The impact of Ki-67 index, squamous differentiation and several clinicopathologic parameters on the recurrence of low and intermediate-risk endometrial cancer

Endometrial endometrioid carcinoma (EEC) represents approximately 75–80% of endometrial carcinoma cases. Three hundred thirty-six patients with EEC followed-up in the authors’ medical center between and 2010–2018 were included in our study. Two hundred seventy-two low- and intermediate- EEC patients were identified using the European Society for Medical Oncology criteria and confirmed by histopathological examination. Recurrence was reported in 17 of these patients. The study group consisted of patients with relapse. A control group of 51 patients was formed at a ratio of 3:1 according to age, stage, and grade, similar to that in the study group. Of the 17 patients with recurrent disease, 13 patients (76.5%) were stage 1A, and 4 patients (23.5%) were stage 1B. No significant difference was found in age, stage, and grade between the case and control groups (p>0.05). Body mass index, parity, tumor size, lower uterine segment involvement, SqD, and Ki-67 index with p<0.25 in the univariate logistic regression analysis were included in the multivariate analysis. Ki-67 was statistically significant in multivariate analysis (p=0.018); however, there was no statistical significance in SqD and other parameters. Our data suggest that the Ki-67 index rather than SqD needs to be assessed for recurrence in patients with low- and intermediate-risk EEC.

Download Full-text

Twin Pregnancies Complicated by a Single Malformed Fetus: Chorionicity, Outcome and Management

Twin Research and Human Genetics ◽

10.1375/twin.13.5.501 ◽

2010 ◽

Vol 13 (5) ◽

pp. 501-507 ◽

Cited By ~ 8

Author(s):

Ali Gedikbasi ◽

Alpaslan Akyol ◽

Gokhan Yildirim ◽

Ali Ekiz ◽

Ahmet Gul ◽

...

Keyword(s):

Gestational Age ◽

Statistical Significance ◽

Expectant Management ◽

Control Group ◽

Study Group ◽

Preliminary Evaluation ◽

Gestational Age At Birth ◽

The Impact ◽

Twin Pregnancies ◽

Age At Birth

The objective of this study was to evaluate the impact of one abnormal fetus in a twin pregnancy, to compare impact of chorionicity and clinical outcome of intervention and expectant management. Thirty-seven dichorionic (DC) twins and 18 monochorionic (MC) twins complicated with one malformed fetus were evaluated for gestational age, birthweight and perinatal outcome. Six hundred and forty-two twin pregnancies were evaluated in the database. The control groups consisted of 429 DC and 86 MC twins without anomalous fetus. Mean birthweight and gestational age at birth for DC control group were (n= 429; 2137g and 34.71 weeks), DC study group,n= 37; 2117g (p= .338) and 33.97 weeks (p= .311), and DC study group with major malformations,n= 30; 2019g (p= .289) and 33.3 weeks (p= .01), and showed only significance for gestational age. There was no statistical significance between MC control group,n= 86; 2097g and 34.93 weeks, and MC study group,n= 18; 2237g (p= .338), and 34.42 weeks (p= .502). Because of limited data, the preliminary evaluation for expectant management and intervention, and survival of at least one normal fetus showed no impact. We conclude that, although, all DC twin pregnancies have a risk for preterm delivery, DC twins complicated with major malformation of one twin, have a lower mean gestational age at birth. Preliminary results for intervention does not improve fetal outcome for DC and MC twins and needs further evaluation with greater studies of impact or review.

Download Full-text

The Connection of the Level of Estradiol in Serum and Obesity with the Endometrial Bleeding in Postmenopausal Women

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.079 ◽

2019 ◽

Vol 7 (1) ◽

pp. 88-91 ◽

Cited By ~ 1

Author(s):

Valentina Tofiloska ◽

Maria Krstevska ◽

Ana Daneva-Markova ◽

Viktorija Jovanovska

Keyword(s):

Endometrial Cancer ◽

Statistical Significance ◽

Abnormal Uterine Bleeding ◽

Control Group ◽

Prospective Clinical Study ◽

Study Group ◽

Gynecology And Obstetrics ◽

Increased Risk ◽

Significant Difference ◽

Post Menopausal

BACKGROUND: Postmenopausis is a period that begins one year after the last menstrual period. Abnormal uterine bleeding could be of different origins. AIM: This study aimed to determine the association of serum estrogen hormone levels and obesity with the occurrence of endometrial bleeding in post-menopausal women. MATERIAL AND METHODS: Prospective clinical study involving 120 postmenopausal patients treated at the University Clinic for Gynecology and Obstetrics-Skopje, divided into two groups: control and study. The control group consisted of 40 postmenopausal patients without endometrial bleeding, hospitalised and operated due to urogenital pathology. The study group consisted of 80 patients with endometrial bleeding who were divided into three subgroups according to the thickness of the endometrium: from 5-8 mm, 8-11 mm and above 11 mm. In all subjects, estradiol and BMI was determined. RESULTS: Estradiol levels were statistically higher in the study group compared to control while statistically significant difference among the three subgroups according to the thickness of the endometrium about the levels of estradiol in blood is not found. About BMI, the results showed that there was no statistical significance between the two examined groups. CONCLUSION: Patients with endometrial bleeding have increased levels of estradiol and are at increased risk of endometrial cancer about controls, the likelihood of endometrial cancer significantly increases by 1,108 times.

Download Full-text

Sirolimus influence on hepatectomy-induced liver regeneration in rats

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/s0100-69912014000300012 ◽

2014 ◽

Vol 41 (3) ◽

pp. 203-207 ◽

Cited By ~ 4

Author(s):

Edimar Leandro Toderke ◽

Giorgio Alfredo Pedroso Baretta ◽

Ozimo Pereira Gama Filho ◽

Jorge Eduardo Fouto Matias

Keyword(s):

Liver Regeneration ◽

Negative Influence ◽

Control Group ◽

Cell Multiplication ◽

Study Group ◽

Adult Rats ◽

Ki 67 ◽

Immunohistochemical Markers ◽

Significant Difference ◽

And Control

OBJECTIVE: To evaluate the influence of sirolimus on liver regeneration triggered by resection of 70% of the liver of adult rats. METHODS: we used 40 Wistar rats randomly divided into two groups (study and control), each group was divided into two equal subgroups according to the day of death (24 hours and seven days). Sirolimus was administered at a dose of 1mg/kg in the study group and the control group was given 1 ml of saline. The solutions were administered daily since three days before hepatectomy till the rats death to removal of the regenerated liver, conducted in 24 hours or 7 days after hepatectomy. Liver regeneration was measured by the KWON formula, by thenumber of mitotic figures (hematoxylin-eosin staining) and by the immunohistochemical markers PCNA and Ki-67. RESULTS: there was a statistically significant difference between the 24h and the 7d groups. When comparing the study and control groups in the same period, there was a statistically significant variation only for Ki-67, in which there were increased numbers of hepatocytes in cell multiplication in the 7d study group compared with the 7d control group (p = 0.04). CONCLUSION: there was no negative influence of sirolimus in liver regeneration and there was a positive partial effect at immunohistochemistry with Ki-67.

Download Full-text

Anthropometric Assessment after Slow Breathing Exercise in Type 2 Diabetic Male Patients

International Journal of Diabetes & Metabolic Disorders ◽

10.33140/ijdmd.05.02.03 ◽

2020 ◽

Vol 5 (2) ◽

Keyword(s):

Statistical Significance ◽

Control Group ◽

Study Group ◽

Physical And Mental Health ◽

Anthropometric Parameters ◽

Breathing Exercise ◽

Male Patients ◽

Slow Breathing ◽

The Impact

Background: Yoga based slow breathing exercise (SBE) has several beneficial effects on physical and mental health. Objectives: To observe the impact of slow breathing exercise on anthropometric parameters in male patients with type 2 diabetes mellitus (T2DM). Methods: This prospective interventional study was conducted on sixty (60) male diagnosed T2DM patients aged 45-55 years with duration of disease 5-10 years enrolled from Out Patients Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, and Dhaka. By simple random technique the subjects were divided into control group (n=30) and study group (n=30). Yoga based slow breathing exercise was practiced by the study group for 30 minutes twice daily for 3 months. Height, weight, body mass index (BMI), waist circumference, hip circumference and waist/hip ratio were assessed at the start of the study and after 3 months. Independent sample and paired t-test were used for statistical analysis and p<0.05was considered as statistical significance. Results: In this study the value of mean BMI was significantly (p=<0.05) reduced after 3 months of SBE. Again, all the anthropometric parameters were significantly (p=>0.05) increased after 3 months in the group who did not undergo SBE. Conclusion: Anthropometric parameters were improved after slow breathing exercise for 3 months.

Download Full-text

Tooth abnormalities in pediatric patients submitted to antineoplastic treatment for central nervous system neoplasms

Brazilian Dental Science ◽

10.14295/bds.2016.v19i3.1263 ◽

2016 ◽

Vol 19 (3) ◽

pp. 39

Author(s):

Ornella Florio Demasi ◽

Marcelo Fava ◽

Camila Merida Carrillo ◽

Terezinha Garrett de Freitas Sampaio Amaral ◽

Vicente Odone Filho

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Pediatric Patients ◽

Statistical Significance ◽

Control Group ◽

Study Group ◽

Central Nervous System Neoplasms ◽

Tooth Abnormalities ◽

Significant Difference ◽

Nervous System Neoplasms

Objective: The aim of this study was to evaluate the frequency of tooth abnormalities in pediatric patients treated for central nervous system neoplasms. Material and methods: This cross-sectional study assessed thirty-one patients, median age 14.2 years (range 5 - 25), who were off therapy for at least one year, comparatively with a control group of thirty-one healthy patients matched for age with the study group. Tooth abnormalities were evaluated by panoramic radiographs. Results: There was no statistical significant evidence that patients of the study group (age range 5 - 25 years) have more frequency of tooth abnormalities comparatively with controls. However, in children who were diagnosed before 5 years of age, microdontia was the most common abnormality with statistically significant difference (P=0.037). Root shortening grade III was observed in patients over 10 years of age at the time of radiographic examination, also with statistical significance (P=0.046). Conclusions: Tooth abnormalities frequency in patients treated for central nervous system neoplasms is directly related to the age of diagnosis and stage of odontogenesis. Microdontia and reduced root surface areas, the most common abnormalities observed, can lead to future oral health impairment due to malocclusion and less periodontal support. It is important to give parents and patients early orientation about maintenance of good oral hygiene and proper treatment by orthodontics or dentofacial orthopedics.

Download Full-text

THE IMPACT OF SPORT GAMES EXERCISE PROGRAMS ON THE DEVELOPMENT OF SPECIFIC MOTOR ABILITIES IN ADOLESCENTS WITH INTELLECTUAL IMPAIRMENT

Facta Universitatis Series Physical Education and Sport ◽

10.22190/fupes190508022p ◽

2020 ◽

pp. 249

Author(s):

Aleksandar Pejčić ◽

Miodrag Kocić

Keyword(s):

Motor Skills ◽

Statistical Significance ◽

Exercise Program ◽

Experimental Program ◽

Control Group ◽

Mental Impairment ◽

Motor Abilities ◽

Significant Difference ◽

And Control ◽

The Impact

The aim of this study was to determine the effects of a sports games experimental program on improving specific motor abilities in adolescents with mental impairment. The study was conducted on a sample of 60 adolescents diagnosed with mild mental impairment, divided into two groups (experimental group EG, and control group CG) with an equal number of participants. The special program of sports games lasted for 12 weeks, with a weekly frequency of four times and a duration of 30 minutes per training. The participants of both groups were tested with the same variables within the specific motor skills for the sport of football and basketball. After a twelve-week experimental program of sports games, there were statistically significant improvements in the EG in the variables: SMFS, SMDR, SMCP with a statistical significance of r=0.000. The results of the ANOVA and MANOVA analyses indicated that after the application of the specific sports games program there was a statistically significant difference in the benefits for the EG compared to the CG, in the parameters of specific motor abilities with a statistical significance r=0.000 and the size of the impact. Based on these research results, it can be concluded that a specific exercise program conducted within twelve-week training of specifically dosed sports activities has significantly contributed the development of specific motor skills for football and basketball.

Download Full-text

The impact of outpatient clinical care on the survival and hospitalisation rate in patients with alcoholic liver cirrhosis

Radiology and Oncology ◽

10.1515/raon-2017-0056 ◽

2017 ◽

Vol 52 (1) ◽

pp. 75-82

Author(s):

Dejan Majc ◽

Bojan Tepes

Keyword(s):

Liver Cirrhosis ◽

Alcohol Consumption ◽

Clinical Care ◽

Hospitalisation Rate ◽

Control Group ◽

Study Group ◽

Alcoholic Liver Cirrhosis ◽

Significant Difference ◽

A Prospective Study ◽

The Impact

AbstractBackgroundIn the study, we aimed to determine whether regular outpatient controls in patients with alcoholic liver cirrhosis have an impact on their survival and hospitalisation rates.Patients and methodsWe included patients with liver cirrhosis and regular outpatient controls as a prospective study group and patients with liver cirrhosis who were admitted to hospital only in cases of complications as a retrospective control group. The study was conducted between 2006 and 2011.ResultsWe included 98 patients in the study group and 101 patients in the control group. There were more outpatient controls in the study group than in the control group (5.54 examinations vs. 2.27 examinations, p = 0.000). Patients in the study group had 25 fewer hospitalisations (10.2%; p = 0.612). The median survival rate was 4.6 years in the study group and 2.9 years in the control group (p = 0.021). Patients with Child A classification had an average survival of one year longer in the study group (p = 0.035). No significant difference was found for Child B patients. Patients with Child C classification had longer survival by 1.6 years in the study group (p = 0.006). Alcohol consumption was lower in the study group than in the control group (p = 0.018).ConclusionsWe confirmed that patients with regular outpatient controls had lower alcohol consumption, a lower hospitalisation rate and significantly prolonged survival time. We confirmed the necessity for the establishment of regular outpatient controls in patients with alcoholic liver cirrhosis.

Download Full-text

P6460The significance of syncope as a presenting symptom in patients with intermediate risk pulmonary embolism

European Heart Journal ◽

10.1093/eurheartj/ehz746.1052 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

S S Natanzon ◽

R Beigel ◽

F Chernomordik ◽

I Mazin ◽

R Herscovici ◽

...

Keyword(s):

Mechanical Ventilation ◽

Hospital Mortality ◽

Medical Center ◽

Statistical Significance ◽

Hemodynamic Instability ◽

Inotropic Support ◽

Intermediate Risk ◽

Escalation Therapy ◽

Significant Difference ◽

Secondary Outcomes

Abstract Background Intermediate risk pulmonary emboli patients are a challenging group with high risk of recurrent VTE, hemodynamic instability and mortality. A gap of knowledge has emerged regarding predictors of clinical deterioration. The prognostic role of syncope presentation is debatable. We thought to investigate the ability of syncope to predict in-hospital complications and the need of escalation therapy among intermediate risk PE patients admitted to the ICCU. Methods Consecutive cohort of all patients hospitalized with a diagnosis of PE, classified as intermediate risk and admitted to the intensive cardiac care unit at the Sheba medical center between the years 2008–2016. Primary outcome: MACE consisting of either one of or a combination of: mechanical ventilation, hemodynamic instability and need for inotropic support, Secondary reperfusion and in-hospital mortality. Secondary outcomes: Each of the individual components including major bleeding and renal failure Results 213 intermediate risk PE patients were analyzed. 40 patients (19%) presented with syncope. Syncope patients had significant higher RV/LV ratio upon computed tomography (1.7±0.6 vs. 1.4±0.4, p=0.011). The presence of either moderate or severe RV dysfunction was more prevalent, without statistical significance (57.5% vs. 41%, p=0.076). Syncope patients had higher prevalence of escalation therapy (28.9% vs 9.4%, p=0.003), as well as in the following individual secondary endpoints: mechanical ventilation (10% vs 1.8%, p=0.026), hemodynamic instability (17.9% vs 2.9%, p=0.02), bleeding rates (15% vs 2.4%, p=0.004), and increased need of inotropic support (10% vs 0.6%, p=0.005). There was no significant difference in the need for reperfusion therapy, both surgical (5% vs. 0.6%, p=0.093) and non- surgical (7.5% vs 6.4%, p=0.732), and in-hospital mortality (2.5% vs 0%, p=0.190). Secondary Outcomes Conclusion The presence of syncope as a presenting symptom is associated with more complicated in-hospital clinical course. These patients warrant more aggressive monitoring and assessment for the need of escalation therapy.

Download Full-text

Impact of Whatsapp in improving learning among 9th semester MBBS students

Medpusle International Journal of Surgery ◽

10.26611/1061917 ◽

2021 ◽

Vol 19 (1) ◽

pp. 27-30

Author(s):

Y Satish Reddy ◽

Keyword(s):

Undergraduate Students ◽

Control Group ◽

P Value ◽

Study Group ◽

Opinion Poll ◽

Didactic Teaching ◽

Significant Difference ◽

Group A ◽

The Mean ◽

The Impact

Background: Interactive Teaching learning can be used in clinical subjects like surgery for better participation of students as one-way didactic lectures do not involve active participation of students. WhatsApp is one of the most famous messaging services which everyone use and it is easy, cheaper, and faster. Objective: the purpose of the study was to study the impact of whatsapp in improving learning in general surgery among 9th semester medical students. Methods: This study was conducted among 9th semester MBBS students in Surgery department. Students were divided into group a (study group) and group b(control group) by a simple random sampling. Gastric cancer was discussed among students of both Groups through didactic teaching. after didactic teaching, only Group A students were exposed to social media type of learning, i.e., using WhatsApp, after the session a multiple-choice questionnaire having 10 MCQs was given to both groups and an additional poll was conducted among the Study-group students to assess their perception towards Whatsapp intervention. the mean score obtained by both the groups were compared with unpaired t test. P-value <0.05 is taken as statistically significant. Results: The mean (SD) score of the Study-group was 8.58(1.18) and the mean (SD) score of the Control-group was 5.41(1.32) and statistically significant difference was found between the two groups scores with a p-value less than 0.05 opinion poll found that the intervention of whatsapp among study group was effective. Conclusion: we observed that the usage of WhatsApp in addition to the didactic teaching was found advantageous and enhanced learning in undergraduate students

Download Full-text

Impact of a nutrition consultation on the rate of high output stoma-related readmission: an ambispective cohort study

Scientific Reports ◽

10.1038/s41598-021-96136-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Manuela Moreno Santamaría ◽

José Javier Arenas Villafranca ◽

Jimena Abilés ◽

Francisco Rivas Ruiz ◽

Pilar Utrilla Navarro ◽

...

Keyword(s):

Cohort Study ◽

Nutritional Status ◽

Statistical Significance ◽

Intestinal Resection ◽

Control Group ◽

Stoma Creation ◽

Significant Difference ◽

The Impact ◽

High Output

AbstractThe aims of this study were to assess the impact of a follow-up nutrition consultation for ostomy patients on the rate of high output stoma (HOS)-related readmissions, as well as on the detection of poor nutritional status and their management, and to determine the associated economic impact. A single-centre ambispective cohort study was conducted in which all adult patients undergoing intestinal resection and stoma creation were recruited. Two nutrition consultations were established for early follow-up after hospital discharge and patients were prospectively included. Additionally, a retrospective search was carried out to include a control group. In both groups, a 12-month follow-up was conducted to record readmissions associated with high output stoma. A multivariate logistic regression was performed. Statistical significance level was established at p < 0.05. 170 patients were recruited, 85 patients in each cohort. Demographic data and clinical characteristics were recorded. A significant difference was observed in HOS-related readmissions, with readmission rates of 28.6% vs 10.3% in the retrospective and prospective cohort, respectively. At the first follow-up consultation, 50.5% of patients presented some degree of protein-calorie malnutrition. A statistically significant improvement in nutritional status was observed in the second evaluation. The intervention carried out resulted in a total saving of €24,175. Early follow-up of patients after discharge resulted in a significant reduction in the rate of HOS-related readmissions and allowed to identify a high percentage of patients with malnutrition. The cost analysis showed the process to be a cost-effective improvement.

Download Full-text