Clinical and diagnostic aspects of deep infiltrative endometriosis (diagnosis, treatment, recurrence)

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 307-313
Author(s):  
Shakhnoza K. Muftaidinova ◽  
Leonid Z. Faizullin ◽  
Vladimir D. Chuprynin ◽  
Nikolai S. Ruseikin ◽  
Tatiana I. Smolnova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hormonal Therapy ◽  
Serum Levels ◽  
Ca 125 ◽  
Prior History ◽  
Deep Endometriosis ◽  
Preoperative Serum ◽  
Peritoneal Endometriosis ◽  
History Of ◽  
Deep Infiltrative Endometriosis

Aim. To analyze the recurrence of endometriosis after surgical treatment of patients with deep endometriosis. Materials and methods. The case histories of 90 patients aged 19 to 45 years were retrospectively analyzed. The study group consisted of 70 endometriosis patients: 20 with peritoneal endometriosis and 50 with deep infiltrative endometriosis (DIЕ). The comparison group included 20 women without endometriosis. There was an in-depth study of anamnestic data in the cohort of patients under study. The results of preoperative laboratory tests, including serum levels of the CA-125 and CA 19-9 oncomarkers, were processed. Results. Analysis of the obtained data showed that about half of the DIE patients (54%) in the main group had a history of surgical interventions for endometriosis. The number of operations was significantly higher in patients compared to the peritoneal endometriosis group (68% vs 20%, respectively; р=0.0012). Two subgroups were formed from the group of women with DIE: patients who had no history of previous surgical treatment for endometriosis and those hospitalized for repeated surgical treatment of endometriosis (patients with recurrent endometriosis). Patients with recurrent endometriosis had a significantly higher incidence of heavy menstruation, pregnancy terminations (abortions), and a high proportion of gastrointestinal diseases. Analysis of the hormonal therapy received in patients with DIE showed that every second patient with relapses (18/53%) after surgical treatment and every third patient without a prior history of surgery (5/31%) received hormonal therapy. Examination of the preoperative serum levels of CA-125 and CA 19-9 serum markers in patients with DIE showed an increase in their serum levels and a correlation with the frequency of endometriosis recurrence and the size of DIE foci. Conclusion. Despite the conservative and surgical treatment of DIE patients, the recurrence rate is still high. At present, there is no satisfactory therapy for all endometriosis patients. Therefore, the development of therapy for the conservative treatment of the disease remains an urgent task.

scholarly journals Obstructive urolithiasis in buffalo calves (Bubalus bubalis): Serum changes of Vitamins A and D and efficacy of surgical management using tube cystostomy

2021 ◽  
Vol 14 (1) ◽  
pp. 129-136
Author(s):  
Abdelmonem Abdallah ◽  
Shimaa Ezzeldein ◽  
Eslam Eisa ◽  
Mustafa Abd El Raouf ◽  
Yasmin Bayoumi
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Serum Levels ◽  
Bubalus Bubalis ◽  
Bladder Rupture ◽  
Control Group ◽  
Buffalo Calves ◽  
Major Health ◽  
History Of ◽  
And Control

Background and Aim: Obstructive urolithiasis is one of the major health problems in livestock animals, mainly in young calves. The present study was designed first to investigate the changes in the serum levels of Vitamins A and D in buffalo calves (Bubalus bubalis) with obstructive urolithiasis and second to investigate the efficacy of tube cystostomy technique in management of such condition. Materials and Methods: One hundred and forty-nine buffalo calves of variable ages ranged from 3 to 7 months with a history of retained urine were examined clinically and ultrasonographically. Then, they were subjected to surgical treatment using the tube cystostomy technique. The serum levels of Vitamins A and D were investigated in retained urine calves in addition to 10 clinically healthy calves of the same age used as a control group. Results: Based on clinical and ultrasonographic findings, the calves were diagnosed as obstructive urolithiasis with intact bladder (n=64 calves) or with bladder rupture (n=85 calves) with the peak incidence in winter months. Tube cystostomy was an efficient and quick surgical technique for the management of such condition and 95.3% of calves returned their normal urination within 7–14 days after surgery. Significant hypovitaminoses A and D were found between retained urine calves and control ones (p= 0.01 and 0.002, respectively). Conclusion: Hypovitaminoses A and D suggested predisposing obstructive urolithiasis in buffalo calves, but further clinical studies are recommended for more confirmation. Surgical treatment using tube cystostomy technique is recommended for the management of obstructive urolithiasis in buffalo calves.

scholarly journals 193. Comparison of Survival for MSSA and MRSA Endocarditis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S116-S116
Author(s):  
Emese Kanyo ◽  
Nabin K Shrestha ◽  
Steven M Gordon
Keyword(s):  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Multivariable Analysis ◽  
Cleveland Clinic ◽  
Invasive Disease ◽  
Small Sample ◽  
Prior History ◽  
Selection Of Variables ◽  
History Of ◽  
The Mean

Abstract Background Prior studies have yielded conflicting findings regarding outcomes for MRSA vs. MSSA infective endocarditis (IE). Our experience suggests that MSSA IE is not any less severe than MRSA IE. The purpose of this study was to compare survival in MSSA and MRSA IE. Methods Episodes of IE caused by Staphylococcus aureus were identified from the Cleveland Clinic Infective Endocarditis Registry. Only the first episode was included for each patient. Acceptance for surgery was considered surgical treatment. Survival from the surgical decision date was compared for MSSA vs. MRSA endocarditis using multivariable Cox proportional hazards regression. Selection of variables for the model was done by stepwise backward elimination from a collection of clinically important baseline variables. Results Between January 1, 2008 and January 1, 2010, 76 episodes of IE caused by S. aureus were identified. The mean (SD) patient age was 58 (15) years, 46 (61%) were males, 14 (18%) had a prior history of IE, 33 (43%) had diabetes mellitus, 22 (29%) had end-stage renal disease (ESRD), 27 (36%) had prosthetic valve endocarditis (PVE), 70 (92%) had left side involvement, 27 (36%) had invasive disease, 59 (78%) were referred patients, and 39 (51%) were treated surgically. The mean (SD) time to decision on surgery was 6 (7) days. Of these episodes 40 (53%) had MSSA IE and 36 (47%) had MRSA IE. There was no difference in hazard of death between MSSA and MRSA IE (HR 0.98, 95% C.I. 0.54–1.78, P-value 0.96), after adjusting for age, ESRD, prior history of IE, PVE, invasive disease, calendar year, and surgical treatment, which were the significant explanatory variables in the multivariable analysis. Survivals predicted by the model for a reference patient with MSSA IE and MRSA IE are shown in the figure. Conclusion Preliminary findings suggest that survival in MSSA IE may be similar to that in MRSA IE. The study is limited by its small sample size. The study finding will need confirmation with a larger sample. Disclosures All authors: No reported disclosures.

Clinical Significance of Preoperative Serum Levels of CA 125 and TAG-72 in Ovarian Carcinoma

1997 ◽  
Vol 12 (3) ◽  
pp. 112-117 ◽  
Author(s):  
A. Gonzalez ◽  
F. Vizoso ◽  
J. Vázquez ◽  
A. Ruibal ◽  
J.L. Balibrea
Keyword(s):  
Overall Survival ◽  
Ovarian Carcinoma ◽  
Residual Disease ◽  
Residual Tumor ◽  
Serum Levels ◽  
Ca 125 ◽  
Preoperative Serum ◽  
Poor Differentiation ◽  
Well Differentiated ◽  
A Prospective Study

In a prospective study we evaluated in 48 patients with primary ovarian carcinoma the prognostic value of the preoperative circulating serum levels of CA 125 and TAG-72. Serum levels of CA 125 were above the cutoff level of 35 U/ml in 68% of patients, TAG-72 levels were higher than 6 U/ml in 50% of patients, while the simultaneous use of the two markers increased the sensitivity to 75%. Pretreatment CA 125 and TAG-72 levels were significantly lower (p < 0.05, for both) in patients with well differentiated tumors than in those with moderate or poor differentiation. Similarly, both marker levels were significantly higher (p < 0.001) in patients with residual disease after cytoreductive surgery than in those with no residual tumor. In addition, the CA 125 levels were also higher in initial stages (I-II) than in more advanced stages (III-IV) (p < 0.05), whereas TAG-72 levels were higher (p < 0.05) in patients with mucinous or endometrioid tumors than in those with serous carcinomas. The results further indicated that high preoperative serum levels of CA 125 and TAG-72 were associated with a shorter overall survival (p < 0.001 and p < 0.01, respectively). Finally, separate Cox multivariate analysis showed that preoperative CA 125 and TAG-72 serum levels were, after stage, the strongest factors to predict overall survival (p < 0.0001, p < 0.05 and p < 0.005, respectively) in patients with ovarian carcinoma.

Patient Selection for Salvage Cryotherapy for Locally Recurrent Prostate Cancer After Radiation Therapy

1999 ◽  
Vol 17 (8) ◽  
pp. 2514-2514 ◽  
Author(s):  
Louis L. Pisters ◽  
Paul Perrotte ◽  
Shellie M. Scott ◽  
Graham F. Greene ◽  
Andrew C. von Eschenbach
Keyword(s):  
Radiation Therapy ◽  
Treatment Failure ◽  
Gleason Score ◽  
Hormonal Therapy ◽  
Specific Antigen ◽  
Disease Free Survival ◽  
Prior History ◽  
History Of ◽  
Salvage Cryotherapy ◽  
Locally Recurrent

PURPOSE: Our objective was to identify clinical pretreatment factors associated with early treatment failure after salvage cryotherapy. PATIENTS AND METHODS: Between 1992 and 1995, 145 patients underwent salvage cryotherapy for locally recurrent adenocarcinoma of the prostate. Treatment failure was defined as an increasing postcryotherapy serial prostate-specific antigen (PSA) level of more than or equal to 2 ng/mL above the postcryotherapy nadir or as a positive posttreatment biopsy. We evaluated the following factors as predictors of treatment failure: tumor stage and grade at initial diagnosis, type of prior therapy, stage and grade of locally recurrent tumor, number of positive biopsy cores at recurrence, and precryotherapy PSA level. RESULTS: Among patients with a prior history of radiation therapy only, the 2-year actuarial disease-free survival (DFS) rates were 74% for patients with a precryotherapy PSA less than 10 ng/mL and 28% for patients with a precryotherapy PSA more than 10 ng/mL, P < .00001. The DFS rates were 58% for patients with a Gleason score of less than or equal to 8 recurrence and 29% for patients with a Gleason score greater than or equal to 9 recurrence, P < .004. Among patients with a precryotherapy PSA less than 10 ng/mL, DFS rates were 74% for patients with a prior history of radiation therapy only and 19% for patients with a history of prior hormonal therapy plus radiation therapy, P < .002. CONCLUSION: Patients failing initial radiation therapy with a PSA more than 10 ng/mL and Gleason score of the recurrent cancer more than or equal to 9 are unlikely to be successfully salvaged. Patients failing initial hormonal therapy and radiation therapy are less likely to be successfully salvaged than patients failing radiation therapy only.

scholarly journals Results of surgical resection of carotid body tumors: A twenty-year experience

Rare Tumors ◽  
2020 ◽  
Vol 12 ◽  
pp. 203636132098281
Author(s):  
January F Moore ◽  
John D Casler ◽  
Warner Andrew Oldenburg ◽  
Ronald Reimer ◽  
Robert E Wharen ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Resection ◽  
Carotid Body ◽  
Prior History ◽  
Neurologic Complications ◽  
Carotid Artery Reconstruction ◽  
History Of ◽  
Cranial Nerve Injury ◽  
Carotid Body Tumors ◽  
Succinate Dehydrogenase Mutation

This study examines whether surgical resection of carotid body tumors (CBTs) is acceptable in light of potential significant neurologic complications. This IRB-approved retrospective study analyzed data from 24 patients undergoing surgical treatment for CBTs between April 1998 and April 2017 at Mayo Clinic (Florida campus only). For patients who underwent multiple CBT resections, only data from the first surgery was used in this analysis. CBT resection occurred in 24 patients with the following demographics: fourteen patients (58.3%) were female, median age was 56.5 years, median BMI was 29. A prior history of neoplasm was found in ten patients (41.7%). A known family history of paraganglioma was present in five patients (20.8%). Two patients were positive for succinate dehydrogenase mutation (8.3%). Multiple paragangliomas were present in seven patients (29.2%). There was nerve sacrifice in three patients (12.5%) during resection. Carotid artery reconstruction and patch angioplasty occurred in one patient (4.2%). Complete resection occurred in 24 patients (100.0%). Postoperatively, one patient (4.2%) suffered stroke. No mortalities occurred within or beyond 30 days of surgery. Persistent cranial nerve injury occurred in two patients (8.3%) with vocal cord paralysis. There was no recurrence of CBT through last follow-up. Five patients (20.8%) were diagnosed with other neoplasms after resection, including basal cell carcinoma, contralateral carotid body tumor, glomus vagale, and glomus jugulare. There was 100% survival at 1 year in patients followed for that time ( n = 17). Surgical treatment remains the first-line curative treatment to relieve symptoms and ensure non-recurrence. While acceptable, neurologic complications are significant and therefore detailed preoperative informed consent is mandatory.

scholarly journals DPP-4 as a Possible Biomarker of Inflammation Before Abdominal Surgery for Chronic Pathology: Our Experience with Elective Cholecystectomy

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 148
Author(s):  
Liliana Valencia-Sánchez ◽  
Rafael Almendra-Pegueros ◽  
Luis Jose Diaz R-Valdez ◽  
David Esmer-Sánchez ◽  
Úrsula Medina ◽  
...  
Keyword(s):  
Serum Levels ◽  
Cross Sectional ◽  
Dipeptidyl Peptidase 4 ◽  
Inflammatory Protein ◽  
Preoperative Serum ◽  
History Of ◽  
Statistical Program ◽  
Early Biomarker ◽  
The Difference ◽  
Elective Cholecystectomy

Background and objectives: Dipeptidyl-Peptidase 4 (DPP-4) is a protein expressed in numerous cells and tissues. Recently it has shown its involvement as a catalyst in the inflammatory response in various pulmonary, autoimmune, intestinal and other pathologies. The objective of this study was to compare the preoperative serum levels of DPP-4 in patients with and without surgical finding of perivesicular inflammation. Materials and methods: a cross-sectional analytical study nested in a prospective cohort, including patients scheduled for elective cholecystectomy, without surgical complications, that were 18–70 years of age, with low cardiovascular risk, without a history of peritonitis, pancreatitis, or jaundice and underwent ERCP protocol, type 2 diabetes mellitus, acute inflammatory (Protein C Reactive < 3 mg/L, leucocytes < 10 1000/mm3), neoplastic, nephrologic or liver disease, the use of anti-inflammatory drugs, steroids and/or antibiotics, the use of pacemakers or metallic implants and without major amputations and whom agreed to participate by providing their informed consent. Ethical and Research register: 45–16. Prior to surgery we compiled anthropometric data and a blood sample to determine the serum levels of DPP-4. The presence of perivesicular inflammation was determined in the surgery. The data was analyzed using the statistical program Rstudio. Results: High BMI values were observed (27.8 ± 6.4); waist circumference (94.7 ± 15.1) and percentage of fat mass (34.7 ± 11.7), showing a cumulative frequency of 65.9% for overweight/obesity. In 27.3% of the interventions, intraoperative perivesicular inflammation findings were reported. The serum levels of DPP-4 were lower in the group of patients with perivesicular inflammation (3947.6 ± 1659.5 vs. 3053.2 ± 1469.6, LC95% of the difference: 160.4–1628.3), being statistically significant (p = 0.018). Conclusions: In the subacute or chronic phases of cholecystitis, there appears to be a constant consumption of DPP-4, which would modulate a better immune response that could be related to the reduction of postoperative complications, so the use of Serum levels of DPP-4 as an early biomarker could improve the diagnostic accuracy of this pathology and the surgical approach.

scholarly journals Preoperative serum CA-125 level as a predictor for the extent of cytoreduction in patients with advanced stage epithelial ovarian cancer

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sebastjan Merlo ◽  
Nikola Besic ◽  
Eva Drmota ◽  
Nina Kovacevic
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Progression Free Survival ◽  
Patient Characteristics ◽  
Serum Levels ◽  
Primary Treatment ◽  
Ca 125 ◽  
Advanced Stage ◽  
Debulking Surgery ◽  
Preoperative Serum

AbstractBackgroundOvarian cancer is the seventh most common cancer in women worldwide and the eighth most common cause of cancer death. Due to the lack of effective early detection strategies and the unspecific onset of symptoms, it is diagnosed at an advanced stage in 75% of cases. The cancer antigen (CA) 125 is used as a prognostic marker and its level is elevated in more than 85% of women with advanced stages of epithelial ovarian cancer (EOC). The standard treatment is primary debulking surgery (PDS) followed by adjuvant chemotherapy (ACT), but the later approach is neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). Several studies have been conducted to find out whether preoperative CA-125 serum levels influence treatment choice, surgical resection and survival outcome. The aim of our study was to analyse experience of single institution as Cancer comprehensive center with preoperative usefulness of CA-125.Patients and methodsAt the Institute of Oncology Ljubljana a retrospective analysis of 253 women with stage FIGO IIIC and IV ovarian cancer was conducted. Women were divided into two groups based on their primary treatment. The first group was the NACT group (215 women) and the second the PDS group (38 women). The differences in patient characteristics were compared using the Chi-square test and ANOVA and the Kaplan-Meier method was used for calculating progression-free survival (PFS) and overall survival (OS).ResultsThe median serum CA-125 level was higher in the NACT group than in the PDS group, 972 IU/ml and 499 IU/ ml, respectively. The PFS in the NACT group was 8 months (95% CI 6.4–9.5) and 18 months (95% CI 12.5–23.4) in the PDS group. The median OS was lower in the NACT group than in the PDS group, 25 months (95% CI 20.6–29.5) and 46 months (95% CI 32.9–62.1), respectively.ConclusionsPreoperative CA-125 cut off value of 500 IU/ml is a promising threshold to predict a successful PDS.

scholarly journals Epidemiology of ovarian cancer in Assiut Governorate, Egypt

2018 ◽  
Vol 7 (11) ◽  
pp. 4575
Author(s):  
Mahmoud Ahmed Gharib ◽  
Mahmoud Hussein El-Shoeiby ◽  
Nagy Mohammed Metwally ◽  
Yostina Maher Rashid
Keyword(s):  
Ovarian Cancer ◽  
Outpatient Clinic ◽  
Malignant Tumors ◽  
Serum Levels ◽  
Average Level ◽  
Ca 125 ◽  
Obstetrics And Gynecology ◽  
Tumor Biomarker ◽  
Seer Data ◽  
History Of

Background: The aim of this study is to assess ovarian cancer epidemiology and detect its prognostic factors in Assuit, Egypt.Methods: This retrospective study was performed between January 2010 and December 2015, on all cases attending to Obstetrics and Gynecology Outpatient Clinic in all central hospitals in Assiut. 378 females (≥40 years old) came to Obstetrics and Gynecology Outpatient Clinic from January 2010 to December 2015. Inclusion criteria: All females (≥40 years old), history of current acute or chronic pelvic pain, mass; fixed, hard consistency, history of previous similar condition.Results: Mean age for whole ovarian cancer cases in this study was 56.44±10.08 (range, 40-85). Nulliparity was found in one case (0.3%), while multiparity was found in 252 cases (66.7%). Grand multiparity was found in 113 cases (29.9%). Twelve cases (3.2%) were virgin. Vaginal ultrasound can find all ovarian cancer cases. Regarding the serum levels of the tumor biomarker, CA-125, the average level of CA-125 is 300-1000 U/ml with 34.9% of cases had readings below to 300-1000 U/ml and 6.1% of cases had readings above to this average level. Regarding treatment, treatment combining surgery with chemotherapy was the main line of management in present study (46.3%). About 33.3% of cases underwent surgery, while only 18.3% took the chance of chemotherapy. Eight cases (2.1%) had no treatment.Conclusions: Epithelial ovarian cancer is a lethal disease. The age incidence of ovarian cancer in present patients is ten years younger than what is re¬ported in US SEER data and other Western countries. CA-125 level and ultrasonography are increasing the rate of suspicious for diagnosis of malignant tumors.

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