su

    2012-06-01

    Full Text Available Systemic administration of cytotoxic drugs is the primary treatment strategy for patients with advanced cancer. The effect of cytotoxic drugs is to disrupt the DNA of the cells, rendering them unable to replicate and finally killing them; therefore, the fundamental role of a wide range of treatment regimens is typically to induce lethal toxicity in the largest possible number of cancer cells. However, these cytotoxic drugs also damage the normal cells of the host, which limits the dose of the cytotoxic drug. Thus, cancer patients are usually treated at or near the maximum tolerated dose with the implicit intent of eradicating (curing the tumor after balancing between efficacy in tumor killing and toxicity to the host. With significantly improving patient care, most efforts are focused on the corollary, “The higher the dose, the better.” However, the concept that cancer could be considered as a chronic disease and might be treated like other chronic diseases to achieve a status called tumor dormancy is gaining popularity. In addition, there has been increasing interest in putting more effort into administering cytotoxic drugs on a more continuous basis, with a much shorter break period, or none at all, and generally lower doses of various cytotoxic drugs or combinations with other newer, targeted therapies, like anti-angiogenesis agents. This practice has come to be known as metronomic chemotherapy. There is still much to be learned in this field, especially with regard to optimization of the proper drugs, dose, schedule, and tumor type applications. This review will explore recent studies that have addressed the mechanism of metronomic chemotherapy in the management of various tumors, especially gynecologic cancers.

  15. Genetics of Breast and Gynecologic Cancers (PDQ®)—Health Professional Version

    Science.gov (United States)

    Expert-reviewed information summary about the genetics of breast and gynecologic cancers, including information about specific genes and family cancer syndromes. The summary also contains information about interventions that may influence the risk of developing breast and gynecologic cancers in individuals who may be genetically susceptible to these diseases. Psychosocial issues associated with genetic testing are also discussed.

  16. The Lymphedema and Gynecologic Cancer (LEG) Study: Incidence, Risk Factors, and | Division of Cancer Prevention

    Science.gov (United States)

    DESCRIPTION (provided by applicant): The proposed study, Lymphedema and Gynecologic cancer (LEG): Incidence, Risk Factors and Impact, will innovatively utilize the cooperative group setting of the GOG (Gynecologic Oncology Group) to prospectively study 1300 women newly diagnosed with cervical, endometrial, or vulvar cancer to determine the incidence and impact of lower extremity lymphedema following surgical treatment of these diseases. |

  17. Enhanced Recovery Pathways in Gynecology and Gynecologic Oncology

    Science.gov (United States)

    Barber, Emma L; Van Le, Linda

    2015-01-01

    Importance Enhanced recovery programs (ERPs) are considered standard of care across a variety of surgical disciplines, but ERPs have not been widely adopted in gynecology. Objective To describe ERP principles and the role of ERPs in gynecology and gynecologic oncology. Evidence Acquisition Comprehensive literature search performed using MEDLINE, the Cochrane Collaboration Database, and PubMed. Results Meta-analyses of a substantial number of randomized-controlled trials have shown that implementation of ERP protocols is associated with decreased length of hospital stay, a decrease in rates of postoperative complication, decreased morbidity, and cost savings while preserving patient satisfaction and quality of life. Conclusions and Relevance High quality evidence exists for improved outcomes among patients in ERPs. ERPs save resources and costs across the health care system. As quality metrics and bundled payments increase in healthcare, ERPs will have increasing prominence. PMID:26676149

  18. Anti-hemorrhagic effect of prophylactic tranexamic acid in benign hysterectomy-a double-blinded randomized placebo-controlled trial

    DEFF Research Database (Denmark)

    Topsoee, Märta Fink; Bergholt, Thomas; Ravn, Pernille

    2016-01-01

    to benign hysterectomy is still missing. OBJECTIVE: To investigate the antihemorrhagic effect of prophylactic tranexamic acid in elective benign hysterectomy. STUDY DESIGN: A double-blinded randomized placebo-controlled trial was conducted at 4 gynecological departments in Denmark from April 2013 to October......BACKGROUND: Hysterectomy is one of the most frequently performed major gynecological surgical procedures. Even when the indication for the procedure is benign, relatively high complication rates have been reported. Perioperative bleeding seems to represent the most common cause of complications...

  19. Estimates of global research productivity in gynecologic oncology.

    Science.gov (United States)

    Klar, Maximilian; Földi, Martha; Denschlag, Dominik; Stickeler, Elmar; Gitsch, Gerald

    2009-05-01

    Societies worldwide invest considerably in research on oncological diseases of women. However, current literature lacks estimating this research production. We therefore evaluated quality and quantity of publications in gynecologic oncology. Revisit of 6119 peer-reviewed articles published in Gynecologic Oncology and the International Journal of Gynecological Cancer from January 1996 to December 2006. Descriptive data on disease origin, main topic, and country of origin were collected and analyzed separately. Research productivity was adjusted to the national population and nominal gross domestic product per capita. Research production and international cooperative teamwork in the 2 main journals of gynecologic oncology increased within the 10 last years; 65.3% of all published articles dealt either with epithelial ovarian cancer, cervical cancer, or endometrial cancer. Endometrial cancer had the worst ratio number of publications to estimated national incidence (United States, 2007). The United States (41.15%) and Europe (29.72%) make up a striking 70.87% of the world's research production in the field of gynecologic oncology. However, the highest rate of increase shows in Turkey (22.5), the People's Republic of China (6.87), and South Korea (5.83). Adjusted to the national GDP per capita and population for the year 2006, research productivity seems best in Israel, Austria, and Turkey. Quantitatively, most publications come from the presumed countries. Within the limits of the methodology used in this study, adjustment to population and GDP per capita provides information on research output. The scientific output on endometrial cancer is comparably low.

  20. Epidemiology of gynecologic cancers in China

    OpenAIRE

    Jiang, Xiyi; Tang, Huijuan; Chen, Tianhui

    2017-01-01

    Cancer has become a major disease burden across the globe. It was estimated that 4.29 million new incident cases and 2.81 million death cases of cancer would occur in 2015 in China, with the age-standardized incidence rate (ASIR) of 201.1 per 100,000 and age-standardized mortality rate (ASMR) of 126.9 per 100,000, respectively. For females, 2 of the top 10 most common types of cancer would be gynecologic cancers, with breast cancer being the most prevalent (268.6 thousand new incident cases) ...

  1. Polymorphisms in estrogen-metabolizing and estrogen receptor genes and the risk of developing breast cancer among a cohort of women with benign breast disease

    International Nuclear Information System (INIS)

    Gallicchio, Lisa; Berndt, Sonja I; McSorley, Meghan A; Newschaffer, Craig J; Thuita, Lucy W; Argani, Pedram; Hoffman, Sandra C; Helzlsouer, Kathy J

    2006-01-01

    A cohort study was conducted to examine the role of genetic polymorphisms in three estrogen metabolizing enzymes (COMT, CYP1A1, CYP1B1) and the two estrogen receptors (ESR1, ESR2) in the progression of benign breast disease (BBD) to breast cancer. Among participants in an ongoing cohort study, 1438 Caucasian women had a breast biopsy for BBD and were successfully genotyped for at least one of the polymorphisms examined in this study. Genotypes were determined using DNA extracted from blood specimens collected in 1989. Incident cases of breast cancer occurring subsequent to BBD diagnosis up to 2003 were identified through cancer registries. Among all participants, the ESR2 *5772G allele was associated with a significant decrease in the risk of breast cancer among women with BBD (Odds Ratio (OR) 0.38; 95% Confidence Interval (CI) 0.15, 0.96). Compared to the reference wild-type genotypes, marginally significant associations with the development of breast cancer were observed between carriers of the variant ESR1 – 104062T allele (OR 0.70, 95% CI 0.45, 1.09), the variant ESR2 *38A allele (OR 1.40; 95% CI 0.88, 2.25), and the variant CYP1B1 453Ser allele (OR 1.48, 95% CI 0.95, 2.32). The results indicate that specific polymorphisms in the CYP1B1, ESR1, and ESR2 genes may play a role in progression of BBD to breast cancer among Caucasian women. Although additional studies are needed to confirm or refute our findings, these results suggest that genetic markers may aid in the identification of women who are at risk for progression of BBD to cancer

  2. Normal myocardial perfusion scan portends a benign prognosis independent from the pretest probability of coronary artery disease. Sub-analysis of the J-ACCESS study

    International Nuclear Information System (INIS)

    Imamura, Yosihiro; Fukuyama, Takaya; Nishimura, Sigeyuki; Nishimura, Tsunehiko

    2009-01-01

    We assessed the usefulness of gated stress/rest 99mTc-tetrofosmin myocardial perfusion single photon emission computed tomography (SPECT) to predict ischemic cardiac events in Japanese patients with various estimated pretest probabilities of coronary artery disease (CAD). Of the 4031 consecutively registered patients for a J-ACCESS (Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT) study, 1904 patients without prior cardiac events were selected. Gated stress/rest myocardial perfusion SPECT was performed and segmental perfusion scores and quantitative gated SPECT results were derived. The pretest probability for having CAD was estimated using the American College of Cardiology/American Heart Association/American College of Physicians- American Society of Internal Medicine guideline data for the management of patients with chronic stable angina, which includes age, gender, and type of chest discomfort. The patients were followed up for three years. During the three-year follow-up period, 96 developed ischemic cardiac events: 17 cardiac deaths, 8 nonfatal myocardial infarction, and 71 clinically driven revascularization. The summed stress score (SSS) was the most powerful independent predictor of all ischemic cardiac events (hazard ratio 1.077, confidence interval (CI) 1.045-1.110). Abnormal SSS (>3) was associated with a significantly higher cardiac event rate in patients with an intermediate to high pretest probability of CAD. Normal SSS (≤3) was associated with a low event rate in patients with any pretest probability of CAD. Myocardial perfusion SPECT is useful for further risk-stratification of patients with suspected CAD. The abnormal scan result (SSS>3) is discriminative for subsequent cardiac events only in the groups with an intermediate to high pretest probability of CAD. The salient result is that normal scan results portend a benign prognosis independent from the pretest probability of CAD. (author)

  3. Ki-67 Expression in Sclerosing Adenosis and Adjacent Normal Breast Terminal Ductal Lobular Units: A Nested Case-Control Study from the Mayo Benign Breast Disease Cohort

    Science.gov (United States)

    Nassar, Aziza; Hoskin, Tanya L.; Stallings-Mann, Melody L.; Degnim, Amy C.; Radisky, Derek C.; Frost, Marlene H.; Vierkant, Robert A.; Hartmann, Lynn C.; Visscher, Daniel W.

    2015-01-01

    Purpose Sclerosing adenosis (SA) increases risk for invasive breast cancer (BC) 2.1 times relative to that in the general population. Here, we sought to evaluate whether the proliferation marker Ki-67 stratifies risk among women with SA. Methods A nested case-control sample of patients with SA was obtained from the Mayo Clinic Benign Breast Disease Cohort. Ki-67 expression was evaluated in SA lesions and in the adjacent normal terminal duct lobular units (TDLU) in women who did (cases, n =133) or did not (controls, n =239) develop BC. Ki67 was scored by intensity and number of positively stained cells per one high-power field (magnification, ×40) (40×HPF) for both SA and normal TDLU. Associations of Ki-67 expression with case-control status were assessed using conditional logistic regression. Results Higher Ki-67 expression was significantly associated with case-control status in both SA (P=.03) and normal background TDLU (P=.006). For the SA lesion, >2 average positively stained cells/40×HPF showed an adjusted odds ratio (OR) of 1.9 (95% CI, 1.1–3.4) compared to samples with an average of ≤2 positively stained cells. For background TDLU, lobules with >2 but ≤6 average positively stained cells showed an adjusted OR of 1.3 to 1.5, whereas those with an average of >6 positively stained cells had an OR of 2.4 (95% CI, 1.1–5.3) compared to those with an average of <2 positively stained cells. Conclusions Among women with SA, increased Ki-67 expression in either the SA lesion or the normal background TDLU carried an approximately 2-fold increased odds of subsequent BC as compared to lower Ki-67 expression. PMID:25863475

  4. Prognostic parameters in benign astrocytomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1993-01-01

    To elucidate the prognosis of different types of benign astrocytomas and to ascertain whether patients with partially resected benign astrocytomas, or any subtype of these, would benefit from postoperative radiotherapy, we studied retrospectively material comprising 300 patients with benign astro...... time of patients with non-pilocytic supratentorial benign astrocytomas. The study emphasizes the necessity of a prospective combined multicenter analysis of the effect of radiation on benign astrocytomas....

  5. Prognostic parameters in benign astrocytomas

    DEFF Research Database (Denmark)

    Westergaard, L; Gjerris, F; Klinken, L

    1993-01-01

    To elucidate the prognosis of different types of benign astrocytomas and to ascertain whether patients with partially resected benign astrocytomas, or any subtype of these, would benefit from postoperative radiotherapy, we studied retrospectively material comprising 300 patients with benign...... time of patients with non-pilocytic supratentorial benign astrocytomas. The study emphasizes the necessity of a prospective combined multicenter analysis of the effect of radiation on benign astrocytomas....

  6. Biliary interventionism in benign disease

    International Nuclear Information System (INIS)

    Marin, Jorge H

    2003-01-01

    The interventionism non-surgical biliary begins with the description of the drainage biliary percutaneous that has presented in the last 20 years a special development with the improvement of the techniques and materials for percutaneous and endoscopic use. At the present time the echographic technique allows a quick diagnosis of the possible causes of the obstructive jaundice and in most of the cases to approach the level of the obstruction; however, for a complete morphologic definition of the biliary tree; the cholangiography retrogrades endoscopic is used like first line of diagnosis and therapeutic leaving the transhepatic percutaneous cholangiography for some patients with bankrupt endoscopy or previous surgery with alteration of the anatomy and impossibility for the endoscopic canulation. Additionally, with the continuous improvement of the resonance images in the biliary duct and the new techniques of multiplanar reconstruction of the TAC have taken to that these techniques are of first diagnostic line and that the percutaneous boarding, is carried out with therapeutic and non diagnostic intention

  7. Efficacy of Single-dose and 2-dose Intravenous Administration of Ramosetron in Preventing Postoperative Nausea and Vomiting After Laparoscopic Gynecologic Operation: A Randomized, Double-blind, Placebo-controlled, Phase 2 Trial.

    Science.gov (United States)

    Lee, Banghyun; Kim, Kidong; Suh, Dong Hoon; Shin, Hyun-Jung; No, Jae Hong; Lee, Jung Ryeol; Jee, Byung Chul; Hwang, Jung Won; Do, Sang Hwan; Kim, Yong Beom

    2017-06-01

    This randomized trial investigated whether a 2-dose administration of intravenous ramosetron (5-hydroxytryptamine type 3 receptor antagonist) is more effective than a single-dose administration in preventing postoperative nausea and vomiting (PONV) in 89 patients who were scheduled to undergo laparoscopic operation for benign gynecologic diseases and to receive intravenous patient-controlled analgesia for relief of postoperative pain. After assignment at a ratio of 1:1, intravenous ramosetron (0.3 mg) was initially administered at the end of skin closure in all patients. Thereafter, ramosetron (0.3 mg) and placebo were administered to the study and control groups, respectively, at 4 hours after the operation. The baseline and operative characteristics were similar between the groups. The incidence of PONV during the 24-hour period after operation which was assessed as the primary endpoint did not differ between the groups. No serious adverse events occurred in either group. A 2-dose administration of intravenous ramosetron may not be superior to a single-dose administration in preventing PONV in patients undergoing laparoscopic operation for benign gynecologic diseases.

  8. CCCT - NCTN Steering Committees - Gynecologic Cancers

    Science.gov (United States)

    The Gynecologic Cancers Steering Committee evaluates and prioritizes concepts for phase 2 and 3 clinical trials in adult gynecologic cancers. The GCSC is also intent on fostering collaboration with international groups and institutions conducting trials.

  9. Benign Cystic Mesothelioma Misdiagnosed as Peritoneal Carcinomatosis

    Directory of Open Access Journals (Sweden)

    Hyun Deok Shin

    2016-04-01

    Full Text Available Benign cystic mesothelioma (BCM is a rare benign disease that forms multicystic masses in the abdomen, pelvis, and retroperitoneum. It occurs predominantly in young to middle-aged women. The majority of cases were associated with a history of abdominal or pelvic operation, a history of endometriosis, and pelvic inflammatory disease. We present a unique case of BCM which is different to the previous cases. The patient was a 52-year-old man showing features of peritoneal carcinomatosis accompanied by ascites on abdominal computed tomography scans. We herein report a case of BCM misdiagnosed with peritoneal carcinomatosis.

  10. Prevalence of autoimmune pancreatitis and other benign disorders in pancreatoduodenectomy for presumed malignancy of the pancreatic head

    NARCIS (Netherlands)

    M. van Heerde (Marc); K. Biermann (Katharina); P.E. Zondervan (Pieter); G. Kazemier (Geert); C.H.J. van Eijck (Casper); C.J. Pek (Chulja); E.J. Kuipers (Ernst); H.R. van Buuren (Henk)

    2012-01-01

    textabstractBackground: Occasionally patients undergoing resection for presumed malignancy of the pancreatic head are diagnosed postoperatively with benign disease. Autoimmune pancreatitis (AIP) is a rare disease that mimics pancreatic cancer. We aimed to determine the prevalence of benign disease

  11. Benign Paroxysmal Positional Vertigo After Nonotologic Surgery: Case Series

    OpenAIRE

    Kansu, Leyla; Aydin, Erdinc; Gulsahi, Kamran

    2012-01-01

    Benign paroxysmal positional vertigo is one of the most common types of vertigo caused by peripheral vestibular dysfunction. Although head trauma, migraine, long-term bed rest, Ménière disease, viral labyrinthitis, and upper respiratory tract infections are believed to be predisposing factors, most cases of benign paroxysmal positional vertigo are idiopathic. Ear surgery is another cause, but after non-otologic surgery, attacks of benign paroxysmal positional vertigo are rare. We describe thr...

  12. [Benign chronic pain].

    Science.gov (United States)

    Serrie, A; Thurel, C

    1994-09-15

    Recent data indicate that 25 to 30% of the population in industrialized countries suffers from benign chronic pain. Among these patients, 50 to 75% are professionally incapable for varied lengths of time, from a few days to some weeks or months, or even definitively. The aetiology and clinical presentation of chronic benign pain are enormously varied because this definition includes such different pathologies as headache, pain of rheumatologic, postsurgical, organic, and post-zoster origin, lombalgia, radiculalgia, post-amputation pain, neuropathologic pain, causalgia, algoneurodystrophic pain, psychosomatic and idiopathic pain. Since these syndromes and causes of pain could not be discussed individually, they have been grouped according to their neurophysiology and pathophysiology.

  13. Benign Jaw Lesions.

    Science.gov (United States)

    Gohel, Anita; Villa, Alessandro; Sakai, Osamu

    2016-01-01

    There are both odontogenic and nonodontogenic benign lesions in the maxilla and mandible. These lesions may have similar imaging features, and the key radiographic features are presented to help the clinician narrow the differential diagnosis and plan patient treatment. Both intraoral and panoramic radiographs and advanced imaging features are useful in assessing the benign lesions of the jaws. The location, margins, internal contents, and effects of the lesions on adjacent structures are important features in diagnosing the lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Present state and perspectives of RIA in obstetrics and gynecology

    International Nuclear Information System (INIS)

    Talas, M.; Fingerova, H.

    1979-01-01

    A survey is presented of RIA methods introduced by the authors in their laboratory in the course of the last eight years. The results obtained by these methods in various physiological and pathological states are evaluated. The authors point to the possibilities of effective use of RIA for diagnostic purposes in obstetrics and gynecology taking into account also economic and organizational aspects. The most important trends of the use of RIA are accentuated not only in gynecological endocrinology and obstetrics but also in some other related fields, especially in the diagnosis and treatment of malignant diseases. (author)

  15. Frequency and Pattern of Gynecological Cancers in Federal ...

    African Journals Online (AJOL)

    rate of cervical cancer.[5] In developed countries, endometrial carcinoma is the commonest gynecological cancer; while in. African countries, carcinoma of the cervix has been reported in many series to be the commonest, with most of the patients presenting in late stages of the disease.[2,6-8]. Ovarian cancer is the second ...

  16. A new method for analyzing diagnostic delay in gynecological cancer

    DEFF Research Database (Denmark)

    Vandborg, Mai Partridge; Edwards, Kasper; Kragtrup, Jakob

    2012-01-01

    OBJECTIVE: The aim of this article is to present a new methodology to illustrate, understand, and measure delay in health care. The method is inspired by process mapping tools as analytical framework and demonstrates its usefulness for studying diagnostic delay in gynecological cancer. MATERIALS...... to responsibilities and was shown to recurrently influence and contribute to the delay in the diagnostic process. Some important contributors to diagnostic delay in gynecological cancer, such as lack of cancer suspicion, competing diseases, negative test results, inexpedient referral patterns, and referrals without...... cancer suspicion, were found. CONCLUSIONS: Our results point out process mapping tools as a potential analytical framework to illustrate, understand, and measure delay in health care. Furthermore, the method was able to identify important contributors to the diagnostic delay in gynecological cancer...

  17. Clinical outcomes research in gynecologic oncology.

    Science.gov (United States)

    Melamed, Alexander; Rauh-Hain, J Alejandro; Schorge, John O

    2017-09-01

    Clinical outcomes research seeks to understand the real-world manifestations of clinical care. In particular, outcomes research seeks to reveal the effects of pharmaceutical, procedural, and structural aspects of healthcare on patient outcomes, including mortality, disease control, toxicity, cost, and quality of life. Although outcomes research can utilize interventional study designs, insightful use of observational data is a defining feature of this field. Many questions in gynecologic oncology are not amenable to investigation in randomized clinical trials due to cost, feasibility, or ethical concerns. When a randomized trial is not practical or has not yet been conducted, well-designed observational studies have the potential to provide the best available evidence about the effects of clinical care. Such studies may use surveys, medical records, disease registries, and a variety of administrative data sources. Even when a randomized trial has been conducted, observational studies can be used to estimate the real-world effect of an intervention, which may differ from the results obtained in the controlled setting of a clinical trial. This article reviews the goals, methodologies, data sources, and limitations of clinical outcomes research, with a focus on gynecologic oncology. Copyright © 2017. Published by Elsevier Inc.

  18. MR imaging in gynecologic oncology

    Energy Technology Data Exchange (ETDEWEB)

    Hricak, H. [Chief Uroradiology Section, San Francisco, CA (United States)

    1993-01-01

    Cross-sectional imaging is becoming an integral part of the diagnostic workup in patients with carcinoma of the female reproductive system. US, CT and MRI, however, are not tissue-specific, and benign and malignant disease cannot be differentiated using these modalities alone. The dignosis is made on clinical grounds and based on history, physical examination and histology. After the diagnosis has been established, cross-sectional imaging is recommended for the non-invasive evaluation of tumor extent, which influences the design of therapy and facilitates more effective treatment. A vast array of imaging options are available, and to avoid duplication and achieve the best results efficiently, it is necessary to understand the advantages and limitations of each of these approaches. This review describes in detail the potential role of MRI in the evaluation of cancer of the endometrium, cervix and ovary, discussing the value of MRI relative to US and CT, and concludes with the recommended imaging approach for each tumor type. (orig.)

  19. Your Daughter's First Gynecological Exam

    Science.gov (United States)

    ... starts, your daughter should continue to go for gynecologic visits every year to keep her informed and healthy. Reviewed by: Elana Pearl Ben-Joseph, MD Date reviewed: October 2013 More on this topic for: Parents Teens Sexual Development About Birth Control: What Parents Need to Know When Should My ...

  20. Sexuality, intimacy, and gynecological cancer

    NARCIS (Netherlands)

    Weijmar Schultz, W.C.M.; van de Wiel, H.B.M.

    2003-01-01

    On a psychological level, not all changes in sexual functioning following gynecological cancer treatment automatically lead to sexual problems or dysfunctions. Whether sexual dissatisfaction occurs will also depend on personal factors, social factors, and the context in which these negative changes

  1. Determination of attitudes with gynecologic examination and anxiety of Turkish women before gynecologic examination

    OpenAIRE

    Nülüfer Erbil; Asuman Şenkul; Yeşim Sağlam; Nesrin Ergül

    2008-01-01

    Objective: This study was planned with the purpose determination of attitudes with gynecologic examination and anxiety of Turkish women before gynecologic examination.Material & Methods: The sample of this descriptive and cross-sectional constituted by 240 women, applying for gynecologic examination in Gynecologic Policlinic of Ordu Maternity-Gynecologic and Child Hospital of who accepted to participate in the research. The data were collected with of a questionnarie form and  State ...

  2. Musculoskeletal Pain in Gynecologic Surgeons

    Science.gov (United States)

    Adams, Sonia R.; Hacker, Michele R.; McKinney, Jessica L.; Elkadry, Eman A.; Rosenblatt, Peter L.

    2013-01-01

    Objective To describe the prevalence of musculoskeletal pain and symptoms in gynecologic surgeons. Design Prospective cross-sectional survey study (Canadian Task Force classification II-2). Setting Virtual. All study participants were contacted and participated via electronic means. Participants Gynecologic surgeons. Interventions An anonymous, web-based survey was distributed to gynecologic surgeons via electronic newsletters and direct E-mail. Measurements and Main Results There were 495 respondents with complete data. When respondents were queried about their musculoskeletal symptoms in the past 12 months, they reported a high prevalence of lower back (75.6%) and neck (72.9%) pain and a slightly lower prevalence of shoulder (66.6%), upper back (61.6%), and wrist/hand (60.9%) pain. Many respondents believed that performing surgery caused or worsened the pain, ranging from 76.3% to 82.7% in these five anatomic regions. Women are at an approximately twofold risk of pain, with adjusted odds ratios (OR) of 1.88 (95% confidence interval [CI], 1.1–3.2; p 5 .02) in the lower back region, OR 2.6 (95% CI, 1.4–4.8; p 5 .002) in the upper back, and OR 2.9 (95% CI, 1.8–4.6; p 5 .001) in the wrist/hand region. Conclusion Musculoskeletal symptoms are highly prevalent among gynecologic surgeons. Female sex is associated with approximately twofold risk of reported pain in commonly assessed anatomic regions. Journal of Minimally Invasive Gynecology (2013) 20, 656-660 PMID:23796512

  3. Variation of autosomes and X chromosome STR in breast cancer and gynecological cancer tissues

    Directory of Open Access Journals (Sweden)

    Hou Youxiang

    2017-04-01

    Full Text Available This study analyses 1000 cases of patients with breast cancer and 2000 cases of patients with gynecological cancer (1000 cases of malignant tumor, 1000 cases of benign tumors, where breast cancer and malignant tumor patients comprise the observation group, while patients with benign tumors comprise the control group. Through DNA extraction, STR genotyping and variation verification, microdissection, individual STR mutation rate and loci STR mutation rate of the two groups of patients were calculated. Results show that there are no significant (P > 0.05 differences in the STR variation of autosomes and X chromosome between patients in the observation group and those in the reference group. However, significant (P < 0.05 intergroup differences were found for STR variation typing between patients with malignant and benign tumors. Using STR genotyping for autosomes and X chromosomes, gynecological cancer patients were found to be more likely to mutate, with a clear relationship between STR variation and tumor differentiation degrees. The study on the variation analysis of autosomes and X chromosome STR in breast and gynecological cancer tissues is expected to have a high application value when applied to medical research and identification processes.

  4. Benign hereditary chorea of early onset maps to chromosome 14q

    NARCIS (Netherlands)

    B.B.A. de Vries (Bert); W.F.M. Arts (Willem Frans); G.J. Breedveld (Guido); J.J. Hoogeboom; M.F. Niermeijer (Martinus); P. Heutink (Peter)

    2000-01-01

    textabstractBenign hereditary chorea (BHC) is an autosomal dominant disorder characterized by an early-onset nonprogressive chorea. The early onset and the benign course distinguishes BHC from the more common Huntington disease (HD). Previous studies on families with

  5. Benign breast lesions in Eastern Nigeria

    International Nuclear Information System (INIS)

    Anyikam, A.; Nzegwn, Martin A.; Olusina, Daniel B.; Okoye, I.; Ozumba, Ben C.

    2008-01-01

    Objective was to characterize benign breast diseases in Eastern Nigeria and to highlight the age variations of these lesions as base line data. The Department of Morbid Anatomy, University of Nigeria Teaching Hospital, Enugu caters for over 30 million African blacks and receives 2000 surgical pathology specimens yearly. Seven hundred and twenty-two benign breast specimens were analyzed over 5 years from Ist January 2000 to 31 December 2004, out of 1050 breast samples received. Of 1050 breast specimens received, 722 (68.8%) were benign. Fibroadenoma was the most common lesion with 318 cases (44%), occurring at a mean age of 16-32 years. Next were fibrocystic changes with 165 cases (22.9%) at a mean age of 23-45 years. Normal breast in the axillary tail region was seen in 32 cases (4.4%), represented as no pathology, with a mean presentation age of 20-46 years. Low grade Phyllodes tumor had 28 cases (3.9%), presenting at an average mean age of 17-32 years. Lactating adenoma had 19 (2.6%) cases. Other lesions made up less than 3% each. Benign breast lesions peaked at the 20-24 age range and then declined. Most were females. Benign breast lesions occur more frequently than malignant breast lesions with a ratio of 2.3:1 and were presented 20 years earlier than their malignant counterparts. Fibroadenoma was the most common benign lesions followed by fibrocystic disease, similar to the findings in Western Nigeria. In Northern Nigeria, fibrocystic breast disease was more common. (author)

  6. Major clinical research advances in gynecologic cancer in 2017.

    Science.gov (United States)

    Suh, Dong Hoon; Kim, Miseon; Lee, Kyung Hun; Eom, Keun Yong; Kjeldsen, Maj Kamille; Mirza, Mansoor Raza; Kim, Jae Weon

    2018-03-01

    In 2017, 10 topics were selected as major clinical research advances in gynecologic oncology. For cervical cancer, efficacy and safety analysis results of a 9-valent human papillomavirus (HPV) vaccine and long-term impact of reduced dose of quadrivalent vaccine were updated. Brief introduction of KEYNOTE trials of pembrolizumab, a monoclonal antibody that blocks the interaction between programmed death (PD)-1 and its ligands, PD-L1 and PD-L2, followed. Tailored surveillance programs for gynecologic cancer related with Lynch syndrome and update on sentinel lymph node mapping were reviewed for uterine corpus cancer. For ovarian cancer, 5 topics were selected including poly(ADP-ribose) polymerases inhibitors and immunotherapy. The other potential practice changers covered in this review were lymphadenectomy in advanced disease, secondary cytoreductive surgery in recurrent disease, weekly dose-dense regimen for first-line chemotherapy, incorporation of bevacizumab maintenance in platinum-sensitive recurrent disease, and effect of platinum-free interval prolongation. Conflicting opinions of academic societies on periodic pelvic examination were introduced in conjunction with relevant literature review. For the field of radiation oncology, results of 2 big trials, The Postoperative Radiation Therapy in Endometrial Carcinoma-3 and Gynecologic Oncology Group-258, for endometrial cancer and recent advance in high-dose-rate brachytherapy for cervical cancer were reported. Topics for breast cancer covered adjuvant capecitabine after preoperative chemotherapy, adjuvant pertuzumab and trastuzumab in early human epidermal growth factor receptor 2-positive disease, olaparib for metastatic cancer in patients with a germline BRCA mutation, 20-year risks of recurrence after stopping endocrine therapy at 5 years, and contemporary hormonal contraception and the risk of breast cancer. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

  7. [Influence of previous abdominopelvic surgery on gynecological laparoscopic operation].

    Science.gov (United States)

    Jin, Haoran; Shi, Wei; Zhou, Yingfang; Wu, Beisheng; Peng, Chao

    2014-09-01

    To investigate the influence of previous abdominopelvic surgery on gynecological laparoscopic operation. A retrospective analysis of 3 283 cases of gynecological diseases by laparoscopic operation patients in Peking University First Hospital from 2007 January to 2012 December, among them, 719 (21.90%) patients with previous abdominopelvic surgery history (study Group), 2 564 (78.10%)patients have no history of abdominopelvic surgery (control group). Study group 719 patients, previous operation times: one time in 525 cases, 194 cases were multiple; previous operation: 185 cases of gynecological surgery, 305 cases of obstetric surgery, 108 cases of general surgery, and 121 complex surgery (include at least two kinds of surgery); previous operative approach: 650 cases laparotomy and 69 cases laparoscopy. Compared two groups of patients with abdominopelvic adhesion and the gynecologic laparoscopic operation situation, analyzed the influence of previous abdominopelvic surgery on abdominopelvic adhesion on and gynecological laparoscopic operation. The incidence of abdominopelvic adhesion in the patients with previous abdominopelvic surgery was 51.2% (368/719), which was significantly higher than that of 8.2% (211/2 564)in patients without previous abdominopelvic surgery (P surgery (23.1%, 166/719) was significantly higher than that in the control group (3.3% , 85/2 564;P laparotomy was 0.6% (4/719) significantly more than the control groups (0.1%, 2/2 564; P = 0.023). Compared with other groups, patients with gynecological or complex surgery or multiple operation history presented more severe abdominopelvic adhesion both in the score and degree (P laparotomy showed no statistical difference between the two groups (P > 0.05). The laparoscopic operation could be carried out successfully and safely in patients with a history of various abdominopelvic operations, but the conversion rate increases, for patients with a history of multiple operation because of pelvic adhesion

  8. The optimal organization of gynecologic oncology services: a systematic review.

    Science.gov (United States)

    Fung-Kee-Fung, M; Kennedy, E B; Biagi, J; Colgan, T; D'Souza, D; Elit, L M; Hunter, A; Irish, J; McLeod, R; Rosen, B

    2015-08-01

    A system-level organizational guideline for gynecologic oncology was identified by a provincial cancer agency as a key priority based on input from stakeholders, data showing more limited availability of multidisciplinary or specialist care in lower-volume than in higher-volume hospitals in the relevant jurisdiction, and variable rates of staging for ovarian and endometrial cancer patients. A systematic review assessed the relationship of the organization of gynecologic oncology services with patient survival and surgical outcomes. The electronic databases medline and embase (ovid: 1996 through 9 January 2015) were searched using terms related to gynecologic malignancies combined with organization of services, patterns of care, and various facility and physician characteristics. Outcomes of interest included overall or disease-specific survival, short-term survival, adequate staging, and degree of cytoreduction or optimal cytoreduction (or both) for ovarian cancer patients by hospital or physician type, and rate of discrepancy in initial diagnoses and intraoperative consultation between non-specialist pathologists and gyne-oncology-specialist pathologists. One systematic review and sixteen additional primary studies met the inclusion criteria. The evidence base as a whole was judged to be of lower quality; however, a trend toward improved outcomes with centralization of gynecologic oncology was found, particularly with respect to the gynecologic oncology care of patients with advanced-stage ovarian cancer. Improvements in outcomes with centralization of gynecologic oncology services can be attributed to a number of factors, including access to specialist care and multidisciplinary team management. Findings of this systematic review should be used with caution because of the limitations of the evidence base; however, an expert consensus process made it possible to create recommendations for implementation.

  9. Repeat FNA Significantly Lowers Number of False Negative Results in Patients with Benign Nodular Thyroid Disease and Features of Chronic Thyroiditis

    Directory of Open Access Journals (Sweden)

    Dorota Słowińska-Klencka

    2014-01-01

    Full Text Available Purpose. The aim of the study was to compare the risk of thyroid malignancy and efficacy of repeat FNA in patients with thyroid nodules diagnosed cytologically as benign lesion (BL with features of chronic thyroiditis (BL-CT and BL without CT features (BL-nCT. Methods. The analysis included 917 patients with BL-CT and 7046 with BL-nCT in the first FNA. Repeat biopsy was carried out in 787 patients of BL-CT and 5147 of BL-nCT; 218 patients of BL-CT and 2462 of BL-nCT were operated; in 88 cases of BL-CT and 563 of BL-nCT both ways of follow-up were available. Results. Outcome of repeat cytology implied surgery more frequently in patients with BL-CT than with BL-nCT—3.2% versus 1.9%, P < 0.05. Incidence of cancer (including incidentalomas was higher in patients with BL-CT operated after one benign cytology than in patients with two benign FNA outcomes: 10.8% versus 1.6%, P < 0.05. In patients with BL-nCT that difference was not significant: 3.2% versus 2.6%. Conclusions. Patients with thyroid nodules diagnosed as BL with CT features have higher risk of malignancy than patients with BL without CT features. Repeat biopsy significantly lowers percentage of FN results in patients with BL-CT in the first FNA.

  10. Benign notochordal cell tumors.

    Science.gov (United States)

    Martínez Gamarra, C; Bernabéu Taboada, D; Pozo Kreilinger, J J; Tapia Viñé, M

    Benign notochordal cell tumors (TBCN) are lesions with notochordal differentiation which affect the axial skeleton. They are characterized by asymptomatic or non-specific symptomatology and are radiologically unnoticed because of their small size, or because they are mistaken with other benign bone lesions, such as vertebral hemangiomas. When they are large, or symptomatic, can be differential diagnosis with metastases, primary bone tumors and chordomas. We present a case of a TBCN in a 50-year-old woman, with a sacral lesion seen in MRI. A CT-guided biopsy was scheduled to analyze the lesion, finding that the tumor was not clearly recognizable on CT, so the anatomical references of MRI were used to select the appropriate plane. The planning of the approach and the radio-pathological correlation were determinant to reach the definitive diagnosis. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Gynecologic cancer treatment: risk factors for therapeutically induced neoplasia

    International Nuclear Information System (INIS)

    Messerschmidt, G.L.; Hoover, R.; Young, R.C.

    1981-01-01

    Therapeutic intervention in a course of illness, while producing the desired result, also may have some adverse long-term effects on the patient. Second malignancies are one of the known complications of therapy. The treatments of gynecologic cancers by surgery, irradiation and chemotherapy have been associated with subsequent neoplasms. Care must be exercised in associating previous therapy and a subsequent malignancy. Naturally occurring second cancers must be separated from those which are iatrogenic. Associations in the literature have been made involving malignancies as a sequelae of prior gynecologic therapy. The use of normal skin from the thigh to fabricate an artificial vagina has resulted in more squamous cell carcinomas than expected. Alkylating agents used in the treatment of ovarian cancer and other diseases have been shown to lead to an increased risk of leukemia. Irradiation therapy, however, has not yet been shown to be related to leukemia in cervical cancer patients. The incidence of lymphoma and uterine, urinary bladder and colon carcinomas has been associated with prior irradiation for gynecologic disease. The literature regarding the therapeutically induced risk factors in gynecologic therapy is reviewed and areas of our knowledge that require more investigation are identified

  12. Recommendations for Follow-up Care for Gynecologic Cancer Survivors.

    Science.gov (United States)

    Elit, Laurie; Reade, Clare J

    2015-12-01

    Gynecologic cancer survivors are expected to increase in number over the coming years. This is attributable in part to an increased incidence of gynecologic malignancies as the population ages. Earlier detection and improved treatments will lead to improved survival. Women who have completed their cancer treatment and are disease-free enter a phase of follow-up care. This care can be provided by gynecologic oncologists, general gynecologists, or primary care practitioners, depending on local practices and geographic area. The key components of follow-up include complete history and physical examination. There should be judicious use of appropriate testing to detect disease recurrence, assessment, and management of therapy-related symptoms and provision of psychosocial support. Well-woman care and ongoing screening for other malignancies remain an important component of care that should not be overlooked. This review provides recommendations regarding follow-up care for women with gynecologic malignancies. There is very little high-quality evidence available to guide such care.

  13. Retroperitoneoscopic nephrectomy in benign pathology.

    Science.gov (United States)

    Quintela, Rodrigo S; Cotta, Leonardo R; Neves, Marcelo F; Abelha, David L; Tavora, Jose E

    2006-01-01

    We report our experience with 43 retroperitoneal laparoscopic nephrectomy for benign kidney disease. All patients had a poor function from obstructive uropathology and renal atrophy. None of these patients had a previous lumbotomy. Retroperitoneoscopy was performed with 4 trocar port technique in a lateral position. The retroperitoneal space is created by using a Gaur's balloon made of sterile glove. The approach to vascular pedicle was done posteriorly and vessels were clipped by metal and Hem-o-lock (Weck Closure Systems, North Carolina, USA) clips. The sample was intact extracted in an Endo-Bag prolonging one trocar incision. Median operative time was 160 minutes and median blood loss was 200 mL. Four cases (9%) were converted to open surgery: one case due to bleeding and 3 cases due to technical difficulties regarding perirenal adherences. Most patients (39) checked out from the Hospital in day two. Four of them were left over 3 days due to wound complications. Retroperitoneoscopy offers a safe, effective and reproductive access to nephrectomy for benign pathologies.

  14. Systematic review of robotic surgery in gynecology: robotic techniques compared with laparoscopy and laparotomy.

    Science.gov (United States)

    Gala, Rajiv B; Margulies, Rebecca; Steinberg, Adam; Murphy, Miles; Lukban, James; Jeppson, Peter; Aschkenazi, Sarit; Olivera, Cedric; South, Mary; Lowenstein, Lior; Schaffer, Joseph; Balk, Ethan M; Sung, Vivian

    2014-01-01

    The Society of Gynecologic Surgeons Systematic Review Group performed a systematic review of both randomized and observational studies to compare robotic vs nonrobotic surgical approaches (laparoscopic, abdominal, and vaginal) for treatment of both benign and malignant gynecologic indications to compare surgical and patient-centered outcomes, costs, and adverse events associated with the various surgical approaches. MEDLINE and the Cochrane Central Register of Controlled Trials were searched from inception to May 15, 2012, for English-language studies with terms related to robotic surgery and gynecology. Studies of any design that included at least 30 women who had undergone robotic-assisted laparoscopic gynecologic surgery were included for review. The literature yielded 1213 citations, of which 97 full-text articles were reviewed. Forty-four studies (30 comparative and 14 noncomparative) met eligibility criteria. Study data were extracted into structured electronic forms and reconciled by a second, independent reviewer. Our analysis revealed that, compared with open surgery, robotic surgery consistently confers shorter hospital stay. The proficiency plateau seems to be lower for robotic surgery than for conventional laparoscopy. Of the various gynecologic applications, there seems to be evidence that renders robotic techniques advantageous over traditional open surgery for management of endometrial cancer. However, insofar as superiority, conflicting data are obtained when comparing robotics vs laparoscopic techniques. Therefore, the specific method of minimally invasive surgery, whether conventional laparoscopy or robotic surgery, should be tailored to patient selection, surgeon ability, and equipment availability. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  15. Does gender discrimination exist in a gynecology training program in a private hospital?

    Science.gov (United States)

    Geisler, J P; Mernitz, C S; Geisler, M J; Harsha, C G; Eskew, P N

    1999-01-01

    Does gender discrimination by attending physicians exists in a residency in regard to residents' opportunities to perform complete/operative management of hysterectomies versus just being surgical assistants? The program studied is a 4-year program in obstetrics and gynecology residency with 3 residents per year. All cases involving a resident were recorded in a computer program designed by one of the authors (C.S.M.) to collect data for Residency Review Committee reports. Data were able to be sorted in a variety of methods including level of management, date of procedure, Physicians' Current Procedural Terminology codes, and attending physician name or resident name. Only intrafascial and extrafascial hysterectomies for benign disease were included in the study. Data were collected from July 1, 1996 to March 31, 1997. Five hundred and forty-nine hysterectomies with residents participating as primary surgeon (complete/operative management) or surgical assistant were performed during the study period. Complete/operative management was performed by the resident in 82.5% of cases while the resident was surgical assistant in 17.5%. Male residents were responsible for complete/operative management in 81.6% of cases and female residents in 83.2% of cases (P = 0.33). Male attending physicians were more likely to allow residents (male or female) to participate as the primary surgeon in abdominal hysterectomies (95.3%) and vaginal hysterectomies (68.5%) than female attending physicians (abdominal, 87.0% and vaginal, 57.3%) (P gender discrimination.

  16. Benign acute childhood myositis.

    Science.gov (United States)

    Rajajee, Sarala; Ezhilarasi, S; Rajarajan, K

    2005-05-01

    To describe the clinical and laboratory features of benign acute childhood myositis. 40 children of BACM were seen during October 2001 to February 2002, 22 (52%) were male with mean age of 5.3 years. Duration of illness was 3.97 days. Preceding symptoms included fever, leg pain, vomiting and inability to walk. A provisional diagnosis of viral myositis was made in 26 (66%). Guillian Barre Syndrome was the most common referral diagnosis. 11 (27.5%) children had leucopenia with lymphocytic response and 16 (40%) had thrombocytopenia. CRP was negative in 32 (80%). CPK was markedly elevated (more than 1000 IU/l) in 18 (45%) and more than 500 IU/l in 11 (27.5%) remaining between 200 to 500 IU/l. Associated features were hepatitis (elevated SGOT & SGPT) in 28 (70%) and shock in 5 (12.5%). Serological test were indicative of dengue virus (Elisa PAN BIO) in 20 (50%) of which 8 (25%) were primary dengue and 12 (30%) were secondary dengue. The outcome of therapy mainly supportive were excellent. Benign acute myositis occurs often in association with viral infection. In the present study, Dengue virus was positive in 20 (50%) children. Benign acute myositis can be differentiated from more serious causes of walking difficulty by presence of calf and thigh muscle tenderness on stretching, normal power and deep tendon reflex and elevated CPK.

  17. Benign pneumatosis in children

    Energy Technology Data Exchange (ETDEWEB)

    Fenton, L.Z.; Buonomo, C. [Department of Radiology, Children' s Hospital, Boston, MA (United States)

    2000-11-01

    Background. In pediatrics, pneumatosis intestinalis (PI) is usually due to necrotizing enterocolitis in premature newborns. Beyond infancy, PI is uncommon. ''Benign pneumatosis'' is PI in patients with few or no symptoms that resolves with conservative management. Objective. Our goal was to better characterize benign PI in children. Our investigation focused on identifying underlying risk factors, symptoms at time of diagnosis, management and outcome. Materials and methods. Available medical records and radiographs of children with pneumatosis intestinalis from 1990 to 1998 were reviewed for underlying conditions, symptoms at time of radiographs, management and outcome. Results. Thirty-seven children (mean age 4 years) were included. Thirty-two children had identifiable risk factors. Twenty -five children were immunocompromised by their underlying conditions or therapeutic regimen. Thirty-five children were managed conservatively with resolution of PI. Two patients, however, required surgery and one patient died. Conclusion. Benign pneumatosis does occur in children. The majority have underlying risk factors, most commonly related to immunosuppression. Clinical deterioration is the most useful indicator for surgical intervention. In most patients PI resolves with conservative management. (orig.)

  18. Expression of GATA-3 in Testicular and Gynecologic Mesothelial Neoplastic and Non-neoplastic Tissues.

    Science.gov (United States)

    Ronaghy, Arash; Xiao, Guang-Qian; Santagada, Eugene; Hasanovic, Adnan; Unger, Pamela

    2018-05-01

    GATA-3 expression in testicular/gynecologic mesothelial neoplasms and benign mesothelia have not been completely investigated. We graded GATA-3, calretinin, and WT1 staining in 20 adenomatoid tumors [9/20 (para)testicular and 11/20 tubal/uterine] and 38 normal mesothelia (20/38 tunica vaginalis and 18/38 fallopian tubes) as either 0 (≤5%), +1 (>5% and 50%). Adenomatoid tumor GATA-3 staining: 2 urologic cases were positive (2/9, +3 and +1), no gynecologic cases were positive (0/11), and all were positive for WT1/calretinin (20/20,+2 to +3). The normal tunica vaginalis mesothelia: 3 of 20 were GATA-3 positive (+2) while 20 of 20 were WT1/calretinin (+2 to +3) positive. The gynecologic cases with walthard nests: are positive for GATA-3 (18/18,+3), WT1 (11/18, +2 to +3), and calretinin (1/18,+2). The nonmetaplastic gynecologic mesothelia were GATA-3 negative (18/18) and WT1/calretinin postive (18/18,+2 to +3). All 18 epididymi were GATA-3 positive (+3) and negative for WT1/calretinin. All 11 efferent ductules examined were negative for GATA-3, WT1/calretinin (0/11). Although GATA-3 rarely stains adenomatoid tumors, gynecologic walthard nests are consistently positive with GATA-3 staining but lose mesothelial markers reflecting a metaplastic change. Excluding the walthard nests, GATA-3 is rarely positive in normal urologic and gynecologic mesothelia. GATA-3 is uniformally positive in epididymi and negative in efferent ductules, which may be due to their embryological evolvement. Awareness of the GATA-3 staining patterns in the genitourinary and gynecologic mesothelial tissues and their respective neoplasms is important to prevent misdiagnosis and possible unnecessary interventions.

  19. Clustered microcalcifications without mass on mammography : benignancy vs. malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Han, Yoon Hee; Do, Young Soo; Oh, Hoon Il; Kim, Ki Hwan; Chin, Soo Yil [Korean Cancer Center Hostpital, Seoul (Korea, Republic of); Cho, Byung Jae [Chung Dam Radiologic Clinics, Seoul (Korea, Republic of); Han, Heon [Chungang Gil Hospital, Seoul (Korea, Republic of); Choi, Yeun Hyeun; Han, Boo Kyung [Sam Sung Medical Center, Seoul (Korea, Republic of); Park, Jung Mi [Asan Medical Center, Seoul (Korea, Republic of)

    1996-11-01

    The purpose of this study is to evaluate the accuracy of differentiation between benign and malignant clustered microcalcifications without mass on mammogram. Fourty six mammograms of 44 patients showing clustered microcalcifications without mass were interpreted blindly by five independent observers majoring in breast imaging from different institutions. Twenty two were malignant (10 infiltrating ductal carcinomas, 12 intraductal carcinomas) and 24 were benign (all fibrocystic disease). The observers judge benignancy or malignancy of microcalcifications. The authors assess the accuracy of differential diagnosis of clustered microcalcifications. Of 24 cases proved benign microcalcifications, five radiologists correctly interpreted 20 on average as benign and of malignant 22 cases, 16 on average were correctly interpreted as malignant. The diagnostic accuracy of malignant microcalcifications was 71.8% on average(63.6%{approx}81.8%) and the diagnostic accuracy for benign microcalcifications was 83% on average(71%{approx}92%). It was 9 among total 46 cases that were misinterpreted by more than three radiologists. Among these 9 cases, malignant microcalcifications that had been misinterpreted as benign were seven, benign microcalcifications misinterpreted as malignant were two. The diagnostic accuracy of clustered malignant microcalcifications(71.8%) without mass on mammogram was lower than that of benign microcalcifications(83.3%). So, in case of suspected malignant microcalcification on mammogram, it is preferable that along with magnification view, histopathologic confirmation by core biopsy must be obtained.

  20. In vivo confocal laser endomicroscopy during laparoscopy for gynecological surgery: A promising tool.

    Science.gov (United States)

    Chene, G; Chauvy, L; Buenerd, A; Moret, S; Nadaud, B; Beaufils, E; Le Bail-Carval, K; Chabert, P; Mellier, G; Lamblin, G

    2017-09-01

    To investigate the technical feasibility of optical biopsy (probe-based confocal laser endomicroscopy [pCLE]) during laparoscopy and by the vaginal route in the exploration of pelvic gynecological cancers. Prospective study including 31 patients undergoing laparoscopic hysterectomy (benign or malignant indication). Confocal microlaparoscopy (analysis of tubes, ovaries, and depending on the type de cancer, pelvic adenopathies) and optical biopsy of the endometrium were first carried out by the vaginal route under general anesthesia. The surgical procedure was then carried out. Thirty-one consecutive patients were included (16 for benign hysterectomy, 12 for endometrial cancer and 3 for ovarian carcinoma). pCLE offered dynamic pictures that were correlated with the histopathological images. pCLE provides high resolution imaging of cancerous and benign tissues in real-time similar to histopathological results. Both feasibility and safety were confirmed. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  1. Familial benign nonprogressive myoclonic epilepsies.

    Science.gov (United States)

    Striano, Pasquale; de Falco, Fabrizio A; Minetti, Carlo; Zara, Federico

    2009-05-01

    Work on the classification of epileptic syndromes is ongoing, and many syndromes are still under discussion. In particular, special difficulty still persists in correctly classifying epilepsies with myoclonic seizures. The existence of special familial epileptic syndromes primarily showing myoclonic features has been recently suggested on the basis of a clear pattern of inheritance or on the identification of new chromosomal genetic loci linked to the disease. These forms in development include familial infantile myoclonic epilepsy (FIME), benign adult familial myoclonic epilepsy (BAFME), or autosomal dominant cortical myoclonus and epilepsy (ADCME), and, maybe, adult-onset myoclonic epilepsy (AME). In the future, the identification of responsible genes and the protein products will contribute to our understanding of the molecular pathways of epileptogenesis and provide neurobiologic criteria for the classification of epilepsies, beyond the different phenotypic expression.

  2. Field-expedient gynecologic examination table.

    Science.gov (United States)

    Hughey, M J; Patel, T G; Herrold, S B

    1997-10-01

    In field operational environments, the gynecologic health needs of women may be difficult to provide because of the lack of a small, lightweight, durable, inexpensive gynecologic examination table. Such a table already exists, in pieces, in the inventory of most field-deploying units of battalion aid station size or larger. Because the table's existence is not commonly known, we describe the assembly and use of this field-expedient gynecologic examination table.

  3. Benign paroxysmal positional vertigo and its variants.

    Science.gov (United States)

    Nuti, D; Masini, M; Mandalà, M

    2016-01-01

    Benign paroxysmal positional vertigo is a common labyrinthine disorder caused by a mechanic stimulation of the vestibular receptors within the semicircular canals. It is characterized by positional vertigo and positional nystagmus, both provoked by changes in the position of the head with respect to gravity. The social impact of the disease and its direct and indirect costs to healthcare systems are significant owing to impairment of daily activities and increased risk of falls. The first description of a patient with benign paroxysmal positional vertigo is from Robert Bárány in 1921, but the features of the syndrome and the diagnostic maneuver were well described by Dix and Hallpike in 1952. Since then, the gradually increasing interest of otolaryngologists and neurologists has led to a progressive advance in the knowledge of this labyrinthine disorder with regard to its epidemiologic, pathophysiologic, clinical, and therapeutic aspects. Despite the often effective diagnosis and treatment of most cases of benign paroxysmal positional vertigo, the physiopathologic explanations of the disease are mainly speculative. In this chapter, we describe the epidemiologic, pathophysiologic, clinical, and therapeutic aspects of benign paroxysmal positional vertigo. © 2016 Elsevier B.V. All rights reserved.

  4. Robot-assisted gynecological surgery in a community setting.

    Science.gov (United States)

    Piquion-Joseph, Johann M; Nayar, Anju; Ghazaryan, Armine; Papanna, Ramesha; Klimek, Waldemar; Laroia, Rahul

    2009-06-01

    The objective of this study is to review our experience using the da Vinci robotic system to perform various gynecological surgeries for benign indications. Between July 2005 and April 2008, 110 patients underwent robot-assisted gynecological surgeries in Rochester General Hospital, NY. The records of these patients were retrospectively reviewed by an independent data collector to analyze the safety, effectiveness, and outcome of the surgeries done using the robotic system. The parameters reviewed include indication for surgery, type of procedure, operative time, blood loss, hospital stay, and intraoperative and post operative complications. The procedures completed include 74 hysterectomies including hysterectomies with bilateral salpingoophorectomy, 15 hysterectomies with sacrocolpopexy and other concomitant procedures, 18 myomectomies, and 3 oophorectomies. All procedures were completed robotically without the need for conversion to an open approach. The mean operation time was 2.15 h. Average estimated blood loss was 160 cc. Complications encountered include one cystotomy which was identified immediately and repaired in addition to one vault dehiscence and two post operative infections. The mean hospital stay was 1 day, with more than half of the patients being discharged within 24 h after the surgery. Post operative pain level was in the range of 0-6 in a scale of 0-10 (0: no pain, 10: worst pain in their life) and relieved by non-steroidal anti-inflammatory drugs. Robot-assisted laparoscopic benign surgical procedures are feasible techniques in a community setting. Robot-assisted laparoscopy has a promising future in minimally invasive surgery as it proved beneficial for our patients who experienced low complication rate and overall fast recovery compared to other approaches.

  5. Pharmacological treatment of the benign prostatic hyperplasia

    International Nuclear Information System (INIS)

    Perez Guerra, Yohani; Molina Cuevas, Vivian; Oyarzabal Yera, Ambar; Mas Ferreiro, Rosa

    2011-01-01

    Benign prostatic hyperplasia is a common disease in over 50 years-old men consisting in uncontrolled and benign growth of prostatic gland that leads to lower urinary tract symptoms. The etiology of benign prostatic hyperplasia is multifactoral involving the increased conversion of testosterone in dihydrotestosterone by the prostatic 5α-reductase action, which brought about events that encourage the prostate growth (static component) and the increase of the bladder and prostate smooth muscle tone (dynamic component) regulated by the aα 1 -adrenoceptors (ADR). The pharmacological treatment of the benign prostatic hyperplasia includes the prostatic 5aα-reductase inhibitors, the aα 1 -adrenoreceptor blockers, their combined therapy and the phytotherapy. This paper was aimed at presenting the most relevant aspects of the pharmacology of drugs used for treating the benign prostatic hyperplasia, and providing elements to analyze their efficacy, safety and tolerability. To this end, a review was made of the different drugs for the treatment of this pathology and they were grouped according to their mechanism of action. Natural products were included as lipid extracts from Serenoa repens and Pygeum africanum as well as D-004, a lipid extract from Roystonea regia fruits, with proved beneficial effects on the main etiological factors of benign prostatic hyperplasia. D-004 is a prostatic 5a-reductase inhibitor, an aα 1 -adrenoceptor antagonist, aα 5-lipooxygenase inhibitor and has antioxidant action, all of which reveals a multifactoral mechanism. The results achieved till now indicate that D-004 is a safe and well-tolerated product

  6. Therapy: a new nonsurgical therapy option for benign thyroid nodules?

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo

    2009-01-01

    Despite the increasing implementation of iodization programs, benign nodular thyroid disease will remain a prevalent therapeutic concern for decades. recent research suggests that nonsurgical therapy, including radioactive iodine, radiofrequency thermal ablation and percutaneous laser ablation...

  7. Paper-Based Survivorship Care Plans May be Less Helpful for Cancer Patients Who Search for Disease-Related Information on the Internet: Results of the Registrationsystem Oncological Gynecology (ROGY) Care Randomized Trial.

    Science.gov (United States)

    Nicolaije, Kim Ah; Ezendam, Nicole Pm; Pijnenborg, Johanna Ma; Boll, Dorry; Vos, Maria Caroline; Kruitwagen, Roy Fpm; van de Poll-Franse, Lonneke V

    2016-07-08

    The Institute of Medicine recommends Survivorship Care Plans (SCPs) for all cancer survivors. However, it is unclear whether certain patient groups may or may not benefit from SCPs. The aim was to assess whether the effects of an automatically generated paper SCP on patients' satisfaction with information provision and care, illness perceptions, and health care utilization were moderated by disease-related Internet use. Twelve hospitals were randomized to either SCP care or usual care in the pragmatic cluster randomized Registrationsystem Oncological GYnecology (ROGY) Care trial. Newly diagnosed endometrial cancer patients completed questionnaires after diagnosis (N=221; response: 74.7%, 221/296), 6 months (n=158), and 12 months (n=147), including patients' satisfaction with information provision and care, illness perceptions, health care utilization (how many times patients visited a medical specialist or primary care physician about their cancer in the past 6 months), and disease-related Internet use (whether patients used the Internet to look for information about cancer). In total, 80 of 221 (36.2%) patients used the Internet to obtain disease-related information. Disease-related Internet use moderated the SCP care effect on the amount of information received about the disease (P=.03) and medical tests (P=.01), helpfulness of the information (P=.01), and how well patients understood their illness (P=.04). All stratified analyses were not statistically significant. However, it appeared that patients who did not seek disease-related information on the Internet in the SCP care arm reported receiving more information about their disease (mean 63.9, SD 20.1 vs mean 58.3, SD 23.7) and medical tests (mean 70.6, SD 23.5 vs mean 64.7, SD 24.9), finding the information more helpful (76.7, SD 22.9 vs mean 67.8, SD 27.2; scale 0-100), and understanding their illness better (mean 6.6, SD 3.0 vs mean 6.1, SD 3.2; scale 1-10) than patients in the usual care arm did. In

  8. Palliative Care Education in Gynecologic Oncology: a Survey of Gynecologic Oncologists and Gynecologic Oncology Fellows in Thailand.

    Science.gov (United States)

    Ratanakaaew, A; Khemapech, N; Laurujisawat, P

    2015-01-01

    The main purpose of this study was to survey the education and training of certified gynecologic oncologists and fellows in Thailand. A secondary objective was to study the problems in fellowship training regarding palliative care for gynecologic cancer patients. A descriptive study was conducted by sending a questionnaire regarding palliative care education to all certified gynecologic oncologists and gynecologic oncology fellows in Thailand. The contents of the survey included fellowship training experience, caring for the dying, patient preparation, attitudes and respondent characteristics. Statistics were analyzed by percentage, mean and standard deviation and chi-square. One hundred seventy completed questionnaires were returned; the response rate was 66%. Most certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards palliative care education, and agree that "psychological distress can result in severe physical suffering". It was found that the curriculum of gynecologic oncology fellowship training equally emphasizes three aspects, namely managing post-operative complications, managing a patient at the end of life and managing a patient with gynecologic oncology. As for experiential training during the fellowship of gynecologic oncology, education regarding breaking bad news, discussion about goals of care and procedures for symptoms control were mostly on-the-job training without explicit teaching. In addition, only 42.9% of respondents were explicitly taught the coping skill for managing their own stress when caring for palliative patients during fellowship training. Most of respondents rated their clinical competency for palliative care in the "moderately well prepared" level, and the lowest score of the competency was the issue of spiritual care. Almost all certified gynecologic oncologists and fellows in gynecologic oncology have a positive attitude towards learning and teaching in palliative care. In this

  9. Benign focal liver lesions: discrimination from malignant mimickers.

    Science.gov (United States)

    Alobaidi, Mohammad; Shirkhoda, Ali

    2004-01-01

    Focal lesions of the liver often have various imaging characteristics which may be interpreted as either benign or malignant. Understanding the underlying pathophysiology of these liver lesions may lead to characteristic imaging manifestations, which direct the radiologist to the diagnosis. Benign lesions include congenital hepatic cyst, autosomal dominant polycystic disease, hemangioma, focal nodular hyperplasia (FNH), hepatic adenoma, inflammatory pseudotumor, peliosis hepatis, focal fatty infiltration, hamartoma, and infectious processes such as hepatic abscess, echinococcal cyst, and candidiasis. Characteristic imaging features, clinical symptoms, and treatment/prognosis will be discussed. Emphasis will be placed on key reliable features of each disease to develop a method of discriminating these lesions from other benign and malignant disorders.

  10. Benign duodenocolic fistula. A case presenting with acidosis

    DEFF Research Database (Denmark)

    Benn, Marianne; Nielsen, F T; Antonsen, H K

    1997-01-01

    A case of benign duodenocolic fistula as a complication to peptic ulcer disease is presented, the case being interesting for the rarity of the diagnosis and by being complicated with acidosis. The etiology, clinical features, diagnosis, and treatment are reviewed.......A case of benign duodenocolic fistula as a complication to peptic ulcer disease is presented, the case being interesting for the rarity of the diagnosis and by being complicated with acidosis. The etiology, clinical features, diagnosis, and treatment are reviewed....

  11. Annual report of the Women's Health Care Committee, Japan Society of Obstetrics and Gynecology, 2016.

    Science.gov (United States)

    Takamatsu, Kiyoshi; Kitawaki, Jo

    2016-11-01

    In order to improve women's quality of life, over the year leading up to June 2016, the Women's Health Care Committee of the Japan Society of Obstetrics and Gynecology focused upon: (i) breast management; (ii) influence of a therapy for gynecologic disease on physical condition; (iii) nonsurgical management of pelvic organ prolapse; (iv) survey of infectious diseases in Obstetrics and Gynecology in Japan; (v) health care for female athletes; (vi) a training program for women's health-care advisers; and (vii) revising the Japanese guideline on hormone-replacement therapy. In order to publicize the activities of our committee widely, the detailed activities of the seven subcommittees are described in this report, which is based on the Japanese version of the annual report (Acta Obst Gynaec Jpn 2016; 68 (6): 1404-1416). © 2016 Japan Society of Obstetrics and Gynecology.

  12. Benign cementoblastoma: A case report

    Directory of Open Access Journals (Sweden)

    Sitapathi Revathi

    2016-03-01

    Full Text Available Benign cementoblastoma is a rare odontogenic tumor of mesenchymal origin comprising only less than 1% of all odontogenic tumors. The radiographic features is very characteristic in which the tumor mass is attached to the root of the tooth. Histopathologically benign cementoblastoma and osteoblastoma are indistinguishable. Here, a case report of 28 year old patient with benign cementoblastoma is presented along with a brief review of literature.

  13. Benign paroxysmal positional vertigo after nonotologic surgery: case series.

    Science.gov (United States)

    Kansu, Leyla; Aydin, Erdinc; Gulsahi, Kamran

    2015-03-01

    Benign paroxysmal positional vertigo is one of the most common types of vertigo caused by peripheral vestibular dysfunction. Although head trauma, migraine, long-term bed rest, Ménière disease, viral labyrinthitis, and upper respiratory tract infections are believed to be predisposing factors, most cases of benign paroxysmal positional vertigo are idiopathic. Ear surgery is another cause, but after non-otologic surgery, attacks of benign paroxysmal positional vertigo are rare. We describe three cases of benign paroxysmal positional vertigo attacks after non-otologic surgery (one patient after a nasal septoplasty and two patients after dental endodontic treatment) and discuss the pathophysiological mechanism of benign paroxysmal positional vertigo seen after non-otologic surgery, its diagnosis and treatment.

  14. The Annual Gynecologic Examination Updated for the 21st Century.

    Science.gov (United States)

    Cappiello, Joyce; Levi, Amy

    2016-01-01

    The concept of an annual gynecologic screening visit to identify disease at an early stage has long been an established component of women's health care. Women and their health care providers have historically accepted the schedule of an annual gynecologic examination with cervical cancer screening and a pelvic examination. Recently, researchers questioned the value of the annual breast and pelvic examinations in asymptomatic women and re-established the intervals for Pap test screening with the addition of human papillomavirus co-testing to establish cervical cancer risk. The updated well woman examination is now an opportunity to engage women in health education, screening for chronic disease risks, and health care concerns such as depression and violence. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  15. Role of interstitial implantation in gynecological cancer

    International Nuclear Information System (INIS)

    Nori, D.; Hilaris, B.S.

    1987-01-01

    Recurrent cancer at any site carries a gloomy prognosis. Cancer of the cervix that recurs after radical surgery or curative radiation therapy is a perplexing problem confronting both gynecological and radiation oncologists. In the authors' series, 45% of the patients survived disease-free at 1 year and 10% survived without disease at 5 years or longer following interstitial implantation for recurrent cervical cancer. The optimal utilization of this procedure seems to depend on the site of recurrence, the extent of the disease in the pelvis, and the status of para-aortic node involvement. This retrospective analysis enabled the authors to identify the prognostic factors. The most favorable group benefited by this technique were those who presented with either central recurrence or unilateral, localized pelvic side wall recurrent disease. The least morbidity was noticed in those patients with minimal surgical manipulations at the time of the interstitial implantation. The authors recommended that only a limited and essential surgical procedure should accompany interstitial implantation, since the associated morbidity and mortality is high and survival brief

  16. MR imaging of cerebrospinal fluid dynamics in health and disease. On the vascular pathogenesis of communicating hydrocephalus and benign intracranial hypertension

    International Nuclear Information System (INIS)

    Greitz, D.; Hannerz, J.; Raehn, T.; Bolander, H.; Ericsson, A.

    1994-01-01

    The CSF flows in the aqueduct and at the foramen magnum were examined in 5 patients with communicating hydrocephalus (HC) and in 10 with benign intracranial hypertension (BIH) as well as in 5 healthy volunteers. As compared to normal individuals, the aqueductal flow in HC was about 10 times larger and the cervical flow was half as large. In BIH the CSF flows were not different from those of normal volunteers. The decreased arterial expansion as reflected in the reduced cervical flow in HC may be due to pathologic changes in the arteries and paravascular spaces. The large aqueductal flow in HC reflects a large brain expansion, causing increased transcerebral mantle pressure gradient and ventricular dilatation. In BIH there is a normal brain expansion (aqueductal flow) and consequently no ventricular dilatation. It is argued that BIH be caused by an obstruction on the venous side, as opposed to the vascular alterations in HC, which are on the arterial side. (orig.)

  17. Major clinical research advances in gynecologic cancer in 2014

    OpenAIRE

    Suh, Dong Hoon; Lee, Kyung-Hun; Kim, Kidong; Kang, Sokbom; Kim, Jae-Weon

    2015-01-01

    In 2014, 9 topics were selected as major advances in clinical research for gynecologic oncology: 2 each in cervical and corpus cancer, 4 in ovarian cancer, and 1 in breast cancer. For cervical cancer, several therapeutic agents showed viable antitumor clinical response in recurrent and metastatic disease: bevacizumab, cediranib, and immunotherapies including human papillomavirus (HPV)-tumor infiltrating lymphocytes and Z-100. The HPV test received FDA approval as the primary screening tool of...

  18. Gynecology

    International Nuclear Information System (INIS)

    Bouchbika, Z.; Benmensour, M.; Bourhaleb, Z.; Benchakroun, N.; Jouhadi, H.; Tawfiq, N.; Sahraoui, S.; Acharki, A.; Benider, A.; Boughrara, W.; Boudraa, B.; Bali, M.S.; Djemaa, A.; Metayer, Y.M.; Peiffert, D.P.; Chemin, A.C.; Malet, C.M.; Meyer, P.M.; Lisbona, A.L.; Charra-Brunaud, C.; Ahmad, F.; Metayer, Y.; Haie, C.; Thomas, L.; Barillot, I.; Castelain, B.; Delannes, M.; Chilles, A.; Tournier Rangeard, L.; Buchheit, I.

    2005-01-01

    Fractionated radiotherapy and chemotherapy in the cancer of the uterine cervix carcinomas, brachytherapy with pulse rate, three dimensional calculations to determine volume to irradiate and then to optimize the dosimetry are the different points tackled in this part devoted to the cervix uterine cancer. (N.C.)

  19. The pattern of expression and role of triiodothyronine (T3) receptors and type I 5'-deiodinase in breast carcinomas, benign breast diseases, lactational change, and normal breast epithelium.

    Science.gov (United States)

    Alyusuf, Raja H; Matouq, Jenan Al; Taha, Safa; Wazir, Javed F

    2014-08-01

    : To study the pattern of expression of triiodothyronine (T3) receptors and type I 5'-deiodinase in various breast pathologies comparing malignant and nonmalignant epithelia that include lactational change. A retrospective study was performed on formalin-fixed, paraffin-embedded archival material from 146 cases of carcinomas, normal breast tissue, breast tissue showing lactational change, and benign breast lesions. Archive tissue blocks were selected and sections were cut for immunohistochemistry to study the expression of thyroid hormone receptor α-1 (THR-α1) in the cytoplasm and nuclei of cells in tissues under study. Thick sections were cut for type I 5'-deiodinase evaluation using reverse transcriptional PCR.THR-α1 showed no nuclear expression in the carcinoma group. Combined nuclear and cytoplasmic expression was seen in 47.6%, 63.4%, 64.3%, and 58.3% in the benign, fibrocystic, fibroadenoma, and lactational change groups, respectively, compared with only 17.4% of cases in the carcinoma group. This suggests deregulation of the thyroid hormone in breast cancer. Theories for the possible role of thyroid hormone in the pathogenesis of breast cancer are discussed.Type I 5'-deiodinase was not shown to be differentially expressed in malignant versus nonmalignant groups. Our study revealed substantial reduction in the protein expression profile of THRs in malignant versus nonmalignant mammary epithelium suggesting a possible role in breast cancer development. The presence of THRs in mammary epithelium seems to be protective against the development of breast cancer. This could serve as a potential prognostic and therapeutic target for breast cancer.

  20. Definitions of Obstetric and Gynecologic Hospitalists.

    Science.gov (United States)

    McCue, Brigid; Fagnant, Robert; Townsend, Arthur; Morgan, Meredith; Gandhi-List, Shefali; Colegrove, Tanner; Stosur, Harriet; Olson, Rob; Meyer, Karenmarie; Lin, Andrew; Tessmer-Tuck, Jennifer

    2016-02-01

    The obstetric hospitalist and the obstetric and gynecologic hospitalist evolved in response to diverse forces in medicine, including the need for leadership on labor and delivery units, an increasing emphasis on quality and safety in obstetrics and gynecology, the changing demographics of the obstetric and gynecologic workforce, and rising liability costs. Current (although limited) research suggests that obstetric and obstetric and gynecologic hospitalists may improve the quality and safety of obstetric care, including lower cesarean delivery rates and higher vaginal birth after cesarean delivery rates as well as lower liability costs and fewer liability events. This research is currently hampered by the use of varied terminology. The leadership of the Society of Obstetric and Gynecologic Hospitalists proposes standardized definitions of an obstetric hospitalist, an obstetric and gynecologic hospitalist, and obstetric and gynecologic hospital medicine practices to standardize communication and facilitate program implementation and research. Clinical investigations regarding obstetric and gynecologic practices (including hospitalist practices) should define inpatient coverage arrangements using these standardized definitions to allow for fair conclusions and comparisons between practices.

  1. Microparticles and Exosomes in Gynecologic Neoplasias

    NARCIS (Netherlands)

    Nieuwland, Rienk; van der Post, Joris A. M.; Lok Gemma, Christianne A. R.; Kenter, G.; Sturk, Augueste

    2010-01-01

    This review presents an overview of the functions of microparticles and exosomes in gynecologic neoplasias. Growing evidence suggests that vesicles released from cancer cells in gynecologic malignancies contribute to the hypercoagulable state of these patients and contribute to tumor progression by

  2. DNA Cytometry and Nuclear Morphometry in Ovarian Benign, Borderline and Malignant Tumors.

    Science.gov (United States)

    El Din, Amina A Gamal; Badawi, Manal A; Aal, Shereen E Abdel; Ibrahim, Nihad A; Morsy, Fatma A; Shaffie, Nermeen M

    2015-12-15

    Ovarian carcinoma is a leading cause of death in gynecological malignancy. Ovarian surface epithelial serous and mucinous tumours are classified as benign, borderline, and malignant. The identification of borderline tumours most likely to act aggressively remains an important clinical issue. This work aimed to study DNA ploidy and nuclear area in ovarian serous and mucinous; benign, borderline and malignant tumours. This study included forty ovarian (23 serous and 17 mucinous) tumours. Paraffin blocks were sectioned; stained with haematoxylin and eosin for histopathologic and morphometric studies and with blue feulgen for DNA analysis. All four serous and six out of nine mucinous benign tumours were diploid. All eight serous and five mucinous malignant tumours were aneuploid. Nine of eleven (81.8%) serous and all three mucinous borderline tumours were aneuploid. There were highly significant differences in mean aneuploid cells percentage between serous benign (1.5%), borderline (45.6%) and malignant (74.5%) (p = 0.0001) and between mucinous benign (13.2%) and both borderline (63.7%) and malignant (68.4%) groups (p = 0.0001). There were significant differences in nuclear area between serous benign (26.191%), borderline (45.619%) and malignant (67.634 %) and a significant positive correlation between mean percentage aneuploid value and mean nuclear area in all serous and mucinous groups. We suggest that DNA ploidy and nuclear area combined, may be adjuncts to histopathology; in ovarian serous and mucinous benign, borderline and malignant neoplasms; identifying the aggressive borderline tumours.

  3. Patient's behavior and attitudes toward the management of benign prostatic hyperplasia among patients with the risk of disease progression: prospective study by "Prostate and Expectations of Treatment Epidemiology Research (PETER) study group".

    Science.gov (United States)

    Weibl, Peter; Klatte, Tobias; Laurinc, Peter; Tomaškin, Roman; Shariat, Shahrokh F; Helbich, Miroslav; Fackovcova, Danica; Bujdák, Peter

    2015-05-01

    The aim of the study was to evaluate patients attitudes with benign prostatic hyperplasia at the risk of progression during a 12-month period of observation. A total of 426 patients from 45 outpatients centers were included and prospectively followed. Inclusion criteria were: age > 50 years, International Prostate Symptom Score (IPSS) > 8, prostate volume > 30 cm(3) (transabdominal ultrasound) and PSA > 1.5 to benign prostatic hyperplasia/lower urinary tract symptoms had no impact on their quality of life (QoL), in 48.1 % only little impact on QoL, and 47.9% patients percepted their symptoms as severe. Out of 71.4% patients treated previously, 26.5% patients were indecisive about the satisfaction of present treatment. Visual analog score was percepted more optimistically rather than the IPSS. Pearson's correlation r = 0.68 at the beginning and r = 0.83 at the end of the study. Prostate and Expectations of Treatment Epidemiology Research study highlights and reflects on patients behavior and self-perception, patients self-perception of the disease and therapeutic priorities during the 1 year of observation.

  4. Benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Guo Xiang-Dong

    2011-01-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is a common clinical disorder characterized by brief recurrent spells of vertigo often brought about by certain head position changes as may occur with looking up, turning over in bed, or straightening up after bending over. It is important to understand BPPV not only because it may avert expensive and often unnecessary testing, but also because treatment is rapid, easy, and effective in >90% of cases. The diagnosis of BPPV can be made based on the history and examination. Patients usually report episodes of spinning evoked by certain movements, such as lying back or getting out of bed, turning in bed, looking up, or straightening after bending over. At present, the generally accepted recurrence rate of BPPV after successful treatment is 40%-50% at 5 years of average follow-up. There does appear to be a subset of individuals prone to multiple recurrences.

  5. Utilization of gynecologic services in women with breast cancer receiving hormonal therapy.

    Science.gov (United States)

    Wright, Jason D; Desai, Vrunda B; Chen, Ling; Burke, William M; Tergas, Ana I; Hou, June Y; Accordino, Melissa; Ananth, Cande V; Neugut, Alfred I; Hershman, Dawn L

    2017-07-01

    The selective estrogen receptor modulator tamoxifen is now widely used for the treatment and prevention of breast cancer. Tamoxifen use has been associated with a variety of gynecologic problems. Despite the frequency with which hormonal therapy is used for the treatment of breast cancer, limited population-level data are available to describe the occurrence of gynecologic conditions and the use of surveillance testing in women receiving tamoxifen and aromatase inhibitors. We performed a population-based analysis among women with breast cancer receiving hormonal therapy with tamoxifen, a drug commonly used in premenopausal and sometimes postmenopausal women, to determine the frequency of gynecologic abnormalities and use of diagnostic and surveillance testing. We compared these findings to women treated with aromatase inhibitors, agents commonly used in postmenopausal women. The MarketScan database was used to identify women diagnosed with breast cancer from 2009 through 2013 who underwent mastectomy or lumpectomy. Women receiving tamoxifen (age gynecologic symptoms and diseases (vaginal bleeding, endometrial polyps, endometrial hyperplasia, and endometrial cancer) and gynecologic procedures and interventions (transvaginal ultrasound, endometrial biopsy, hysteroscopy/dilation and curettage, and hysterectomy). Time-dependent analyses were performed to examine symptoms and testing. A total of 75,170 women, including 15,735 (20.9%) age gynecologic symptom or pathologic diagnosis during the study period was 20.2%, 12.3%, and 3.5%, respectively (P gynecologic procedure or intervention during the study period was 34.2%, 20.9%, and 9.0%, respectively (P gynecologic symptoms, procedures, and pathology are higher for both premenopausal and postmenopausal women with breast cancer on tamoxifen. Increased efforts to curb use of gynecologic interventions in asymptomatic women are needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Italian survey on benign paroxysmal positional vertigo

    OpenAIRE

    Messina, A.; Casani, A.P.; Manfrin, M.; Guidetti, G.

    2017-01-01

    SUMMARY Benign paroxysmal positional vertigo (BPPV) is the most common type of peripheral vertigo. BPPV often relapses after the first episode, with a recurrence rate between 15% and 50%. To date both the aetiopathogenetic processes that lead to otoconia detachment and the factors that make BPPV a relapsing disease are still unclear, but recent epidemiological studies have shown a possible association with cardiovascular risk factors. The aim of the present study (Sesto Senso Survey) was to e...

  7. [Benign prostatic hypertrophy and prostate cancer].

    Science.gov (United States)

    Mourey, Loïc; Doumerc, Nicolas; Gaudin, Clément; Gérard, Stéphane; Balardy, Laurent

    2014-01-01

    Prostatic diseases are extremely common, especially in older men. Amongst them, benign prostatic hypertrophy may affect significantly the quality of life of patients by the symptoms it causes. It requires appropriate care. Prostate cancer is the second most common cancer in men after lung cancer and the fifth leading cause of cancer deaths in the world. It affects preferentially older men. An oncogeriatric approach is required for personalised care.

  8. Obstetrics and Gynecology Hospitalist Fellowships.

    Science.gov (United States)

    Vintzileos, Anthony M

    2015-09-01

    This article establishes the rationale and development of an obstetrics and gynecology (OB/GYN) hospitalist fellowship program. The pool of OB/GYN hospitalists needs to be drastically expanded to accommodate the country's needs. Fellowship programs should provide extra training and confidence for recent resident graduates who want to pursue a hospitalist career. Fellowships should train physicians in a way that aligns their interests with those of the hospital with respect to patient care, teaching, and research. Research in the core measures should be a necessary component of the fellowship so as to provide long-term benefits for all stakeholders, including hospitals and patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. [HYPNOSIS IN OBSTETRICS AND GYNECOLOGY].

    Science.gov (United States)

    Rabinerson, David; Yeoshua, Effi; Gabbay-Ben-Ziv, Rinat

    2015-05-01

    Hypnosis is an ancient method of treatment, in which an enhanced state of mind and elevated susceptibility for suggestion of the patient, are increased. Hypnosis is executed, either by a caregiver or by the person himself (after brief training). The use of hypnosis in alleviating labor pain has been studied as of the second half of the 20th century. In early studies, the use of hypnosis for this purpose has been proven quite effective. However, later studies, performed in randomized controlled trial terms, have shown controversial results. Other studies, in which the effect of hypnosis was tested in various aspects of both obstetrics and gynecology and with different levels of success, are elaborated on in this review.

  10. Gynecologic management of neuropathic pain.

    Science.gov (United States)

    Tu, Frank F; Hellman, Kevin M; Backonja, Miroslav M

    2011-11-01

    Obstetrician/gynecologists often are the initial management clinicians for pelvic neuropathic pain. Although treatment may require comprehensive team management and consultation with other specialists, there are a few critical and basic steps that can be performed during an office visit that offer the opportunity to improve quality of life significantly in this patient population. A key first step is a thorough clinical examination to map the pain site physically and to identify potentially involved nerves. Only limited evidence exists about how best to manage neuropathic pain; generally, a combination of surgical, manipulative, or pharmacologic methods should be considered. Experimental methods to characterize more precisely the nature of the nerve dysfunction exist to diagnose and treat neuropathic pain; however, additional scientific evidence is needed to recommend these options unanimously. In the meantime, an approach that was adopted from guidelines of the International Association for the Study of Pain has been tailored for gynecologic pain. Copyright © 2011 Mosby, Inc. All rights reserved.

  11. A New Method for Analyzing Diagnostic Delay in Gynecological Cancer

    DEFF Research Database (Denmark)

    Vandborg, Mai Partridge; Edwards, Kasper; Kragstrup, Jakob

    2012-01-01

    AND METHODS: Six women with a diagnostic delay of 6 weeks or more before treatment of gynecological cancer at a specialized regional department (the Department of Gynecology and Obstetrics, Odense University Hospital, Denmark) were included in the study. Maps of existing processes were performed for each...... patient reflecting the patients' pathway through the course of the disease. We combined 2 process mapping tools, namely, value stream mapping and business process modeling notation. The first method identifies the flow in a process as timelines. The latter introduces a set of easily recognizable graphical...... elements. RESULTS: Detailed information concerning the cancer patients' pathway was obtained. The method visualized the complexities within the diagnostic pathway. The role of different participants (patient, general practitioner, and local hospitals) became clear by arranging activities according...

  12. On use of ultrasonography in obstetrics and gynecology

    International Nuclear Information System (INIS)

    Woo, Kwang Suk; Lee, Yong Woo

    1984-01-01

    Ultrasonography is playing an very important in diagnosis of normal pregnancy and the other diseases in the fields of obstetrics and gynecology. It is mainly used B-mode and Real time linear scan for pregnancy such as fetal movement during its early stage, fetal position, placenta location and biparietal diameter during its middle stage, and amniotic fluid and placenta previa during its late stage, as well as tumor accompanying pregnancy. Ultrasonography has been extensively used in the fields of obstetrics and gynecology for obtaining detailed images of soft tissues without hazard to the fetus and pregnant woman. In view of the need for its professionalism of high degree of skill, this treatise will introduce clinical instances and images obtained in the sonography room of the Seoul National University Hospital

  13. On use of ultrasonography in obstetrics and gynecology

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Kwang Suk; Lee, Yong Woo [Seoul National University Hospital, Seoul (Korea, Republic of)

    1984-08-15

    Ultrasonography is playing an very important in diagnosis of normal pregnancy and the other diseases in the fields of obstetrics and gynecology. It is mainly used B-mode and Real time linear scan for pregnancy such as fetal movement during its early stage, fetal position, placenta location and biparietal diameter during its middle stage, and amniotic fluid and placenta previa during its late stage, as well as tumor accompanying pregnancy. Ultrasonography has been extensively used in the fields of obstetrics and gynecology for obtaining detailed images of soft tissues without hazard to the fetus and pregnant woman. In view of the need for its professionalism of high degree of skill, this treatise will introduce clinical instances and images obtained in the sonography room of the Seoul National University Hospital.

  14. Imaging of gynecologic emergencies; Bildgebende Diagnostik gynaekologischer Notfaelle

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Matthias W. [Universitaetsspital Zuerich (Switzerland). Inst. fuer Diagnostische und Interventionelle Radiologie; Huisman, Thierry A.G.M. [John Hopkins Bayview Medical Center, Baltimore, MD (United States). Dept. of Imaging and Imaging Science; John Hopkins Bayview Medical Center, Baltimore, MD (United States). Dept. of Pediatrc Radiology and Pediatric Neuroradiology; Kubik, Rahel A. [Kantonsspital Baden AG, Baden (Switzerland). Inst. fuer Radiologie

    2016-09-15

    Acute abdominal pain related to the female genital organs is frequently encountered in the emergency department. Gynecological emergencies are diseases of the female reproductive system that are potentially life-threatening and peril the sexual function and fertility. In the diagnostic work-up of acute abdominal pain, a wide variety of differential diagnoses needs to be considered depending on the age of the patient and a concomitant pregnancy. There is significant clinical overlap with gastrointestinal emergencies. Therefore, imaging plays a key role in diagnosing the cause of the pain and the planning of the therapy. The aim of this review is to illustrate the significant role of imaging in frequently encountered gynecologic emergencies.

  15. Replicating viruses for gynecologic cancer therapy.

    Science.gov (United States)

    Park, J W; Kim, M

    2016-01-01

    Despite advanced therapeutic treatments, gynecologic malignancies such as cervical and ovarian cancers are still the top ten leading cause of cancer death among women in South Korea. Thus a novel and innovative approach is urgently needed. Naturally occurring viruses are live, replication-proficient viruses that specifically infect human cancer cells while sparing normal cell counterparts. Since the serendipitous discovery of the naturally oncotropic virus targeting gynecologic cancer in 1920s, various replicating viruses have shown various degrees of safety and efficacy in preclinical or clinical applications for gynecologic cancer therapy. Cellular oncogenes and tumor suppressor genes, which are frequently dysregulated in gynecologic malignancies, play an important role in determining viral oncotropism. Published articles describing replicating, oncolytic viruses for gynecologic cancers are thoroughly reviewed. This review outlines the discovery of replication-proficient virus strains for targeting gynecologic malignancies, recent progresses elucidating molecular connections between oncogene/tumor suppressor gene abnormalities and viral oncotropism, and the associated preclinical/clinical implications. The authors would also like to propose future directions in the utility of the replicating viruses for gynecologic cancer therapy.

  16. Benign breast lesions in Kano | Ochicha | Nigerian Journal of ...

    African Journals Online (AJOL)

    This was followed by fibroadenoma accounting for 28.8% with a mean age of 21 years, thus occurring a decade earlier than fibrocystic disease of the breast. Inflammatory breast diseases accounted for 8.1%. Conclusion: This study has shown that benign diseases are common in our environment, and with few exceptions ...

  17. How long can you keep working with benign multiple sclerosis?

    Science.gov (United States)

    Glad, Solveig B; Nyland, Harald; Aarseth, Jan Harald; Riise, Trond; Myhr, Kjell-Morten

    2011-01-01

    To study employment in benign multiple sclerosis (MS), the frequency of employment was analysed and the effect of early clinical and demographic factors on time to disability pension was evaluated in a population based MS cohort. The frequency of depression, cognitive function, fatigue and pain between benign and non-benign MS patients was compared, and their impact on employment in benign MS was studied. All 188 patients alive, including 60 benign patients with onset of MS during 1976-1986 in Hordaland County, Western Norway, were interviewed and clinically examined in 2003. The Expanded Disability Status Scale (EDSS), depression (Beck Depression Inventory), cognitive function, fatigue, pain, year of disability pension, employment and type of occupation were registered. Benign MS was defined as an EDSS score ≤3.0 at least 10 years after disease onset. After a mean disease duration of 22.2 years, 32.4% of the cohort were still employed. A relapsing-remitting course, higher educational level and light physical work were significantly associated with longer time to disability pension in the general MS population. Thirty-nine (65.0%) benign MS patients were employed, independent of light or heavy physical work. Mild depressive symptoms were markedly associated with not being employed in benign MS (OR=7.3). A relapsing-remitting course, higher educational level and light physical work significantly predicted longer time to disability pension in the total MS population. Among the benign MS patients, depressive symptoms, although mild, were strongly associated with not being employed.

  18. Nihilism: a benign denial.

    Science.gov (United States)

    Skandalakis, John E; Mirilas, Petros

    2003-06-01

    Nihilism is the belief that all possible knowledge on a given topic has been amassed and codified. Ranging from benign denial to deliberate attempts at excommunication, nihilism is often encountered in the history of medicine. Eustachius, Columbus, and Sylvius strongly criticized Vesalius and defended the authority of Galen. Riolan fervently rejected Harvey's monumental work on the circulation of blood. Gross stated that no honest and sensible surgeon would ever sanction thyroidectomy. Sandstrom's discovery of the parathyroids was met with silence. Transplantation of parathyroids by Mandl was not appreciated when announced. Aristotle's dictum that the heart cannot withstand serious injury led to Paget's statement that cardiac surgery had reached the limits set by nature, which no new techniques could overcome. The first Billroth I operation was welcomed as, "Hopefully, also the last." Pancreatic surgery was opposed because the organ was of no clinical interest and was impossible for surgeons to reach. Pancreatic transplantation was rejected for many years, despite good results. When Blundell used blood transfusion for postpartum hemorrhage, critics averred that his next exploit would be radical removal of the spleen. Bassini stated that it could be risky to publish more about radical treatment of inguinal hernias. Carcinomas of the lower sigmoid and upper rectum were deemed untreatable because of their inaccessibility. Colostomy during pediatric surgery was rejected many times. Although it is difficult for the human mind to move from a familiar point of view, this propensity should not infect science, thereby impeding advancement.

  19. 21 CFR 884.1720 - Gynecologic laparoscope and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gynecologic laparoscope and accessories. 884.1720... Devices § 884.1720 Gynecologic laparoscope and accessories. (a) Identification. A gynecologic laparoscope...) Class II (performance standards). (2) Class I for gynecologic laparoscope accessories that are not part...

  20. Combination of signal intensity measurements of lesions in the peripheral zone of prostate with MRI and serum PSA level for differentiating benign disease from prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Engelhard, K.; Kreckel, M. [Department of Radiology, Martha-Maria Hospital Nuernberg (Germany); Hollenbach, H.P.; Deimling, M. [Siemens Medical Engineering Group, Erlangen (Germany); Riedl, C. [Dept. of Urology, University of Erlangen-Nuernberg, Erlangen (Germany)

    2000-12-01

    The aim of this study was to predict the benign or malignant nature of a prostatic lesion by defining a threshold value of signal intensity ratio and a limiting value of serum prostate-specific antigen (PSA) in patients with elevated PSA level. Twenty-six patients with elevated PSA level and no hypoechogenic lesions at endosonography underwent MR imaging using an endorectal body phased-array coil at 1.5 T (Siemens Magnetom Symphony). A T2-weighted turbo-spin-echo (TSE) pulse sequence was applied in a transverse orientation. Two radiologists evaluated the images. In the presence of a pathological finding they defined regions of interest (ROI) in the suspicious pathological area of the peripheral zone and in muscle for reference. The quotient of the two ROIs was calculated and then correlated with the actual PSA level. Diagnosis was confirmed by prostate biopsy. Ten of 12 patients with quotients smaller than 4 showed cancer at histology. Nine of 12 men with cancer proven by biopsy had PSA levels higher than 10 ng/ml. A significant difference (p < 0.001) was found between the quotients of cancer and quotients of chronic prostatitis, fibrosis, or glandular atrophy. The accuracy of tumor differentiation of the method was 77 %. Measurement of signal intensity quotients in the peripheral zone of the prostate in combination with knowledge of defined limits of PSA levels the technique could be helpful in detecting additional cancer areas for prostate biopsy. False-negative tumor results of standard sextant biopsy can be reduced. In men with high PSA values the method has a role in differentiating between patients who require prostate biopsy and those of clinical observation. (orig.)

  1. A Cohert Study of the Relationship Between c-erbB-2 and Cyclin D1 Overexpression, p53 Mutation and/or Protein Accumulation, and Risk of Progression from Benign Breast Disease to Breast Cancer; and Creation of a Bank of Benign Breast Tissue

    National Research Council Canada - National Science Library

    Kandel, Rita

    2000-01-01

    ... increase in risk to develop breast cancer. The purpose of this project is: 1) collect paraffm-embedded benign breast tissue from the remaining 4,336 cohort members who were not part of the case-control study. (2...

  2. Obstetrics and Gynecology: Considerations in Career Selection

    Science.gov (United States)

    Stephen Petrilli, Edmund

    1981-01-01

    Current training programs in obstetrics and gynecology are not producing an excess of specialists in view of future manpower needs. In addition to being specialists and consultants, obstetrician-gynecologists also function as providers of primary care for women. During the last decade, three formal sub-specialties of obstetrics and gynecology have evolved: gynecologic oncology, maternal-fetal medicine and reproductive endocrinology. These have improved patient care and have altered the structure of resident education. With more American medical school graduates entering this specialty, the quality of resident applicants has improved, creating intense competition for desirable training positions. Those inclined toward a career in obstetrics and gynecology can be assured that it will provide an increasingly favorable and challenging environment for professional activity in the future. PMID:7210670

  3. Durvalumab, Tremelimumab + Radiotherapy in Gynecologic Cancer

    Science.gov (United States)

    2018-01-30

    Recurrent Gynecological Cancer; Metastatic Cervical Cancer; Metastatic Ovarian Cancer; Metastatic Vaginal Cancer; Metastatic Vulvar Cancer; Metastatic Endometrial Cancer; Recurrent Cervical Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Vaginal Cancer; Recurrent Vulvar Cancer; Recurrent Endometrial Cancer

  4. Benign Breast Problems and Conditions

    Science.gov (United States)

    ... with a needle. Another example is a simple fibroadenoma . Simple fibroadenomas usually shrink or go away on their own. ... Cyst: A sac or pouch filled with fluid. Fibroadenoma: A type of solid, benign breast mass. Hormone: ...

  5. Promoting Gynecologic Cancer Awareness at a Critical Juncture—Where Women and Providers Meet

    Science.gov (United States)

    Cooper, Crystale Purvis; Rodriguez, Juan; Hawkins, Nikki A

    2015-01-01

    Given the absence of effective population-based screening tests for ovarian, uterine, vaginal, and vulvar cancers, early detection can depend on women and health care providers recognizing the potential significance of symptoms. In 2008, the Centers for Disease Control and Prevention’s (CDC) Inside Knowledge campaign began distributing consumer education materials promoting awareness of gynecologic cancer symptoms. We investigated providers’ in-office use of CDC gynecologic cancer materials and their recognition of the symptoms highlighted in the materials. We analyzed data from a national 2012 survey of US primary care physicians, nurse practitioners, and gynecologists (N = 1,380). Less than a quarter of providers (19.4 %) reported using CDC gynecologic cancer education materials in their offices. The provider characteristics associated with the use of CDC materials were not consistent across specialties. However, recognition of symptoms associated with gynecologic cancers was consistently higher among providers who reported using CDC materials. The possibility that providers were educated about gynecologic cancer symptoms through the dissemination of materials intended for their patients is intriguing and warrants further investigation. Distributing consumer education materials in health care provider offices remains a priority for the Inside Knowledge campaign, as the setting where women and health care providers interact is one of the most crucial venues to promote awareness of gynecologic cancer symptoms. PMID:24214840

  6. Promoting gynecologic cancer awareness at a critical juncture--where women and providers meet.

    Science.gov (United States)

    Cooper, Crystale Purvis; Gelb, Cynthia A; Rodriguez, Juan; Hawkins, Nikki A

    2014-06-01

    Given the absence of effective population-based screening tests for ovarian, uterine, vaginal, and vulvar cancers, early detection can depend on women and health care providers recognizing the potential significance of symptoms. In 2008, the Centers for Disease Control and Prevention's (CDC) Inside Knowledge campaign began distributing consumer education materials promoting awareness of gynecologic cancer symptoms. We investigated providers' in-office use of CDC gynecologic cancer materials and their recognition of the symptoms highlighted in the materials. We analyzed data from a national 2012 survey of US primary care physicians, nurse practitioners, and gynecologists (N = 1,380). Less than a quarter of providers (19.4%) reported using CDC gynecologic cancer education materials in their offices. The provider characteristics associated with the use of CDC materials were not consistent across specialties. However, recognition of symptoms associated with gynecologic cancers was consistently higher among providers who reported using CDC materials. The possibility that providers were educated about gynecologic cancer symptoms through the dissemination of materials intended for their patients is intriguing and warrants further investigation. Distributing consumer education materials in health care provider offices remains a priority for the Inside Knowledge campaign, as the setting where women and health care providers interact is one of the most crucial venues to promote awareness of gynecologic cancer symptoms.

  7. Small cell carcinoma of the gynecologic tract: a multifaceted spectrum of lesions.

    Science.gov (United States)

    Atienza-Amores, Maria; Guerini-Rocco, Elena; Soslow, Robert A; Park, Kay J; Weigelt, Britta

    2014-08-01

    Small cell carcinoma (SmCC) of the female genital tract constitutes a diagnostic and clinical challenge given its rarity and the lack of standardized therapeutic approaches. Here we review the morphological, clinical and molecular features of gynecologic SmCCs and discuss potential areas for future research. Data for this review article were identified by searches of PubMed, EMBASE and the Internet using the search terms "small cell carcinoma" or "neuroendocrine carcinoma" and "gynecologic", "uterine cervix", "cervix", "uterus", "endometrium", "ovary", "vagina", "fallopian tube" or "vulva", and research articles published in English between 1972 and February 2014 were included. SmCCs arising from different organs within the gynecologic tract share the same histopathologic characteristics, which closely resemble those of small cell lung carcinoma. The expression of at least one immunohistochemical neuroendocrine marker is a common finding. The uterine cervix is the most frequent site of SmCC in the female genital tract. HPV infection seems to play a role in the development of cervical SmCC but not in cancers of other gynecologic sites. FIGO stage is an established prognostic factor, in particular in SCCs of the cervix. Irrespective of the site, SmCCs of the gynecologic tract display an aggressive clinical behavior with few reported long-term survivors. The therapeutic management includes surgery, radiotherapy and chemotherapy. Despite the potential differences in etiology and risk factors, SmCCs from different sites of the gynecologic tract have similar morphologic appearances and clinical behavior. Recent genomic analyses of small cell carcinoma of the lung have revealed potential driver genomic alterations. We posit that the comprehensive genomic characterization of gynecologic SmCCs may lead to the identification of markers that result in an improvement of diagnostic reproducibility of SmCCs of the gynecologic tract, and of molecular aberrations that may be

  8. Alternatives to commonly used pelvic reconstruction procedures in gynecologic oncology.

    Science.gov (United States)

    Chao, Albert H; McCann, Georgia A; Fowler, Jeffrey M

    2014-07-01

    The objective of this review is to discuss alternatives to commonly used methods of soft tissue reconstruction in patients with gynecologic malignancies, and in particular alternatives to skin grafts, local skin flaps, and rectus abdominis/gracilis flaps. A review of the literature was performed on soft tissue reconstruction in patients with gynecologic malignancies. Soft tissue reconstruction is often necessary to achieve successful wound healing, minimize complications, and to restore anatomic form and function. Commonly used methods such as skin grafts, local skin flaps, and rectus abdominis/gracilis flaps are effective, but many scenarios exist where they may be suboptimal or unavailable for use. Situations faced by the gynecologic oncologist where this may be the case include patients in whom prior treatments and/or tumor involvement have affected the vascular supply and tissues of commonly used options, those with disease recurrence who have previously undergone tumor extirpation and reconstruction, and patients undergoing radical surgery where commonly used options alone are inadequate. Under these circumstances, there are several alternative options, and an understanding of the full spectrum of reconstructive techniques is essential. Many clinical scenarios exist where commonly used options for soft tissue reconstruction are suboptimal or unavailable. Current evidence supports use of alternative methods of reconstruction in these situations. However, further larger scale and comparative studies are needed to refine surgical decision-making. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Gynecologic reconstruction with a rectus abdominis myocutaneous flap: an update.

    Science.gov (United States)

    Carlson, J W; Carter, J R; Saltzman, A K; Carson, L F; Fowler, J M; Twiggs, L B

    1996-06-01

    This series reports the outcomes and significant complications associated with the rectus myocutaneous flap when used for pelvic or inguinal reconstruction in patients with gynecologic cancers. Perioperative variables were retrospectively reviewed to identify social and medical risk factors as well as intraoperative and postoperative complications that predisposed to rectus flap failure. Fifteen patients with gynecologic malignancies underwent reconstructive procedures using a vertically oriented rectus abdominis myocutaneous flap for either vaginal (n = 14) or inguinal (n = 1) reconstruction. The patients' primary cancers were cervical (n = 11), rectal (n = 1), ovarian (n = 1), vulvar (n = 1), and vaginal (n = 1). The median age was 50 years. The median follow-up was 17 months. All flaps were mobilized in conjunction with a radical salvage operation. There were no cases of vaginal prolapse and no abdominal wound infections. However, 4 patients (27%) had major postoperative morbidity in this small series. There was one wound dehiscence and three episodes of necrosis of the subcutaneous and cutaneous portions of the flap. All 4 of these patients required additional operative intervention or debridement. Eleven patients had complete healing of the flap. The rectus abdominis myocutaneous flap is a valuable option for gynecologic reconstructive procedures. Perioperative strategies for improving flap viability include the identification of risk factors that may compromise flap perfusions such as prior abdominal incisions, peripheral vascular disease, and obesity. Meticulous surgical technique is required to preserve the vascular pedicle. These strategies may be useful in preoperative counseling, the perioperative evaluation, and the intraoperative management.

  10. Major clinical research advances in gynecologic cancer in 2014.

    Science.gov (United States)

    Suh, Dong Hoon; Lee, Kyung Hun; Kim, Kidong; Kang, Sokbom; Kim, Jae Weon

    2015-04-01

    In 2014, 9 topics were selected as major advances in clinical research for gynecologic oncology: 2 each in cervical and corpus cancer, 4 in ovarian cancer, and 1 in breast cancer. For cervical cancer, several therapeutic agents showed viable antitumor clinical response in recurrent and metastatic disease: bevacizumab, cediranib, and immunotherapies including human papillomavirus (HPV)-tumor infiltrating lymphocytes and Z-100. The HPV test received FDA approval as the primary screening tool of cervical cancer in women aged 25 and older, based on the results of the ATHENA trial, which suggested that the HPV test was a more sensitive and efficient strategy for cervical cancer screening than methods based solely on cytology. For corpus cancers, results of a phase III Gynecologic Oncology Group (GOG) 249 study of early-stage endometrial cancer with high-intermediate risk factors are followed by the controversial topic of uterine power morcellation in minimally invasive gynecologic surgery. Promising results of phase II studies regarding the effectiveness of olaparib in various ovarian cancer settings are summarized. After a brief review of results from a phase III study on pazopanib maintenance therapy in advanced ovarian cancer, 2 outstanding 2014 ASCO presentations cover the topic of using molecular subtypes in predicting response to bevacizumab. A review of the use of opportunistic bilateral salpingectomy as an ovarian cancer preventive strategy in the general population is presented. Two remarkable studies that discussed the effectiveness of adjuvant ovarian suppression in premenopausal early breast cancer have been selected as the last topics covered in this review.

  11. Contemporary Quality of Life Issues Affecting Gynecologic Cancer Survivors

    Science.gov (United States)

    Carter, Jeanne; Penson, Richard; Barakat, Richard; Wenzel, Lari

    2015-01-01

    Gynecologic cancers account for approximately 11% of the newly diagnosed cancers in women in the United States and 18% in the world.1 The most common gynecologic malignancies occur in the uterus and endometrium (53%), ovary (25%), and cervix (14%).2 Cervical cancer is most prevalent in premenopausal women, during their childbearing years, whereas uterine and ovarian cancers tend to present in the perimenopausal or menopausal period. Vaginal and vulvar cancers and malignancies arising from gestation, or gestational trophoblastic neoplasms, occur to a lesser extent. Regardless of cancer origin or age of onset, the disease and its treatment can produce short- and long-term sequelae (ie, sexual dysfunction, infertility, or lymphedema) that adversely affect quality of life (QOL). This article outlines the primary contemporary issues or concerns that may affect QOL and offers strategies to offset or mitigate QOL disruption. These contemporary issues are identified within the domains of sexual functioning, reproductive issues, lymphedema, and the contribution of health-related QOL (HRQOL) in influential gynecologic cancer clinical trials. PMID:22244668

  12. Circulating insulin-like growth factor-I, insulin-like growth factor binding protein-3 and terminal duct lobular unit involution of the breast: a cross-sectional study of women with benign breast disease.

    Science.gov (United States)

    Horne, Hisani N; Sherman, Mark E; Pfeiffer, Ruth M; Figueroa, Jonine D; Khodr, Zeina G; Falk, Roni T; Pollak, Michael; Patel, Deesha A; Palakal, Maya M; Linville, Laura; Papathomas, Daphne; Geller, Berta; Vacek, Pamela M; Weaver, Donald L; Chicoine, Rachael; Shepherd, John; Mahmoudzadeh, Amir Pasha; Wang, Jeff; Fan, Bo; Malkov, Serghei; Herschorn, Sally; Hewitt, Stephen M; Brinton, Louise A; Gierach, Gretchen L

    2016-02-18

    Terminal duct lobular units (TDLUs) are the primary structures from which breast cancers and their precursors arise. Decreased age-related TDLU involution and elevated mammographic density are both correlated and independently associated with increased breast cancer risk, suggesting that these characteristics of breast parenchyma might be linked to a common factor. Given data suggesting that increased circulating levels of insulin-like growth factors (IGFs) factors are related to reduced TDLU involution and increased mammographic density, we assessed these relationships using validated quantitative methods in a cross-sectional study of women with benign breast disease. Serum IGF-I, IGFBP-3 and IGF-I:IGFBP-3 molar ratios were measured in 228 women, ages 40-64, who underwent diagnostic breast biopsies yielding benign diagnoses at University of Vermont affiliated centers. Biopsies were assessed for three separate measures inversely related to TDLU involution: numbers of TDLUs per unit of tissue area ("TDLU count"), median TDLU diameter ("TDLU span"), and number of acini per TDLU ("acini count"). Regression models, stratified by menopausal status and adjusted for potential confounders, were used to assess the associations of TDLU count, median TDLU span and median acini count per TDLU with tertiles of circulating IGFs. Given that mammographic density is associated with both IGF levels and breast cancer risk, we also stratified these associations by mammographic density. Higher IGF-I levels among postmenopausal women and an elevated IGF-I:IGFBP-3 ratio among all women were associated with higher TDLU counts, a marker of decreased lobular involution (P-trend = 0.009 and women with elevated mammographic density (P-interaction women with high mammographic density and limited TDLU involution, two markers that have been related to increased breast cancer risk. If confirmed in prospective studies with cancer endpoints, these data may suggest that evaluation of IGF

  13. Benign bone-forming tumors

    International Nuclear Information System (INIS)

    Heuck, A.; Staebler, A.; Steinborn, M.; Woertler, K.

    2001-01-01

    Benign bone-forming tumors include osteomas, enostomas, osteoid osteomas, and osteoblastomas. These lesions are often characterized by typical imaging findings on radiographs, CT and MR imaging studies. Radiologic findings and additional clinical information allow for a specific diagnosis in most cases. This review article emphasizes the radiological patterns of benign boneforming tumors as well as their epidemiological, clinical, and pathological characteristics. In addition, minimally invasive interventional procedures for the therapy of osteoid osteoma are reviewed. (orig.) [de

  14. Gynecologic imaging: Current and emerging applications

    Directory of Open Access Journals (Sweden)

    Iyer V

    2010-01-01

    Full Text Available Common diagnostic challenges in gynecology and the role of imaging in their evaluation are reviewed. Etiologies of abnormal uterine bleeding identified on pelvic sonography and sonohysterography are presented. An algorithmic approach for characterizing an incidentally detected adnexal mass and use of magnetic resonance imaging for definitive diagnosis are discussed. Finally, the role of F18-fluorodeoxyglucose positron emission tomography in the management of gynecological malignancies, and pitfalls associated with their use are examined.

  15. Benign paroxysmal positional vertigo and comorbid conditions.

    Science.gov (United States)

    Cohen, Helen S; Kimball, Kay T; Stewart, Michael G

    2004-01-01

    To determine the prevalence of comorbid disease in patients with benign paroxysmal positional vertigo (BPPV) and the relationship of comorbid disease to symptoms of vertigo, disequilibrium, and anxiety. Patients who had posterior semicircular canal BPPV and who had been referred for vestibular rehabilitation at a tertiary care center completed a health status questionnaire and the Vertigo Symptom Scale, answered questions about level of vertigo, and were tested on computerized dynamic posturography. Subjects had high rates of diabetes, mild head trauma, and probable sinus disease. Balance was generally impaired, worse in diabetics and subjects with significant vestibular weakness. Subjects who smoked or had had mild head trauma had higher levels of anxiety. Comorbid conditions, particularly diabetes, mild head trauma, and sinus disease, are unusually prevalent in BPPV patients. Message: Patients with comorbid disease are at risk for having increased vertigo, anxiety, and disequilibrium compared to other patients. Copyright 2004 S. Karger AG, Basel

  16. Sexuality in Irish women with gynecologic cancer.

    Science.gov (United States)

    Cleary, Vicki; Hegarty, Josephine; McCarthy, Geraldine

    2011-03-01

    To investigate sexual self-concept, sexual relationships, and sexual functioning, and the relationship between these and certain demographic variables of Irish women, following a diagnosis of gynecologic cancer. Descriptive, correlational. Outpatient gynecologic oncology clinic in a large university hospital in Southern Ireland. 106 women with a diagnosis of and treatment for various gynecologic cancers (cervical, ovarian, endometrial, and vulvar). The Body Image Scale, Sexual Esteem Scale, and Sexual Self-Schema Scale were administered to women a minimum of six weeks postdiagnosis of any form of gynecologic cancer to measure sexual self-concept; the Intimate Relationships Scale to measure sexual relationships; and the Arizona Sexual Experiences Scale to measure sexual functioning. Sexual self-concept, body image, sexual esteem, sexual self-schema, sexual relationships, and sexual functioning. Participants reported negative changes in relation to their sexual self-concept, sexual relationships, and sexual functioning. Participants reported negative changes in relation to all stages of the sexual response cycle. Gynecologic cancer has the potential to negatively affect a woman's sexual self-concept, sexual relationships, and sexual functioning. Sexuality is a multidimensional construct and must be measured in this way. Healthcare professionals must use a holistic approach when providing information and support to patients with gynecologic cancer. Information must be provided to women on how cancer and its treatment has the potential to affect their sexual self-concept, sexual relationships, and sexual functioning, including information on how to overcome these alterations.

  17. Proof of concept of the WOMED model of benign thyroid disease: Restitution of thyroid morphology after correction of physical and psychological stressors and magnesium supplementation

    Directory of Open Access Journals (Sweden)

    Roy Moncayo

    2015-06-01

    General significance: Our results challenge validity of the prevailing dogma of a destructive unstoppable “autoimmune” destructive process of the gland. At the same time it shows new therapeutic options for patients with thyroid disease.

  18. Intraoperative radiation therapy for locally advanced gynecological malignancies

    International Nuclear Information System (INIS)

    Haddock, M.G.; Petersen, I.A.; Webb, M.J.; Wilson, T.O.; Podratz, K.C.; Gunderson, L.L.

    1996-01-01

    Purpose: Evaluate disease control and survival in patients with locally advanced gynecological malignancies who received intraoperative radiation therapy with electrons (IOERT) as a component of treatment. Methods and Materials: Between March 1983 and June 1995, 63 patients (pts) with locally advanced primary (9 pts) or recurrent (54 pts) gynecological malignancies received IOERT as a component of attempted curative therapy. The site of origin was uterine cervix in 40 pts, uterine corpus in 16 pts, vagina in 5 pts, and ovary in 2 pts. Thirty-eight patients with recurrent disease had been previously irradiated (median prior RT dose 5040 cGy, range 900-8400). External beam radiotherapy (EBRT) was given to 43 of 63 pts either before or after IOERT (900-6570 cGy, median 4960 cGy). Chemotherapy was given to 21 pts prior to IOERT and following IOERT in 2 pts. IOERT doses ranged from 800 cGy to 2500 cGy with a median of 1750 cGy. The median IOERT dose was 2000 cGy in 20 patients with gross residual disease and 1500 cGy in 43 patients with microscopic residual disease. Endpoints included central control within the IOERT cone, local control, distant failure, disease free survival and overall survival. Variables evaluated for impact on disease outcome included tumor grade, primary site, prior RT, IOERT dose, EBRT dose, residual disease at time of IOERT, and use of chemotherapy. Results: Survival and disease control data are presented in the table below. There was no impact of any disease or treatment related variable on local or central failure. Pts with microscopic residual disease at the time of IOERT had significantly fewer distant metastases than pts with gross residual (5 yr 31% vs. 77%, p = 0.001) and improved survival (5 yr 37% vs. 10%, p = 0.02). Patients with recurrent disease after previous RT had survival and disease control rates which were similar to those seen in pts without priot RT. Toxicity ≥ grade 3 due to IOERT was observed in 11 pts (17%). Conclusion: A

  19. Benign mixed tumor of the lacrimal sac

    Directory of Open Access Journals (Sweden)

    Jong-Suk Lee

    2015-01-01

    Full Text Available Neoplasms of the lacrimal drainage system are uncommon, but potentially life-threatening and are often difficult to diagnose. Among primary lacrimal sac tumors, benign mixed tumors are extremely rare. Histologically, benign mixed tumors have been classified as a type of benign epithelial tumor. Here we report a case of benign mixed tumor of the lacrimal sac.

  20. Mesothelioma - benign-fibrous

    Science.gov (United States)

    ... the cancerous type of this disease, called malignant mesothelioma , which is caused by exposure to asbestos. SFT is not caused by asbestos exposure. Treatment Treatment is usually to remove the tumor. Outlook ( ...

  1. Factors Affecting Gynecologic and Sexual Assessment in Older Women: A Lesson for Primary Care Providers

    Directory of Open Access Journals (Sweden)

    Ayasha Thomason

    2015-08-01

    Full Text Available Guidelines for screening of cervical cancer and pelvic exams for older women have recently changed. These changes may have unexpected sequelae in women over 65 years of age. This manuscript provides a review of gynecologic screening recommendations for older women in the U.S. and potential ramifications of these recent changes. Peer reviewed guidelines from the American College of Obstetrics and Gynecology, U.S. Preventative Task Force Services, the American Cancer Society, The Centers for Disease Control, and multiple original research articles and reviews were reviewed for this manuscript. Women over 65 are at greatest risk to develop late stage diagnoses of cancers, pelvic organ disease, incontinence, and infections. Clinicians will need to acutely consider this fact when communicating and screening this population. We conclude that practitioners should be aware of the new guidelines and should consider including gynecologic health history and symptom analysis as part of annual exams in women of all ages.

  2. Annual report of the Women's Health Care Committee, Japan Society of Obstetrics and Gynecology, 2015.

    Science.gov (United States)

    Wakatsuki, Akihiko; Takamatsu, Kiyoshi

    2016-02-01

    The activity of the Women's Health Care Committee over a two year period up to June 2015 focused upon: (i) management of breast diseases in obstetrics and gynecology; (ii) investigation of lifestyle-related disease and bone mineral density after gynecologic cancer therapy; (iii) postoperative women's health care; (iv) current surgical treatment for pelvic organ prolapse among gynecologists in Japan; (v) cesarean indication for pregnant women with active/inactive genital viral lesions; (vi) health care of young female athletes concerned about menstrual cycle abnormalities, stress fractures and premenstrual syndrome/premenstrual dysphoric disorder; (vii) a training program for women's health care advisers; and (viii) a new edition of the oral contraceptive and low-dose estrogen-progestogen guideline. Detailed activities of the eight subcommittees are described in the text. © 2015 Japan Society of Obstetrics and Gynecology.

  3. Annual report of the Women's Health Care Committee, Japan Society of Obstetrics and Gynecology, 2017.

    Science.gov (United States)

    Takamatsu, Kiyoshi; Kitawaki, Jo

    2018-01-01

    To improve women's quality of life, the activity of the Women's Health Care Committee over a year up to July 2017 focused upon: (i) breast management; (ii) the influence of gynecological disease therapy on physical condition; (iii) non-surgical management of pelvic organ prolapse; (iv) survey of infectious diseases in obstetrics and gynecology in Japan; (v) health care for female athletes; (vi) a training program for women's health care advisors; (vii) revising the Japanese guidelines on hormone replacement therapy; and (viii) revising the 2016 Japanese guidelines for the proper use of emergency contraceptives. The detailed activity of the eight subcommittees is described herein. This report is based on the Japanese version of our annual report (Acta Obst Gynaec Jpn 2017;69(6):1480-1491), to publicize the activities of our committee. © 2017 The Authors. Journal of Obstetrics and Gynaecology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics and Gynecology.

  4. Benign intracranial hypertension diagnosed with bilateral papilloedema

    Directory of Open Access Journals (Sweden)

    K. C. Phillips

    2013-12-01

    Full Text Available This article presents a case of benign intracranial hypertension (BIH diagnosed from the presence of papilloedema. This potentially sight-threatening condition particularly affects younger obese females and can be idiopathic, caused by adverse reaction to certain prescription medications or by systemic disease. Prompt treatment is essentialto avoid optic atrophy and low energy diet and exercise forms part of long-term treatment to avoid relapse. Optometrists can play a critical primary health care role in the detection of papilloedema and referring appropriately.

  5. Asian Society of Gynecologic Oncology International Workshop 2014

    Science.gov (United States)

    Park, Jeong-Yeol; Ngan, Hextan Yuen Sheung; Park, Won; Cao, Zeyi; Wu, Xiaohua; Ju, Woong; Chung, Hyun Hoon; Chang, Suk-Joon; Park, Sang-Yoon; Ryu, Sang-Young; Kim, Jae-Hoon; Cho, Chi-Heum; Lee, Keun Ho; Lee, Jeong-Won; Kumarasamy, Suresh; Kim, Jae-Weon; Wilailak, Sarikapan; Kim, Byoung-Gie; Kim, Dae-Yeon; Konishi, Ikuo; Lee, Jae-Kwan; Wang, Kung-Liahng

    2015-01-01

    The Asian Society of Gynecologic Oncology International Workshop 2014 on gynecologic oncology was held in Asan Medical Center, Seoul, Korea on the 23rd to 24th August 2014. A total of 179 participants from 17 countries participated in the workshop, and the up-to-date findings on the management of gynecologic cancers were presented and discussed. This meeting focused on the new trends in the management of cervical cancer, fertility-sparing management of gynecologic cancers, surgical management of gynecologic cancers, and recent advances in translational research on gynecologic cancers. PMID:25609163

  6. Environmentally Benign Stab Detonators

    Energy Technology Data Exchange (ETDEWEB)

    Gash, A E

    2006-07-07

    The coupling of energetic metallic multilayers (a.k.a. flash metal) with energetic sol-gel synthesis and processing is an entirely new approach to forming energetic devices for several DoD and DOE needs. They are also practical and commercially viable manufacturing techniques. Improved occupational safety and health, performance, reliability, reproducibility, and environmentally acceptable processing can be achieved using these methodologies and materials. The development and fielding of this technology will enhance mission readiness and reduce the costs, environmental risks and the necessity of resolving environmental concerns related to maintaining military readiness while simultaneously enhancing safety and health. Without sacrificing current performance, we will formulate new impact initiated device (IID) compositions to replace materials from the current composition that pose significant environmental, health, and safety problems associated with functions such as synthesis, material receipt, storage, handling, processing into the composition, reaction products from testing, and safe disposal. To do this, we will advance the use of nanocomposite preparation via the use of multilayer flash metal and sol-gel technologies and apply it to new small IIDs. This work will also serve to demonstrate that these technologies and resultant materials are relevant and practical to a variety of energetic needs of DoD and DOE. The goal will be to produce an IID whose composition is acceptable by OSHA, EPA, the Clean Air Act, Clean Water Act, Resource Recovery Act, etc. standards, without sacrificing current performance. The development of environmentally benign stab detonators and igniters will result in the removal of hazardous and toxic components associated with their manufacturing, handling, and use. This will lead to improved worker safety during manufacturing as well as reduced exposure of Service personnel during their storage and or use in operations. The

  7. Benign Parathyroid Adenoma Presenting with Unusual Parathyroid Crisis, Anemia and Myelofibrosis

    OpenAIRE

    Shu-Chuan Huang; Vin-Cent Wu; Guan Chou; Tzu-Yu Huang; Shih-Yi Lin; Wayne Huey-Herng Sheu

    2007-01-01

    Although the clinical symptoms of patients with benign parathyroid adenoma are usually nonspecific and benign, a malignant presentation of the benign disease may sometimes occur. Here, we report a case of a 58-year-old woman who presented with aggravated sacrum pain, general malaise, and polydipsia. Initial laboratory findings revealed hypercalcemia, normocytic anemia, and impaired renal function. Acute hyper-calcemic crisis manifested and primary hyperparathyroidism was diagnosed together wi...

  8. Pitfalls in diagnostic imaging and assessment of benign asbestos-related thoracic diseases; Fallstricke in der radiologischen Diagnostik und Begutachtung der benignen asbestbedingten Erkrankungen des Thorax

    Energy Technology Data Exchange (ETDEWEB)

    Rehbock, B. [Praxis fuer Diagnostische Radiologie am St.-Hedwig-Krankenhaus Berlin-Mitte, Berlin (Germany). Diagnostische Radiologie; Hofmann-Preiss, K. [Radiologische Gemeinschaftspraxis Erlangen (Germany). Radiologische Diagnostik; Kraus, T. [Universitaetsklinikum der RWTH Aachen (Germany). Inst. fuer Arbeits- und Sozialmedizin

    2012-05-15

    The recognition of asbestos-related diseases of the lung and/or pleura as an occupational disease is of psychosocial, medical and legal importance to the insured person. Radiological imaging is an essential part of the assessment and requires an increasingly high level of competence in the field of radiological diagnosis of pneumoconiosis in interdisciplinary collaboration with occupational medicine and pneumonology. The chest radiogram remains an integral part of basic diagnostic procedures in asbestos-related diseases of the lungs and/or pleura. Its importance lies in the detection of extended pleural changes as well as substantial fibrosis. The inherent low sensitivity and specificity of projection radiography is taken into account by the increasing use of multi-slice high resolution (HR) CT (in low dose technique). Radiological pitfalls in pleural plaque assessment with respect to plain chest X-ray concern all structures that superimpose on the pleural circumference, particularly the anatomical layers of the chest wall (extra-pleural fatty tissue, muscles, thoracic skeleton) as well as other pulmonary findings that can only be reliably assigned using CT. Even if state-of the-art CT is applied, asymmetries and abnormal expression of anatomical structures and variants (e.g. muscles and blood vessels) can lead to false-positive findings. The interstitial fibrosis of asbestosis, manifested as usual interstitial pneumonia (UIP) is non-pathognomonic for asbestosis. Therefore, parietal pleural thickening as a coincident finding to UIP is considered as being the main feature and a highly suggestive indicator of asbestosis in patients with a history of asbestos exposure. (orig.)

  9. les tumeurs benignes de la parotide benign parotid tumors

    African Journals Online (AJOL)

    Materials and Methods: We report a retrospective study of 48 cases of benign parotid tumors, collected over a period of 7 years. (2004-2010). ... superficial lobe tumor, a total parotidectomy was performed in 5 patients, an exofacialparotidectomy in 35 patients and a single tumor ..... Cancer Radiother 2005;9:251-60.

  10. Concomitant Repair of Pelvic Floor Disorders in Women Undergoing Surgery for Gynecologic Malignancies.

    Science.gov (United States)

    Bochenska, Katarzyna; Mueller, Margaret; Geynisman-Tan, Julia; Leader-Cramer, Alix; Davé, Bhumy; Lewicky-Gaupp, Christina; Kenton, Kimberly

    2018-04-04

    The aims of this study were to determine the rate and describe 30-day postoperative complications of concomitant pelvic organ prolapse and/or urinary incontinence (POPUI) procedures in women undergoing surgery for a gynecologic malignancy. Women who underwent surgical intervention for a gynecologic malignancy between 2010 and 2014 were identified using postoperative International Classification of Diseases, Ninth Revision codes 179.0 to 184.9 in the American College of Surgeons National Surgical Quality Improvement Program database. Women who underwent POPUI procedures were identified using Current Procedural Terminology codes between 51840 and 58294. Infectious, pulmonary, cardiac, and venous thromboembolism complication rates were calculated. Patient demographics and postoperative complication rates were analyzed using Student t, χ, and Fisher exact tests and compared between women with a gynecologic malignancy who did and did not undergo concomitant POPUI procedures. We identified 23,501 women with a diagnosis of a gynecologic malignancy. The most common included uterine (63%), ovarian (25%), and cervical cancer (8%). Only a small proportion of the women undergoing gynecologic cancer surgery (n = 556 [2.4%]) had concomitant POPUI procedures. The most commonly performed POPUI procedures included anterior and/or posterior colporrhaphy (n = 205 [32%]), laparoscopic colpopexy (n = 181 [28.2%]), and midurethral sling (n = 70 [10.9%]). There were no differences in 30-day reoperation; infectious, pulmonary, and cardiac complications; or venous thromboembolic events between women who did and did not have concomitant POPUI surgery. Using a large national surgical database, only 2.4% of women undergoing gynecologic cancer surgery had a concomitant POPUI procedure. Our data suggest that postoperative complications may not increase when concomitant surgery for POPUI is done at the time of gynecologic cancer surgery.

  11. ANALYSIS OF QUALITY MANAGEMENT OF GYNECOLOGIC SURGERY

    Directory of Open Access Journals (Sweden)

    Borut Kobal

    2003-12-01

    Full Text Available Background. The »Quality Management Project«, prepared by the Slovene Medical Chamber, served as the basis for determination of the quality-control indicators for gynecologic surgery. The authors have created a questionnaire that enables the analysis of these indicators. A pilot data entry was carried out between April and October 2001; since January 2002 the data entry has been done regularly in all departments of obstetrics and gynecology in Slovenia. At the National Congress of Obstetricians and Gynecologists of Slovenia, the analysis of quality-control indicators for gynecologic surgery will be presented and discussed in order to determine the standards of quality management in this field.

  12. Reasons for diagnostic delay in gynecological malignancies

    DEFF Research Database (Denmark)

    Vandborg, Mai Partridge; Christensen, René dePont Christensen; Kragstrup, Jakob

    2011-01-01

    Aim The primary aim of this study was to identify and describe different delay types in women with gynecologic cancer, and to analyze the relationship between diagnostic delay and a number of characteristics for patients, cancers and the health care system. Setting A cohort study of women newly......) and The Danish Gynecological Cancer Database (DGCD). 161 women were included; ovarian cancer: 63, endometrial cancer: 50, cervical cancer: 34 and vulvar cancer: 14. Outcome measures were different delay types counted in days and the influence of four clinical important variables: Presence of alarm symptoms, age...... (≤ or > 60 years), performance of gynecological examination by the GP and notification of cancer suspicion on first referral from GP’s on the diagnostic delay (short delay ≤90 days and long delay >90 days). Results Across cancer type a median total delay of 101 days was observed. The 10% of women...

  13. Pelvic Surgical Site Infections in Gynecologic Surgery

    Directory of Open Access Journals (Sweden)

    Mark P. Lachiewicz

    2015-01-01

    Full Text Available The development of surgical site infection (SSI remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery.

  14. Malignant transformation from benign papillomatosis of the external auditory canal.

    Science.gov (United States)

    Miah, Mohammed S; Crawford, Mairi; White, Sharon J; Hussain, Syed Shah Musheer

    2012-06-01

    Report a case of malignant transformation of benign ear canal papillomatosis to malignant squamous cell carcinoma (SCC) of the temporal bone. A 73-year-old with papillomata involving the posterior and inferior walls of the right external auditory canal (EAC), which subsequently transformed into SCC. Radical mastoidectomy and excision of the tumor and then radical radiotherapy. Loco-regional disease control. Recovery of facial nerve function. Approximately 20 months post-treatment, the patient remains disease free. No recovery of facial nerve function. Malignant transformation of a benign EAC papilloma to SCC of the temporal bone has not been reported previously. The association of human papillomavirus with temporal bone SCC has been reported in small number of studies with human papillomavirus subtypes 16 and 18 isolated in a high proportion of cases. With the increased availability in genotyping, the question over whether there should be further genetic analysis of benign lesions to assess their susceptibility to malignant transformation has merit.

  15. Gynecologic melanomas: A clinicopathologic and molecular analysis.

    Science.gov (United States)

    Udager, Aaron M; Frisch, Nora K; Hong, Linda J; Stasenko, Marina; Johnston, Carolyn M; Liu, J Rebecca; Chan, May P; Harms, Paul W; Fullen, Douglas R; Orsini, Amy; Thomas, Dafydd G; Lowe, Lori; Patel, Rajiv M

    2017-11-01

    Melanoma originating from gynecologic sites (MOGS), including the vulva, vagina, and cervix, is a rare and aggressive form of melanoma with poor long-term clinical outcome. The clinicopathologic features of vulvar and non-vulvar tumors remain relatively understudied, and in contrast to cutaneous melanomas at non-sun-exposed sites, MOGS typically do not harbor BRAF mutations. Thus, we sought to analyze the clinicopathologic and molecular features of MOGS. A large retrospective cohort of patients with MOGS (n=59) at a single large academic institution over a 28-year period was identified. Associations among clinicopathologic characteristics were assessed via standard statistical approaches, and clinical outcome was examined using Cox regression analysis. Sanger sequencing was utilized to identify mutations in hotspot regions of BRAF, KIT, NRAS, and CTNNB1. Tumors involving the vagina and/or cervix (non-vulvar) are significantly associated with high-risk clinicopathologic features, including increased tumor thickness, ulceration, positive resection margins, lymph node metastasis, and poor long-term clinical outcome (with increased risk of death due to disease). The aggressive clinical behavior of non-vulvar tumors is independent of advanced clinical stage and lymph node metastasis in multivariate analysis. Targeted molecular analysis confirms an overall low rate of oncogenic mutations in our MOGS cohort, although KIT mutations (particularly in exon 11) are relatively enriched. Overall, our results show that non-vulvar MOGS are aggressive tumors with poor long-term clinical outcome and indicate that few targeted therapeutic options are currently available to patients with MOGS. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Early experience with the da Vinci® surgical system robot in gynecological surgery at King Abdulaziz University Hospital

    Directory of Open Access Journals (Sweden)

    Sait KH

    2011-07-01

    Full Text Available Khalid H SaitObstetrics and Gynecology Department, Faculty of Medicine, Gynecology Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi ArabiaBackground: The purpose of this study was to review our experience and the challenges of using the da Vinci® surgical system robot during gynecological surgery at King Abdulaziz University Hospital.Methods: A retrospective study was conducted to review all cases of robot-assisted gynecologic surgery performed at our institution between January 2008 and December 2010. The patients were reviewed for indications, complications, length of hospital stay, and conversion rate, as well as console and docking times.Results: Over the three-year period, we operated on 35 patients with benign or malignant conditions using the robot for a total of 62 surgical procedures. The docking times averaged seven minutes. The mean console times for simple hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic lymphadenectomy were 125, 47, and 62 minutes, respectively. In four patients, laparoscopic procedures were converted to open procedures, giving a conversion rate of 6.5%. All of the conversions were among the first 15 procedures performed. The average hospital stay was 3 days. Complications occurred in five patients (14%, and none were directly related to the robotic system.Conclusion: Our early experience with the robot show that with proper training of the robotic team, technical difficulty with the robotic system is limited. There is definitely a learning curve that requires performance of gynecological surgical procedures using the robot.Keywords: da Vinci robot, gynecological surgery, laparoscopy

  17. A prospective study of breast anthropomorphic measurements, volume and ptosis in 605 Asian patients with breast cancer or benign breast disease.

    Directory of Open Access Journals (Sweden)

    Nai-Si Huang

    Full Text Available The current study aims to summarize breast anthropomorphic measurement features in Chinese patients with breast diseases and to investigate their potential correlations with demographic factors.Fifteen breast anthropomorphic parameters of 605 Chinese female patients were collected prospectively. Breast ptosis status was scaled by two methods and breast volume was calculated according to a modified formula of BREAST-V.Among 1210 breasts, the average breast volume was 340.0±109.1 ml (91.8-919.2 ml. The distance from the nipple to the inframammary fold was 7.5±1.6 cm in the standing position. The width of the breast base was 14.3±1.4 cm (8.5-23.5 cm. The incidence of breast ptosis was 22.8% (274/1204, of which 37 (23.5% and 79 (31.7% women had severe ptosis assessed by different criteria. Increased height (OR[odds ratio] = 1.500, P<0.001, post-menopausal status (OR = 1.463, P = 0.02, increased BMI, breastfeeding for 7-12 months (OR = 1.882, P = 0.008 and more than one year (OR = 2.367, P = 0.001 were risk factors for an increased breast volume. Post-menopausal status (OR = 2.390, P<0.001 and OR = 2.621, P<0.001 for different scales, BMI≥24.7 kg/m2 (OR = 3.149, P<0.001 and OR = 2.495, P = 0.002, breastfeeding for 7-12 months (OR = 4.136, P = 0.004 and OR = 4.010, P = 0.002, and breastfeeding for more than one year (OR = 6.934, P<0.001 and OR = 6.707, P<0.001 were independent risk factors for breast ptosis.The current study provides anthropomorphic measurements data of Chinese women with breast diseases, which are useful for cosmetic and reconstructive breast surgery decisions. Post-menopausal status, increased BMI, and breastfeeding for more than six months were independent risk factors for both increased breast volume and breast ptosis.

  18. Benign paroxysmal positional vertigo treatment

    DEFF Research Database (Denmark)

    West, Niels; Hansen, Søren; Bloch, Sune Land

    2017-01-01

    Benign paroxysmal positional vertigo (BPPV) remains the most frequent cause of vertigo. The TRV chair is a mechanical device suited for optimization of managing complex cases of BPPV. Although the use of repositioning devices in the management of BPPV is increasing, no applicable guide for the TRV...

  19. Scintigraphy in benign bone tumours

    African Journals Online (AJOL)

    1989-08-05

    Aug 5, 1989 ... benign osteoblastoma. Case 3. An 18-year-old boy presented to hospital with progressively worsening pain in the right buttock, which he related to a fall the previous year. Physical examination elicited an area of tenderness over the sacrum with an area of paraesthesia over the right buttock. Radiography ...

  20. Benign prostatic hyperplasia: epidemiology, economics and evaluation.

    Science.gov (United States)

    Vuichoud, Camille; Loughlin, Kevin R

    2015-10-01

    Benign prostatic hyperplasia (BPH) is arguably the most common benign disease of mankind. As men age, the prostate inexorably grows often causing troubling symptoms causing them to seek out care. While traditionally treated by transurethral resection or open surgical removal of the hypertrophied adenoma, today the urologist has numerous medical, surgical and minimally invasive techniques available. In this supplement The Canadian Journal of Urology provides a review of the various techniques and medications available today. As an introduction to the supplement, the aim of this article is to review the epidemiology and economy of BPH as well as its natural history and diagnosis. A systematic review of available literature was looking for articles on BPH and its epidemiology, economics, natural history and management using PubMed database. The prevalence of this condition is increasing with the population aging and so does the economic burden. The exact etiology of this condition is unknown, but some risk factors have been identified. The diagnostic and treatment of this very common disease should rely on a strong collaboration between primary care physician and urologist. There are multiple options in treating BPH including medical, surgical and newer minimally invasive options. The challenge with having a variety of options is to review them with the patient and help the patient select the best treatment option for their condition.

  1. Emotional personality/proximity versus emotional authenticity in patient-physician communication in healthy study participants, and in patients with benign breast disease, and breast cancer: a prospective case-control study in Finland.

    Science.gov (United States)

    Eskelinen, Matti; Korhonen, Riika; Selander, Tuomas; Ollonen, Paula

    2015-03-01

    The associations between emotional personality, proximity and authenticity in patient-physician communication during breast cancer (BC) consultations are rarely considered together in a prospective study. We, therefore, investigated emotional personality/proximity versus authenticity in patient-physician communication in healthy study subjects (HSS) and in patients with benign breast disease (BBD) and breast cancer (BC). In the Kuopio Breast Cancer Study, 115 women with breast symptoms were evaluated regarding emotional personality, proximity and authenticity in their a patient-physician communication before any diagnostic procedures were carried-out. The emotional personality and the emotional proximity in patient-physician communication was highly significantly positively correlated in the BBD group. The kappa-values for emotional personality versus emotional proximity in the HSS, BBD and BC groups were statistically significant. There was also a highly significant positive correlation between emotional personality and emotional authenticity in the HSS, BBD and BC groups and the kappa values in the HSS, BBD and BC groups were statistically significant. There was a highly significant positive correlation between emotional proximity and emotional authenticity in the BBD group, and the weighted kappa-values in the BBD group were statistically significant. The results of the present study support a powerful link between emotional personality/proximity and emotional authenticity, and provides new information in patient-physician communication in the HSS, BBD and BC groups. This finding is of clinical importance, since during breast disease consultation, barriers to patient-physician communication may be associated with difficulties in early BC diagnosis in the breast cancer diagnostic unit. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  2. Laparoscopic major gynecologic surgery in patients with prior laparotomy bowel resection.

    Science.gov (United States)

    Fanning, James; Hojat, Rod; Deimling, Timothy

    2011-01-01

    To review the success and morbidity of laparoscopic major gynecologic surgery in patients with prior laparotomy bowel resection. Review of a prospective surgical database of all cases of laparoscopic major gynecologic surgery in patients with prior laparotomy bowel resection. No cases were excluded. Bowel diagnoses and procedures were total colectomy for inflammatory bowel disease (4), partial colectomy for colon cancer (6), partial small bowel resection for obstruction (1), and Whipple for pancreatic cancer (2). Two patients had 3 prior laparotomies, 8 patients had 2 prior laparotomies, and 3 patients had 1 prior laparotomy. All prior abdominal incisions were midline. Gynecologic diagnoses and procedures were laparoscopic cytoreduction for ovarian cancer (1), lsh/bso/staging for ovarian cancer (1), lavh/bso/lymphadenectomy for endometrial cancer (4), and lavh/bso, lsh/bso, or bso for large ovarian mass (7). Median patient age was 57 years, median BMI was 31kg/m(2), and all patients had medical comorbidities. All 13 laparoscopic gynecologic surgeries were successful without trocar insertion injury, conversion to laparotomy, and without enterotomy. Abdominal adhesions were present in all cases. Median operative time was 2 hours, median blood loss was 100cc, and median hospital stay was 1 day. There were no postoperative complications. Laparoscopic major gynecologic surgery in patients with prior laparotomy bowel resection is feasible for experienced laparoscopic surgeons.

  3. [Evaluation of gynecologic morbidity in female cadets of military universities of St. Petersburg].

    Science.gov (United States)

    Artiukhova, N S; Shmidt, A A; Abashin, V G

    2012-08-01

    In-depth medical examination carried out a comprehensive survey of the dynamic female cadets of higher military educational institutions of the city of St. Petersburg in order to analyze the health of the troops of the Russian Federation Ministry of Defense personnel in the learning process, their level of gynecological diseases, as a possible consequence of influence of combat training. Following the study, shape, volume and frequency of activities to assess the health of women students, as well as a set of measures for the prevention of gynecological morbidity and dispensary of the contingent were developed.

  4. 42 CFR 493.945 - Cytology; gynecologic examinations.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Cytology; gynecologic examinations. 493.945 Section... gynecologic examinations (Pap smears) in cytology, a program must provide test sets composed of 10- and 20... Nonwaived Testing Proficiency Testing Programs by Specialty and Subspecialty § 493.945 Cytology; gynecologic...

  5. 42 CFR 493.855 - Standard; Cytology: gynecologic examinations.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Cytology: gynecologic examinations. 493... Complexity, Or Any Combination of These Tests § 493.855 Standard; Cytology: gynecologic examinations. To participate successfully in a cytology proficiency testing program for gynecologic examinations (Pap smears...

  6. 21 CFR 884.4550 - Gynecologic surgical laser.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gynecologic surgical laser. 884.4550 Section 884.4550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED....4550 Gynecologic surgical laser. (a) Identification. A gynecologic surgical laser is a continuous wave...

  7. 21 CFR 884.4120 - Gynecologic electrocautery and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gynecologic electrocautery and accessories. 884.4120 Section 884.4120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Surgical Devices § 884.4120 Gynecologic electrocautery and accessories. (a) Identification. A gynecologic...

  8. Sexual self-schema and sexual morbidity among gynecologic cancer survivors.

    Science.gov (United States)

    Andersen, B L; Woods, X A; Copeland, L J

    1997-04-01

    Longitudinal research indicates that approximately 50% of women treated for gynecologic cancer have sexual dysfunctions as they recover and become cancer survivors. This outcome occurs in the context of satisfactory quality of life in other domains. This study, comparing gynecologic cancer survivors (n = 61) and gynecologically healthy women (n = 74), documents the reliability of the latter observations with measures of quality of life (general, depressive symptoms, social contacts, and stress), sexual functioning, and health. Of added importance are analyses focused on variables that may predict risk for sexual morbidity. Specifically, sexual self-schema is tested as an important, sexually relevant individual difference. In regression analyses that controlled for estimates of precancer sexual behavior (intercourse frequency), extent of disease-treatment, and menopausal symptoms, sexual self-schema accounted for significant variance in predicting current sexual behavior and responsiveness.

  9. Radiotherapy for gynecologic cancer in nonagenarian patients: a framework for new paradigms.

    Science.gov (United States)

    Méry, Benoîte; Ndong, Sylvie Mengue; Guy, Jean-Baptiste; Assouline, Avi; Falk, Alexander T; Valeille, Anaïs; Trone, Jane-Chloé; Rivoirard, Romain; Auberdiac, Pierre; Vallard, Alexis; Espenel, Sophie; Moriceau, Guillaume; Collard, Olivier; Bosacki, Claire; Jacquin, Jean-Philippe; de Laroche, Guy; Fournel, Pierre; Chargari, Cyrus; Magné, Nicolas

    2016-05-09

    No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenarian patients. We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic cancer (6 endometrial cancers, 6 cervical cancers, 4 vulvar cancers, and 3 vaginal cancers) who were treated with radiotherapy. Radiotherapy was performed mainly in a palliative setting (n = 12; 63.2%), with a median dose of 45 Gy (range, 6-76 Gy). Infrequent major acute or late toxicities were reported. Among 19 patients, 9 (47.4%) experienced tumor progression, 5 (26.3%) experienced complete response, 2 (10.5%) experienced stable disease and/or partial response. At last follow-up, 12 patients (63.2%) had died; most deaths (n = 9) occurred because of the cancer. These results suggest that radiotherapy is feasible in the treatment of nonagenarian patients with gynecologic cancer.

  10. Conscious sedation for the performance of gynecologic examination of individuals with intellectual disability.

    Science.gov (United States)

    Jaffe, Joshua S

    2005-05-01

    Gynecologic examination of some individuals with intellectual disability can be especially problematic. Many of these women reside in a community setting and a widely applicable method for performing these examinations is desirable. Intellectually disabled women were referred by their primary care providers for gynecologic examinations under sedation in the emergency room facility of a community hospital. Intravenous conscious sedation was administered under the direction of an emergency room physician. Thirteen adult women underwent 22 examinations over a four-year period. Papanicolau smears, screening for sexually transmitted disease and cervical and endometrial biopsies were obtained without complications. Hospital charges were relatively low and lengths of stay were short. In selected individuals with intellectual disability, intravenous conscious sedation in a community hospital emergency room setting provides a safe, effective and relatively inexpensive means for performing gynecologic examinations.

  11. Patterns of care for radiotherapy in vulvar cancer: a Gynecologic Cancer Intergroup study

    DEFF Research Database (Denmark)

    Gaffney, David K; Du Bois, Andreas; Narayan, Kailash

    2009-01-01

    BACKGROUND: This study aimed to describe radiotherapeutic practice in the treatment of vulvar cancer in member study groups of the Gynecologic Cancer Intergroup (GCIG). METHODS: A survey was developed and distributed to representatives of the member study groups of the GCIG, targeting the use...... of radiotherapy (RT) in vulvar cancer. RESULTS: Thirty-two surveys were returned from 12 different cooperative groups. The most common indications for neoadjuvant RT include unresectable disease or International Federation of Gynecology and Obstetrics stage >/=III. For the neoadjuvant treatment of vulvar cancer...... of a broadly accepted standard. This underscores the importance of international cooperation as in GCIG to gather more reliable data for uncommon tumors in gynecologic oncology....

  12. Nutritional status of patients with gynecologic and breast cancer.

    Science.gov (United States)

    Zorlini, R; Akemi Abe Cairo, A; Salete Costa Gurgel, M

    2008-01-01

    To identify the preoperative nutritional status of women with gynecologic or breast cancer, in correlation with disease site and staging as well as previous treatments. A cross-sectional study of 250 women evaluated by Body Mass Index (BMI) and Subjective Global Assessment (SGA). For data analysis, the chi-square test was applied. Breast cancer was the most frequent cancer, predominating in 56.2%. The median age of the patients was 52 years. In about 57% of these women, the tumor was restricted to clinical stages 0, I and II and 77% of the women had not undergone any other oncologic treatment prior to surgery. Subjective Global Assessment detected 76% of nourished women and 24% undernourished women, while Body Mass Index identified 34% of nourished women, 3.6% undernourished women and 62.4% overweight/obese women. A low level of diagnostic agreement between normal nutrition and malnutrition by both methods was observed (63.8%; kappa (95% CI) = 0.0884 (-0.07-0.24). No correlation between nutritional evaluation and previous treatment and disease staging was observed. Concerning anatomic site, it was subjectively observed that women with cancer of the uterine corpus were more malnourished than the rest (p = 0.02). The findings suggest that a more careful evaluation should be employed to identify preoperative nutritional status in women with gynecologic or breast cancer.

  13. Leiomyoma of Testis –Rare Benign Mimicker of Testicular Malignancy

    Directory of Open Access Journals (Sweden)

    Asif Baliyan

    2017-10-01

    Full Text Available Leiomyomas are benign tumours that originate from any organ containing smooth muscles. The testis is an extremely rare site. We report a case of testicular leiomyoma in a 50-year-old. Testis-associated leiomyomas are a benign and rare disease presenting as a painless, slowly-growing mass. Only histological examination with immunohistochemistry can validate the diagnosis.

  14. Experience with diagnostic laparoscopy for gynecological indications

    African Journals Online (AJOL)

    2012-02-27

    Feb 27, 2012 ... Diagnostic laparoscopy for gynecological indications is safe and wider application of this modern ... JI Ikechebelu. Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, and Life Fertility. Centre .... The hemorrhage would have been controlled or control attempted ...

  15. Integrating Prevention into Obstetrics/Gynecology.

    Science.gov (United States)

    Carey, J. Christopher

    2000-01-01

    Discusses formats to teach preventive medicine in obstetrics and gynecology (including learning objectives, lectures/seminars, and rounds/office practice) and evaluation methods (oral examinations, computerized question banks, objective structured clinical examinations). Offers examples from specific programs at American medical schools, including…

  16. [GnRH-agonists in gynecology I].

    Science.gov (United States)

    Herrera Suastegui, T; Garza Evia, A G; Reyes Cuervo, H; Alvarado Durán, A

    1992-05-01

    The present review has the objective to describe the chemical and pharmacological characteristics of GnRH analogs and the present time indications of it's use in gynecology. It is a critical review about use of GnRH analogs in: Anticonception, Assisted Reproduction, Uterine leiomyomas, Endometriosis, Polycystic Ovarian Syndrome, Precosious Puberty, Premenstrual Tension Syndrome and Breast Cancer.

  17. [GnRH-agonists in gynecology II].

    Science.gov (United States)

    Herrera Suastegui, T; Garza Evia, A G; Reyes Cuervo, H; Alvarado Durán, A

    1992-06-01

    The present review has the objective to describe the chemical and pharmacological characteristics of GnRH analogs and the present time indications of it's use in gynecology. It is a critical review about use of GnRH analogs in: Anticonception, Assisted reproduction, Uterine leiomyomas, Endometriosis, Polycystic ovarian syndrome, Precocious puberty, Premenstrual tension syndrome and breast cancer.

  18. Structural determination and gynecological tumor diagnosis using ...

    African Journals Online (AJOL)

    Purpose: To identify markers for gynecological tumor diagnosis using antibody chip capture. Methods: Marker proteins, including cancer antigen 153 (CA153), CA125, and carcinoembryonic antigen (CEA), were analyzed using antibody chip capture of serum samples. Fifteen agglutinin types that specifically recognized five ...

  19. Bowel injury following gynecological laparoscopic surgery | Elbiss ...

    African Journals Online (AJOL)

    The role of robotic surgery and three-dimensional laparoscopic gynecological surgery on bowel injury needs to be further assessed. Conclusion: Early recognition of bowel injury is crucial for a favorable clinical outcome. A combined collaboration between gynecologists and general surgeons is important for timely and ...

  20. Gynecologic screening in hereditary nonpolyposis colorectal cancer

    NARCIS (Netherlands)

    Rijcken, FEM; Mourits, MJE; Kleibeuker, JH; Hollema, H; van der Zee, AGJ

    2003-01-01

    Objective. In hereditary nonpolyposis colorectal cancer (HNPCC), women with a mismatch repair (MMR) gene mutation have a cumulative lifetime risk of 25-50% for endometrial cancer and 8-12% for ovarian cancer. Therefore, female members of HNPCC families are offered an annual gynecologic and

  1. Bowel injury following gynecological laparoscopic surgery.

    African Journals Online (AJOL)

    Abstract. Background: Bowel injury remains a serious complication of gynecological laparoscopic surgery. We aimed to review the literature on this topic, combined with personal experiences, so as to give recommendations on how to avoid and manage this complication. Methods: We performed a narrative review on bowel ...

  2. Ureteric injuries complicating obstetric and gynecologic operations ...

    African Journals Online (AJOL)

    A retrospective study to determine the rate and pattern of ureteric injuries complicating gynecologic and obstetric operations in the University of Calabar Teaching Hospital (UCTH) during a ten-year period (1990 –1999) was undertaken. The number of major operations carried out during the period was 9350. Of these, 8670 ...

  3. Major clinical research advances in gynecologic cancer in 2014

    Science.gov (United States)

    Lee, Kyung-Hun; Kim, Kidong; Kang, Sokbom

    2015-01-01

    In 2014, 9 topics were selected as major advances in clinical research for gynecologic oncology: 2 each in cervical and corpus cancer, 4 in ovarian cancer, and 1 in breast cancer. For cervical cancer, several therapeutic agents showed viable antitumor clinical response in recurrent and metastatic disease: bevacizumab, cediranib, and immunotherapies including human papillomavirus (HPV)-tumor infiltrating lymphocytes and Z-100. The HPV test received FDA approval as the primary screening tool of cervical cancer in women aged 25 and older, based on the results of the ATHENA trial, which suggested that the HPV test was a more sensitive and efficient strategy for cervical cancer screening than methods based solely on cytology. For corpus cancers, results of a phase III Gynecologic Oncology Group (GOG) 249 study of early-stage endometrial cancer with high-intermediate risk factors are followed by the controversial topic of uterine power morcellation in minimally invasive gynecologic surgery. Promising results of phase II studies regarding the effectiveness of olaparib in various ovarian cancer settings are summarized. After a brief review of results from a phase III study on pazopanib maintenance therapy in advanced ovarian cancer, 2 outstanding 2014 ASCO presentations cover the topic of using molecular subtypes in predicting response to bevacizumab. A review of the use of opportunistic bilateral salpingectomy as an ovarian cancer preventive strategy in the general population is presented. Two remarkable studies that discussed the effectiveness of adjuvant ovarian suppression in premenopausal early breast cancer have been selected as the last topics covered in this review. PMID:25872896

  4. [Etiology and pathophysiology of benign prostate hyperplasia].

    Science.gov (United States)

    Roosen, A; Gratzke, C; Herrlemann, A; Magistro, G; Strittmatter, F; Weinhold, P; Tritschler, S; Stief, C G

    2013-02-01

    The pathogenesis of benign prostate hyperplasia (BPH) is still unclear. It is a common disease affecting exclusively humans in its full clinical appearance. There is a broad variety of possible underlying mechanisms which most likely interact in the pathogenesis of the disease: inflammatory processes taking place predominantly in the stroma and inducing proliferation of all tissues within the transitional zone, an imbalance of androgens and estrogens and their receptors, hyperinsulinemia and hypercholesterolemia (metabolic syndrome) as direct promoters of glandular growth and autosomal dominant inheritance. The detrusor muscle responds to the increased outflow resistance with muscular hypertrophy. Decreased compliance of the bladder wall results in voiding difficulties while electric instability of the hypertrophied detrusor muscle and increased recruiting of otherwise silent afferent fibres cause storage symptoms.

  5. Clinical and genetic heterogeneity in benign hereditary chorea.

    NARCIS (Netherlands)

    Breedveld, G.J.; Percy, A.K.; MacDonald, M.E.; Vries, L.B.A. de; Yapijakis, C.; Dure, L.S.; Ippel, E.F.; Sandkuijl, L.A.; Heutink, P.; Arts, P.J.W.

    2002-01-01

    BACKGROUND: Benign hereditary chorea (BHC) is an autosomal dominant disorder that can be distinguished from Huntington disease by its early onset, stable or only slightly progressive course, and absence of mental deterioration. The variation in clinical features is such that its very existence has

  6. Danish gynecologists' opinion about hysterectomy on benign indication

    DEFF Research Database (Denmark)

    Gimbel, Helga; Ottesen, Bent; Tabor, Ann

    2002-01-01

    AIMS: To survey Danish gynecologists' recommendations concerning hysterectomy and its method for benign diseases. METHODS: A questionnaire of seven clinical cases was sent to all gynecologists in Denmark (n = 450). The gynecologists were asked to recommend one of 14 possible treatments as the mos...

  7. Trends in malpractice claims for obstetric and gynecologic procedures, 2005 through 2014.

    Science.gov (United States)

    Glaser, Laura M; Alvi, Farah A; Milad, Magdy P

    2017-09-01

    Interest in medical malpractice and areas of medicolegal vulnerability for practicing obstetricians and gynecologists has grown substantially, and many providers report changing surgical practice out of fear of litigation. Furthermore, education on medical malpractice and risk management is lacking for obstetrics and gynecology trainees. Recent obstetric and gynecologic malpractice claims data are lacking. We report on recent trends in malpractice claims for obstetrics and gynecology procedures, and compare these trends to those of other medical specialties. We sought to evaluate recent trends in malpractice claims for obstetrics and gynecology procedures and compare these to other medical specialties. A search was performed on all medicolegal claims data for obstetrics and gynecology procedures from Jan. 1, 2005, through Dec. 31, 2014, using the Physician Insurers' Association of America data-sharing project, which was created to identify medical professional liability trends. Data from 20 insurance carriers were reviewed based on a search using International Classification of Diseases, Ninth Revision codes and unique database-specific codes. Of the 10,915 total claims closed from 2005 through 2014, the majority (59.5%) were dropped, withdrawn, or dismissed. The average indemnity of the remaining paid claims (31.1%) was $423,250. The most frequently litigated procedure was operative procedures on the uterus; 27.8% of cases were paid with an average indemnity of $279,384. The procedure associated with the highest proportion of paid claims was vacuum extraction. The average indemnity for paid obstetrics and gynecology procedural claims was 27% higher than that for all medical specialties combined. Obstetrics and gynecology procedural claims had the second highest average indemnity payment and the fifth highest paid-to-closed ratio of all medical specialties. Litigation claims for obstetrics and gynecology procedures have higher average indemnity payments and higher

  8. Serum galectin-9 as a noninvasive biomarker for the detection of endometriosis and pelvic pain or infertility-related gynecologic disorders.

    Science.gov (United States)

    Brubel, Reka; Bokor, Attila; Pohl, Akos; Schilli, Gabriella Krisztina; Szereday, Laszlo; Bacher-Szamuel, Reka; Rigo, Janos; Polgar, Beata

    2017-12-01

    To investigate the usefulness of soluble galectin-9 (Gal-9) in the noninvasive laboratory diagnosis of endometriosis and various gynecologic disorders. Prospective case-control study. University medical centers. A total of 135 women of reproductive age were involved in the study, 77 endometriosis patients, 28 gynecologic controls, and 30 healthy women. Diagnostic laparoscopy and collection of tissue biopsies, peritoneal cells, and native peripheral blood from different case groups of gynecology patients and healthy women. The expression of mRNA and serum concentration of Gal-9. Semiquantitative reverse transcription-polymerase chain reaction analysis and serum soluble Gal-9 ELISA were performed on three different cohorts of patients: those with endometriosis, those with benign gynecologic disorders, and healthy controls. Differences in the Gal-9 concentrations between the investigated groups and the stability of Gal-9 in the serum and diagnostic characteristics of Gal-9 ELISA were determined by statistical evaluation and receiver operating characteristic (ROC) curve analysis. Significantly elevated Gal-9 levels were found in both minimal-mild (I-II) and moderate-severe (III-IV) stages of endometriosis in comparison with healthy controls. At a cutoff of 132 pg/mL, ROC analysis revealed an excellent diagnostic value of Gal-9 ELISA in endometriosis (area under the curve = 0.973) with a sensitivity of 94% and specificity of 93.75%, indicating better diagnostic potential than that of other endometriosis biomarkers. Furthermore, various pelvic pain or infertility-associated benign gynecologic conditions were also associated with increased serum Gal-9 levels. Our results suggest that Gal-9 could be a promising noninvasive biomarker of endometriosis and a predictor of various infertility or pelvic pain-related gynecologic disorders. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Enhanced recovery pathways in gynecologic oncology.

    Science.gov (United States)

    Nelson, Gregg; Kalogera, Eleftheria; Dowdy, Sean C

    2014-12-01

    Many commonplace perioperative practices are lacking in scientific evidence and may interfere with the goal of optimizing patient recovery. Individual components of perioperative care have therefore been scrutinized, resulting in the creation of so-called "enhanced recovery" pathways (ERP), with the goal of hastening surgical recovery through attenuation of the stress response. In this review we examine the evidence for ERP in gynecologic oncology using data from our specialty and general surgery. We performed a systematic literature search on ERP in gynecologic oncology in June 2014 using PubMed/MEDLINE, EMBASE, and The Cochrane Library. All study types were included. References were hand reviewed to ensure completeness. The Enhanced Recovery After Surgery (ERAS) Society was contacted to identify any unpublished protocols. Seven investigations were identified that examined the role of ERP in gynecologic oncology. Common interventions included allowing oral intake of fluids up to 2 hours before induction of anesthesia, solids up to 6 hours before anesthesia, carbohydrate supplementation, intra- and postoperative euvolemia, aggressive nausea/vomiting prophylaxis, and oral nutrition and ambulation the day of surgery. In addition, bowel preparations, the NPO after midnight rule, nasogastric tubes, and intravenous opioids were discontinued. While no randomized data are available in gynecologic oncology, significant improvements in patient satisfaction, length of stay (up to 4 days), and cost (up to $7600 in savings per patient) were observed in ERP cohorts compared to historical controls. Morbidity, mortality, and readmission rates were no different between groups. Enhanced recovery is a safe perioperative management strategy for patients undergoing surgery for gynecologic malignancies, reduces length of stay and cost, and is considered standard of care at a growing number of institutions. Our specialty would benefit from a formalized ERP such as ERAS which audits

  10. Encapsulated lipomas of the tongue in benign symmetric lipomatosis.

    Science.gov (United States)

    Ettl, Tobias; Gaumann, Andreas; Ehrenberg, Ramin; Reichert, Torsten E; Driemel, Oliver

    2009-05-01

    Benign symmetric lipomatosis (Madelung disease) is a rare disorder of unknown etiology characterized by diffuse growth of unencapsulated lipomas predominantly in the head, neck and shoulder region. Involvement of the tongue has been previously described in only five cases. A 49-year-old man with alcoholic liver cirrhosis presented with an 11-year history of benign symmetric lipomatosis complaining of increasing dysphagia, dysarthria and hoarseness. Clinical intraoral examination revealed asymmetric, globular, firm, circumscribed masses on both borders of the tongue. During surgery, the masses seemed encapsulated from surrounding muscles and could easily be extirpated. However, "satellite fat cells" became obvious, which might give rise to the development of new lipomas.

  11. Scope of global health training in U.S. obstetrics and gynecology residency programs.

    Science.gov (United States)

    Hung, Kristin J; Tsai, Alexander C; Johnson, Timothy R B; Walensky, Rochelle P; Bangsberg, David R; Kerry, Vanessa B

    2013-11-01

    To enumerate global health training activities in U.S. obstetrics and gynecology residency programs and to examine the worldwide distribution of programmatic activity relative to the maternal and perinatal disease burden. Using a systematic, web-based protocol, we searched for global health training opportunities at all U.S. obstetrics and gynecology residency programs. Country-level data on disability-adjusted life-years resulting from maternal and perinatal conditions were obtained from the Global Burden of Disease study. We calculated Spearman's rank correlation coefficients to estimate the cross-country association between programmatic activity and disease burden. Of the 243 accredited U.S. obstetrics and gynecology residency programs, we identified 41 (17%) with one of several possible predefined categories of programmatic activity. Thirty-three residency programs offered their residents opportunities to participate in one or more elective-based rotations, eight offered extended field-based training, and 18 offered research activities. A total of 128 programmatic activities were dispersed across 64 different countries. At the country level, the number of programmatic activities had a statistically significant association with the total disease burden resulting from maternal (Spearman's ρ=0.37, 95% confidence interval [CI] 0.14-0.57) and perinatal conditions (ρ=0.34, 95% CI 0.10-0.54) but not gynecologic cancers (ρ=-0.24, 95% CI -0.46 to 0.01). There are few global health training opportunities for U.S. obstetrics and gynecology residents. These activities are disproportionately distributed among countries with greater burdens of disease. II.

  12. The Scope of Global Health Training in U.S. Obstetrics and Gynecology Residency Programs

    Science.gov (United States)

    Hung, Kristin J.; Tsai, Alexander C.; Johnson, Timothy R.B.; MD, MPH, Rochelle P.; Bangsberg, David R.; Kerry, Vanessa B.

    2013-01-01

    Objective To enumerate global health training activities in U.S. obstetrics and gynecology residency programs, and to examine the worldwide distribution of programmatic activity relative to the maternal and perinatal disease burden. Methods Using a systematic, Web-based protocol, we searched for global health training opportunities at all U.S. obstetrics and gynecology residency programs. Country-level data on disability-adjusted life years due to maternal and perinatal conditions were obtained from the Global Burden of Disease study. We calculated Spearman’s rank correlation coefficients to estimate the cross-country association between programmatic activity and disease burden. Results Of the 243 accredited U.S. obstetrics and gynecology residency programs, we identified 41 (17%) with one of several possible predefined categories of programmatic activity. Thirty-three residency programs offered their residents opportunities to participate in one or more elective-based rotations, eight offered extended field-based training, and 18 offered research activities. A total of 128 programmatic activities were dispersed across 64 different countries. At the country level, the number of programmatic activities had a statistically significant association with the total disease burden due to maternal (Spearman’s ρ=0.37; 95% confidence interval [CI], 0.14-0.57) and perinatal conditions (ρ=0.34; 95% CI, 0.10-0.54) but not gynecologic cancers (ρ=−0.24; 95% CI, −0.46 to 0.01). Conclusions There are few global health training opportunities for U.S. obstetrics and gynecology residents. These activities are disproportionately distributed among countries with greater burdens of disease. PMID:24104785

  13. Use of stereotactic radiosurgery in the treatment of gynecologic malignancies: A review

    Science.gov (United States)

    Long, Beverly; Eskander, Ramez N; Tewari, Krishnansu S

    2014-01-01

    Recent retrospective studies have reported the use of stereotactic radiosurgery (SRS) in the treatment of gynecologic cancers. SRS uses real-time imaging and high dose radiation beams attached to precise robotic arms to target malignant lesions while sparing normal tissue. The purpose of this review is to examine the indications for SRS in gynecologic oncology, review the current literature regarding the use of SRS in gynecologic cancers, and identify future directions for research in this area. Literature on stereotactic radiosurgery was reviewed using the PubMed search engine. Articles written in English from 1993-2013 were reviewed, and 20 case series and clinical trials were included. The safety and efficacy SRS has been demonstrated in all gynecologic disease sites including cervical, endometrial, vulvar, vaginal, and ovarian cancers. Indications for its use include non-central pelvic recurrences in previously irradiated patients, complex or non-resectable disease recurrence, and solitary brain metastases. Toxicities are usually mild, though grade 3-4 toxicities have been reported. SRS is a promising second line treatment modality for patients with primary or recurrent disease who cannot undergo standard surgical or radiation therapy. Further research is required to determine optimal dosing and fractionation schedules, delineate appropriate patient populations, and assess longterm morbidity and survival. PMID:24976937

  14. Imaging of Benign Odontogenic Lesions.

    Science.gov (United States)

    Scarfe, William C; Toghyani, Shiva; Azevedo, Bruno

    2018-01-01

    Numerous benign cysts or solid tumors may present in the jaws. These arise from tooth-forming tissues in the dental alveolus or from nonodontogenic tissues in the basal bone of the mandible and maxilla. Radiologists provide 2 deliverables to assist in diagnosis and management: (1) appropriately formatted images demonstrating the location and extent of the lesion and (2) interpretive reports highlighting specific radiologic findings and an impression providing a radiologic differential diagnosis. This article provides guidance on essential image protocols for planning treatments, a radiologic differential diagnostic algorithm based on location and pattern recognition, and a summary of the main features of benign odontogenic lesions. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. [Management of benign paroxysmal positional vertigo in first care centers].

    Science.gov (United States)

    Carnevale, C; Muñoz-Proto, F; Rama-López, J; Ferrán-de la Cierva, L; Rodríguez-Villalba, R; Sarría-Echegaray, P; Mas-Mercant, S; Tomás-Barberán, M

    2014-01-01

    The benign paroxysmal positional vertigo is the most common disease in the group of peripheral vertigo. It's characterized by vertiginous sensation triggered by the positional changes of the head and usually lasts less than one minute. It is most frequently seen in middle-aged patients (40-50 years old) and in up 50% of cases we do not know the cause, so we refer to them as idiopathic benign paroxysmal positional vertigo. Because of the high incidence of benign paroxysmal positional vertigo in general population, it is of utmost importance to be aware of the differential diagnosis and to be able to treat this pathology with efficacy, because in most cases we can achieve excellent results performing specific and simple maneuvers. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  16. Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo

    Directory of Open Access Journals (Sweden)

    Muhammed Dagkiran

    2015-12-01

    Full Text Available Benign paroxysmal positional vertigo is the cause of peripheral vertigo, which only takes seconds posed by certain head and body position and led to severe attacks of vertigo. Therefore, it is a disturbance that causes a continuous fear of fall and anxiety in some patients. Although benign paroxysmal positional vertigo is the most common cause of peripheral vertigo, it may cause unnecessary tests, treatment costs and the loss of labor due to the result of the delay in the diagnosis and treatment stages. Diagnosis and treatment of this disease is easy. High success rates can be achieved with appropriate repositioning maneuvers after taking a detailed medical history and accurate assessment of accompanying nystagmus. The aim of this paper was to review the updated information about benign paroxysmal positional vertigo. [Archives Medical Review Journal 2015; 24(4.000: 555-564

  17. Benign chondroblastoma - malignant radiological appearances

    Energy Technology Data Exchange (ETDEWEB)

    Schulze, K.; Treugut, H.; Mueller, G.E.

    1980-04-01

    The very rare benign chondroblastoma occasionally invades soft tissues and may grow beyond the epiphysis into the metaphysis. In the present case such a tumour did not show the typical radiological appearances, but presented malignant features both on plain films and on the angiogram. The importance of biopsy of tumours which cannot be identified with certainty must be stressed before radical surgery is carried out.

  18. Blue breath holding is benign.

    OpenAIRE

    Stephenson, J B

    1991-01-01

    In their recent publication in this journal, Southall et al described typical cyanotic breath holding spells, both in otherwise healthy children and in those with brainstem lesions and other malformations. Their suggestions regarding possible autonomic disturbances may require further study, but they have adduced no scientific evidence to contradict the accepted view that in the intact child blue breath holding spells are benign. Those families in which an infant suffers an 'apparently life t...

  19. Gynecologic Oncologist Views Influencing Referral to Outpatient Specialty Palliative Care.

    Science.gov (United States)

    Hay, Casey M; Lefkowits, Carolyn; Crowley-Matoka, Megan; Bakitas, Marie A; Clark, Leslie H; Duska, Linda R; Urban, Renata R; Chen, Lee-May; Creasy, Stephanie L; Schenker, Yael

    2017-03-01

    Early specialty palliative care is underused for patients with advanced gynecologic malignancies. We sought to understand how gynecologic oncologists' views influence outpatient specialty palliative care referral to help inform strategies for improvement. We conducted a qualitative interview study at 6 National Cancer Institute-designated cancer centers with well-established outpatient palliative care services. Between September 2015 and March 2016, 34 gynecologic oncologists participated in semistructured telephone interviews focused on attitudes, experiences, and preferences related to outpatient specialty palliative care. A multidisciplinary team analyzed transcripts using constant comparative methods to inductively develop a coding framework. Through an iterative, analytic process, codes were classified, grouped, and refined into themes. Mean (SD) participant age was 47 (10) years. Mean (SD) interview length was 25 (7) minutes. Three main themes emerged regarding how gynecologic oncologists view outpatient specialty palliative care: (1) long-term relationships with patients is a unique and defining aspect of gynecologic oncology that influences referral, (2) gynecologic oncologists value palliative care clinicians' communication skills and third-party perspective to increase prognostic awareness and help negotiate differences between patient preferences and physician recommendation, and (3) gynecologic oncologists prefer specialty palliative care services embedded within gynecologic oncology clinics. Gynecologic oncologists value longitudinal relationships with patients and use specialty palliative care to negotiate conflict surrounding prognostic awareness or the treatment plan. Embedding specialty palliative care within gynecologic oncology clinics may promote communication between clinicians and facilitate gynecologic oncologist involvement throughout the illness course.

  20. Radioiodine therapy in benign thyroid diseases

    DEFF Research Database (Denmark)

    Bonnema, Steen Joop; Hegedüs, Laszlo

    2012-01-01

    , and they may even interact mutually and counteract each other. Numerous studies have evaluated the effect of (131)I therapy, but results have been conflicting due to differences in design, sample size, patient selection, and dose calculation. It seems clear that no single factor reliably predicts the outcome...... of an exact thyroid dose is error-prone due to imprecise measurement of the (131)I biokinetics, and the importance of internal dosimetric factors, such as the thyroid follicle size, is probably underestimated. Besides these obstacles, several potential confounders interfere with the efficacy of (131)I therapy...

  1. Sexuality in gynecological patients undergoing radiation therapy treatments

    International Nuclear Information System (INIS)

    Dolan, M.E.

    1987-01-01

    The gynecology patient undergoing radiation therapy treatments may experience physiological and psychological problems related to sexuality. The needs of this group must be met by the radiation oncology staff by their being informed, interested, and experienced in dealing with sexual problems created by radiation therapy treatments. Opportunities to obtain information and for discussion about how the disease and its treatments will affect sexual functioning must be provided for the patient and partner. It is important to remember that the ability to seek and preserve gratifying sexual function is of great importance to almost all women, regardless of age. The patient may feel much personal distress related to the disease, the treatments, and how they affect the way she feels as a sexual human being. Opportunities must be provided to share the feelings created by the treatment process and trained therapists should be available when intensive sexual counseling is needed

  2. Gynecological applications of helical CT using SmartPrep

    Energy Technology Data Exchange (ETDEWEB)

    Sakurada, Akira; Kakizaki, Dai; Abe, Kimihiko [Tokyo Medical Coll. (Japan)

    1999-11-01

    SmartPrep is software program for scanning a given region of interest (ROI) at optimal contrast density. An operator can arbitrarily define ROI and preset the CT value at which scanning should be started. After the injection of a contrast medium, system conducts continuous monitoring of the ROI and the operator starts helical scanning of the planned region when the present CT value has been reached. In comparison with conventional helical CT that requires a period of time from the beginning of contrast medium injection to the beginning of scanning, SmartPrep minimizes personal error and better depicts the artery-predominant phase under optimal conditions. In this study we examine the usefulness of contrast-enhanced helical CT using SmartPrep in the evaluation of gynecological disease. When the contrast medium was injected into the dorsal vein of the hand at a rate of 3 ml/sec, strong staining of pelvic arteries was observed in the CT images started at 17 to 23 sec after injection. The early-phase helical CT obtained under these conditions provided good depiction of lesions in cases of placenta accreta and invasive mole, as well as clear demonstration of tumor angiogenesis and evaluation of laterality in cases of cervical cancer. Comparison of the early and delayed phase also facilitated easier evaluation of lymph nodes than conventional comparison of simple and contrast-enhanced CT. The results thus suggest the usefulness of contrast-enhanced helical CT using SmartPrep in gynecology. (author)

  3. Group Medical Visits to Provide Gynecologic Care for Women Affected by Breast Cancer

    Directory of Open Access Journals (Sweden)

    Sally R. Greenwald

    2017-01-01

    Full Text Available Purpose: Women with breast cancer have complex and unique gynecologic needs that are challenging to effectively and comprehensively meet in a traditional gynecology visit format. Group medical visits are an effective and well-received model of care in other disease settings and can provide comprehensive health education as an adjunct to one-on-one evaluation and treatment. There are limited data regarding the use of this type of health care delivery in providing gynecology-focused care to women affected by breast cancer. Methods: A group medical visit model was created for gynecology providers to see new breast cancer patient consults. From May 2012 to February 2014, 148 patients (3–6 per group participated in a 1-hour informational session followed by a 15- to 30-minute individual visit with a physician that included history, physical examination and evaluation. We surveyed 101 women who attended these visits to evaluate a group model for providing gynecologic care and educational support to women with breast cancer. Results: Of those who responded to the survey question, 100% agreed or somewhat agreed that their expectations for an initial intake visit were met during the group visit; 81% agreed or somewhat agreed that they felt a group visit was preferable to an individual introductory visit. More than 95% agreed or somewhat agreed that the information was understandable and their questions were answered during the visit. Only 5 respondents expressed dissatisfaction with the additional time commitment for this type of visit. Conclusions: The majority of women surveyed expressed satisfaction with their experience with a group visit format. The women who participated preferred this format compared to an individual intake appointment when establishing gynecology care after breast cancer diagnosis/treatment, regardless of age, menopausal status, cancer stage or hormone receptor status. While further studies are warranted to directly compare and

  4. Robot-assisted surgery in gynecological oncology

    DEFF Research Database (Denmark)

    Kristensen, Steffen E; Mosgaard, Berit J; Rosendahl, Mikkel

    2017-01-01

    INTRODUCTION: Robot-assisted surgery has become more widespread in gynecological oncology. The purpose of this systematic review is to present current knowledge on robot-assisted surgery, and to clarify and discuss controversies that have arisen alongside the development and deployment. MATERIAL...... was performed by screening of titles and abstracts, and by full text scrutiny. From 2001 to 2016, a total of 76 references were included. RESULTS: Robot-assisted surgery in gynecological oncology has increased, and current knowledge supports that the oncological safety is similar, compared with previous......-term detailed prospective cohorts or randomized controlled trials. The costs associated with acquisition, application, and maintenance have an unfavorable impact on cost-benefit evaluations, especially when compared with laparoscopy. Future developments in robot-assisted surgery will hopefully lead...

  5. Gynecological pelvic pain as emergency pathology.

    Science.gov (United States)

    Rivera Domínguez, A; Mora Jurado, A; García de la Oliva, A; de Araujo Martins-Romeo, D; Cueto Álvarez, L

    Acute pelvic pain is a common condition in emergency. The sources of acute pelvic pain are multifactorial, so it is important to be familiar with this type of pathologies. The purpose of this article is review the main causes of gynecological acute pelvic pain and their radiologic appearances to be able to make an accurate diagnosis and provide objective criteria for patient management. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Impact of a Pediatric and Adolescent Gynecology Curriculum on an Obstetrics and Gynecology Residency.

    Science.gov (United States)

    Palaszewski, Dawn M; Miladinovic, Branko; Caselnova, Petra M; Holmström, Shelly W

    2016-12-01

    To determine the effectiveness of a new pediatric and adolescent gynecology (PAG) curriculum for improving obstetrics/gynecology resident physician knowledge and comfort level in patient management and to describe the current deficiencies in resident physician knowledge and comfort level in PAG. A PAG curriculum was implemented for the obstetrics/gynecology resident physicians (n = 20) at the University of South Florida in July 2013. Before and after the curriculum was introduced, resident physicians and recent graduates of the residency program completed a survey to assess their comfort level and a knowledge assessment consisting of 20 case-based questions. University-based residency program. Resident physicians and recent resident physician graduates in the Department of Obstetrics and Gynecology. Introduction of a PAG curriculum during the 2013-2014 academic year. Improvement in resident physicians' comfort level and knowledge in PAG. After the curriculum was introduced, comfort increased in examining the genitals of a pediatric gynecology patient (median difference = 1.5; P = .003) and history-taking, physical examination skills, and management (median difference = 1; P = .002) compared with before the curriculum. There was no significant difference in overall quiz score (15.5 ± 1.87 vs 15.8 ± 1.3; P = .78). A curriculum in PAG did improve resident comfort level in managing PAG patients, but did not significantly improve knowledge of this topic. Copyright © 2016.

  7. Gynecologic cancer disparities: a report from the Health Disparities Taskforce of the Society of Gynecologic Oncology.

    Science.gov (United States)

    Collins, Yvonne; Holcomb, Kevin; Chapman-Davis, Eloise; Khabele, Dineo; Farley, John H

    2014-05-01

    To review the extent of health disparities in gynecologic cancer care and outcomes and to propose recommendations to help counteract the disparities. We searched the electronic databases PubMed and the Cochrane Library. We included studies demonstrating quantifiable differences by race and ethnicity in the incidence, treatment, and survival of gynecologic cancers in the United States (US). Most studies relied on retrospective data. We focused on differences between Black and White women, because of the limited number of studies on non-Black women. White women have a higher incidence of ovarian cancer compared to Black women. However, the all-cause ovarian cancer mortality in Black women is 1.3 times higher than that of White women. Endometrial and cervical cancer mortality in Black women is twice that of White women. The etiology of these disparities is multifaceted. However, much of the evidence suggests that equal care leads to equal outcomes for Black women diagnosed with gynecologic cancers. Underlying molecular factors may play an additional role in aggressive tumor biology and endometrial cancer disparities. Gynecologic cancer disparities exist between Black and White women. The literature is limited by the lack of large prospective trials and adequate numbers of non-Black racial and ethnic groups. We conclude with recommendations for continued research and a multifaceted approach to eliminate gynecologic cancer disparities. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. THREE-DIMENSIONAL ULTRASOUND IN GYNECOLOGIC ONCOLOGY

    Directory of Open Access Journals (Sweden)

    Iztok Takač

    2003-12-01

    Full Text Available Background. Although three-dimensional ultrasound (3D US imaging has been used for a decade, debate continues about its potential clinical aplications in gynecology. The same is true for the field of gynecologic oncology. Also, reports regarding usfulness of 3D US in gynecologic oncology are limited. A few potentially useful clinical applications have been described and some of these are now gaining general acceptance. In this paper, the usfulness of 3D US in the main areas of its application is demonstrated: diagnostics of cervical, endometrial, ovarian and breast cancer.Conclusions. An important advantage of 3D US over conventional two-dimensional imaging is the ability to reconstruct and display any arbitrarily chosen section within the volume dataset as well as ability to measure the volume of pelvic organs regardless of their shape. 3D US also allows the realtime analysis of the acquired image data to be conducted at a later time when the patient is off the examination table.

  9. Physicians' liability in obstetric and gynecology practice.

    Science.gov (United States)

    Mavroforou, Anna; Koumantakis, Evgenios; Michalodimitrakis, Emmanuel

    2005-03-01

    Litigation in obstetric and gynecologic practice has arisen as an important issue. This article aims to highlight issues related to malpractice in obstetrics and gynecology in order to point out several important aspects of medical practice, which may offer adequate professional protection. Search of the current relevant literature. The four most common clinical causes of medical litigation in obstetrics and gynecology are cases involving fetal distress, uterine rupture after a vaginal birth in a woman with a previous Cesarean section, shoulder dystocia, and misdiagnosis of breast cancer. Litigation raised in most of the cases is driven by bad outcomes and not by malpractice. Additionally, both juries and the public often expect perfection as the natural result of pregnancy and any deviation from this expectation has to be the result of someone's negligence. For this reason it has become mandatory for doctors in hospitals and private practices to acquire a sufficient knowledge relating to modem management, to document carefully in writing their procedural and management plans and to become familiar with the legal aspects of medical practice. Adequate communication and a written patient's consent form are of paramount importance. Maintenance of high standards in daily practice with continuous training, clear communication and a signed Patient's Informed Consent Form along with the appropriate documentation of any procedure carried out may provide professional safety to practicing obstetricians and gynecologists in case of medical litigation.

  10. Major clinical research advances in gynecologic cancer in 2013.

    Science.gov (United States)

    Suh, Dong Hoon; Kim, Jae-Weon; Kang, Sokbom; Kim, Hak Jae; Lee, Kyung-Hun

    2014-07-01

    In 2013, 10 topics were selected for major clinical research advances in gynecologic oncology; these included three topics regarding cervical cancer, three regarding ovarian cancer, two regarding endometrial cancer, and one each regarding breast cancer and radiation oncology. For cervical cancer, bevacizumab was first demonstrated to exhibit outstanding clinical efficacy in a recurrent, metastatic setting. Regarding cervical cancer screening, visual inspections with acetic acid in low-resource settings, p16/Ki-67 double staining, and the follow-up results of four randomized controlled trials of human papillomavirus-based screening methods were reviewed. Laparoscopic para-aortic lymphadenectomy before chemoradiation for locally advanced cervical cancer was the final topic for cervical cancer. Regarding front-line ovarian cancer therapies, dose-dense paclitaxel and carboplatin, intraperitoneal chemotherapy, and other targeted agents administered according to combination or maintenance schedules were discussed. Regarding recurrent ovarian cancer treatment, cediranib, olaparib, and farletuzumab were discussed for platinum-sensitive disease. The final overall survival data associated with a combination of bevacizumab and chemotherapy for platinum-resistant disease were briefly summarized. For endometrial cancer, the potential clinical efficacy of metformin, an antidiabetic drug, in obese patients was followed by integrated genomic analyses from the Cancer Genome Atlas Research Network. For breast cancer, three remarkable advances were reviewed: the long-term effects of continued adjuvant tamoxifen for 10 years, the effects of 2-year versus 1-year adjuvant trastuzumab for human epidermal growth factor receptor 2-positive disease, and the approval of pertuzumab in a neoadjuvant setting with a pathologic complete response as the surrogate endpoint. Finally, the recent large studies of intensity-modulated radiotherapy for gynecologic cancer were briefly summarized.

  11. Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria

    Directory of Open Access Journals (Sweden)

    Iyoke CA

    2014-01-01

    Full Text Available Chukwuemeka Anthony Iyoke,1 George Onyemaechi Ugwu,1 Euzebus Chinonye Ezugwu,1 Frank Okechukwu Ezugwu,2 Osaheni Lucky Lawani,3 Azubuike Kanayo Onyebuchi3 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Park Lane, Enugu, 3Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Background: There are reports of increasing incidence of gynecological cancers in developing countries and this trend increases the need for more attention to gynecological cancer care in these countries. Objective: The purpose of this study was to describe the presentation and treatment of gynecological cancers and identify barriers to successful gynecological cancer treatment in a tertiary hospital in South East Nigeria. Methods: This study was a retrospective longitudinal analysis of the presentation and treatment of histologically diagnosed primary gynecological cancers from 2000 to 2010. Analysis was by descriptive and inferential statistics at the 95% level of confidence using Statistical Package for the Social Sciences version 17 software. Results: Records of 200 gynecological cancers managed during the study period were analyzed. Over 94% of cervical cancers presented in advanced stages of the disease and received palliative/symptomatic treatment. Only 1.9% of cervical cancer patients had radical surgical intervention, and postoperative mortality from these radical surgeries was 100%. Approximately 76% of patients with ovarian cancer had debulking surgery as the mainstay of treatment followed by adjuvant chemotherapy. Postoperative mortality from ovarian cancer surgery was 63%. Cutting edge cytotoxic drugs were not used as chemotherapy for ovarian and chorionic cancers. Compliance with chemotherapy was poor, with over 70% of ovarian cancer patients failing to complete the

  12. Blue breath holding is benign.

    Science.gov (United States)

    Stephenson, J B

    1991-01-01

    In their recent publication in this journal, Southall et al described typical cyanotic breath holding spells, both in otherwise healthy children and in those with brainstem lesions and other malformations. Their suggestions regarding possible autonomic disturbances may require further study, but they have adduced no scientific evidence to contradict the accepted view that in the intact child blue breath holding spells are benign. Those families in which an infant suffers an 'apparently life threatening event' deserve immense understanding and help, and it behoves investigators to exercise extreme care and self criticism in the presentation of new knowledge which may bear upon their management and their morale. PMID:2001115

  13. Manobra de Epley na vertigem posicional paroxística benigna associada à doença de Ménière Epley’s maneuver in benign paroxysmal positional vertigo associated with Meniere’s disease

    Directory of Open Access Journals (Sweden)

    Cristina Freitas Ganança

    2007-08-01

    Full Text Available Os efeitos da manobra de Epley na vertigem posicional paroxística benigna (VPPB associada à doença de Ménière são controvertidos. OBJETIVO: Avaliar a vertigem e o nistagmo de posicionamento após uma ou mais manobras de Epley na vertigem posicional paroxística benigna (VPPB associada à doença de Ménière e na recorrência da VPPB. MATERISL E MÉTODO: Estudo retrospectivo de 62 pacientes com VPPB associada à doença de Ménière submetidos à manobra de Epley e acompanhados durante 12 meses após a extinção do nistagmo de posicionamento. RESULTADOS: Para abolir o nistagmo de posicionamento, foi necessária uma manobra de Epley em 80,7% dos pacientes, duas em 16,1% e três em 3,2%. A vertigem foi eliminada em 71,0% dos pacientes, melhorou em 27,4% e permaneceu inalterada em 1,6%. Quatro semanas após a extinção do nistagmo de posicionamento, todos os pacientes ficaram assintomáticos. Recorrência da VPPB foi observada em 19,4% dos casos, com eliminação da vertigem e nistagmo de posicionamento à manobra específica para o canal afetado. CONCLUSÕES: Na VPPB associada à doença de Ménière, vertigem e nistagmo de posicionamento foram eliminados com uma, duas ou três manobras de Epley. A recorrência da VPPB foi resolvida com uma manobra para o canal envolvido.The effects of Epley’s maneuver in benign paroxysmal positional vertigo (BPPV associated with Menière’s disease are controversial. AIMS: To evaluate the progression of positional vertigo and nystagmus after one or more of Epley’s maneuvers in BPPV associated with Menière’s disease, and the recurrence of BPPV. METHOD: a retrospective study of 62 patients with BPPV associated with Menière’s disease, that underwent Epley’s maneuver, and that were monitored during 12 months after elimination of positional nystagmus. RESULTS: One Epley’s maneuver was required to eliminate positional nystagmus in 80.7% of the patients, two in 16.1%, and three in 3.2%; after

  14. Gynecologic anatomic abnormalities following anorectal malformations repair.

    Science.gov (United States)

    Vilanova-Sanchez, Alejandra; Reck, Carlos A; McCracken, Kate A; Lane, Victoria A; Gasior, Alessandra C; Wood, Richard J; Levitt, Marc A; Hewitt, Geri D

    2018-04-01

    Patients may present with gynecologic concerns after previous posterior sagittal anorectoplasty (PSARP) for repair of an anorectal malformation (ARM). Common findings include an inadequate or shortened perineal body, as well as introital stenosis, retained vaginal septum, and remnant rectovestibular fistula. An inadequate or shortened perineal body may impact fecal continence, sexual function and recommendations regarding obstetrical mode of delivery. We describe our experience with female patients referred to our center for evaluation of their previously repaired ARM, with a specific focus on perineal body anatomy and concomitant gynecologic abnormalities. We outline our collaborative evaluation process and findings as well as subsequent repair and outcomes. A single site retrospective chart review from May 2014 to May 2016 was performed. Female patients with a history of prior ARM repair who required subsequent reoperative surgical repair with perineoplasty were included. The decision for reoperation was made collaboratively after a multidisciplinary evaluation by colorectal surgery, urology, and gynecology which included examination under anesthesia (EUA) with cystoscopy, vaginoscopy, rectal examination, and electrical stimulation of anal sphincters. The type of original malformation, indication for reoperative perineoplasty, findings leading to additional procedures performed at time of perineoplasty, postoperative complications, and the length of follow up were recorded. During the study period 28 patients were referred for evaluation after primary ARM repair elsewhere and 15 patients (60%) met inclusion criteria. Thirteen patients (86.6%) originally had a rectovestibular fistula with prior PSARP and 2 patients (13.4%) originally had a cloacal malformation with prior posterior sagittal anorectovaginourethroplasty. The mean age at the time of the subsequent perineoplasty was 4.6years (0.5-12). Patients had an inadequate perineal body requiring reoperative

  15. [Benign partial epilepsies of childhood].

    Science.gov (United States)

    Palencia, R

    To carry out, by means of a literature review, an update of the entities that can be included within the group of benign partial epilepsies of childhood. Among partial epilepsies with onset in the first stages of life, a group extended in the last years with a favourable course and a trend to reverse, even spontaneously, has been identified. Some of these entities have a genetic origin but we do not know the mechanisms by which these epilepsies show a self limited course, which have given rise to the denomination of epilepsy that comes and goes; nevertheless, an evolution to other more complex forms is also possible. Benign partial epilepsies of childhood constitute a wide group of conditions of varied semiology, usually with a good prognosis even without treatment. Occasionally, these epilepsies may show a more unfavourable course with a worsening, in spite of medication, and the appearance of neurologic and neuropsychologic disorders. All these aspects must be known and considered by the physician in charge of these patients management.

  16. Normal Variants and Pitfalls Encountered in PET Assessment of Gynecologic Malignancies.

    Science.gov (United States)

    Yu, Jian Q; Doss, Mohan; Alpaugh, R Katherine

    2018-04-01

    Combined PET/computed tomography is used for oncological indications. PET/computed tomography benefits from the metabolic information of PET and the anatomic localization of computed tomography. The integrated scanner provides data with accurate registration of anatomy and molecular information. Many physiologic conditions, normal variants, and benign lesions within the pelvis and the body can cause confusion and uncertainty. False-negative results owing to low 18 F-fluorodeoxyglucose uptake from the tumor can produce diagnostic challenges and inaccurate conclusions. This article reviews normal variants and potential pitfalls encountered in PET assessment of gynecologic malignancies to provide useful information for the referring and reporting physicians. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Total Robotic Hysterectomy: Thailand’s First Case Report of Gynecologic Robotic Surgery

    Directory of Open Access Journals (Sweden)

    Korakot Sirimai

    2016-01-01

    Full Text Available Objective: This study aimed to report the feasibility, trouble shooting and surgical technique in the total robotic hysterectomy for the patient with adenomyoma uteri. Methods: A 51 year-old patient was diagnosed with adenomyosis. Total robotic hysterectomy was performed. Results: Total operating time was 350 min, estimated blood loss was 50 ml, and length of hospitalization was 6 days. The pathologic section revealed adenomyosis with myoma uteri. The intraoperative and post-operative complications were unremarkable. The patient was in good conditions at 6th week, 3rd, 6th, 12th and 24th month. Conclusion: Total robotic hysterectomy for benign gynecologic condition, such as adenomyosis, is safe and feasible. However, the sustained high consuming cost must be weighted with the patient’s advantages.

  18. Hemihypertrophy, renal dysplasia and benign nephromegaly.

    Science.gov (United States)

    Memon, Mohammad Amin; Mohanty, Suravi; Das, Kanishka; Garg, Isha; D'Cruz, Ashley Lucien Joseph

    2005-06-01

    Hemihypertrophy is associated with malignant visceral abdominal neoplasms in childhood. Benign nephromegaly and nephroblastomas are both known to occur with hemihypertrophy; however, association with renal dysplasia has not previously reported. We describe an infant presenting with recurrent haematuria who had segmental hemihypertrophy, ipsilateral renal dysplasia and contralateral benign nephromegaly. Although debated, renal dysplasia may predispose to and predate malignant change. Rational management and optimal surveillance of renal dysplasia and benign nephromegaly in hemihypertrophy is discussed.

  19. Benign osteoblastoma of the mandible in a 12-year-old female: A case report

    Science.gov (United States)

    MARDALEISHVILI, KONSTANTINE; KAKABADZE, ZURAB; MACHAVARIANI, AVTANDIL; GRDZELIDZE, TEIMURAZ; KAKABADZE, ANNA; SUKHITASHVILI, NATIA; KURASHVILI, TAMAR; SHONIA, NESTAN; MENABDE, GIORGI; ABIATARI, IVANE

    2014-01-01

    Benign osteoblastoma refers to a benign tumor of the bone. Osteoblastoma most commonly affects the vertebrae and long tubular bones, however, in rare cases is observed in the facial bones. The current study presents the case of a 12-year-old female patient with a tumor in the mandibular body. Radiological imaging revealed a lesion with regular contours. The lesion was radically resected and histological analysis of the specimen demonstrated features that are typical of a benign osteoblastoma. The consequential defects of the jaw were reconstructed using titanium implants and autologous bone transplantation. The patient remains disease free subsequent to a five-month follow-up period. The aim of the present report is to present a rare case of benign osteoblastoma of the mandible. This study demonstrated that correct diagnosis and complete surgical excision are important to reduce the risk of recurrence of a benign osteoblastoma. PMID:25364451

  20. Phase II clinical trial of robotic stereotactic body radiosurgery for metastatic gynecologic malignancies

    Directory of Open Access Journals (Sweden)

    Charles eKunos

    2012-12-01

    Full Text Available Background Recurrent gynecologic cancers are often difficult to manage without significant morbidity. We conducted a phase II study to assess the safety and the efficacy of ablative robotic stereotactic body radiosurgery (SBRT in women with metastatic gynecologic cancers. Methods A total of 50 patients with recurrent gynecologic cancer who had single or multiple (≤4 metastases underwent robotic-armed Cyberknife SBRT (24Gy/3 daily doses. Toxicities were graded prospectively by common toxicity criteria for adverse events (version 4.0. SBRT target responses were recorded following RECIST criteria (version 1.0. Rates of clinical benefit for SBRT and non-radiosurgical disease relapse were calculated. Disease-free and overall survivals were estimated by the Kaplan-Meier method and the Cox proportional hazards model was used to control for prognostic variables.Findings SBRT was safely delivered, with 49 (98% of 50 patients completing three prescribed fractions. The most frequent grade 2 or higher adverse events attributed to SBRT included fatigue (16%, nausea (8% and diarrhea (4%. One (2% grade 4 hyperbilirubinemia occurred. SBRT target response was 96% (48 of 50 patients. A 6-month clinical benefit was recorded in 34 (68% [95% CI, 53.2, 80.1] patients. No SBRT-targeted disease progressed. Non-radiosurgical disease relapse occurred in 31 (62% patients. Median disease-free survival was 7.8 months (95% CI, 4.0, 11.6. Median overall survival was 20.2 months (95% CI, 10.9, 29.5.Interpretation SBRT safely controlled metastatic gynecologic cancer targets. Given an observed high rate of non-radiosurgical disease relapse, a phase I trial assessing co-administration of SBRT and cytotoxic chemotherapy is underway.Funding Case Comprehensive Cancer Center

  1. Phase II Clinical Trial of Robotic Stereotactic Body Radiosurgery for Metastatic Gynecologic Malignancies

    International Nuclear Information System (INIS)

    Kunos, Charles A.; Brindle, James; Waggoner, Steven; Zanotti, Kristine; Resnick, Kimberly; Fusco, Nancy; Adams, Ramon; Debernardo, Robert

    2012-01-01

    Background: Recurrent gynecologic cancers are often difficult to manage without significant morbidity. We conducted a phase II study to assess the safety and the efficacy of ablative robotic stereotactic body radiosurgery (SBRT) in women with metastatic gynecologic cancers. Methods: A total of 50 patients with recurrent gynecologic cancer who had single or multiple (≤4) metastases underwent robotic-armed Cyberknife SBRT (24Gy/3 daily doses). Toxicities were graded prospectively by common toxicity criteria for adverse events (version 4.0). SBRT target responses were recorded following RECIST criteria (version 1.0). Rates of clinical benefit for SBRT and non-radiosurgical disease relapse were calculated. Disease-free and overall survivals were estimated by the Kaplan–Meier method and the Cox proportional hazards model was used to control for prognostic variables. Findings: SBRT was safely delivered, with 49 (98%) of 50 patients completing three prescribed fractions. The most frequent grade 2 or higher adverse events attributed to SBRT included fatigue (16%), nausea (8%), and diarrhea (4%). One (2%) grade four hyperbilirubinemia occurred. SBRT target response was 96% (48 of 50 patients). A 6-month clinical benefit was recorded in 34 [68% (95% CI, 53.2, 80.1)] patients. No SBRT targeted disease progressed. Non-radiosurgical disease relapse occurred in 31 (62%) patients. Median disease-free survival was 7.8 months (95% CI, 4.0, 11.6). Median overall survival was 20.2 months (95% CI, 10.9, 29.5). Interpretation: SBRT safely controlled metastatic gynecologic cancer targets. Given an observed high rate of non-radiosurgical disease relapse, a phase I trial assessing co-administration of SBRT and cytotoxic chemotherapy is underway. Funding: Case Comprehensive Cancer Center.

  2. Gynecological disorders in bladder pain syndrome/interstitial cystitis patients.

    Science.gov (United States)

    Cervigni, Mauro; Natale, Franca

    2014-04-01

    Bladder pain syndrome/interstitial cystitis, a chronic inflammatory condition of the bladder, is the source of pain in over 30% of female patients with chronic pelvic pain. The aim of the present study was to evaluate the most frequent associations between bladder pain syndrome/interstitial cystitis and gynecological disorders. A literature review of the previous 10 years was carried out to evaluate the incidence of gynecological diseases in patients with bladder pain syndrome/interstitial cystitis. Hypertonic pelvic floor dysfunction with associated voiding dysfunction can be present in bladder pain syndrome/interstitial cystitis patients. It has been estimated that the prevalence ranges from 50% to 87%. Endometriosis affects 1-7% of the general population and up to 70% of women with endometriosis have some type of pain symptoms, a recent systematic review estimated the prevalence of bladder pain syndrome to be 61%, of endometriosis to be 70%, and coexisting bladder pain syndrome and endometriosis to be 48%. Vulvodynia is represented by pain, or an unpleasant altered sensation, in the vulva. Women with vestibulodynia are likely to have other additional pain conditions, such as fibromyalgia, irritable bowel syndrome or chronic fatigue syndrome. Recent data reported that vestibulodynia affects 25% of women with bladder pain syndrome/interstitial cystitis. Bladder pain syndrome/interstitial cystitis is a complex pathology often associated with vulvodynia, endometriosis and pelvic floor dysfunctions. Therefore, it is of utmost importance to obtain an accurate evaluation ruling out confusable disease, such as pudendal neuropathy. The optimal approach is a combined treatment oriented not only to treat the bladder, but also the other components responsible for the pain disorder. © 2014 The Japanese Urological Association.

  3. Menopause education: needs assessment of American obstetrics and gynecology residents.

    Science.gov (United States)

    Christianson, Mindy S; Ducie, Jennifer A; Altman, Kristiina; Khafagy, Ayatallah M; Shen, Wen

    2013-11-01

    This study aims to understand the current teaching of menopause medicine in American obstetrics and gynecology residency programs. A Web-based survey was e-mailed to all American obstetrics and gynecology residency directors, with a request that they forward it to their residents. Of 258 residency program directors contacted, 79 (30.6%) confirmed forwarding the survey. In all, 1,799 people received the survey, with 510 completions, for a response rate of 28.3%. Most residents reported that they had limited knowledge and needed to learn more about these aspects of menopause medicine: pathophysiology of menopause symptoms (67.1%), hormone therapy (68.1%), nonhormone therapy (79.0%), bone health (66.1%), cardiovascular disease (71.7%), and metabolic syndrome (69.5%). Among fourth-year residents who will be entering clinical practice soon, a large proportion also reported a need to learn more in these areas: pathophysiology of menopause symptoms (45.9%), hormone therapy (54.2%), nonhormone therapy (69.4%), bone health (54.2%), cardiovascular disease (64.3%), and metabolic syndrome (63.8%). When asked to rate the most preferred modalities for learning about menopause, the top choice was supervised clinics (53.2%), followed by case presentations (22.2%), formal lectures (21.3%), small groups (14.7%), Web-based learning (7.8%), and independent reading (5.2%). Only 20.8% of residents reported that their program had a formal menopause medicine learning curriculum, and 16.3% had a defined menopause clinic as part of their residency. It seems that some American residency programs do not fulfill the educational goals of their residents in menopause medicine. A curriculum would be beneficial for increasing knowledge and clinical experience on menopause issues.

  4. Breast and Gynecologic Cancer | Division of Cancer Prevention

    Science.gov (United States)

    [[{"fid":"184","view_mode":"default","fields":{"format":"default","field_file_image_alt_text[und][0][value]":"Breast and Gynecologic Cancer Research Group Homepage Logo","field_file_image_title_text[und][0][value]":"Breast and Gynecologic Cancer Research Group Homepage Logo","field_folder[und]":"15"},"type":"media","attributes":{"alt":"Breast and Gynecologic Cancer Research Group Homepage Logo","title":"Breast and Gynecologic Cancer Research Group Homepage Logo","height":"266","width":"400"," | Prevention and early detection of breast, cervix, endometrial and ovarian cancers and their precursors.

  5. The spectrum of benign esophageal lesions: imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Kyung Mi; Lee, Kyung Soo; Lee, Soon Jin; Kim, Eun A; Kim, Tae Sung; Han, Dae Hee; Shim, Young Mog [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2002-09-01

    Benign esophageal lesions occur in various diseases. Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease. Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread. In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up. The advent of helical computed tomography and its volume data set allows the acquisition of multiplanar images, and magnetic resonance imaging is useful both for this and for tissue characterization. Thus, multiplanar cross-sectional imaging further extends the role of imaging modalities to the evaluation of benign esophageal lesions. Through an awareness of the multiplanar cross-sectional appearances of various benign esophageal lesions, the radiologist can play an important role in the detection, diagnosis, further diagnostic planning, and treatment of the diseases in which they occur.

  6. Prevalence of benign tumors among patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Aryan Rafiee Zadeh

    2015-10-01

    Full Text Available Multiple sclerosis (MS, an inflammatory autoimmune disease, affects almost 1% of world’s population in which myelin sheaths of neurons are targeted by immune cells. Association of different factors and diseases with MS provides new insights into possible pathogenesis and treatment for this disease. In this regard, we investigated the association of benign tumors with MS disease by studying total Isfehan multiple sclerosis (TIMS records for MS patients registered in Isfahan Multiple Sclerosis Society (IMSS who had developed any kind of benign tumors whether before MS diagnosis or after it. This study was performed in Isfahan province, third large province of Iran, with 4,815,863 populations located 1590 meters above sea level between latitudes 30 and 34 degrees north of the equator, and longitude 49-55 east. Among 4950 registered patients, 28 patients were discovered to have three types of benign tumors; pituitary adenoma in 22, meningioma in 5 and lipoma in 1 patient. The incidence rate of developing pituitary adenoma and meningioma were higher than in general population (OR 95%CI: 1.110; range: 0.731-1.685 and 1.035; range: 0.431-2.487 respectively but these findings were not statistically significant (p= 0.624 for pituitary adenoma and p= 0.939 for meningioma. But the incidence rate for lipoma was lower among MS patients (OR 95%CI: 0.020; range: 0.003-0.143 which was statistically significant (p <0.001.

  7. Impact of the care provided by gynecologic oncologists on outcomes of cervical cancer patients treated with radical hysterectomy.

    Science.gov (United States)

    Wu, Miao-Fang; Li, Jing; Lu, Huai-Wu; Wang, Li-Juan; Zhang, Bing-Zhong; Lin, Zhong-Qiu

    2016-01-01

    For many malignant diseases, specialized care has been reported to be associated with better outcomes. The purpose of this study is to investigate the influence of gynecologic oncologists on treatment outcomes for cervical cancer patients treated by radical hysterectomy. Records of patients who received radical hysterectomy between January 2005 and June 2010 were reviewed. Perioperative morbidity, recurrence-free survival, and cancer-specific survival were assessed. Cox regression model was used to evaluate gynecologic oncologists as an independent predictor of survival. A total of 839 patients were included. Of these patients, 553 were treated by gynecologic oncologists, while 286 were treated by other subspecialties. With regard to operative outcomes, significant differences in favor of operation by gynecologic oncologists were found in number of patients receiving para-aortic node sampling and dissection (P=0.038), compliance with surgical guidelines (P=0.003), operative time (Pgynecologic oncologists had longer recurrence-free survival (P=0.001; hazard ratio [HR] =0.64; 95% confidence interval [CI] [0.48, 0.84]) and cancer-specific survival (P=0.005; HR=0.64; 95% CI [0.47, 0.87]), and this association remained significant in patients with locally advanced disease. Care by gynecologic oncologists was an independent predictor for improved recurrence-free survival (Pgynecologic oncologists results in significantly improved surgical and survival outcomes. The importance of the subspecialty of a gynecologist for cervical cancer patients should be addressed in clinical practice, especially for those in developing countries.

  8. Robot-assisted Surgery in Gynecologic Cancers.

    Science.gov (United States)

    Zanagnolo, Vanna; Garbi, Annalisa; Achilarre, Maria Teresa; Minig, Lucas

    Robotic-assisted surgery is a technological advancement that facilitates the application of minimally invasive techniques for complex operations in gynecologic oncology. The objective of this article was to review the literature regarding the role of robotic-assisted surgery to treat women with gynecologic cancers. The majority of publications on robotic surgery are still retrospective or descriptive in nature; however, the data for managing patients with a robotic-assisted approach show comparable, and at times improved, outcomes compared with both laparoscopy (2-dimensional) and laparotomy approaches. Robotic-assisted surgery has been used for patients with endometrial cancer and resulted in the increased use of minimally invasive surgery with improved outcomes compared with laparotomy and partially with laparoscopy. This has been shown in large cohorts of patients as well as in obese patients in whom the complication rates have significantly decreased. For early cervical cancer, robotic radical hysterectomy seems to be safe and feasible and to be preferable to laparotomy with seemingly comparable oncologic outcomes. Robotic-assisted surgery and conventional laparoscopy to stage women with early-stage ovarian cancer seem to have similar surgical and oncologic outcomes, with a shorter learning curve for robotic-assisted surgery. However, robotic-assisted surgery appears to be more expensive than laparotomy and traditional laparoscopy. In conclusion, robotic-assisted surgery appears to facilitate the surgical approach for complex operations to treat women with gynecologic cancers. Although randomized controlled trials are lacking to further elucidate the equivalence of robot-assisted surgery with conventional methods in terms of oncologic outcome and patients' quality of life, the technology appears to be safe and effective and could offer a minimally invasive approach to a much larger group of patients. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights

  9. Variáveis reprodutivas e risco para doenças benignas de mama: estudo caso-controle Reproductive variables and risk of benign breast diseases: a case-control study

    Directory of Open Access Journals (Sweden)

    Ellen E. Hardy

    1990-10-01

    Full Text Available Foram estudadas 257 mulheres com diagnóstico de doença benigna de mama (DBM, atestado por anatomopatológico ou citologia, e um controle para cada uma delas. Foram apresentados resultados das possíveis relações entre variáveis reprodutivas e o risco para DBM. Os casos e controles foram comparados levando em conta a idade na menarca e na menopausa, o número de gravidezes, de meses em que amamentaram e de ciclos menstruais ovulatórios, e os antecedentes familiares de câncer de mama. Mostraram influência significativa, em relação às DBM, a nuliparidade, aumentando o risco enquanto a idade de 30 ou mais anos no primeiro parto o reduziu; o número de ciclos ovulatórios, que foi significativamente maior para os casos, e a média de meses de uso de pílula, menor entre as mulheres com DBM. O uso de contraceptivos orais apresentou um efeito protetor apenas quando a duração total do uso foi maior que dois anos. Os resultados não se revelaram novos ou diferentes se comparados com outros estudos, mas confirmam a relativa concordância entre os fatores de risco para DBM e para câncer de mama, ainda que as relações entre esses fatores e as DBM não sejam tão claras como o são para o câncer, e existam também algumas discrepâncias.The purpose of the study was the identification of risk factors for benign breast diseases (BBD; 257 women with BBD diagnosed through pathological anatomy or citology and a matched control for each were studied. Subjects were selected at The State University of Campinas Hospital and at a private clinic. To enter the study cases had to have a first diagnosis of BBD between October 1979 and August 1984. The following BBD were considered: dysplasia, fibroadenoma, cystic disease, papilloma and ductal ectasia. Reproductive variables were studied as risk factors, including menstrual ovulatory cycles. The date on which the BBD was diagnosed was defined as the index date. For controls, data were considered up to when

  10. Consideration of Drug Therapy in Benign Prostatic Hypertrophy

    Directory of Open Access Journals (Sweden)

    G. Diamantis

    2015-01-01

    Full Text Available Benign prostatic hypertrophy (BPH has become a major global health problem both in its frequency by which it determines the complications and the problems of diagnosis and treatment it requires. BPH is a heterogeneous disease. The symptoms attributed to BPH may have other coexisting causes and growth factors both androgen-dependent and independent, which promotes prostate enlargement. It is well known that prostate size correlates poorly with the symptoms so that reducing prostate using 5-alphareductase or alphablocants inhibitors may not always be sufficient. A better understanding of the pathophysiology of BPH and its interactions with other drugs will help the development of new substances with a better efficiency. This present work aims to be a modest contribution related to medical treatment in benign prostatic hyperplasia and the role that the generalist practitioner should play in managing of this urinary disease quite common in elderly men.

  11. Design of environmentally benign processes

    DEFF Research Database (Denmark)

    Hostrup, Martin; Harper, Peter Mathias; Gani, Rafiqul

    1999-01-01

    This paper presents a hybrid method for design of environmentally benign processes. The hybrid method integrates mathematical modelling with heuristic approaches to solving the optimisation problems related to separation process synthesis and solvent design and selection. A structured method...... of solution, which employs thermodynamic insights to reduce the complexity and size of the mathematical problem by eliminating redundant alternatives, has been developed for the hybrid method. Separation process synthesis and design problems related to the removal of a chemical species from process streams...... because of environmental constraints are particularly suited for solution with the hybrid method. Application of the hybrid method is highlighted through two illustrative examples. The first example involves the determination of an optimal flowsheet for the removal of a chemical species from an azeotropic...

  12. Benign paroxysmal torticollis in infancy

    Directory of Open Access Journals (Sweden)

    Dimitrijević Lidija

    2006-01-01

    Full Text Available Background. Benign paroxysmal torticollis (BPT is an episodic functional disorder of unknown etiology, characterized by the periods of torticollic posturing of the head, that occurs in the early months of life in healthy children. Case report. We reported two patients with BPT. In the first patient the symptoms were observed at the age of day 20, and disappeared at the age of 3 years. There were 10 episodes, of which 2 were followed by vomiting, pallor, irritability and the abnormal trunk posture. In the second patient, a 12-month-old girl, BPT started from day 15. She had 4 episodes followed by vomiting in the first year. Both girls had the normal psychomotor development. All diagnostical tests were normal. Conclusion. The recognition of BPT, as well as its clinical course may help to avoid not only unnecessary tests and the treatment, but also the anxiety of the parents.

  13. Literature Review of Benign Müllerian Papilloma Contrasted With Vaginal Rhabdomyosarcoma.

    Science.gov (United States)

    McQuillan, Sarah K; Grover, Sonia R; Pyman, Jan; Jayasinghe, Yasmin L

    2016-08-01

    Benign müllerian papillomas of the genital tract are rare and, hence, can be mistaken for vaginal rhabdomyosarcoma on initial clinical review. This review of the literature will consolidate the previous cases of müllerian papilloma reported and looks for clues to differentiate the 2 entities. We provide a case report and literature review, with patients from a pediatric adolescent gynecology clinic in a tertiary center. We conducted a search of English-language publications from 1951 (the first case report) until January 2014 by using the search words "Müllerian papilloma" and "prepubertal bleeding." References from previous published reports were also obtained for completeness. Literature review of benign müllerian papilloma. Since 1951, 56 cases of müllerian papilloma were reported, including 4 cases at our institution. Comorbid conditions were found in 31.5% of cases (with 3 cases associated with mesenchymal tumors). The average length of time from onset of symptoms (primarily vaginal bleeding) to diagnosis was 6.7 months (range, 1 day to 3 years), with only 1 case diagnosed incidentally. Median age of presentation was 5 years (range, 1 day to 52 years). Most cases were localized and resected with ease. Histology reveals complex papillary lesions without cytologic atypia. Benign müllerian papilloma is distinguished from the more significant diagnosis of vaginal rhabdomyosarcoma by initial length of vaginal bleeding at presentation, lack of vaginal wall extension, ease of resection, and histopathology. This is compared with vaginal rhabdomyosarcoma which commonly exhibits both localized and distant spread. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  14. Gynecologic and other infections in pregnancy.

    Science.gov (United States)

    Torres, Mercedes; Moayedi, Siamak

    2012-11-01

    The treatment of gynecologic and other infections in obstetric patients involves consideration of the physiologic changes of pregnancy, the clinical implications of the infection for the patient as well as the fetus, and the safety of antimicrobials available for therapy. This article highlights the treatment of infections of the vagina, uterus, and urinary tract, with a focus on how therapy changes in obstetric patients. In addition, the emergency department management of other clinically important infections in pregnancy, such as those caused by the human immunodeficiency virus, influenza viruses, methicillin-resistant Staphylococcus aureus, Parvovirus, Listeria, and others is reviewed. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Evaluation of the value of combined measurement of three tumor markers for diagnosis and therapy in gynecologic tumors

    International Nuclear Information System (INIS)

    Zhou Zhongling; Luo Nanping; Yang Daoli

    2001-01-01

    Objective: To evaluate the value of combined analysis of serum CA-125, CEA and AFP for the diagnosis and therapy in gynecologic tumors. Methods: Measurements were carried out by radioimmunoassay. Results: The positive rates of CA-125, CEA and AFP were respectively 80.85% (38/47), 8.51% (4/47) and 14.89% (7/47) in gynecologic malignancies. The combined positive rate of the three above-mentioned was 95.7% (45/47). The average level of CA-125 was 22.02 +- 15.35 in benign tumor and 213 +- 127.26 in malignant tumor (P < 0.01). The average level of CA-125 dropped from 213.59 +- 127.26 to 34.23 +- 20.52 postoperatively (P < 0.01). Conclusion: The combined analysis of serum CA-125, CEA and AFP could improve the diagnostic accuracy in gynecologic tumors. CA-125 could also used for long-time monitoring after surgery

  16. Levels and determinants of gynecological morbidity in a district of south India.

    Science.gov (United States)

    Bhatia, J C; Cleland, J; Bhagavan, L; Rao, N S

    1997-06-01

    This article presents the results of an assessment of gynecological morbidity among 385 women with young children residing in a district of Karnataka State, South India. All three main modes of assessment (clinical examination, laboratory tests, and self-reports) reveal a high burden of reproductive tract infections. The two most common conditions, identified by laboratory tests, were bacterial vaginosis and mucopurulent cervicitis. Approximately one-fourth of the women had clinical evidence of pelvic inflammatory disease, cervical ectopy, and fistula. The contribution of sexually transmitted diseases to overall gynecological morbidity appears to be relatively modest; 10 percent were so diagnosed. Associated conditions of anemia and chronic energy deficiency were common. Severe anemia was found in 17 percent of cases and severe chronic energy deficiency in 12 percent. These results indicate that radical improvements in women's health in India will require far more than the diagnosis and treatment of reproductive tract infections.

  17. Interobserver Reproducibility Among Gynecologic Pathologists in Diagnosing Heterologous Osteosarcomatous Component in Gynecologic Tract Carcinosarcomas.

    Science.gov (United States)

    Sangoi, Ankur R; Kshirsagar, Malti; Roma, Andres A; Horvai, Andrew E; Chivukula, Mamatha; Ellenson, Lora H; Fadare, Oluwole; Folkins, Ann K; Garg, Karuna; Hanley, Krisztina; Longacre, Teri A; Haas, Jacqueline; McCluggage, W Glenn; McKenney, Jesse K; Nucci, Marisa R; Oliva, Esther; Park, Kay J; Parkash, Vinita; Quick, Charles M; Rabban, Joseph T; Rutgers, Joanne K L; Soslow, Robert; Vang, Russell; Yemelyanova, Anna; Zaloudek, Charles; Beck, Andrew H

    2017-07-01

    Distinguishing hyalinized stroma from osteoid production by a heterologous osteosarcomatous component can be challenging in gynecologic tract carcinosarcomas. As heterologous components in a carcinosarcoma may have prognostic and therapeutic implications, it is important that these are recognized. This study examines interobserver reproducibility among gynecologic pathologists in the diagnosis of osteosarcomatous components, and its correlation with expression of the novel antibody SATB2 (marker of osteoblastic differentiation) in these osteosarcomatous foci. Digital H&E images from 20 gynecologic tract carcinosarcomas were reviewed by 22 gynecologic pathologists with a request to determine the presence or absence of an osteosarcomatous component. The 20 preselected cases included areas of classic heterologous osteosarcoma (malignant cells producing osteoid; n=10) and osteosarcoma mimics (malignant cells with admixed nonosteoid matrix; n=10). Interobserver agreement was evaluated and SATB2 scored on all 20 cases and compared with the original diagnoses. Moderate agreement (Fleiss' κ=0.483) was identified for the 22 raters scoring the 20 cases with a median sensitivity of 7/10 and a median specificity of 9/10 for the diagnosis of osteosarcoma. SATB2 showed 100% sensitivity (10/10) and 60% (6/10) specificity in discriminating classic osteosarcoma from osteosarcoma mimics. Utilizing negative SATB2 as a surrogate marker to exclude osteosarcoma, 73% (16/22) of the reviewers would have downgraded at least 1 case to not contain an osteosarcomatous component (range, 1-6 cases, median 1 case). Gynecologic pathologists demonstrate only a moderate level of agreement in the diagnosis of heterologous osteosarcoma based on morphologic grounds. In such instances, a negative SATB2 staining may assist in increasing accuracy in the diagnosis of an osteosarcomatous component.

  18. Benign Osteoblastoma Located in the Parietal Bone

    OpenAIRE

    Lee, Yong Gun; Cho, Chang Won

    2010-01-01

    Benign osteoblastoma is an uncommon primary bone tumor, extremely rare in calvarium. We present a case of a 25-year-old female with an osteoblastoma of parietal bone which was totally resected. The authors discussed the clinical presentation, radiographic finding, differential diagnosis and management of the benign calvarial osteoblastoma with a review of the literature.

  19. Assessing the prevalence of autoimmune, endocrine, gynecologic, and psychiatric comorbidities in an ethnically diverse cohort of female fibromyalgia patients: does the time from hysterectomy provide a clue?

    Science.gov (United States)

    Brooks, Larry; Hadi, Joseph; Amber, Kyle T; Weiner, Michelle; La Riche, Christopher L; Ference, Tamar

    2015-01-01

    This retrospective chart review investigated differences in the prevalence of medical comorbidity between women with fibromyalgia (FM) (n=219) and a control group women with chronic pain (CP) without FM (n=116). The specific aims were to compare the prevalence of autoimmune, psychiatric, endocrine, gynecologic pathology, the relationship between timing of gynecologic surgery, and pain onset. We additionally sought to compare the number of comorbidities in an ethnically diverse cohort. This was a retrospective chart review of patients seen in FM or CP clinics at an academic medical center in 2009-2010. Logistic regression modeling found that gynecologic, endocrine, and autoimmune diagnoses were independently associated with a diagnosis of FM. Detailed analyses showed that thyroid disease (Pgynecologic surgery (Pgynecologic, or psychiatric pathologies. A relationship was observed between the timing of gynecologic surgery and pain onset in FM, with more surgeries observed in the years just prior to pain onset or in the year after pain onset. A similar pattern was not found in the control group. This study demonstrates that autoimmune, endocrine, and gynecologic pathologies occur more commonly in women with FM than in those with CP, which is consistent with findings in less ethnically diverse samples. Moreover, a relationship was found between timing of pain onset and gynecologic surgery. A larger prospective study of the relationship between gynecologic surgery and pain onset in FM is warranted.

  20. A qualitative study of Japanese patients' perspectives on post-treatment care for gynecological cancer.

    Science.gov (United States)

    Oshima, S; Kisa, K; Terashita, T; Habara, M; Kawabata, H; Maezawa, M

    2011-01-01

    The perspectives of cancer patients are important for designing a medically and economically effective follow-up program to help in the rapid recovery of patients. However, research focusing on the perspectives of Japanese gynecological cancer patients on follow-up programs is extremely scarce. In this study, we explored the perspectives and expectations of Japanese gynecological cancer patients with regard to post-treatment follow-up. Twenty-eight patients recruited through a gynecological cancer support group were included in focus groups 1-10 years post-treatment. Participants' accounts related to their perspectives on follow-up were coded and grouped into themes according to commonalities and differences. Seven themes emerged as follows: (1) living with uncertainty, (2) monitoring recurrence, (3) test content and frequency, (4) coping with "another illness", (5) provider communication and attitude, (6) holistic care, and (7) compromising with the reality of changed body. While these Japanese gynecological patients regarded follow-up as an opportunity for reassurance, they also wanted treatment for adverse effects and the opportunity to discuss their concerns. On the basis of the study findings, we conclude that during follow-up after cancer treatment, Japanese gynecological cancer patients not only prioritize recurrence management of cancer but also place a significant amount of importance on the management of symptoms and doctor-patient communication. However, these expectations for communication and care are often unmet. Thus, there is a need to fulfill the gap between the current follow-up programs and patients' expectations by reviewing and changing the hospital's policy that mainly focuses on the detection of recurrent diseases.

  1. An analysis of the impact of pathology review in gynecological cancer

    International Nuclear Information System (INIS)

    Chafe, S.; Honore, L.; Pearcey, R.; Capstick, V.

    1996-01-01

    Objective: To analyze the impact of pathology review in gynecological malignancies. Materials and Methods: A retrospective chart review of all new gynecological patients seen between Dec. 2, 1993 and Jan. 4, 1996 was conducted to determine if a pathological review by the Institute's consultant pathologist altered the diagnosis, and if so whether the alteration changed patient management. A total of 528 patients were seen of which 124 had cervix cancer, 235 had endometrial cancer, 122 had a primary ovarian or peritoneal malignancy, 9 had a vaginal malignancy, 28 had vulvar cancer and 10 had a miscellaneous gynecological malignancy. Results: On pathology review the initial diagnosis was changed in 199 patients. This altered management of 63 patients. For patients with cervical cancer, the grade of tumor was the main alteration in pathological diagnosis, with occasional change in the presence of lymph vascular invasion. These did not translate into patient management changes. The occasional change in depth of invasion altered management in one patient. For endometrial primaries the changes in pathological diagnosis included grade, depth of invasion, and the presence of cervical involvement. This did change management in some cases. For the ovarian malignancies the main changes were grade, extent of disease or variation in histology, some of which resulted in changes in management. One patient with a vaginal lesion had the diagnosis changed which did change management. Of the patients diagnosed with vulvar cancer the pathological diagnosis changed in 8 patients. This included changes in grade and depth of invasion. This altered patient management in 2 patients. The remaining miscellaneous gynecological malignancies had only two diagnosis alterations which did alter management. Conclusion: Pathological reviews of gynecological malignancies are justified as it can alter patient management. In addition, the process facilitates the cooperation of the multidisciplinary team

  2. Benign cystic mesothelioma of the appendix presenting in a woman: a case report

    LENUS (Irish Health Repository)

    O' Connor, Donal B

    2010-12-03

    Abstract Introduction Benign cystic mesothelioma or peritoneal inclusion cysts are rare benign abdominal tumors usually occurring in females of reproductive age. These cysts present as abdominopelvic pain or masses but are often found on imaging or incidentally at surgery. They are commonly associated with pelvic inflammatory disease, endometriosis, or ovarian cysts. We report what is, to the best of our knowledge, the first case of a benign cystic mesothelioma complicating a presentation of acute appendicitis. Case Presentation A 19-year-old Irish Caucasian woman presented with abdominal pain. Imaging suggested appendicitis with abscess formation. She was treated with antibiotics and scheduled for interval appendicectomy. At laparoscopy, an unusual cystic mass was found arising from the appendix. Histology revealed benign cystic mesothelioma. Conclusion We report what is, to the best of our knowledge, the first case of a benign cystic mesothelioma arising from the appendix and complicating a presentation of acute appendicitis. This is a benign pathology, but recurrences are not uncommon. Benign cystic mesothelioma should be included in the differential when investigating pelvic masses or abscesses associated with either appendicitis or pelvic inflammatory disease in women.

  3. Benign cystic mesothelioma of the appendix presenting in a woman: a case report

    Directory of Open Access Journals (Sweden)

    Beddy David

    2010-12-01

    Full Text Available Abstract Introduction Benign cystic mesothelioma or peritoneal inclusion cysts are rare benign abdominal tumors usually occurring in females of reproductive age. These cysts present as abdominopelvic pain or masses but are often found on imaging or incidentally at surgery. They are commonly associated with pelvic inflammatory disease, endometriosis, or ovarian cysts. We report what is, to the best of our knowledge, the first case of a benign cystic mesothelioma complicating a presentation of acute appendicitis. Case Presentation A 19-year-old Irish Caucasian woman presented with abdominal pain. Imaging suggested appendicitis with abscess formation. She was treated with antibiotics and scheduled for interval appendicectomy. At laparoscopy, an unusual cystic mass was found arising from the appendix. Histology revealed benign cystic mesothelioma. Conclusion We report what is, to the best of our knowledge, the first case of a benign cystic mesothelioma arising from the appendix and complicating a presentation of acute appendicitis. This is a benign pathology, but recurrences are not uncommon. Benign cystic mesothelioma should be included in the differential when investigating pelvic masses or abscesses associated with either appendicitis or pelvic inflammatory disease in women.

  4. Survival of gynecological cancers in Turkey: where are we at?

    Science.gov (United States)

    Gultekin, Murat; Dundar, Selin; Kucukyildiz, Irem; Karaca, Mujdegul Zayifoglu; Boztas, Guledal; Turan, Semra Hatice; Hacikamiloglu, Ezgi; Keskinkilic, Bekir

    2017-11-01

    To investigate the 5-year relative survival rates in gynecological cancers diagnosed and treated in Turkey by year 2009 and to compare the results with developed countries. Data of patients diagnosed for ovarian, corpus uteri or cervix uteri cancer at year 2009 are collected from 9 national cancer registry centers. Date of deaths are retracted from governmental Identity Information Sharing System (KPS). In order to calculate relative survival rates, national general population mortality tables are obtained from Turkish Statistical Institute (TurkStat). Hakulinen method is used for computing curves by R program. Data for European, Asian and some developed countries were obtained from official web pages. A total of 1,553 patients are evaluated. Among these, 713 (45.9%) are corpus uteri cancers, while remaining 489 (31.5%) are ovarian and 351 (22.6%) are cervix uteri. Five-year overall relative survival rates are 85%, 50%, and 62% for corpus uteri, ovarian, and cervix uteri, respectively. These figures are between 73%-87% for corpus uteri, 31%-62% for ovarian and 61%-80% for cervix uteri in developed countries. Stage is the most important factor for survival in all cancers. Five-year relative survival rates in corpus uteri cancers are 92%, 66%, and 38% for localized, regional, and distant metastatic disease, respectively. These figures are 77%, 57%, and 29% for ovarian; 80%, 50%, and 22% for cervix uteri. This is the first report from Turkey giving national overall relative survival for gynecological cancers from a population based cancer registry system.

  5. Inappropriate oophorectomy at time of benign premenopausal hysterectomy.

    Science.gov (United States)

    Mahal, Amandeep S; Rhoads, Kim F; Elliott, Christopher S; Sokol, Eric R

    2017-08-01

    We assessed rates of oophorectomy during benign hysterectomy around the release of the American College of Obstetricians and Gynecologists 2008 practice bulletin on prophylactic oophorectomy, and evaluated predictors of inappropriate premenopausal oophorectomy. A cross-sectional administrative database analysis was performed utilizing the California Office of Statewide Health Planning Development Patient Discharge Database for years 2005 to 2011. After identifying all premenopausal women undergoing hysterectomy for benign conditions, International Classification of Diseases (ICD)-9 diagnosis codes were reviewed to create a master list of indications for oophorectomy. We defined appropriate oophorectomy as cases with concomitant coding for ovarian cyst, breast cancer susceptibility gene carrier status, and other diagnoses. Using patient demographics and hospital characteristics to predict inappropriate oophorectomy, a logistic regression model was created. We identified 57,776 benign premenopausal hysterectomies with oophorectomies during the period studied. Of the premenopausal oophorectomies, 37.7% (21,783) were deemed "inappropriate" with no documented reason for removal. The total number of premenopausal inpatient hysterectomies with oophorectomy decreased yearly (12,227/y in 2005 to 5,930/y in 2011). However, the percentage of inappropriate oophorectomies remained stable. In multivariate analysis, Hispanic and African American ethnicity/race associated with increased odds of inappropriate oophorectomy (P Urban and at low Medi-Cal utilization hospitals showed increased odds of inappropriate oophorectomy. In premenopausal women undergoing benign hysterectomy, over one-third undergo oophorectomy without an appropriate indication documented. The rate of inappropriate oophorectomy in California has not changed since the 2008 American College of Obstetricians and Gynecologists guidelines. Whereas the absolute number of inpatient hysterectomies for benign

  6. Endometrial aspiration cytology in gynecological disorders

    Directory of Open Access Journals (Sweden)

    Meenal V Jadhav

    2016-01-01

    Full Text Available Context: Endometrial aspiration is not a popular modality for the study of the endometrium despite its simplicity and potential utility. Aim: The present study was aimed at evaluating the utility of endometrial aspiration in various gynecological disorders. Materials and Methods: In this diagnostic accuracy study, 55 prospectively registered women with various gynecological disorders were evaluated clinically and subjected to endometrial aspiration cytology and study of endometrial histology. Endometrial aspiration was performed by infant feeding tube in 10 cases and intra cath cannula in 45 cases. The slides were stained with rapid Papanicolaou (PAP stain and Leishman stain. Results: Endometrial aspiration cytology showed 90% and 94.6% sampling adequacy with infant feeding tube and intra cath cannula, respectively. Intra cath cannula was very convenient to handle and superior to infant feeding tube in aspirating the endometrium. Of the two stains used, rapid PAP stain was less time-consuming and superior to Leishman stain in studying the nuclear details. Leishman stain was helpful in detecting cytoplasmic vacuoles of secretory endometrium. Overall diagnostic accuracy of endometrial cytology was 90.4% while that for morphological hormonal evaluation was 97.6%. It enjoyed a sensitivity of 91.66%, a specificity of 88.23%, positive predictive value of 94.28%, and negative predictive value of 83.33%. Conclusion: Intra cath cannula emerged as an inexpensive, effective, and convenient device for endometrial aspiration. Endometrial aspiration proved to be a fairly effective, simple, and informative diagnostic modality.

  7. The representations of adolescents about gynecological consultation

    Directory of Open Access Journals (Sweden)

    Vera Lúcia de Oliveira Gomes

    2014-06-01

    Full Text Available Objective: To analyze the social representation of adolescents about gynecological consultation and the influence of those in searching for consultations. Method: Qualitative descriptive study based on the Social Representations Theory, conducted with 50 adolescents in their last year of middle school. The data was collected between April and May of 2010 by Evocations and a Focal Group. The software EVOC and contextual analysis were used in the data treatment. Results: The elements fear and constraint, constant in the central nucleus, can justify the low frequency of adolescents in consultations. The term embarrassment in the peripheral system reinforce current sociocultural norms, while prevention, associated with learning about sex and clarifying doubts, allows to envision an educative function. Obtained testimonies in the focal groups exemplify and reinforce those findings. Conclusion: For an effective health education, professionals, including nurses, need to clarify the youth individually and collectively about their rights to privacy, secrecy, in addition to focus the gynecological consultation as a promotion measure to sexual and reproductive health.

  8. Robotic-assisted surgery in gynecologic oncology.

    Science.gov (United States)

    Sinno, Abdulrahman K; Fader, Amanda N

    2014-10-01

    The quest for improved patient outcomes has been a driving force for adoption of novel surgical innovations across surgical subspecialties. Gynecologic oncology is one such surgical discipline in which minimally invasive surgery has had a robust and evolving role in defining standards of care. Robotic-assisted surgery has developed during the past two decades as a more technologically advanced form of minimally invasive surgery in an effort to mitigate the limitations of conventional laparoscopy and improved patient outcomes. Robotically assisted technology offers potential advantages that include improved three-dimensional stereoscopic vision, wristed instruments that improve surgeon dexterity, and tremor canceling software that improves surgical precision. These technological advances may allow the gynecologic oncology surgeon to perform increasingly radical oncologic surgeries in complex patients. However, the platform is not without limitations, including high cost, lack of haptic feedback, and the requirement for additional training to achieve competence. This review describes the role of robotic-assisted surgery in the management of endometrial, cervical, and ovarian cancer, with an emphasis on comparison with laparotomy and conventional laparoscopy. The literature on novel robotic innovations, special patient populations, cost effectiveness, and fellowship training is also appraised critically in this regard. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Culturally sensitive gynecologic care in adolescence.

    Science.gov (United States)

    Pons, José Enrique

    2012-01-01

    Culturally sensitive gynecologic care means rendering gynecologic care taking into account adolescents' needs, problems and feelings, as seen by adolescents themselves. Adolescence is a period of turmoil, where limits are being tested and risks taken. A certain degree of rebellion is necessary and normal. In contemporary societies, risk-taking behaviors seem to outnumber any previous historical period. Antagonistic depictions of 'two worlds', transforms the question into one between a culture and a counterculture. Sometimes, the perspectives are exaggerated by attitudes of superiority, leading to inadequate or punitive practices. Health providers need to confront their own prejudices, so as to understand that in their role as health workers, what adolescents ask for is help to cope with their problems in the fields that professionals are qualified for, but not to behave as policemen, judges or priests. Adolescents also need help to overcome resistance to formal environments. In order to achieve success, they have to have the opportunity to be heard and to participate in tailoring programs. These undertakings should be aimed at contributing to health promotion, encouraging self-care and reaffirming confidence in adolescents' responsibility, while generating trust in health services and professionals. Copyright © 2012 S. Karger AG, Basel.

  10. Ultrasonography in obstetrics and gynecology, 2nd edition

    International Nuclear Information System (INIS)

    Callen, P.W.

    1988-01-01

    A text on obstetric and gynecologic ultrasound for radiologists, OB/GYN practitioners, and radiologic technicians. The second edition places greater emphasis on diagnosis of specific systemic disorders in the fetus, as well as the most current applications of ultrasound in gynecologic diagnosis

  11. Incidence and survival of gynecologic sarcomas in England.

    Science.gov (United States)

    Francis, Matthew; Dennis, Nicola L; Hirschowitz, Lynn; Grimer, Robert; Poole, Jason; Lawrence, Gill; Nordin, Andy

    2015-06-01

    Gynecologic sarcomas account for approximately 3% to 4% of all gynecologic malignancies and are associated with poor outcomes compared with gynecologic carcinomas. The aim of this study is to report the incidence and survival rates of the main gynecologic sarcomas using national English cancer registration data. Records of gynecologic sarcomas diagnosed between 1985 and 2008 were extracted from the English National Cancer Data Repository. ICD-O3 morphology codes were used to assign tumor records to specific histologic subgroups. Incidence and 5-year relative survival rates were calculated. There were 5316 new cases of gynecologic sarcoma diagnosed in England between 1985 and 2008. Incidence rates increased significantly in the early 1990s, probably due to coding changes. Age-specific incidence rates were highest in women aged between 45 and 64 years. In the most recent period studied (2001-2008), incidence rates fluctuated between 8 and 9.6 per million. The most common anatomical site was the uterus (83% of all diagnoses), and the most common histologic diagnosis was leiomyosarcoma (52% of all diagnoses). Overall 5-year relative survival increased significantly between 1985-1989 and 2000-2004, from 34% to 48%. Gynecologic sarcoma incidence rates have varied little since 1993, whereas survival has improved significantly. These results are consistent with previously published small series and case studies, and provide a more complete picture of gynecologic sarcoma incidence and survival patterns in England.

  12. Architectural overlap between benign endocervix and pattern-A endocervical adenocarcinoma: Are all pattern-A tumors invasive?

    Science.gov (United States)

    Douglas, Gregory; Howitt, Brooke E; Schoolmeester, John K; Schwartz, Lauren; Kos, Zuzana; Islam, Shahidul; Djordjevic, Bojana; Parra-Herran, Carlos

    2017-07-01

    Studies on the pattern-based classification for invasive endocervical adenocarcinoma showed that tumors with nondestructive invasion (pattern-A) have a 0% rate of nodal metastases. Our understanding of pattern-A tumors and their distinction from in-situ adenocarcinoma requires further study. Thirteen sections diagnosed independently as pattern-A adenocarcinoma by three gynecologic pathologists, and 14 sections of benign endocervix were selected. Three additional pathologists (reviewers) evaluated a digital image from each section and classified it as pattern-A or benign based on architecture only. To blind the interpretation to cytologic features, nuclei and cytoplasm were obscured using morphometric software (Zen 2011, Carl Zeiss Microscopy, Germany). 13/27 cases (48%; 8 pattern-A, 5 benign) were correctly classified by all reviewers; 19/27 (70%; 10 pattern-A, 9 benign) were correctly classified by ≥2 reviewers. 3/13 pattern-A cases (23%) were interpreted as benign by ≥2 reviewers. Conversely, 5/14 benign cervices (36%) were misinterpreted as pattern-A by ≥2 reviewers. The number of glands per 20× field was higher in pattern-A cases with high reviewer agreement (p=0.004). An abnormal architecture is seen in many pattern-A adenocarcinomas in support of their invasive nature; some, however, have architecture that overlaps with that of benign endocervix thus may actually represent in-situ lesions. Likewise, normal cervix can be architecturally complex and mirror patterns that pathologists would classify as pattern-A if malignant cytologic features were present. Based on this overlap and the nil risk of nodal spread, an emphasis on the non-destructive, rather than the invasive, nature of pattern-A adenocarcinoma is recommended. Copyright © 2017 Elsevier GmbH. All rights reserved.

  13. Italian survey on benign paroxysmal positional vertigo.

    Science.gov (United States)

    Messina, A; Casani, A P; Manfrin, M; Guidetti, G

    2017-08-01

    Benign paroxysmal positional vertigo (BPPV) is the most common type of peripheral vertigo. BPPV often relapses after the first episode, with a recurrence rate between 15% and 50%. To date both the aetiopathogenetic processes that lead to otoconia detachment and the factors that make BPPV a relapsing disease are still unclear, but recent epidemiological studies have shown a possible association with cardiovascular risk factors. The aim of the present study (Sesto Senso Survey) was to evaluate in the Italian population through an observational survey, the main demographic and clinical characteristics of patients with BPPV (first episode or recurrent) with particular focus on the potential cardiovascular risk factors. The survey was conducted in 158 vestibology centres across Italy on 2,682 patients (mean age 59.3 ± 15.0 years; 39.1% males and 60.9% females) suffering from BPPV, from January 2013 to December 2014. The results showed a high prevalence of cardiovascular risk factors such as high blood pressure (55.8%), hypercholesterolaemia (38.6%) and diabetes (17.7%), as well as a family history of cardiovascular disease (49.4%). A high percentage of patients also had hearing loss (42.9%), tinnitus (41.2%), or both (26.8%). The presence of hypertension, dyslipidaemia and pre-existing cardiovascular comorbidities were significantly related to recurrent BPPV episodes (OR range between 1.84 and 2.31). In addition, the association with diabetes and thyroid/autoimmune disease (OR range between 1.73 and 1.89) was relevant. The survey results confirm the significant association between cardiovascular comorbidities and recurrent BPPV and identify them as a potential important risk factor for recurrence of BPPV in the Italian population, paving the way for the evaluation of new therapeutic strategies in the treatment of this disease. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  14. Optical coherence tomography in gynecology: a narrative review

    Science.gov (United States)

    Kirillin, Mikhail; Motovilova, Tatiana; Shakhova, Natalia

    2017-12-01

    Modern gynecologic practice requires noninvasive diagnostics techniques capable of detecting morphological and functional alterations in tissues of female reproductive organs. Optical coherence tomography (OCT) is a promising tool for providing imaging of biotissues with high resolution at depths up to 2 mm. Design of the customized probes provides wide opportunities for OCT use in gynecology. This paper contains a retrospective insight into the history of OCT employment in gynecology, an overview of the existing gynecologic OCT probes, including those for combination with other diagnostic modalities, and state-of-the-art application of OCT for diagnostics of tumor and nontumor pathologies of female genitalia. Perspectives of OCT both in diagnostics and treatment planning and monitoring in gynecology are overviewed.

  15. Subspecialist training in surgical gynecological oncology in the nordic countries

    DEFF Research Database (Denmark)

    Antonsen, Sofie L; Avall-Lundqvist, Elisabeth; Salvesen, Helga B

    2011-01-01

    To survey the centers that can provide subspecialty surgical training and education in gynecological oncology in the Nordic countries we developed an online questionnaire in cooperation with the Nordic Society of Gynecological Oncology. The link to the survey was mailed to 22 Scandinavian...... gynecological centers in charge of surgical treatment of cancer patients. Twenty centers (91%) participated. Four centers reported to be accredited European subspecialty training centers, a further six were interested in being accredited, and 11 centers were accredited by the respective National Board. Fourteen...... (74%) centers were interested in being listed for exchange of fellows. Our data show a large Nordic potential and interest in improving the gynecologic oncology standards and can be used to enhance the awareness of gynecological oncology training in Scandinavia and to facilitate the exchange...

  16. Improving quality and decreasing cost in gynecologic oncology care. Society of gynecologic oncology recommendations for clinical practice.

    Science.gov (United States)

    Rimel, B J; Burke, William M; Higgins, Robert V; Lee, Paula S; Lutman, Christopher V; Parker, Lynn

    2015-05-01

    To identify potential cost savings in gynecologic oncology care without sacrificing quality. Members of the Clinical Practice Committee of the Society of Gynecologic Oncology were asked to review current practice patterns in gynecologic oncology and assess the potential for cost savings founded on evidence-based medicine and current guidelines. Five clinical practices were identified including the following: vaginal cytology for endometrial cancer survivors; colposcopy for low grade cytologic abnormalities for cervical cancer survivors; routine imaging studies for gynecologic cancer survivors; screening for ovarian cancer with serum biomarkers and ultrasound; and improving palliative care for gynecologic cancer patients. Review of the published literature and guidelines were performed to make evidence-based recommendations for cost effective quality gynecologic oncology care. • Do not perform Pap tests of the vaginal cuff in patients with a history of endometrial cancer. • Do not perform colposcopy for low grade Pap tests in women with a history of cervical cancer. • Avoid routine imaging for cancer surveillance in asymptomatic women with gynecologic cancer, specifically ovarian, endometrial, cervical, vulvar and vaginal cancer. • Do not screen women at low risk for ovarian cancer with ultrasound or CA-125 or other biomarkers. • Do not delay basic level palliative care for women with advanced or relapsed gynecologic cancer, do refer to a palliative care specialist when needed, and avoid unnecessary treatments at life's end. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Acute hemorrhagic edema of infancy: a worrisome presentation, but benign course

    OpenAIRE

    Alhammadi, Ahmed H; Adel, Ashraf; Hendaus, Mohamed A

    2013-01-01

    Ahmed H Alhammadi, Ashraf Adel, Mohamed A Hendaus Department of Pediatrics, Section of General Pediatrics, Hamad Medical Corporation, Doha, Qatar Abstract: Acute hemorrhagic edema of infancy (AHEI) is a benign type of leukocytoclastic vasculitis. It is a benign phenomenon although it manifests with fever, large palpable purpuric skin lesions, and edema. The presentation of AHEI can often resemble that of Henoch-Schönlein purpura. Since AHEI is a self-limited disease, conservative m...

  18. Acute hemorrhagic edema of infancy: a worrisome presentation, but benign course

    Science.gov (United States)

    Alhammadi, Ahmed H; Adel, Ashraf; Hendaus, Mohamed A

    2013-01-01

    Acute hemorrhagic edema of infancy (AHEI) is a benign type of leukocytoclastic vasculitis. It is a benign phenomenon although it manifests with fever, large palpable purpuric skin lesions, and edema. The presentation of AHEI can often resemble that of Henoch-Schönlein purpura. Since AHEI is a self-limited disease, conservative management is the most commonly followed approach. Our patient had complete resolution of AHIE without medical treatment. PMID:24043950

  19. Gynecologic examination and cervical biopsies after (chemo) radiation for cervical cancer to identify patients eligible for salvage surgery

    NARCIS (Netherlands)

    Nijhuis, Esther R.; van der Zee, Ate G. J.; In 't Hout, Bertha A.; Boomgaard, Jantine J.; de Hullu, Joanne A.; Pras, Elisabeth; Hollema, Harry; Aalders, Jan G.; Jijman, Hans W.; Willemse, Pax H. B.; Mourits, Marian J. E.

    2006-01-01

    Purpose: The aim of this study was to evaluate efficacy of gynecologic examination under general anesthesia with cervical biopsies after (chemo) radiation for cervical cancer to identify patients with residual disease who may benefit from salvage surgery. Methods and Materials: In a retrospective

  20. Gynecologic examination and cervical biopsies after (chemo) radiation for cervical cancer to identify patients eligible for salvage surgery.

    NARCIS (Netherlands)

    Nijhuis, E.R.; Zee, A.G. van der; Hout, B.A. van; Boomgaard, J.J.; Hullu, J.A. de; Pras, E.; Hollema, H.; Aalders, J.G.; Nijman, H.W.; Willemse, P.H.B.; Mourits, M.J.E.

    2006-01-01

    PURPOSE: The aim of this study was to evaluate efficacy of gynecologic examination under general anesthesia with cervical biopsies after (chemo) radiation for cervical cancer to identify patients with residual disease who may benefit from salvage surgery. METHODS AND MATERIALS: In a retrospective

  1. Management of Benign Biliary Strictures

    International Nuclear Information System (INIS)

    Laasch, Hans-Ulrich; Martin, Derrick F.

    2002-01-01

    Benign biliary strictures are most commonly a consequence of injury at laparoscopic cholecystectomy or fibrosis after biliary-enteric anastomosis. These strictures are notoriously difficult to treat and traditionally are managed by resection and fashioning of acholedocho- or hepato-jejunostomy. Promising results are being achieved with newer minimally invasive techniques using endoscopic or percutaneous dilatation and/or stenting and these are likely to play an increasing role in the management. Even low-grade biliary obstruction carries the risks of stone formation, ascending cholangitis and hepatic cirrhosis and it is important to identify and treat this group of patients. There is currently no consensus on which patient should have what type of procedure, and the full range of techniques may not be available in all hospitals. Careful assessment of the risks and likely benefits have to be made on an individual basis. This article reviews the current literature and discusses the options available. The techniques of endoscopic and percutaneous dilatation and stenting are described with evaluation of the likely success and complication rates and compared to the gold standard of biliary-enteric anastomosis

  2. Recurrent Benign Salivary Gland Neoplasms.

    Science.gov (United States)

    Witt, Robert Lee; Nicolai, Piero

    2016-01-01

    The most important causes of recurrence of benign pleomorphic adenoma are enucleation with intraoperative spillage and incomplete tumor excision in association with characteristic histologic findings for the lesion (incomplete pseudocapsule and the presence of pseudopodia). Most recurrent pleomorphic adenomas (RPAs) are multinodular. MRI is the imaging method of choice for their assessment. Nerve integrity monitoring may reduce morbidity of RPA surgery. Although treatment of RPA must be individualized, total parotidectomy is generally recommended given the multicentricity of the lesions. However, surgery alone may be inadequate for controlling RPA over the long term. There is growing evidence from retrospective series that postoperative radiotherapy results in significantly better local control. A high percentage of RPAs are incurable. All patients should therefore be informed about the possibility of needing multiple treatment procedures, with possible impairment of facial nerve function, and radiation therapy for RPA. Reappearance of Warthin tumor is a metachronous occurrence of a new focus or residual incomplete excision of all primary multicentric foci of Warthin tumor. Selected cases can be observed. Conservative surgical management can include partial superficial parotidectomy or extracapsular dissection. Not uncommonly, other major and minor salivary gland neoplasms, including myoepithelioma, basal cell adenoma, oncocytoma, canalicular adenoma, cystadenoma, and ductal papilloma, follow an indolent course after surgical resection, with rare cases of recurrence. © 2016 S. Karger AG, Basel.

  3. Nocturia and benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    Laketić Darko

    2008-01-01

    Full Text Available Background/Aim. Nocturia often occurs in patients with benign prostate hyperplasia (BPH. The aim of the study was to investigate the frequency of nocturia in patients with BPH. Nocturia and other factors associated with it were also investigated. Methods. Forty patients with the confirmed diagnosis of BPH were studied. Transurethral and transvesical prostatectomy were performed in all the patients. Symptoms were evaluated with the International Prostate Symptom Score before, as well as three and six months after the surgery. All the results were compared with the control group. Results. There was no statistically significant difference between the patients before and after the surgery regarding nocturia. There was, however, a statistically significant difference between the operated patients and the control group regarding nocturia, as well as a statistically significant correlation between noctruia and the age of the patients in both the investigated and the control group. A correlation also existed between nocturia and the prostatic size. Conclusion. There was no statistically significant improvement in symptoms of nocturia after the surgery. It is necessary to be very careful in decision making in patients with nonabsolute indiction for surgery and isolated bothersome symptom of nocturia. Age of a patient should also be considered in the evaluation of favorable result of the surgery because of a significant correlation between noctura and the age of a patient.

  4. Intraoperative radiation therapy in gynecologic cancer: update of the experience at a single institution

    International Nuclear Information System (INIS)

    Garton, Graciela R.; Gunderson, Leonard L.; Webb, Maurice J.; Wilson, Timothy O.; Cha, Stephen S.; Podratz, Karl C.

    1997-01-01

    Purpose: To update the Mayo Clinic experience with intraoperative radiation therapy (IORT) in patients with gynecologic cancer. Methods and Materials: Between January 1983 and June 1991, 39 patients with recurrent or locally advanced gynecologic malignancies received intraoperative radiation therapy with electrons. The anatomical area treated was pelvis (side walls or presacrum) or periaortic nodes or a combination of both. In addition to intraoperative radiation therapy, 28 patients received external beam irradiation (median dose, 45 Gy; range, 0.9 to 65.7 Gy), and 13 received chemotherapy preoperatively. At the time of intraoperative radiation therapy and after maximum debulking operation, 23 patients had microscopic residual disease and 16 had gross residual disease up to 5 cm in thickness. Median follow-up for surviving patients was 43.4 months (range, 27.1 to 125.4 months). Results: The 5-year actuarial local control with or without central control was 67.4%, and the control within the IORT field (central control) was 81%. The risk of distant metastases at 5 years was 52% (82% in patients with gross residual disease and 33% in patients with only microscopic disease postoperatively). Actuarial 5-year overall survival and disease-free survival was 31.5 and 40.5%, respectively. Patients with microscopic disease had 5-year disease-free and overall survival of 55 and 50%, respectively. Grade 3 toxicity was directly associated with IORT in six patients (15%). Conclusion: Patients with local, regionally recurrent gynecologic cancer may benefit from maximal surgical debulking and IORT with or without external beam irradiation, especially those with microscopic residual disease

  5. Statin use and survival outcomes in endocrine-related gynecologic cancers: A systematic review and meta-analysis.

    Science.gov (United States)

    Xie, Weimin; Ning, Li; Huang, Yuenan; Liu, Yan; Zhang, Wen; Hu, Yingchao; Lang, Jinghe; Yang, Jiaxin

    2017-06-20

    Previous studies investigating the association between statin use and survival outcomes in gynecologic cancers have yielded controversial results. We conducted a systematic review and meta-analysis to evaluate the association based on available evidence. We searched the databases of the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and PubMed from inception to January 2017. Studies that evaluated the association between statin use and survival outcomes in gynecologic cancers were included. Pooled hazard ratios (HRs) for overall survival, disease-specific survival and progression-free survival were calculated using a fixed-effects model. A total of 11 studies involving more than 6,920 patients with endocrine-related gynecologic cancers were identified. In a meta-analysis of 7 studies involving 5,449 patients with endocrine-related gynecologic cancers, statin use was linked to improved overall survival (HR, 0.71; 95% confidence interval [CI], 0.63 to 0.80) without significant heterogeneity (I2 = 33.3%). Statin users also had improved disease-specific survival (3 studies, HR, 0.72; 95% CI, 0.58 to 0.90, I2 = 35.1%) and progression-free survival (3 studies, HR, 0.68; 95% CI, 0.49 to 0.93, I2 = 33.6%) in endocrine-related gynecologic cancers. Our findings support that statin use has potential survival benefits for patients with endocrine-related gynecologic cancers. Further large-scale prospective studies are required to validate our findings.

  6. Compliance with research standards within gynecologic oncology fellowship: A Gynecologic Oncology Fellowship Research Network (GOFRN) study.

    Science.gov (United States)

    Moulton, Laura J; Michener, Chad M; Levinson, Kimberly; Cobb, Lauren; Tseng, Jill; Jernigan, Amelia

    2017-09-01

    Participation in clinical and basic science research is emphasized in gynecologic oncology training. We sought to identify trends in adherence to expected research practices and reasons for non-adherence among gynecologic oncology fellows. An anonymous 31-question online survey assessing academic behaviors, including IRB compliance, authorship assignment, data sharing, and potential barriers to non-adherence was distributed to all SGO gynecologic oncology fellow members in July 2016. Descriptive statistics and univariate analyses were performed. Of 190 members, 35.3% (n=67) responded. 73% (n=49) of respondents reported personal non-compliance and 79.1% (n=53) reported having witnessed others being non-complaint with at least one expected research practice. Areas of compliance failure included changing a research question without appropriate IRB amendment (20%; n=14), conducting research under a nonspecific IRB (13.9%; n=9), and performing research without IRB approval (6.1%; n=4). Longer institutional time for IRB approval was significantly associated with IRB non-adherence (p1000 patients. Thirty respondents (45.5%) assigned authorship to someone who failed to meet ICMJE criteria and twelve (18.5%) accepted authorship without meeting ICMJE criteria. Most commonly cited reasons for non-adherence were: cumbersome IRB processes (80.3%), pressure from senior authors (78.8%), fear of someone else publishing first, (74.2%) and lack of support navigating appropriate research practices (71.2%). Fellow non-compliance with expected research practices is high, particularly with regards to secure storage of PHI and appropriate authorship assignment. Time-consuming and cumbersome IRB procedures, perceived pressure from senior authors, and lack of research support contribute to non-adherence. Further support and education of gynecologic oncology fellows is needed in order to help address these barriers. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Benign Paroxysmal Positional Vertigo: An Integrated Perspective

    Directory of Open Access Journals (Sweden)

    Kourosh Parham

    2014-01-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV, the most common cause of dizziness, occurs in all age groups. It presents with vertigo on head movement, but in older patients presentation may be typical and thus accounting for a low recognition rate in the primary care setting. It may be recurrent in up to 50% of cases. BPPV is associated with displacement of fragments of utricular otoconia into the semicircular canals, most commonly the posterior semicircular canal. Otoconia are composed of otoconin and otolin forming the organic matrix on which calcium carbonate mineralizes. Otoconia may fragment with trauma, age, or changes in the physiology of endolymph (e.g., pH and calcium concentration. Presentation varied because otoconia fragments can be displaced into any of the semicircular canals on either (or both side and may be free floating (canalolithiasis or attached to the cupula (cupulolithiasis. Most cases of BPPV are idiopathic, but head trauma, otologic disorders, and systemic disease appear to be contributory in a subset. Positional maneuvers are used to diagnose and treat the majority of cases. In rare intractable cases surgical management may be considered. A strong association with osteoporosis suggests that idiopathic BPPV may have diagnostic and management implications beyond that of a purely otologic condition.

  8. The Danish Gynecological Cancer Nursing Database

    DEFF Research Database (Denmark)

    Seibæk, Lene; Jakobsen, Dorthe Hjort; Høgdall, Claus

    2018-01-01

    Database (DGCD) established a nursing database in 2011. The aim of DGCD Nursing is to monitor the quality of preoperative and postoperative care and to generate data for research. MATERIAL AND METHODS: In accordance with the current data protection legislation, real-time data are entered by clinical nurses...... at all national cancer centers. The DGCD Nursing includes data of preoperative and postoperative care, and nurses are independently represented in the steering committee. The aim of the present article is to present the first results from DGCD Nursing and the national care improvements that have followed......, pain score, vital functions, and psychosocial support. CONCLUSIONS: At national level, DGCD offers a comprehensive overview of the total patient pathway within gynecological cancer surgery. The DGCD Nursing has added to the quality and implementation of evidence-based preoperative and postoperative...

  9. Plasminogen and angiostatin levels in female benign breast lesions

    Directory of Open Access Journals (Sweden)

    A. A. Tykhomyrov

    2015-10-01

    Full Text Available It is known that benign breast tissue exhibit relatively low angiogenic capacity. Activation of angiogenesis in mammary pre-malignant lesions could be associated with disease progression and high risk of transformation into the breast cancer. However, insight into the underlying molecular mechanisms involved in angiogenesis regulation in non-cancerous breast pathologies is still poorly defined. The purpose of the present study was to determine levels of plasminogen and its proteolytic fragments (angiostatins in mammary dysplasia (mastopathy and breast cyst and benign neoplasms (fibroadenomas. Plasminogen and angiostatins were analyzed using immunoblotting and quantified by densitometric scanning. The significant increase in plasminogen levels was found in fibrocystic, cysts, and non-proliferatious fibroadenoma masses (4.7-, 3.7-, and 3.5-fold, respectively compared to healthy breast tissues (control. In the same benign lesions, 6.7-, 4-, and 3.7-fold increase in plasminogen 50 kDa fragment (angiostatin levels as compared with control were also observed. Activation of matrix metalloproteinase-9, which was detected using gelatine zymography, could be responsible for plasminogen cleavage and abundance of angiostatin in fibrocystic and cyst masses. In contrast, dramatic decrease of both plasminogen and angiostatin levels (3.8- and 5.3-folds, respectively was shown in tissues of proliferatious form of fibroadenoma in comparison with that of the dormant type of this neoplasm. Based on the obtained results, we concluded that angiostatin, a potent vessel growth inhibitor and anti-inflammatory molecule, can play a crucial role in pathophysiology of non-cancerous breast diseases. Further studies are needed to evaluate potential diagnostic and clinical implications of these proteins for prediction and therapy of benign breast pathologies.

  10. Assessment of palliative care training in gynecologic oncology: A gynecologic oncology fellow research network study

    Science.gov (United States)

    Eskander, Ramez N.; Osann, Kathryn; Dickson, Elizabeth; Holman, Laura L.; Rauh-Hain, J. Alejandro; Spoozak, Lori; Wu, Eijean; Krill, Lauren; Fader, Amanda Nickles; Tewari, Krishnansu S.

    2014-01-01

    Objective Palliative care is recognized as an important component of oncologic care. We sought to assess the quality/quantity of palliative care education in gynecologic oncology fellowship. Methods A self-administered on-line questionnaire was distributed to current gynecologic oncology fellow and candidate members during the 2013 academic year. Descriptive statistics, bivariate and multivariate analyses were performed. Results Of 201 fellow and candidate members, 74.1% (n = 149) responded. Respondents were primarily women (75%) and white (76%). Only 11% of respondents participated in a palliative care rotation. Respondents rated the overall quality of teaching received on management of ovarian cancer significantly higher than management of patients at end of life (EOL), independent of level of training (8.25 vs. 6.23; p Gynecologic oncology fellow/candidate members reported insufficient palliative care education. Those respondents reporting higher quality EOL training felt more prepared to care for dying patients and to address complications commonly encountered in this setting. PMID:24887355

  11. Women's experiences of the gynecologic examination: factors associated with discomfort.

    Science.gov (United States)

    Hilden, Malene; Sidenius, Katrine; Langhoff-Roos, Jens; Wijma, Barbro; Schei, Berit

    2003-11-01

    The aim of this study was to evaluate how women experience the gynecologic examination and to assess possible factors associated with experiencing discomfort during the gynecologic examination. Consecutive patients visiting the Department of Obstetrics and Gynecology at Glostrup County Hospital, Denmark, were invited to participate in the study, and received a postal questionnaire that included questions about the index visit, obstetric and gynecologic history and sexual abuse history. The response rate was 80% (n = 798). The degree of discomfort during the gynecologic examination was indicated on a scale from 0 to 10. Experiencing discomfort was defined as a score of 6 or more, based on the 75th percentile. Discomfort during the gynecologic examination was strongly associated with a negative emotional contact with the examiner and young age. Additionally, dissatisfaction with present sexual life, a history of sexual abuse and mental health problems such as depression, anxiety and insomnia were significantly associated with discomfort. The emotional contact between patient and examiner seemed to have great importance when focusing on discomfort during the gynecologic examination. Furthermore, we found that discomfort was associated with a number of factors that are seldom known to the gynecologists, such as sexual abuse history, mental health problems and patients' sexual life. Gynecologists need to focus on the emotional contact and to reevaluate issues for communication before the examination.

  12. Extreme Sport/Adventure Activity Correlates in Gynecologic Cancer Survivors.

    Science.gov (United States)

    Crawford, Jennifer J; Vallance, Jeff K; Holt, Nicholas L; Courneya, Kerry S

    2016-03-01

    We examined the demographic, medical and behavioral correlates of participation and interest in extreme sport/adventure activities (ESAA) in gynecologic cancer survivors. A random sample of 621 gynecologic cancer survivors in Alberta, Canada, completed a mailed self-report questionnaire assessing medical, demographic, and behavioral variables and participation and interest in ESAA. Multivariate analyses revealed that gynecologic cancer survivors were more likely to participate in ESAA if they met aerobic exercise guidelines (OR=1.75 [95%CI:1.02-2.99]), had better general health (OR=1.71 [95%CI: 1.01-2.90]), had cervical or ovarian cancer (OR=1.95 [95%CI:0.97-3.93]), were employed (OR=1.71 [95%CI:0.95-3.08]), and were of healthy weight (OR=1.58 [95%CI:0.93-2.68]). Moreover, gynecologic cancer survivors were more likely to be interested in trying an ESAA if they had cervical or ovarian cancer (OR=1.76 [95%CI:0.94-3.27]) and were meeting the strength exercise guidelines (OR=1.68 [95%CI:0.95-2.98]). Medical, demographic, and behavioral variables correlate with participation and interest in ESAA in gynecologic cancer survivors. The pattern of correlates suggests that gynecologic cancer survivors are more likely to participate in ESSA if they have the physical capability and financial resources. Interventions to promote ESAA in gynecologic cancer survivors need to address these 2 key barriers.

  13. Horizontal Canal Benign Positional Vertigo

    Directory of Open Access Journals (Sweden)

    Mohtaram Najafi

    1998-03-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is a syndrome characterized by transient episodes of vertigo in association with rapid changes in head position in Dix-Halpike Maneuver. This kind of vertigo is thought to be caused by migration of otoconial debris into canals other than the posterior canal, such as the anterior or lateral canals. It is also theoretically possible for many aberrant patterns of BPPV to occur from an interaction of debris in several canals, location of debris within the canal, and central adaptation patterns to lesions. The symptoms of BPPV are much more consistent with free-moving densities (canaliths in the posterior SCC rather than fixed densities attached to the cupula. While the head is upright, the particles sit in the PSC at the most gravity-dependent position. The best method to induce and see vertigo and nystagmus in BPPV of the lateral semicircular canal is to rotate head 90°while patient is in the supine position, nystagmus would appear in the unaffected side weaker but longer than the affected side. canal paresis has been described in one third of the patients with BPPV. Adaptation which is one of the remarkable features of BPPV in PSC is rarely seen in LSC. Rotations of 270° or 360° around the yaw axis (the so-called barbecue maneuver toward the unaffected ear are popular methods for the treatment of geotropic HC-BPPV. These maneuvers consist of sequential head turning of 90° toward the healthy side while supine. With these maneuvers, the free-floating otoconial debris migrates in the ampullofugal direction, finally entering the utricle through the nonampullated end of the horizontal canal. This kind of vertigo recovers spontaneously more rapidly and suddenly.

  14. Thermotherapy and thermoablation for benign prostatic hyperplasia

    NARCIS (Netherlands)

    Gravas, Stavros; Laguna, Pilar; de la Rosette, Jean

    2003-01-01

    PURPOSE OF REVIEW: From all the available thermoablative methods for the treatment of symptomatic benign prostatic hyperplasia, transurethral microwave thermotherapy is considered as standard in minimally invasive management. The literature is enriched by several new studies on transurethral

  15. Genetics Home Reference: benign recurrent intrahepatic cholestasis

    Science.gov (United States)

    ... expand/collapse boxes. Description Benign recurrent intrahepatic cholestasis (BRIC) is characterized by episodes of liver dysfunction called ... a lack of appetite. A common feature of BRIC is the reduced absorption of fat in the ...

  16. Drug utilization study of gynecology OPD: In a tertiary care hospital.

    Directory of Open Access Journals (Sweden)

    Baig MS, Bagle TR,Gadappa SN, Deshpande Sonali, Doifode SM

    2013-04-01

    Full Text Available Background: The treatment of diseases by use of essential medicines, prescribed by generic names, has been emphasized by WHO and National Health Policy of India. Drugs used in gynaecology are one of the top selling drugs in India; however they are least studied with respect to drug utilization. Thus present study was undertaken to analyze drug utilization pattern of gynecology OPD in a tertiary care hospital. Materials and Methods: A retrospective, cross sectional, observational study of prescriptions in Gynecology OPD. Data was obtained from an electronic medical record database of patients that attended Gynecology OPD during the study period. Prescription records of patients were screened as per inclusion and exclusion criteria and 300 prescriptions were randomly selected by Openepi software. Patient related and drug related information was collected on a customized data collection sheet. Results: The mean age of patients was 30.19+9.83 years and common age of presentation was >18-30 years. In infective cases, vaginal discharge (10.33% was common, and in non-infective cases, menstrual disorders (24% were common. The average number of drugs per prescription was 3.47+1.53. In drug category, minerals (30.94% were most commonly prescribed, followed by antimicrobials (24.98%, and NSAIDs (13.37%. Polypharmacy was observed in 96.33% of the prescriptions. Conclusion: It is only by drug utilization studies that burden of diseases and corresponding utilization of drugs in gynecology can be measured. In our study majority of the drugs prescribed were generic which were from the essential medical list NLEM and WHO.

  17. Immunoprofile of benign and malignant fibrohistiocytic tumors.

    Science.gov (United States)

    Regezi, J A; Zarbo, R J; Tomich, C E; Lloyd, R V; Courtney, R M; Crissman, J D

    1987-05-01

    Formalin-fixed, paraffin-embedded tissue sections from 26 malignant fibrous histiocytomas (MFH) and 61 benign fibrohistiocytic proliferations (BFHP) were evaluated immunohistochemically. An avidinbiotin-peroxidase technique was used to determine immunoreactivity for alpha-1 antichymotrypsin, muramidase, HLA-DR, leucocyte common antigen, S-100 protein, vimentin, desmin, and keratin. MFHs were consistently positive for ACT and vimentin and inconsistently reactive for the other antigens. MFHs were negative for LCA suggesting a mesenchymal origin for these lesions. In the MFH histologic subtypes, antigen expression was not significantly different to be useful in their classification. Also no distinctive pattern emerged relative to immunoreactivity and tumor location. The benign lesions, giant cell tumor of tendon sheath, dermatofibroma, and oral benign fibrous histiocytoma differed from the MFHs in that they were often LCA positive, suggesting origin from hematopoetic mononuclear-macrophages. The immunoprofiles of peripheral fibromas and "giant cell" fibromas were felt to be consistent with origin from mesenchymal cells. Several of the antigens studied could be used to differentiate the benign lesions studied from other benign neoplasms. The antigens were, however, of little value in separation of benign and malignant lesions.

  18. 21 CFR 884.4530 - Obstetric-gynecologic specialized manual instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric-gynecologic specialized manual... Gynecological Surgical Devices § 884.4530 Obstetric-gynecologic specialized manual instrument. (a) Identification. An obstetric-gynecologic specialized manual instrument is one of a group of devices used during...

  19. Solitary, multiple, benign, atypical, or malignant: the "Granular Cell Tumor" puzzle.

    Science.gov (United States)

    Machado, Isidro; Cruz, Julia; Lavernia, Javier; Llombart-Bosch, Antonio

    2016-05-01

    The clinical evolution and biology of granular cell tumors (GCT) are poorly understood and treatment remains an issue of discussion. The majority of GCT are benign, although some display malignant behavior. The distinction between benign, atypical, and malignant GCT is controversial due to morphological and immunohistochemical overlap and lack of consistent histological and phenotypic criteria that predict behavior. Although histological criteria may indicate increased risk of malignant evolution, some GCT with evident benign appearance exceptionally progress towards metastatic disease. In this review, we discuss current knowledge on GCT, including histologic, immunophenotypic, and molecular characteristics and differential diagnosis. We focus on the following problematic items in GCT: (1) evolution of classification, (2) neural versus non-neural GCT, (3) neoplastic versus reactive disease, (4) malignant transformation of benign GCT, and (5) multiple versus metastatic GCT. We conclude that although a Ki-67 index >10 % and the presence of mitoses and/or of necrosis are frequently associated with malignant behavior, metastasis remains the only unequivocal sign of malignancy in GCT. An infiltrative growth pattern and vascular and/or perineural invasion are not indicative of malignancy. GCT with atypical/uncertain features almost never metastasize, and many of these tumors either behave in a benign fashion or only recur locally (similar to incompletely excised benign tumors). We therefore propose that classical and atypical histological variants form a single group of GCT. GCT with various unfavorable histological features might be labeled as "GCT with increased risk of metastasis" rather than malignant GCT.

  20. Role of Intraoperative Ultrasound to Extend the Application of Minimally Invasive Surgery for Treatment of Recurrent Gynecologic Cancer.

    Science.gov (United States)

    Mascilini, Floriana; Quagliozzi, Lorena; Moro, Francesca; Moruzzi, Maria Cristina; Gallotta, Valerio; Alletti, Salvatore Gueli; Scambia, Giovanni; Testa, Antonia Carla; Fagotti, Anna

    2018-01-08

    To describe the potential role of intraoperative ultrasound (IOUS) in the detection and localization of recurrent disease in gynecologic cancer patients during minimally invasive surgery (MIS). A prospective cohort study (Canadian Task Force classification II-1). A university hospital. Fifty-one gynecologic cancer patients with isolated recurrent disease. IOUS during secondary cytoreductive surgery (SCS) by MIS. From November 2015 to February 2017 51 gynecologic cancer patients with isolated recurrent disease and candidates for SCS were treated by MIS. Recurrent tumor was preoperatively assessed at clinical examination, transvaginal and transabdominal sonography, and radiologic evaluation in all women. Twelve of 51 women (23.5%) needed IOUS. Type of disease was ovarian in 5 women (42%), endometrial in 4 (33%), cervical in 1 (8%), vaginal cancer in 1 (8%), and uterine sarcoma in 1 (8%). Recurrence was localized deep in the pelvis in 7 cases (58%), lymph nodes in 3 (25%), and extraperitoneal in 2 cases (17%). Recurrence was dimmed in the surgical field, due to either presence of adherences, deep anatomic position, small size, and/or lack of tactile feeling. IOUS was able to identify the lesions in all women, allowing MIS (83% laparoscopy and 17% robotic) complete cytoreduction, with no conversion to laparotomy. Median operative time was 150 minutes (range, 77-280). No intraoperative/postoperative complications occurred. Histologic examination confirmed the presence of recurrence in 11 of 12 cases (92%), whereas the remaining case showed inflammatory tissue. With a median follow-up time of 15 months (range, 6-19), all patients except 2 were still alive. About 1 of 4 patients (25%) with single gynecologic cancer recurrence needs IOUS to benefit from MIS for complete secondary cytoreduction. Copyright © 2018 American Association of Gynecologic Laparoscopists. Published by Elsevier Inc. All rights reserved.