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https://www.readbyqxmd.com/read/29328939/outcome-of-patients-with-uterine-fibroids-after-3-month-ulipristal-acetate-therapy
#1
Jean-Luc Brun, José Rajaonarison, Alizée Froeliger, Anne-Coline Monseau-Thiburce, Rado Randriamboavonjy, Andrej Vogler
OBJECTIVES: To determine the proportion and the characteristics of patients who did or did not respond after 3 months of ulipristal acetate (UPA) therapy. STUDY DESIGN: In this retrospective cohort study conducted in the University Hospital of Bordeaux (France) and University Medical Center Ljubljana (Slovenia), symptomatic non-menopausal patients with fibroids that qualified for surgery were pretreated by 3 months of oral UPA 5 mg/day. Clinical success was defined by normalization of the bleeding score, and/or regression of pelvic pain, and/or abdominal distension...
December 19, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29324609/outcomes-of-planned-compared-with-urgent-deliveries-using-a-multidisciplinary-team-approach-for-morbidly-adherent-placenta
#2
Alireza A Shamshirsaz, Karin A Fox, Hadi Erfani, Steven L Clark, Amir A Shamshirsaz, Ahmed A Nassr, Nathan C Sundgren, Jeffery A Jones, Matthew L Anderson, Elias Kassir, Bahram Salmanian, Alexandra W Buffie, Shiu-Ki Hui, Jimmy Espinoza, Lynda A Tyer-Viola, Martha Rac, Niloofar Karbasian, Jerasimos Ballas, Gary A Dildy, Michael A Belfort
OBJECTIVE: To compare outcomes between planned and urgent cesarean hysterectomy for morbidly adherent placenta managed by a multidisciplinary team. METHODS: This is a retrospective case-control study of women with singleton pregnancies with antenatally suspected and pathologically confirmed morbidly adherent placenta who underwent cesarean hysterectomy between January 1, 2011, and February 30, 2017. Timing of delivery was classified as either planned (delivery at 34-35 weeks of gestation) or urgent (need for urgent delivery as a result of uterine contractions, bleeding, or both)...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29320751/uterine-rhabdomyosarcoma-in-adults
#3
Andre Pinto, Ryan M Kahn, Andrew E Rosenberg, Brian Slomovitz, Charles Matthew Quick, Michella K Whisman, Marilyn Huang
Rhabdomyosarcoma (RMS) is an aggressive mesenchymal tumor most commonly diagnosed in the pediatric population, and when occurring in adults, tends to develop in the deep soft tissue of the limbs. Primary uterine RMS comprises an even more restricted subset, with little known or reported when compared to most other gynecologic sarcomas. Our goal with this study was to retrospectively evaluate cases from two academic institutions and describe the main histopathologic findings of this rare gynecologic malignancy...
January 7, 2018: Human Pathology
https://www.readbyqxmd.com/read/29319588/abnormal-uterine-bleeding-treatment-options
#4
Erica Oberman, Valentina Rodriguez-Triana
Abnormal uterine bleeding is one of the most common reasons for outpatient gynecologic visits. Proper evaluation and diagnosis is essential and allows the clinician to present individualized treatment options to their patients.
January 9, 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29310371/treatment-of-cornual-pregnancy-in-a-patient-with-adenomyosis-by-high-intensity-focused-ultrasound-hifu-ablation-a-case-report
#5
Lixia Yu, Linying Xu, Xiaoyan Xu
RATIONALE: Cornual ectopic pregnancy in adenomyosis patients is a rare clinical condition, which may require careful approach for accurate diagnosis and treatment. PATIENT CONCERNS: A 38-year-old woman presented with amenorrhea for 8 weeks and serum HCG levels of 1455 mmol/L. The B ultrasound showed an endometrial thickness of 1.7 cm, and the presence of a cystic structure (16 6 mm) at the right uterine horn. Color Doppler flow imaging (CDFI) accurately detected and confirmed the position of the cystic structure with its clear boundaries...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29301605/extrarenal-wilms-tumor-of-the-female-genital-system-a-case-report-and-literature-review
#6
Min-Min Cao, Cui-Ping Huang, Ya-Fen Wang, De-Mei Ma
Extrarenal Wilms' Tumors (ERWTs) are rare. There have been only 25 cases of ERWT arising from the female genital system reported in the literature. In this paper, we report a 60-year-old woman with a complaint of vaginal bleeding and a polypoid mass in the uterine cavity by sonography that was demonstrated as ERWT by pathology after resection. The pathological characteristics, histological origination, diagnosis, therapy and prognosis of ERWT in female reproductive system are discussed in this paper in the purpose of improving the diagnosis and therapy of this rare tumor...
December 30, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/29298793/spontaneous-rupture-of-uterine-smooth-muscle-tumour-presenting-acute-abdominal-pain-and-haemoperitoneum
#7
Hanako Oda, Hiroshi Hirakawa
Uterine smooth muscle tumours are histologically categorised into benign leiomyoma, malignant leiomyosarcoma or smooth muscle tumours of uncertain malignant potentials (STUMPs).1 Common symptoms of uterine tumours are hypermenorrhea, dysmenorrhea, lumbago or irregular genital bleeding. We experienced a case of uterine tumour with atypical clinical behaviour. A 40-year-old woman who had been diagnosed with leiomyoma presented with severe abdominal pain and intraperitoneal haemorrhage. By emergent surgery, we found that the uterine tumour had ruptured spontaneously...
January 3, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29295659/optimal-timing-of-antenatal-corticosteroids-in-women-with-bleeding-placenta-previa-or-low-lying-placenta
#8
Eman Alsayegh, Jon Barrett, Nir Melamed
BACKGROUND: Administrating a single course of antenatal corticosteroids to women at risk of preterm birth between 24 and 34 weeks of gestation has been shown to decrease neonatal morbidity and mortality. There is evidence that the optimal timing for the administration of antenatal corticosteroids is within 1-7 days before birth as the effect of antenatal corticosteroids has been shown to decline 7 days after administration. Therefore, given that antenatal corticosteroids are the single most effective intervention in cases of preterm birth, efforts should be made to optimize the timing of administration of antenatal corticosteroids...
January 2, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29288921/outcome-of-magnetic-resonance-guided-focused-ultrasound-surgery-mrgfus-for-figo-class-1-fibroids
#9
Roy Mashiach, Yael Inbar, Jaron Rabinovici, Aya Mohr Sasson, Aviva Alagem-Mizrachi, Ronit Machtinger
OBJECTIVE: Intracavitary uterine fibroids and fibroids that distort the uterine cavity are associated with excessive vaginal bleeding and infertility. While intracavitary fibroids smaller than 4 cm are usually treated safely by operative hysteroscopy, larger fibroids may require multiple surgeries or more extensive surgery with possible damage to the integrity of the uterine wall. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a noninvasive approach for treating uterine fibroids, mainly the intramural type...
December 14, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29288653/long-term-outcomes-after-elective-sterilization-procedures-a-comparative-retrospective-cohort-study-of-medicaid-patients
#10
Rachel Steward, Patricia Carney, Amy Law, Lin Xie, Yuexi Wang, Huseyin Yuce
OBJECTIVES: Compare the long-term outcomes, including hysterectomy, chronic pelvic pain (CPP), and abnormal uterine bleeding (AUB) in women post-hysteroscopic sterilization (HS) and laparoscopic tubal ligation (TL) in the Medicaid population. STUDY DESIGN: Retrospective observational cohort analysis using data from the US Medicaid Analytic Extracts (MAX) Encounters database. Women aged 18 to 49years with at least one claim for HS (n=3929) or TL (n=10,875) between July 1, 2009, through December 31, 2010 were included...
December 27, 2017: Contraception
https://www.readbyqxmd.com/read/29288067/nationwide-trends-in-the-utilization-of-and-payments-for-hysterectomy-in-the-united-states-among-commercially-insured-women
#11
Daniel M Morgan, Neil S Kamdar, Carolyn W Swenson, Emily K Kobernik, Anne G Sammarco, Brahmajee Nallamothu
BACKGROUND: Laparotomy followed by inpatient hospitalization has traditionally been the most common surgical care for hysterectomy. The financial implications of the increased use of laparoscopy and outpatient hysterectomy are unknown. OBJECTIVES: To quantify the increasing use of laparoscopy and outpatient hysterectomy and to describe the financial implications among women with commercially based insurance in the United States. STUDY DESIGN: Hysterectomies between 2010 and 2013 were identified in the Health Care Cost Institute, a national dataset with inpatient and outpatient private insurance claims for more than 25 million women...
December 26, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29260904/ulipristal-acetate-for-the-management-of-acute-heavy-menstrual-bleeding-without-fibroids
#12
Josep Estadella, Pia Español, Fiorella Ascencio, Josep Perelló, Joaquim Calaf
Heavy menstrual bleeding is a common condition among women of childbearing age. Although hysterectomy was the usual approach in acute cases in the past, other minimally invasive therapies or pharmacological alternatives, such as the levonorgestrel intrauterine device have shown to be highly effective. This case report presents the case of a pluripathological patient with acute heavy menstrual bleeding and severe anemia, who was successfully managed with ulipristal acetate, a selective progesterone receptor modulator...
December 20, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29259654/a-case-of-large-cell-neuroendocrine-carcinoma-of-the-uterine-cervix-misdiagnosed-as-adenocarcinoma-in-thinprep-cytology-test
#13
Jong-Hee Nam, Jongin Na, Nah-Ihm Kim, Ga-Eon Kim, Chang-Soo Park, Yoo-Duk Choi
Large cell neuroendocrine carcinoma (LCNEC) of uterine cervix is a rare malignancy with aggressive behavior and poor clinical outcome even in its early stage. Few cytopathologic features of cervical LCNEC have been reported previously. A 57-year-old postmenopausal African American female, presented to the local health department with a chief complaint of heavy vaginal bleeding. A 45-year-old female presented with 20 months of vaginal pruritus and foul odor. Cervical malignancy was suspected by pelvis magnetic resonance imaging...
2017: CytoJournal
https://www.readbyqxmd.com/read/29250979/pharmacokinetic-drug-evaluation-of-ulipristal-acetate-for-the-treatment-of-uterine-fibroids
#14
Simone Ferrero, Valerio Gaetano Vellone, Fabio Barra
Uterine fibroids are the most common form of benign gynecological tumors in women of reproductive ages. Although surgery is the main option to treat them, alternative pharmacological approaches are being investigated to control their symptoms. Among them, ulipristal acetate (UPA) has been the first selective progesterone-receptor modulator (SPRM) approved for the pre-operative and long-term treatment of uterine fibroids. Areas covered: The aim of this article is to review the literature on the pharmacodynamics, pharmacokinetics (PK), clinical efficacy and safety of UPA for the treatment of uterine fibroids...
January 2018: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29250683/hemorrhagic-polypoid-gastric-and-colonic-metastases-nine-years-after-uterine-leiomyosarcoma-case-report
#15
Nicoleta Puie, Lavinia Patricia Trică, Georgiana Anca Nagy, Ioana Rusu, Alina Simona Şovrea, Carmen Georgiu
INTRODUCTION: Uterine leiomyosarcoma (ULMS) is a rare tumor, representing 1-2% of all uterine malignancies. It is highly aggressive, with high metastatic rate, especially in lungs, peritoneal cavity, retroperitoneum, bones and liver, usually during the first years after diagnosis. CASE PRESENTATION: A 58-year-old woman, with subtotal hysterectomy and bilateral adnexectomy, followed by radiochemotherapy for spindle-type ULMS nine years ago, presented with gastrointestinal bleeding and severe anemia...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/29245338/multifaceted-spiral-suture-a-hemostatic-technique-in-managing-placenta-praevia-or-accrete-a-retrospective-study
#16
Yifan Meng, Peng Wu, Dongrui Deng, Jianli Wu, Xingguang Lin, Rajluxmee Beejadhursing, Ying Zha, Fuyuan Qiao, Ling Feng, Haiyi Liu, Wanjiang Zeng
Patients with total placenta previa and past history of cesarean delivery often experience overwhelming hemorrhage during childbirth. In order to control intraoperative and postoperative bleeding, we propose a novel multifaceted spiral suture of the lower uterine segment which directly sutures the bleeding site.To evaluate the efficacy and safety of multifaceted spiral suture, a retrospective study was conducted using data from 33 patients with total placenta praevia and caesarean history.All participants underwent multifaceted spiral suture and no patient experienced uncontrollable bleeding or underwent hysterectomy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29245268/posterior-reversible-encephalopathy-syndrome-after-postpartum-hemorrhage-and-uterine-artery-embolization-a-case-report
#17
Fangfang Shi, Liwei Shen, Yonghui Shi, Lei Shi, Xiaoli Yang, Zhi Jin, Wenpeng Liu, Danhong Wu
RATIONALE: Posterior reversible encephalopathy syndrome (PRES) is characterized by clinical and radiological features, including headache, disturbed consciousness, seizures, and cortical blindness associated with findings indicating posterior leukoencephalopathy on imaging studies. Ours is the first case of PRES developing after postpartum hemorrhage and uterine artery embolization. PATIENT CONCERNS: An 18-year-old patient had postpartum hemorrhage after a normal delivery...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29241929/fertility-outcomes-following-pelvic-embolization-in-women-with-acquired-uterine-arteriovenous-malformation
#18
Cheng-Yu Ho, Kok-Min Seow, Lee-Wen Huang, Yieh-Loong Tsai
OBJECTIVE: Acquired uterine arteriovenous malformation (UAVM) is a rare, life-threatening disease. Angiography with uterine arterial embolization (UAE) is the diagnostic tool and a choice of fertility-sparing treatment. Here, we present a series of five successful pregnancies after embolization of UAVM. CASE REPORTS: Three reproductive aged women were treated for UAVM, resulting in five successful pregnancies. Their past history suggested that three cases had had previous uterine procedures, including second trimester abortion and elective dilatation and curettage...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29241597/understanding-patient-preference-in-female-pelvic-imaging-transvaginal-ultrasound-and-mri
#19
Michelle D Sakala, Ruth C Carlos, Mishal Mendiratta-Lala, Elisabeth H Quint, Katherine E Maturen
RATIONALE AND OBJECTIVES: Women with pelvic pain or abnormal uterine bleeding may undergo diagnostic imaging. This study evaluates patient experience in transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) and explores correlations between preference and symptom severity. MATERIALS AND METHODS: Institutional review board approval was obtained for this Health Insurance Portability and Accountability Act-compliant prospective study. Fifty premenopausal women with pelvic symptoms evaluated by recent TVUS and MRI and without history of gynecologic cancer or hysterectomy were included...
December 11, 2017: Academic Radiology
https://www.readbyqxmd.com/read/29234102/endometrial-apoptosis-and-neutrophil-infiltration-during-menstruation-exhibits-spatial-and-temporal-dynamics-that-are-recapitulated-in-a-mouse-model
#20
Gregory M Armstrong, Jacqueline A Maybin, Alison A Murray, Moira Nicol, Catherine Walker, Philippa T K Saunders, Adriano G Rossi, Hilary O D Critchley
Menstruation is characterised by synchronous shedding and restoration of tissue integrity. An in vivo model of menstruation is required to investigate mechanisms responsible for regulation of menstrual physiology and to investigate common pathologies such as heavy menstrual bleeding (HMB). We hypothesised that our mouse model of simulated menstruation would recapitulate the spatial and temporal changes in the inflammatory microenvironment of human menses. Three regulatory events were investigated: cell death (apoptosis), neutrophil influx and cytokine/chemokine expression...
December 12, 2017: Scientific Reports
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