scholarly journals A Structured Assessment to Decrease the Amount of Inconclusive Endometrial Biopsies in Women with Postmenopausal Bleeding

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
M. C. Breijer ◽  
N. C. M. Visser ◽  
N. van Hanegem ◽  
A. A. van der Wurff ◽  
B. C. Opmeer ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Endometrial Hyperplasia ◽  
Outcome Measure ◽  
Endometrial Biopsy ◽  
Initial Assessment ◽  
Postmenopausal Bleeding ◽  
Pathology Laboratory ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Objective.To determine whether structured assessment of outpatient endometrial biopsies decreases the number of inconclusive samples.Design.Retrospective cohort study.Setting.Single hospital pathology laboratory.Population.Endometrial biopsy samples of 66 women with postmenopausal bleeding, collected during the usual diagnostic work-up and assessed as insufficient for a reliable histological diagnosis.Methods.Endometrial biopsy samples were requested from the pathology laboratories. The retrieved samples were systematically reassessed by a single pathologist specialized in gynecology.Main Outcome Measure.Disagreement between initial assessment and conclusion after structured reassessment.Results.We retrieved 36 of 66 endometrial biopsy samples from six different pathology laboratories. Structured reassessment of the retrieved samples by a single pathologist specialized in gynecology did not change the conclusion in 35 of the 36 samples. The remaining sample contained a large amount of endometrial tissue and the diagnosis at reassessment was endometrial hyperplasia without atypia. All other samples contained insufficient material for a reliable diagnosis.Conclusion.A structured reassessment of endometrial biopsies samples, which were classified as inconclusive due to insufficient material, did not change the conclusion. Although it might be helpful for pathologists to have diagnostic criteria for adequacy and/or inadequacy of an endometrial biopsy sample, the gain in efficiency is likely to be small.

scholarly journals Granulomatosis with Polyangiitis as a Cause of Sudden-Onset Bilateral Sensorineural Hearing Loss: Case Report and Recommendations for Initial Assessment

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Paul R. Ratmeyer ◽  
Benjamin R. Johnson ◽  
Luis P. Roldan ◽  
Tania L. Kraai
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Granulomatosis With Polyangiitis ◽  
Early Recognition ◽  
Sensorineural Hearing ◽  
Initial Assessment ◽  
Laboratory Evaluation ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Granulomatosis with polyangiitis (GPA) is a severe systemic vasculitis that commonly affects the paranasal sinuses, upper and lower respiratory tracts, and kidneys. GPA has also been associated with sensorineural hearing loss (SNHL), through inflammation of the cochlear apparatus. Early recognition, diagnostic laboratory evaluation, and appropriate treatment are essential to improve outcomes and achieve remission for patients with GPA. Here, we present a case of bilateral sudden sensorineural hearing loss (SSNHL) and distal symmetric polyneuropathy as the first presenting signs of GPA. A specific diagnostic work-up to rule out autoimmune inner-ear disease in patients with bilateral SSNHL is not clearly stated in the clinical practice guidelines from the American Academy of Otolaryngology-Head and Neck Surgery. The aim of this paper is to delineate an appropriate diagnostic work-up for patients with bilateral SSNHL when there is concern for autoimmune disease.

Diagnostic Work-Up for Postmenopausal Bleeding - A Randomized Controlled Trial

2014 ◽  
Vol 21 (6) ◽  
pp. S22-S23
Author(s):  
L. van Hanegem ◽  
M. Breijer ◽  
M. Bongers ◽  
B.W. Mol ◽  
A. Timmermans
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Postmenopausal Bleeding ◽  
Randomized Controlled ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up
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