Retrospective analysis of ultrasound criteria for newly diagnosed extragenital endometriosis detected during preventive examinations

Endometriosis is a common pathological condition characterized by the presence of endometrial glands and stroma outside the uterus, most frequently in the pelvis. Despite the ability to demonstrate infiltrative growth and tendency to local recurrence and invasion, endometriosis is considered as a benign proliferative disease. An increasing incidence of extragenital endometriosis (including that in young patients) and difficulties associated with its visualization during ultrasonography lead to a delayed diagnosis, resulting in an increase in the number of cases of advanced endometriosis, which requires long-term treatment. The improvement of a screening ultrasound tomography technique and development of specific ultrasound criteria for preventive examination will ensure rapid identification of patients requiring treatment. In this retrospective study, we analyzed 57 cases of extragenital endometriosis detected during preventive examinations of women between 2014 and 2019. Each case was analyzed with the consideration of ultrasound characteristics together with clinical and gynecological data. We evaluated location, size, contours, and structure of foci. We propose a method of extended ultrasound examination in women with suspected extragenital endometriosis.

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Extensive skull base osteomyelitis, devastating complication of otitis externa: A case report and review of the literature

The Gazette of Medical Sciences ◽

10.46766/thegms.neuro.21051201 ◽

2021 ◽

Vol 2 (3) ◽

pp. 1-7

Author(s):

Khadija El Bouhmadi ◽

◽

Myriam Loudghiri ◽

Youssef Oukessou ◽

Sami Rouadi ◽

...

Keyword(s):

Skull Base ◽

Otitis Externa ◽

Delayed Diagnosis ◽

Petrous Bone ◽

Term Treatment ◽

Skull Base Osteomyelitis ◽

Long Term Treatment ◽

Orbital Wall ◽

The Right

Skull base osteomyelitis (SBO), also referred to as malignant otitis externa (MOE) in its typical form, is usually a complication of otitis externa and severe uncommon and life-threatening condition requiring early diagnosis and long-term treatment in order to avoid its neurologic sequelae. We report the case of 69 years old female with a history of uncontrolled type 2 diabetes, who presented refractory and chronic right-sided purulent otorrhea with temporal headaches for 6 months, treated with no improvement by multiple attempts of ambulatory empiric therapy. After the appearance of grade III facial palsy and painful swelling in the right periorbital and zygomatic areas, the patient consulted in our department where a CT scan showed massive cortical and trabecular destruction of the right petrous bone and the mastoid extended to the lateral orbital wall, the zygomatic arch and the greater sphenoid wing realising extensive osteomyelitis of the skull base and the lateral face. The treatment was started immediately based on intravenous broad-spectrum antibiotics. Despite aggressive long-term treatment, the patient passed away, underlying the increased SBO morbidity and mortality secondary to delayed diagnosis.

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How to treat a newly diagnosed young patient with multiple myeloma

Hematology ◽

10.1182/asheducation-2009.1.555 ◽

2009 ◽

Vol 2009 (1) ◽

pp. 555-565 ◽

Cited By ~ 12

Author(s):

Jesús F. San-Miguel ◽

María-Victoria Mateos

Keyword(s):

Survival Rates ◽

Conditioning Regimen ◽

Young Patients ◽

Allogeneic Transplantation ◽

Term Treatment ◽

Newly Diagnosed ◽

Long Term Treatment ◽

Investigational Procedure ◽

New Strategies

AbstractSurvival rates of young patients with myeloma have increased markedly in the last decade, mainly due to the use of autologous stem cell transplantation (ASCT) and new, highly efficient rescue treatments. In order to improve the survival of newly diagnosed young patients further, the next steps need to focus on increasing the activity of upfront or debulking regimens, improving the efficacy of ASCT, mainly through the conditioning regimen, and increasing the duration of responses through more effective maintenance or consolidation therapies. Nevertheless, this approach is being challenged by the favorable results obtained with long-term treatment with novel agents and the possibility of reserving the ASCT until relapse. Allogeneic transplantation in newly diagnosed patients should be considered as an investigational procedure and used only in well-designed clinical trials. This review covers the new strategies that are currently under investigation with the aim of optimizing the outcome for newly diagnosed young patients with myeloma.

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Tetrahydrobiopterin Deficiency: From Phenotype to Genotype

Pteridines ◽

10.1515/pteridines.1993.4.1.1 ◽

1993 ◽

Vol 4 (1) ◽

pp. 1-10 ◽

Cited By ~ 53

Author(s):

Nenad Blau ◽

Beat Thöny ◽

Claus W. Heizmann ◽

Jean-Louis Dhondt

Keyword(s):

Rapid Identification ◽

Term Treatment ◽

Gtp Cyclohydrolase I ◽

E Coli ◽

Tetrahydrobiopterin Deficiency ◽

Biological Studies ◽

Long Term Treatment ◽

Type Gene ◽

Neurotransmitter Precursors

Summary As a result of the selective screening worldwide during the last 18 years, approximately 250 patients with tetrahydrobiopterin deficiency were discovered. Most patients suffer from 6-pyruvoyl tetrahydropterin synthase deficiency (58%), followed by dihydropteridine reductase deficiency (35%), GTP cyclohydrolase I deficiency (3%), and “primapterinuria” (4%). The patients can be treated with neurotransmitter precursors, as well as with tetrahydrobiopterin. However, data on long term treatment are still scarce and it is therefore of great value to investigate all newborns with even mild hyperphenylalaninemia. Cloning of the enzymes involved in the biosynthesis and regeneration of tetrahydrobiopterin makes them to be easily accessible for biochemical and biological studies. So far, all proteins expressed heterologous are active in E. coli. Cloning of the wild type gene and mutant analysis of patients allow the rapid identification of the defective gene on the molecular level.

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THERAPY OF ENDOCRINE DISEASE: Surgery in microprolactinomas: effectiveness and risks based on contemporary literature

Acta Endocrinologica ◽

10.1530/eje-16-0087 ◽

2016 ◽

Vol 175 (3) ◽

pp. R89-R96 ◽

Cited By ~ 20

Author(s):

Metaxia Tampourlou ◽

Raluca Trifanescu ◽

Alessandro Paluzzi ◽

Shahzada K Ahmed ◽

Niki Karavitaki

Keyword(s):

Transsphenoidal Surgery ◽

Young Patients ◽

Cost Effective ◽

High Volume ◽

Term Treatment ◽

Long Term Results ◽

Complication Rates ◽

Management Algorithm ◽

Long Term Treatment

Microprolactinomas are the most common pituitary adenomas. In symptomatic patients, dopamine agonists are the first-line treatment of choice; when cabergoline is used, biochemical control rates between 85 and 93% have been reported. Long-term treatment is needed in most of the cases with compliance, patient convenience, and potential adverse effects representing areas requiring attention. Based on the literature published in the past 15 years, transsphenoidal surgery can lead to normal prolactin in the postoperative period in usually 71–100% of the cases with very low postoperative complication rates. Surgical expertise is the major determinant of the outcomes, and it may be a cost-effective option in young patients with life expectancy greater than 10 years (provided it is performed by experienced surgeons at high volume centers with confirmed optimal outcomes). Larger series of patients with adequate follow-up could further validate the place of transsphenoidal surgery (particularly through the endoscopic approach for which long-term results are currently limited) in the management algorithm of patients with microprolactinoma.

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