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https://www.readbyqxmd.com/read/29153363/uterine-fibroids-influence-of-t2-rim-sign-on-immediate-therapeutic-responses-to-magnetic-resonance-imaging-guided-high-intensity-focused-ultrasound-ablation
#1
Sin Yuin Yeo, Young-Sun Kim, Hyo Keun Lim, Hyunchul Rhim, Sin-Ho Jung, Na Young Hwang
OBJECTIVES: To investigate the influence of a high-signal-intensity peripheral rim on T2-weighted MR images (i.e., T2-rim sign) on the immediate therapeutic responses of MR-guided high intensity focused ultrasound (MR-HIFU) ablation of uterine fibroids. METHODS: This retrospective study was approved by the institutional review board, and patient informed consent was obtained for MR-HIFU ablation. In total, 196 fibroids (diameter 6.2±2.6cm) in 123 women (age 43...
December 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/29152282/incarcerated-giant-uterine-leiomyoma-within-an-incisional-hernia-a-case-report
#2
Georgios Exarchos, Nikolaos Vlahos, Dionysios Dellaportas, Linda Metaxa, Theodosios Theodosopoulos
Uterine leiomyomas presenting as incarcerated or strangulated hernias in surgical emergencies are extremely rare and should be considered in the differential diagnosis in patients with known uterine fibroids and an irreducible ventral abdominal wall hernia. Detailed history and multidisciplinary approach optimize the diagnosis and decision making toward surgical treatment.
November 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29149644/assessing-the-risk-of-laparoscopic-morcellation-of-occult-uterine-sarcomas-during-hysterectomy-and-myomectomy-literature-review-and-the-isge-recommendations
#3
REVIEW
Ornella Sizzi, Lucia Manganaro, Alfonso Rossetti, Matteo Saldari, Giuseppe Florio, Alessandro Loddo, Robert Zurawin, Bruno van Herendael, Dusan Djokovic
OBJECTIVE: This project of the International Society for Gynecologic Endoscopy (ISGE) had the objective to review the literature and provide recommendations on the occult sarcoma risk assessment in patients who are candidates for minimally invasive gynecological surgery involving intra-abdominal electromechanical tissue morcellation. STUDY DESIGN: The ISGE Task Force for Estimation of the Risk in Endoscopic Morcellation initially defined key topics and clinical questions which may guide a comprehensive preoperative patient assessment...
November 7, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29149020/role-of-transforming-growth-factor-%C3%AE-in-uterine-fibroid-biology
#4
REVIEW
Michał Ciebiera, Marta Włodarczyk, Małgorzata Wrzosek, Błażej Męczekalski, Grażyna Nowicka, Krzysztof Łukaszuk, Magdalena Ciebiera, Aneta Słabuszewska-Jóźwiak, Grzegorz Jakiel
Uterine fibroids (UFs) are benign tumors of the female genital tract made of the smooth muscle of the uterus. UF growth depends mostly on the influence of the steroid hormones and selected growth factors. Transforming growth factor β (TGF-βs) is a polypeptide that consists of three isoforms: TGF-β1, TGF-β2, and TGF-β3. At present, TGF-β is considered to be one of the key factors in the pathophysiology of UFs. It plays a major role in cellular migration within the tumor, stimulates tumor growth, and enhances tumor metabolism...
November 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29141456/increased-serum-levels-of-mbdnf-in-women-with-minimal-and-mild-endometriosis-have-no-predictive-power-for-the-disease
#5
Alexandra Perricos, Kazem Ashjaei, Heinrich Husslein, Katharina Proestling, Lorenz Kuessel, Reinhard Obwegeser, Rene Wenzl, Iveta Yotova
The objective of our pilot clinical, prospective study was to determine the serum levels of mature brain-derived neurotrophic factor, in of women with endometriosis and controls and explore whether mature brain-derived neurotrophic factor is a potential biomarker for the disease. The patients were selected from the Endometriosis Marker Austria prospective cohort study conducted at the tertiary referral certified Endometriosis Center of the Medical University of Vienna. All women underwent laparoscopic surgery because there was a suspicion of endometriosis, or the women had pelvic pain, adnexal cysts, unexplained infertility, or uterine fibroids...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29139277/tailor-management-to-the-patient-with-fibroids
#6
Marie O'Sullivan, Caroline Overton
Fibroids are benign, hormone-dependent tumours of uterine smooth muscle and connective tissue. They are commonly asymptomatic, but can cause symptoms such as heavy menstrual bleeding and pelvic pressure symptoms. Between 20 to 30% of women with heavy menstrual bleeding have fibroids. Fibroids are most prevalent in women aged 30-50 years and there may be a genetic predisposition. They are more common in black women than white women. Other risk factors include obesity and nulliparity. Asymptomatic women should only be referred if their uterus is palpable abdominally, if fibroids distort the uterine cavity or the uterus is larger than 12 cm in length...
March 2017: Practitioner
https://www.readbyqxmd.com/read/29139105/preoperative-medical-therapy-before-surgery-for-uterine-fibroids
#7
REVIEW
Anne Lethaby, Lucian Puscasiu, Beverley Vollenhoven
BACKGROUND: Uterine fibroids occur in up to 40% of women aged over 35 years. Some are asymptomatic, but up to 50% cause symptoms that warrant therapy. Symptoms include anaemia caused by heavy menstrual bleeding, pelvic pain, dysmenorrhoea, infertility and low quality of life. Surgery is the first choice of treatment. In recent years, medical therapies have been used before surgery to improve intraoperative and postoperative outcomes. However, such therapies tend to be expensive.Fibroid growth is stimulated by oestrogen...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29138584/repeated-intermittent-ulipristal-acetate-in-the-treatment-of-uterine-fibroids-a-cost-effectiveness-analysis
#8
Kirk Geale, Ertan Saridogan, Matthieu Lehmann, Pablo Arriagada, Marcus Hultberg, Martin Henriksson
There are limited treatment options available for women with moderate to severe symptoms of uterine fibroids (UFs) who wish to avoid surgery. For these women, treatment with standard pharmaceuticals such as contraceptives is often insufficient to relieve symptoms, and patients may require surgery despite their wish to avoid it. Clinical trials demonstrate that ulipristal acetate 5 mg (UPA) is an effective treatment for this patient group, but its cost-effectiveness has not been assessed in this population. A decision-analytic model was developed to simulate a cohort of patients in this population under treatment with UPA followed by surgery as needed compared to treatment with iron and non-steroidal anti-inflammatory drug (NSAID) followed by surgery as needed (best supportive care, BSC)...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29136018/adverse-obstetric-outcomes-in-pregnant-women-with-uterine-fibroids-in-china-a-multicenter-survey-involving-112-403-deliveries
#9
Rong Zhao, Xin Wang, Liying Zou, Guanghui Li, Yi Chen, Changdong Li, Weiyuan Zhang
OBJECTIVE: To estimate the association between uterine fibroids and adverse obstetric outcomes. METHODS: This was a retrospective cross-sectional study of 112,403 deliveries from 14 provinces and 39 different hospitals in 2011 in mainland China. We compared pregnancy outcomes in women with and without uterine fibroids who underwent detailed second trimester obstetric ultrasonography during 18 to 22 weeks. Obstetric outcomes include cesarean delivery, breech presentation, preterm delivery, placenta previa, placental abruption, premature rupture of membranes and neonatal birthweight...
2017: PloS One
https://www.readbyqxmd.com/read/29133752/proportion-of-uterine-malignant-tumors-in-patients-with-laparoscopic-myomectomy-a-national-multicenter-study-in-china
#10
Hua Yang, Xiao-Chuan Li, Chen Yao, Jing-He Lang, Hang-Mei Jin, Ming-Rong Xi, Gang Wang, Lu-Wen Wang, Min Hao, Yan Ding, Jie Chen, Jian-Qing Zhang, Lu Han, Cheng-Xiu Guo, Xiang Xue, Yan Li, Jian-Hua Zheng, Man-Hua Cui, Huai-Fang Li, Guang-Shi Tao, Long Chen, Su-Min Wang, An-Wei Lu, Ze-Hua Huang, Qing Liu, Ya-Li Zhuang, Xiang-Hua Huang, Gen-Hai Zhu, Ou-Ping Huang, Li-Na Hu, Mu-Jun Li, Hong-Lin Zhou, Jing-Hui Song, Lan Zhu
BACKGROUND: The Food and Drug Administration recently announced that the use of morcellation may cause fibroids or pelvic dissemination and metastasis of uterine sarcoma; therefore, the use of morcellation is limited in the USA. A large sample study is necessary to assess the proportion of uterine malignant tumors found in patients with laparoscopic myomectomy. METHODS: A national multicenter study was performed in China. From 2002 to 2014, 33,723 cases were retrospectively selected...
November 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29129517/comparison-of-three-different-hemostatic-devices-in-laparoscopic-myomectomy
#11
Hui-Yu Huang, Yu-Cheng Liu, Yi-Chieh Li, Hsin-Hong Kuo, Chin-Jung Wang
BACKGROUND: To compare conventional electrosurgery, LigaSure (Valleylab, Boulder, CO), and Harmonic scalpel (Ethicon Endosurgery, Cincinnati, OH) in terms of perioperative and postoperative outcomes during laparoscopic myomectomy (LM). METHODS: We retrospectively studied 817 women with symptomatic fibroids who underwent LM between January 1997 and September 2015. Three different instruments were used separately during surgery. The number and weight of removed fibroids, blood loss, operative time, postoperative decrease in the hemoglobin level, and length of hospital stay were measured for statistical analysis...
November 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29129378/transvaginal-natural-orifice-transluminal-endoscopic-surgery-a%C3%A2-new-approach-to-myomectomy
#12
Jan Baekelandt
OBJECTIVE: To demonstrate a new approach for performing a myomectomy via transvaginal natural-orifice transluminal endoscopic surgery (vNOTES) as an alternative to laparoscopic myomectomy. DESIGN: Stepwise explanation of the technique with the use of original video footage. SETTING: Hospital. PATIENT(S): Eight patients were treated transvaginally for intramural, subserosal, and pedunculated myomas. INTERVENTION(S): In case of a posterior myoma, a 2...
November 9, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29128980/reducing-the-spread-of-occult-uterine-sarcoma-at-the-time-of-minimally-invasive-gynecologic-surgery
#13
Marron Wong, Rudy Leon De Wilde, Keith Isaacson
PURPOSE: This review covers the most recent evidence to discuss the incidence of occult uterine sarcoma, whether morcellation increases tumor dissemination or mortality, and whether there is a difference between different types of morcellation. We will also discuss techniques to reduce the spread of an undiagnosed uterine sarcoma. METHOD: A comprehensive literature search was made in Pubmed, Medline, the Cochrane Library, and Google Scholar for articles related to the incidence of occult uterine sarcoma after morcellation...
November 11, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29126743/benign-and-malignant-pathology-of-the-uterus
#14
REVIEW
V Tanos, K E Berry
The diagnosis of a uterine myoma size and location can be very precise when a 3D sonograph and knowledge are available. The majority of fibroids are asymptomatic, and expectant management is recommended. In young patients, fibroids cause infertility and in middle-aged women, abnormal uterine bleedings. Laparoscopic myomectomy is the preferred way of surgery for IM and SS fibroids, versus hysteroscopy for SM fibroids. In both cases, the size, number of fibroids and the surgeon's experience determine the limitations of the MIGS...
October 16, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29123444/imaging-findings-of-the-unusual-presentations-associations-and-clinical-mimics-of-acute-appendicitis
#15
REVIEW
Mustafa Kemal Demir, Yildiray Savas, Yavuz Furuncuoglu, Tarik Cevher, Serdar Demiral, Babek Tabandeh, Melisa Aslan
There are many kinds of unusual presentations or associations and clinical mimics of acute appendicitis, and definitive diagnosis requires knowledge of the imaging findings in some cases. The unusual presentations and associations of acute appendicitis included in this study are perforated appendicitis, acute appendicitis occurring in hernias, acute appendicitis with cystic endosalpingiosis, intussusception of appendix, and acute appendicitis with pregnancy. We also present uncommon gastrointestinal, urinary and gynecologic clinical mimics of acute appendicitis including anomalous congenital band, duplication cysts, giant Meckel's diverticulitis, inflammatory fibroid polyp, renal artery thrombosis, spontaneous urinary extravasation and OHVIRA syndrome...
October 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/29113583/aberrant-akt-activation-during-implantation-window-in-infertile-women-with-intramural-uterine-fibroids
#16
Annu Makker, Madhu Mati Goel, Dipti Nigam, Abbas Ali Mahdi, Vinita Das, Anjoo Agarwal, Amita Pandey, Abnish Gautam
The objective of the study was to examine the expression and cellular distribution of key signaling components of the phosphatidylinositol-3-kinase (PI3K)/Phosphatase and Tensin Homolog Deleted on Chromosome Ten (PTEN)/Protein Kinase B (PKB/Akt) pathway during the window of implantation in infertile women with noncavity-distorting intramural uterine fibroids (n = 21) as compared to fertile controls (n = 15). Relative gene expression analysis of PIK3CA, PTEN, Akt1, and Akt2 genes in midluteal endometrial biopsies was performed by real-time polymerase chain reaction...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/29111313/prevalence-and-confounders-of-chronic-endometritis-in-premenopausal-women-with-abnormal-bleeding-or-reproductive-failure
#17
Dongmei Song, Xiangdong Feng, Qian Zhang, Enlan Xia, Yu Xiao, Wei Xie, Tin Chiu Li
In this retrospective cohort study, a consecutive series of 1551 premenopausal women underwent hysteroscopy and endometrial biopsy. Chronic endometritis was diagnosed when plasma cell in endometrial tissue was detected by immunohistochemistry using CD138 epitope. The overall prevalence of chronic endometritis in the population studied was 24.4% The prevalence was significantly increased in the following conditions: recurrent implantation failure (40.8%; P < 0.001), abnormal uterine bleeding (40.7 %; P < 0...
October 6, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/29105778/sonographically-guided-insertion-of-intrauterine-device-indications-and-results
#18
Adrian C Balica, Chi-Son Kim, Susan Egan, Charletta A Ayers, Gloria A Bachmann
From 2011 to 2015, a total of 67 patients were referred for IUD insertion guided with transabdominal sonography (TAS). Fifty-six of the 67 patients had successful IUD insertion under TAS guidance. The clinical indications for referral included fibroids, uterine position, previous history of IUD expulsion, and limited tolerance of pelvic examination. Reasons for failed TAS-guided IUD insertion included patient discomfort, cervical stenosis, and inability to remove and replace an existing device. Ultrasound guidance could help broaden the patient population that may benefit from the therapeutic value of an IUD...
November 4, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29105584/is-ulipristal-acetate-the-new-drug-of-choice-for-the-medical-management-of-uterine-fibroids-res-ipsa-loquitur
#19
Funlayo Odejinmi, Reeba Oliver, Rebecca Mallick
Ulipristal acetate (Esmya(©)) has been hailed the new wonder drug with regard to the medical management of uterine fibroids, and many postulate that it will remove the need for surgical treatment in the future. While the results from the PEARL studies are certainly promising and its amenorrhoeic rates and reduction in fibroid size are unquestionable, there is still a paucity of data with regard to its long-term effects, the effects on its usage prior to surgery and its variable efficacy in different ethnic populations...
November 1, 2017: Women's Health
https://www.readbyqxmd.com/read/29103894/robot-assisted-myomectomy
#20
REVIEW
Celine Lonnerfors
Uterine fibroids are the most common tumors of the uterus and the female pelvis and are associated with substantial morbidity for several women. In women with a wish to preserve fertility, a myomectomy is the surgical procedure of choice when medical therapy is inadequate. Despite evidence that minimally invasive surgery is preferable to laparotomy, most myomectomies are still performed by laparotomy. Robotic surgery was introduced to overcome some of the difficulties associated with laparoscopic surgery. A myomectomy is a suture-intensive surgery where the properties of a surgical robot have been suggested to be of particular value...
September 29, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
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