scholarly journals Association between Endometrial Polyps and Chronic Endometritis: Is It Time for a Paradigm Shift in the Pathophysiology of Endometrial Polyps in Pre-Menopausal Women? Results of a Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2182
Author(s):  
Amerigo Vitagliano ◽  
Mariangela Cialdella ◽  
Rossana Cicinelli ◽  
Carla Mariaflavia Santarsiero ◽  
Pantaleo Greco ◽  
...  
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Pathological Process ◽  
Reproductive Age ◽  
Secondary Outcome ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Menopausal Women ◽  
Quantitative Synthesis

Background: Chronic endometritis (CE) and endometrial polyps (EPs) are common conditions in reproductive age women. CE is an infectious disorder of the endometrium characterized by signs of chronic inflammation at hysteroscopic and histological analyses. EPs are abnormal endometrial growths containing glands, stroma and blood vessels projecting from the lining of the uterus. During the last years, different authors have investigated the correlation between CE and EPs, with controversial results. The aim of this study was to summarize available evidence on the potential correlation between CE and EPs. Design: Systematic literature review and meta-analysis. Methods: Observational-studies were identified by searching electronic databases from their inception to September 2021. Only studies on pre-menopausal women were included. Statistical analysis was performed using MedCalc 16.4.3 (Ostend, Belgium) and Review Manager version 5.3 (Nordic Cochrane Centre, Cochrane Collaboration). The summary measures were reported as pooled proportion or odds ratio (OR) with 95% confidence interval (CI). The primary outcome was to evaluate the prevalence of CE in women with EPs. The secondary outcome was to determine the prevalence of CD-138-positive EPs among EPs. Tertiary outcomes were to compare the prevalence of CE in women with EPs versus women with a non-polypoid endometrium and to compare the prevalence of CE in women with a single EP versus women with multiple EPs. Results: Eight observational studies (n = 3225 patients) were included in quantitative synthesis. Pooled prevalence of CE among women with EPs was 51.35% (95% CI, 27.24–75.13%). Pooled proportion of CD-138-positive EPs among EPs was 70.73% (95% CI, 55.73–83.68%). Women with EPs showed higher prevalence of CE compared to women without EPs (OR 3.07, 95% CI 1.59–5.95). Women with ≥3 EPs had higher prevalence of CE then women with a single EP (OR 3.43, 95% CI 1.83–6.46). Conclusions: In pre-menopausal women, CE and EPs may have a dependent relationship and may represent two consequent steps of a common pathological process.

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

Effectiveness of Acupuncture in Postpartum Depression: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 36 (5) ◽  
pp. 295-301 ◽  
Author(s):  
Shanshan Li ◽  
Weiqiang Zhong ◽  
Wen Peng ◽  
Gaofeng Jiang
Keyword(s):  
Postpartum Depression ◽  
Rating Scale ◽  
Meta Analysis ◽  
Depression Scale ◽  
Cochrane Collaboration ◽  
Clinical Effectiveness ◽  
Effective Rate ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Control Group

Objective To assess the clinical effectiveness of acupuncture in the treatment of postpartum depression (PPD). Methods The following electronic databases were systematically searched: PubMed, Cochrane Library, SCI, Elsevier SDOL, China National Knowledge, Wan Fang database and Chinese Science and Technology Periodical Database. Only randomised controlled trials (RCTs) of acupuncture for PPD were considered. Primary outcomes were the Hamilton Rating Scale for Depression (HAMD) or the Edinburgh Postnatal Depression Scale (EPDS) scores and effective rate. Our secondary outcome was the level of oestradiol. The quality of all included trials was evaluated according to the Cochrane Collaboration. This protocol was registered in PROSPERO (CRD42016048528). Results Nine trials involving 653 women were selected. The result of this meta-analysis demonstrated that the acupuncture group had a significantly greater overall effective rate compared with the control group (seven trials, n=576, I2=24%; relative risk (RR) 1.15, 95% CI 1.06 to 1.24; P<0.001). Moreover, acupuncture significantly increased oestradiol levels compared with the control group (mean difference (MD) 36.92, 95% CI 23.14 to 50.71, P<0.001). Regarding the HAMD and EPDS scores, no difference was found between the two groups (five trials, n=276, I2=82%; MD−1.38, 95% CI −3.40 to 0.64; P=0.18; two trials, n=60, I2=16%; MD 1.08, 95% CI −1.09 to 3.26; P=0.33). Conclusions Acupuncture appears to be effective for postpartum depression with respect to certain outcomes. However, the evidence thus far is inconclusive. Further high-quality RCTs following standardised guidelines with a low risk of bias are needed to confirm the effectiveness of acupuncture for postpartum depression.

Treatment Emergent Sexual Dysfunction Related to Antidepressants: A Meta-analysis

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Chiesa ◽  
A. Serretti ◽  
R. Calati ◽  
D. de Ronchi
Keyword(s):  
Sexual Dysfunction ◽  
Meta Analysis ◽  
Antidepressant Drugs ◽  
Cochrane Collaboration ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Open Label ◽  
Significant Difference ◽  
Total Treatment ◽  
The Cochrane Collaboration

Objective:Sexual dysfunction is an important under-estimated side effect of antidepressant drugs. Patients, in fact, if not directly questioned, tend to scarcely report them. Thus, the aim of the present meta-analysis is to quantify sexual dysfunction caused by antidepressants on the basis of studies where sexual functioning was purposely investigated through direct inquiry and specific questionnaires.Methods:A literature search was conducted using Medline, Isi web of Knowledge and references of selected articles. Selected studies performed on patients without previous sexual dysfunction were entered in the Cochrane Collaboration Review Manager Software (RevMan version 4.2). Our primary outcome measure was the rate of total treatment emergent sexual dysfunction. Our secondary outcome measures were the rates of treatment emergent desire, arousal and orgasm dysfunction.Results:Our analyses indicated significantly higher rates of treatment emergent sexual dysfunction as well as specific phases dysfunction compared to placebo for the following drugs: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, venlafaxine, clomipramine, imipramine and phenelzine, whereas no significant difference with placebo was found for the following antidepressants: amineptine, bupropion, moclobemide, mirtazapine and nefazodone. Nonetheless sufficient evidences (>100 subjects) are available only for bupropion, citalopram, fluoxetine, paroxetine, sertraline and venlafaxine.Discussion:Present evidence on treatment emergent sexual dysfunction caused by antidepressant is sufficiently studied only for few drugs. Furthermore some statistical limiting assumptions, as the inclusion of open label or small studies and the presence of an evident publication bias, could reduce the significativity of our findings. Thus, treatment emergent sexual dysfunction should be more deeply investigated.

scholarly journals Surgical Management of Endometrial Polyps in Infertile Women: A Comprehensive Review

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Nigel Pereira ◽  
Allison C. Petrini ◽  
Jovana P. Lekovich ◽  
Rony T. Elias ◽  
Steven D. Spandorfer
Keyword(s):  
Observational Studies ◽  
Detrimental Effect ◽  
Expectant Management ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Vitro Fertilization ◽  
Infertile Women ◽  
The Cost ◽  
Infertile Patients

Endometrial polyps are benign localized lesions of the endometrium, which are commonly seen in women of reproductive age. Observational studies have suggested a detrimental effect of endometrial polyps on fertility. The natural course of endometrial polyps remains unclear. Expectant management of small and asymptomatic polyps is reasonable in many cases. However, surgical resection of endometrial polyps is recommended in infertile patients prior to treatment in order to increase natural conception or assisted reproductive pregnancy rates. There is mixed evidence regarding the resection of newly diagnosed endometrial polyps during ovarian stimulation to improve the outcomes of fresh in vitro fertilization cycles. Hysteroscopy polypectomy remains the gold standard for surgical treatment. Evidence regarding the cost and efficacy of different methods for hysteroscopic resection of endometrial polyps in the office and outpatient surgical settings has begun to emerge.

scholarly journals Effects of Cigarette Smoking on Retinal and Choroidal Thickness: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Tian-Ke Yang ◽  
Xiao-Gang Huang ◽  
Jing-Yan Yao
Keyword(s):  
Cigarette Smoking ◽  
Tobacco Smoking ◽  
Observational Studies ◽  
Choroidal Thickness ◽  
Meta Analysis ◽  
Future Research ◽  
Cross Sectional ◽  
Thickness Change ◽  
Subgroup Analyses ◽  
Quantitative Synthesis

Background. Cigarette smoking has been regarded as a risk factor for the incidence of a wide variety of chronic illness; however, its effect on thickness of the retina or choroid is still unknown. Methods. A consummate literature search was conducted in PubMed and Embase up to January, 2018. The quantitative synthesis was conducted by Stata 12.0. Results. A total of 13 observational studies were included in this meta-analysis. In this meta-analysis of all available observational studies, no significant effect of tobacco smoking on retinal or choroidal thickness change was detected. However, advanced analyses showed that smoking would influence the thickness of RNFL (average: SMD, −0.332; 95% CI, −0.637 to −0.027; inferior: SMD, −0.632; 95% CI, −1.092 to −0.172; and superior: SMD, −0.720; 95% CI, −0.977 to −0.463) and GCL (superior: SMD, −0.549; 95% CI, −0.884 to −0.215; inferior: SMD, −0.602; 95% CI, −0.938 to −0.265). Meanwhile, subgroup analyses demonstrated that the results based on studies in some regions (America and Africa) and cross-sectional studies showed a reduced choroidal thickness in smokers. No publication bias was detected in this study. Conclusion. In conclusion, no significant effect of tobacco smoking on retinal or choroidal thickness change was detected. However, smoking would influence the thickness of RNFL and GCL. Future research on this field would help in the prevention and treatment of smoking-associated disorders.

The prevalence of depression in menopausal women in China: A meta-analysis of observational studies

2019 ◽  
Vol 256 ◽  
pp. 337-343 ◽  
Author(s):  
Liang-Nan Zeng ◽  
Yuan Yang ◽  
Yuan Feng ◽  
Xiling Cui ◽  
Rixin Wang ◽  
...  
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Menopausal Women ◽  
Prevalence Of Depression

scholarly journals Prevalence of the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) in Patients With Brucellosis: A Meta-Analysis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A525-A525
Author(s):  
Mouhand F H Mohamed ◽  
Mhd Baraa Habib ◽  
Arwa Alsaud ◽  
Ashraf O Ahmed
Keyword(s):  
Antidiuretic Hormone ◽  
Observational Studies ◽  
Meta Analysis ◽  
Middle Eastern ◽  
Hormone Secretion ◽  
Adverse Outcomes ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Antidiuretic Hormone Secretion ◽  
Quantitative Synthesis ◽  
Chronic Fever

Abstract Background: Hyponatremia is prevalent amongst hospitalized patients and is associated with adverse outcomes. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a common cause of hyponatremia. In our experience in a middle eastern country, we observed a relationship between brucellosis and SIADH associated hyponatremia. Nonetheless, there is limited literature describing this association. Thus, we aimed to systematically review the literature and pool the prevalence of SIADH in patients with brucellosis. Methods: We comprehensively searched PubMed, EMBASE, and Google scholar (first 100 hits) for observational studies ascertaining the prevalence of SIADH in brucellosis patients. We had no age, language, or date limitations. We used a proportion meta-analysis utilizing the random-effects model with double arcsine transformation. I2 was used to ascertain heterogeneity. We used MetaXl software for statistical analysis. The protocol was preregistered at PROSPERO. Results: Our search in PubMed and EMBASE retrieved 107 articles, of which only four observational studies were relevant. Aysha et al. conducted the first analysis of 58 brucellosis patients in which 24% had sodium levels of less than 130 mmol/L. We excluded this study from our quantitative synthesis as the SIADH prevalence could not be accurately ascertained. Finally, the quantitative synthesis comprised three studies encompassing 306 patients and revealed a pooled SIADH prevalence of 20% (95% CI 0-52%, I2 96%). The quality assessment revealed low to moderate quality of included studies. Conclusion: The reported prevalence of SIADH in individual studies included in our analysis ranged from 3-56%. The results were heterogeneous, as depicted by a high I2. This varying prevalence is perhaps due to the varying age of included participants, definitions used by the primary studies, and the included data’s observational nature. Nonetheless, our meta-analysis revealed a relatively high prevalence of SIADH of 20% in patients with brucellosis. Hence, hyponatremia in patients with chronic fever should prompt a workup for SIADH and brucellosis, especially in endemic areas for brucellosis. Larger prospective studies are needed to ascertain the exact prevalence of SIADH in this patient cohort and its impact on the overall prognosis.

scholarly journals MORPHOLOGICAL FEATURES OF UTERINE POLYPS IN FEMALES OF REPRODUCTIVE AGE

2019 ◽  
pp. 47-52 ◽  
Author(s):  
N. Ye. Gorban ◽  
T. D. Zadorozhna ◽  
I. B. Vovk ◽  
I. V. Zhulkevych
Keyword(s):  
Inflammatory Process ◽  
Morphological Features ◽  
The Body ◽  
Reproductive Age ◽  
Inflammatory Factor ◽  
Medical Sciences ◽  
Women Of Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis

According to modern views based on evidence-based medicine, the concept of "poly-endometrium" is defined as a benign, exophytic nodophilic formation of the uterine mucus that consists of glands and stroma, predominantly fibrous, containing a "tangle" of thick-walled blood vessels. The aim of the study – to learn the morphological features of tissues of polyps of the body of the uterus and endometrium with the establishment of the role of inflammatory factor in the pathogenesis of hyperproliferative changes in women of reproductive age. Materials and Methods. The article presents the results of a survey of 62 patients of reproductive age with polyps in the body of the uterus. The presence of the glandular component in 79.03 % of cases, fibrotic polyps – 12.9 %, and micro-polyps – 8.06 % were determined, respectively. The combination of polyps with non-atypical endometrial hyperplasia was detected in 80 % of patients with micro-polyposis, in 63.6 % of women – with glandular-cystic polyps of the uterine body, in 44.4 % of the examined – with glandular-fibrous endometrial polyps and in 37.5 % of patients – with fibrous polyps. Immunohistochemically, CD138 expression was detected both in the tissues of the polyps of the uterus and adjacent endometrial tissues in 43.5 % of cases, which became a marker of the chronic endometritis in the part of the surveyed, which formed the basis of the pathogenetic approaches in the treatment of such a pathology. For processing data standard procedures using Microsoft Excel were used. The research was conducted in the Laboratory of Pathomorphology of the Department of O. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the National Academy of Medical Sciences of Ukraine, head of the department – Corresponding Member of the National Academy of Medical Sciences of Ukraine, Professor T. Zadorozhna. Results and Discussion. In clinical analysis of complaints of polyps of the body of the uterus, clinical manifestations in the form of menstrual cord disturbance were 13 (20.97 %) patients, in 11 (17.74 %) patients there were no complaints about the desired pregnancy, at the same time as 38 (61.29 %) women were asked to carry out a preventive examination, which does not contradict the results of other researchers. During the morphological study, we established the following features of the polyps of the body of the uterus in women of reproductive age: the most frequently tested polyps of the body of the uterus, which had the glandular component – in 49 (79.03 %) cases, of which the glandular-cystic structure was found in 22 (35.48 %) of patients, the glandular-fibrous structure was in 27 (43.55 %) patients, approximately the same values ​​were found in fibrous polyps of the body of the uterus – 8 (12.90 %) of women and micropolymers of endometrium – in 5 (8.06 %) cases respectively. We found that in all groups of patients with polyps in the body of the uterus, there were signs of non-atypical hyperplasia of the endometrium. It should be noted that, according to literature, endometrial polyps larger than 15 mm were associated with hyperplasia. The above data is an important indication that the unidirectional determination of the positive expression of the CD138 inflammatory marker, both in the tissue of the polyp of the uterus and in the endometrial tissue, indicates the unity of the inflammatory factor in the pathogenesis of hyperproliferative processes and proves the significant role of the inflammatory process in the development of its pathological conditions and justifies the necessity take into account this fact in approaches to the tactics of patient management. Conclusions. The results of the conducted morphological and immunohistochemical research indicate that the basis of the formation of polyps of the body of the uterus is the inflammatory process, which is confirmed morphologically with the presence of chronic endometritis and a positive reaction to CD138. The study of pathogenetic mechanisms for the formation of endometrial pathology is a key factor in the development of methods for correction of these pathological processes, which thus allows to increase the efficiency of treatment and preserve reproductive health.

scholarly journals Gender differences in symptomatology in people with psychotic spectrum disorders: protocol for a systematic review and pairwise meta-analysis of observational studies

2021 ◽  
Author(s):  
Helena García Mieres ◽  
Marta Ferrer Quintero ◽  
Irene Bighelli ◽  
Judith Usall ◽  
Susana Ochoa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gender Differences ◽  
Observational Studies ◽  
Meta Analysis ◽  
Men And Women ◽  
Ultra High Risk ◽  
Quantitative Synthesis ◽  
Paranoid Symptoms ◽  
Symptomatic Outcome ◽  
Spectrum Disorders

Gender differences in symptomatology in people with psychosis have been studied extensively in last decades. Previous narrative reviews have shown some evidence of gender differences in depressive, negative and paranoid symptoms, but yielding inconclusive findings. These reviews are limited by not doing systematic searches nor performing quantitative synthesis of the evidence. Therefore, we aimed to systematically investigate if there are gender differences in symptoms in people with psychosis. We describe the protocol for a systematic review and pairwise meta-analysis comparing a range of symptomatic outcome measures between men and women diagnosed with a psychotic spectrum disorder at different stages of the disorder (ultra-high risk for psychosis, early psychosis and established psychosis) in observational studies.

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