scholarly journals The recurrence rate of ovarian endometrioma in women aged 40–49 years and impact of hormonal treatment after conservative surgery

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Nara Lee ◽  
Seunggi Min ◽  
Seyeon Won ◽  
Yeon Jean Cho ◽  
Miseon Kim ◽  
...  
Keyword(s):  
Risk Factor ◽  
Recurrence Rate ◽  
Hormonal Treatment ◽  
Conservative Surgery ◽  
Disease Recurrence ◽  
Cystic Mass ◽  
Time To Recurrence ◽  
Ovarian Endometrioma ◽  
Surgical History ◽  
History Of

Abstract The aim of this study was to evaluate the rate of and risk factors for recurrence ovarian endometrioma after conservative surgery in patients aged 40–49 years. This retrospective, single-center study included 408 women between January 2008 and November 2018. All patients underwent ovarian cyst enucleation, were pathologically diagnosed with ovarian endometrioma and were followed up for ≥ 6 months. Recurrence was defined as a cystic mass with diameter ≥ 2 cm detected by sonography. Recurrence rate after conservative surgery and risk factor of recurrence were analyzed. The median follow-up duration after surgery was 32.0 ± 25.9 months (range 6–125 months). Ovarian endometrioma recurred in 34 (8.3%) of included women and median time to recurrence was 22.4 ± 18.2 months. The cumulative recurrences rate at 12, 24, 36, and 60 months were 3.7%, 6.7%, 11.1%, and 16.7%, respectively. Recurrence was correlated with multilocular cysts (p = 0.038), previous surgical history of ovarian endometrioma (p = 0.006) and salpingectomy (p = 0.043), but not use or duration of post-operative medication. In multivariate analysis, large cyst size (> 5.5 cm) was only risk factor for recurrence in this age group. Post-operative medication did not reduce disease recurrence rate, and thus may be administered for endometriosis-associated pain rather than to prevent recurrence in patients aged 40–49 years.

scholarly journals Total Laparoscopic Conservative Surgery for an Intramural Ectopic Pregnancy

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Hiroshi Nabeshima ◽  
Mitsuo Nishimoto ◽  
Hiroki Utsunomiya ◽  
Maiko Arai ◽  
Tomohisa Ugajin ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Conservative Surgery ◽  
Cystic Mass ◽  
Heart Beat ◽  
Transvaginal Sonography ◽  
Chorionic Villi ◽  
Pathologic Evaluation ◽  
History Of ◽  
Gestational Sac ◽  
Laparoscopic Removal

A 38-year-old woman, gravida 3, para 1 with a history of a left salpingectomy for an ectopic pregnancy was admitted for treatment of a presumed ectopic pregnancy. Transvaginal sonography revealed an ill-defined gestational sac and fetal heart beat within the fundal myometrium adjacent to the left cornua. Laparoscopy was performed for a suspected left cornual pregnancy or intramural pregnancy. A cystic mass 3 cm in diameter was visible within the fundal myometrium. Total laparoscopic removal of the gestational sac was performed, and the uterus was preserved. Pathologic evaluation of the excised mass demonstrated chorionic villi involving the myometrium. In the literature, only one other case describing the laparoscopic removal of an intramural pregnancy has been reported. However, in the prior report, the patient still required hysterectomy after conservative surgery. Therefore, this is the first report of the successful treatment of an intramural pregnancy exclusively with laparoscopy.

The Effect of Seromuscular-Dermal and All Layer-Dermal Suturing on the Rate of Early Stomal Mucocutaneous Separation: A Retrospective Study

2021 ◽  
Vol 67 (3) ◽  
pp. 21-28
Author(s):  
Yusuke Ohara ◽  
Tsuyoshi Enomoto ◽  
Yohei Owada ◽  
Daichi Kitaguchi ◽  
Katsuji Hisakura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retrospective Study ◽  
Odds Ratio ◽  
Suture Technique ◽  
Short Term ◽  
Steroid Use ◽  
Surgical History ◽  
History Of ◽  
Independent Risk Factors

BACKGROUND: Stomal mucocutaneous separation (SMS) is a serious and common short-term and long-term complication of ostomy surgery, but optimal methods to help prevent it have not been established. The authors hypothesized that seromuscular-dermal (SM-D) suturing may be better than all layer-dermal (AL-D) suturing to help prevent SMS. METHODS: This retrospective study evaluated the short-term SMS rate of patients who underwent colostomy or ileostomy surgery between 2015 and 2019. Patient demographics, medical and surgical history variables, as well as SMS outcomes were abstracted. Postoperative SMS severity was categorized by extent as follows: grade A (mild), grade B (moderate), and grade C (severe). RESULTS: In total, 105 patients (AL-D group, 45 patients; SM-D group, 60 patients) were enrolled in the study. SMS occurred in 24 patients (23%). The overall SMS rate was 18% (n = 11) in the SM-D group and 29% (n = 13) in the AL-D group (P = .202). The occurrence of severe (grade C) or moderate and severe SMS (grades B + C) in the SM-D compared with the AL-D group was significantly different (2% vs 16% [P = .011] and 10% vs 24% [P = .047], respectively). A history of steroid use was a risk factor for moderate and severe SMS (P = .016, odds ratio 5.694). Stomal height ≤1 cm was a a risk factor for all cases of SMS (P = .037, odds ratio 2.650). AL-D suture technique and a history of steroid use were independent risk factors for severe and moderate plus severe SMS (P = .021, odds ratio 12.844 and P = .027, odds ratio 4.808, respectively). CONCLUSION: In this study, use of the AL-D suturing technique and a history of steroid use were independent risk factors for the short-term development of moderate or severe SMS. Patients whose stoma was secured using the SM-D technique had a significantly lower rate of moderate or severe SMS.

Primary peritoneal mucinous cystadenocarcinoma mimicking possible recurrent ovarian mucinous cystadenoma: coincidental pathology or a spectrum of disease?

2021 ◽  
Vol 14 (7) ◽  
pp. e242478
Author(s):  
Claire Filippini ◽  
Sarah Smyth ◽  
Hooman Soleymani Majd ◽  
Catherine Johnson
Keyword(s):  
Magnetic Resonance ◽  
Young Patient ◽  
Management Strategies ◽  
Mucinous Cystadenoma ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Cystic Mass ◽  
Mucinous Cystadenocarcinoma ◽  
Surgical History ◽  
History Of ◽  
Well Differentiated

We present the case of a 32-year-old woman with a previous surgical history of benign mucinous cystadenoma resected in 2012 who underwent magnetic resonance cholangiopancreatography following her second pregnancy in 2020. This demonstrated a large cystic mass in the left subdiaphragmatic space. Histopathology confirmed a well-differentiated primary peritoneal mucinous cystadenocarcinoma displaying cells of a Mullerian origin. We subsequently discuss the aetiology of these conditions separately and explore the possibility of a connection between the two regarding origin or potential malignant transformation that may otherwise have occurred coincidentally in this young patient. We also acknowledge a paucity of evidence regarding subsequent management strategies.

Hormonal stimulation and some risk factors studied to improve bovine pregnancy rate at the Coastal areas of Barisal district of Bangladesh

2018 ◽  
Vol 52 (1-4) ◽  
pp. 22-30
Author(s):  
A K Paul ◽  
S M T Rahman
Keyword(s):  
Pregnancy Rate ◽  
Coastal Region ◽  
Hormonal Treatment ◽  
Coastal Areas ◽  
Pregnancy Rates ◽  
Hormonal Stimulation ◽  
Crossbred Cows ◽  
Treatment Groups ◽  
History Of ◽  
Group A

Hormonal treatment of cows at the coastal region of Barisal district of Bangladesh was performed to assess the improvement of pregnancy rate. A total of 100 cows and heifers with irregular history of cyclicity were selected randomly and divided into five treatment groups. The groups were A (treated with anthelmintic), B (treated with anthelmintic, vitamin ADE and multivitamin powder), C (treated with PGF2α), D (treated with GnRH) and E (treated with GnRH and PGF2α). Each group comprised of 20 animals. The age, breed and parity of experimental cows were considered during treatment. In the study, the cows treated with both GnRH and PGF2α (group E) showed significantly (p<0.05) higher estrus (80%) and pregnancy rate (60%) than that of group A, B, C and D. The overall estrus rates of local and crossbred cows were 64% and 70%, respectively and the pregnancy rates were 40 and 52%, respectively. The crossbred cows responded significantly (p<0.05) to hormonal treatment than that of local cows. Parity-2 cows showed higher estrus sign than that of other parities. However, the pregnancy rates were higher significantly (p<0.05) in parity-2 and parity ≥4 cows than that of parity-0, parity-1 and parity-3 cows. The pregnancy rate was also found higher in case of 4 to <5 years old cows than that of 2 to <3, 3 to <4, 5 to <6, and ≥6 years old. It may conclude that the hormonal regimen increases the pregnancy rate as well as decreases the undesired waiting of estrus and conception. Further study with more sample size will reveal the more effective treatment for cows at the coastal areas of Bangladesh.

Hormonal stimulation and some risk factors studied to improve bovine pregnancy rate at the Coastal areas of Barisal district of Bangladesh

2018 ◽  
Vol 52 (1-4) ◽  
pp. 22-30
Author(s):  
A K Paul ◽  
S M T Rahman
Keyword(s):  
Pregnancy Rate ◽  
Coastal Region ◽  
Hormonal Treatment ◽  
Coastal Areas ◽  
Pregnancy Rates ◽  
Hormonal Stimulation ◽  
Crossbred Cows ◽  
Treatment Groups ◽  
History Of ◽  
Group A

Hormonal treatment of cows at the coastal region of Barisal district of Bangladesh was performed to assess the improvement of pregnancy rate. A total of 100 cows and heifers with irregular history of cyclicity were selected randomly and divided into five treatment groups. The groups were A (treated with anthelmintic), B (treated with anthelmintic, vitamin ADE and multivitamin powder), C (treated with PGF2α), D (treated with GnRH) and E (treated with GnRH and PGF2α). Each group comprised of 20 animals. The age, breed and parity of experimental cows were considered during treatment. In the study, the cows treated with both GnRH and PGF2α (group E) showed significantly (p<0.05) higher estrus (80%) and pregnancy rate (60%) than that of group A, B, C and D. The overall estrus rates of local and crossbred cows were 64% and 70%, respectively and the pregnancy rates were 40 and 52%, respectively. The crossbred cows responded significantly (p<0.05) to hormonal treatment than that of local cows. Parity-2 cows showed higher estrus sign than that of other parities. However, the pregnancy rates were higher significantly (p<0.05) in parity-2 and parity ≥4 cows than that of parity-0, parity-1 and parity-3 cows. The pregnancy rate was also found higher in case of 4 to <5 years old cows than that of 2 to <3, 3 to <4, 5 to <6, and ≥6 years old. It may conclude that the hormonal regimen increases the pregnancy rate as well as decreases the undesired waiting of estrus and conception. Further study with more sample size will reveal the more effective treatment for cows at the coastal areas of Bangladesh.

Premorbid migraine history as a risk factor for vestibular and oculomotor baseline concussion assessment in pediatric athletes

2019 ◽  
Vol 23 (4) ◽  
pp. 465-470 ◽  
Author(s):  
Ryan N. Moran ◽  
Tracey Covassin ◽  
Jessica Wallace
Keyword(s):  
Risk Factor ◽  
Smooth Pursuit ◽  
Migraine Headache ◽  
Visual Motion ◽  
Assessment Tools ◽  
Motion Sensitivity ◽  
Ocular Reflex ◽  
Migraine Headaches ◽  
Vestibular Ocular Reflex ◽  
History Of

OBJECTIVEMigraine history has recently been identified as a risk factor for concussion and recovery. The authors performed a cross-sectional study examining baseline outcome measures on newly developed and implemented concussion assessment tools in pediatrics. The purpose of this study was to examine the effects of premorbid, diagnosed migraine headaches as a risk factor on vestibular and oculomotor baseline assessment in pediatric athletes.METHODSPediatric athletes between the ages of 8 and 14 years with a diagnosed history of migraine headache (n = 28) and matched controls without a history of diagnosed migraine headache (n = 28) were administered a baseline concussion assessment battery, consisting of the Vestibular/Ocular Motor Screening (VOMS), near point of convergence (NPC), and the King-Devick (K-D) tests. Between-groups comparisons were performed for vestibular symptoms and provocation scores on the VOMS (smooth pursuit, saccades, convergence, vestibular/ocular reflex, visual motion sensitivity), NPC (average distance), and K-D (time).RESULTSIndividuals diagnosed with migraine headaches reported greater VOMS smooth pursuit scores (p = 0.02), convergence scores (p = 0.04), vestibular ocular reflex scores (p value range 0.002–0.04), and visual motion sensitivity scores (p = 0.009). Differences were also observed on K-D oculomotor performance with worse times in those diagnosed with migraine headache (p = 0.02). No differences were reported on NPC distance (p = 0.06) or headache symptom reporting (p = 0.07) prior to the VOMS assessment.CONCLUSIONSPediatric athletes diagnosed with migraine headaches reported higher baseline symptom provocation scores on the VOMS. Athletes with migraine headaches also performed worse on the K-D test, further illustrating the influence of premorbid migraine headaches as a risk factor for elevated concussion assessment outcomes at baseline. Special consideration may be warranted for post-concussion assessment in athletes with migraine headaches.

scholarly journals Parenchymal mucinous cystadenoma of the kidney: a case report and literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mahmoudreza Kalantari ◽  
Shakiba Kalantari ◽  
Mahdi Mottaghi ◽  
Atena Aghaee ◽  
Salman Soltani ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Left Kidney ◽  
Previous History ◽  
Mucinous Cystadenoma ◽  
Single Layer ◽  
Renal Cysts ◽  
Cystic Mass ◽  
Flank Pain ◽  
History Of

Abstract Background Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts. Case presentation A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month. Conclusion It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.

scholarly journals Unusual Tissue – Unusual Issue: Pancreatic Heterotopia Presenting as Gastric Outlet Obstruction

2021 ◽  
pp. 338-343
Author(s):  
Thu L. Nguyen ◽  
Shivani Kapur ◽  
Stephen C. Schlack-Haerer ◽  
Grzegorz T. Gurda ◽  
Milan E. Folkers
Keyword(s):  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Needle Aspiration ◽  
Pancreatic Tissue ◽  
Cystic Mass ◽  
Pancreatic Heterotopia ◽  
History Of

Pancreatic heterotopia (PH) is a common, but typically small (<1 cm), incidental and asymptomatic finding; however, PH should be considered even for large and symptomatic upper gastrointestinal masses. A 27-year-old white woman presented with a 3-week history of burning epigastric pain, nausea, early satiety, and constipation. Physical examination revealed epigastric and right upper quadrant tenderness with normal laboratory workup, but imaging revealed a 5-cm, partly cystic mass arising from the gastric antrum with resulting pyloric stenosis and partial gastric outlet obstruction. Endoscopic ultrasound-guided fine needle aspiration revealed PH – an anomalous pancreatic tissue lying in a nonphysiological site. The patient ultimately underwent a resection and recovered uneventfully, with a complete pathologic examination revealing normal exocrine pancreatic tissue (PH type 2) without malignant transformation. We report a case of heterotopic pancreas manifesting as severe gastric outlet obstruction, in addition to a thorough diagnostic workup and surgical follow-up, in a young adult. Differential diagnoses and features that speak to benignity of a large, symptomatic mass lesion (PH in particular) are discussed.

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