scholarly journals Endometriosis - Morphology, clinical presentations and molecular pathology

2010 ◽  
Vol 2 (01) ◽  
pp. 001-009 ◽  
Author(s):  
Neha Agarwal ◽  
Arulselvi Subramanian

ABSTRACTEndometriosis is found predominantly in women of childbearing age. The prevalence of endometriosis is difficult to determine accurately. Laparoscopy or surgery is required for the definitive diagnosis. The most common symptoms are dysmenorrhea, dyspareunia, and low back pain that worsen during menses. Endometriosis occurring shortly after menarche has been frequently reported. Endometriosis has been described in a few cases at the umbilicus, even without prior history of abdominal surgery. It has been described in various atypical sites such as the fallopian tubes, bowel, liver, thorax, and even in the extremities. The most commonly affected areas in decreasing order of frequency in the gastrointestinal tract are the recto-sigmoid colon, appendix, cecum, and distal ileum. The prevalence of appendiceal endometriosis is 2.8%. Malignant transformation is a well-described, although rare (<1% of cases), complication of endometriosis. Approximately 75% of these tumors arise from endometriosis of the ovary. Other less common sites include the rectovaginal septum, rectum, and sigmoid colon. Unopposed estrogens therapy may play a role in the development of such tumors. A more recent survey of 27 malignancies associated with endometriosis found that 17 (62%) were in the ovary, 3 (11%) in the vagina, 2 (7%) each in the fallopian tube or mesosalpinx, pelvic sidewall, and colon, and 1 (4%) in the parametrium. Two cases of cerebral endometriosis and a case of endometriosis presenting as a cystic mass in the cerebellar vermis has been described. Treatment for endometriosis can be expectant, medical, or surgical depending on the severity of symptoms and the patient’s desire to maintain or restore fertility.

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 48-52
Author(s):  
E N Kravchenko ◽  
R A Morgunov

The aim of the study. Assess the importance of pregravid preparation and outcomes of pregnancy and childbirth, depending on the reproductive attitudes of women in the city of Omsk. Materials and methods. The study included 92 women who were divided into groups: group A (n=43) - women whose pregnancy was planned; group B (n=49) - women whose pregnancy occurred accidentally. Each group was divided into subgroups depending on age: from 18 to 30 and from 31 to 49 years. For each patient included in the study, a specially designed map was filled out. These patients were interviewed at the City Clinical Perinatal Center. Results. Comparative analysis revealed the relationship between the reproductive settings of women of childbearing age and the peculiarity of the course of pregnancy and childbirth in these patients. Summary. The majority of women of fertile age are married: in subgroup AA - 25 (96.2%), AB - 13 (76.5%), BA - 25 (92.6%), BB - 20 (91.0%). The predominant number of women of fertile age have one or more abortions: in subgroup AA - 12 (46.2%), AB - 6 (35.3%), in subgroups of comparison BA - 8 (29.6%), BB - 6 (27.3%). More than half of the women of fertile age surveyed have a history of untreated cervical pathology (from 40.8% to 64.7%). The course of pregnancy in women planning pregnancy in most cases proceeded without complications: in subgroup AA - 13 (50.0%), AB - 11 (64.7%). The most common cause of complicated pregnancy in women whose pregnancy occurred accidentally is the threat of spontaneous miscarriage: in subgroup BA - 15 (55.6%), BB - 16 (72.7%). The uncomplicated course of labor more often [subgroup AA - 19 (73.0%), AB - 12 (70.6%)] was observed in women whose pregnancy was planned and they were motivated to give birth to a healthy child.


1996 ◽  
Vol 110 (2) ◽  
pp. 192-195 ◽  
Author(s):  
Thomas W. Mesko ◽  
Julie Friedman ◽  
Harry Sendzischew ◽  
Daniel D. Nixon

AbstractClinically evident metastases to the thyroid gland are rarely found antemortem. A case of a 59-year-old woman with a history of rectal carcinoma, who presented with low back pain and a mass in the right lobe of her thyroid gland, is presented. The tumour of the thyroid was found to be metastatic adenocarcinoma from her previous rectal cancer. Other synchronous metastases were noted in her lumbar spine and kidneys.The clinical finding of metastases to the thyroid gland is rare, particularly from a colorectal primary. One must consider, however, the possibility of a tumour of the thyroid gland representing a secondary malignancy in any patient with a prior history of cancer.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Nour Abdul Halim ◽  
Imad Uthman ◽  
Rayan Rammal ◽  
Hazem I. Assi

Idiopathic granulomatous mastitis is a rare benign inflammatory breast disease that affects women of childbearing age with a history of breastfeeding. It usually presents as an enlarging breast mass that can greatly mimic breast cancer. Moreover, it does not have a specific radiographic finding, so the only way to reach a definitive diagnosis is by core biopsy and histology. Furthermore, a consensus regarding the best treatment modality has not been reached yet. In this report, we describe the cases of two patients who suffered from this disease, and to our knowledge, such a report is the first of its kind to address this topic in this region. Therefore, because of its uncommon nature and obscure presentation, we hereby report two cases of idiopathic granulomatous mastitis. The clinical presentation, treatment, and pathological findings are described, and a literature review on idiopathic granulomatous mastitis will be reported.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Tariku Tesfaye Bekuma ◽  
Belaynesh Firrisa ◽  
Melese Girmaye Negero ◽  
Gemechu Kejela ◽  
Haile Bikila

Background. Access to proper medical attention and hygienic conditions during delivery can reduce the risk of complications and infections that may lead to serious illness or death or for the mother, baby, or both. In Ethiopia, the high maternal mortality rate with delivery by unskilled birth attendants shows low utilization of maternal health services. Objective. This study was aimed at assessing factors determining the choice of childbirth place among women of childbearing age in Jimma Arjo District. Method. A cross-sectional design was conducted in Jimma Arjo District, East Wollega Zone, Ethiopia, from March 20 to April 20, 2018. Multistage sampling technique was used to select a total sample of 506 participants. Data were collected using structured questionnaires to interview women of childbearing age with two trained data collectors. Data was entered into Epi Info and exported to SPSS software version 20 for analysis. Data was checked for its completeness, cleaned, entered, and analyzed accordingly. Bivariate and multivariable data analyses were used to examine factors affecting choice of childbirth place. Results. A total of 506 women participated in this study, giving a response rate of 97.8%. The study investigated that home delivery was found to be 200 (39.5%)in the study area. Factors found to be statistically associated with choice of institutional delivery at p<0.05 were history of obstetric difficulties (AOR=6, 95%CI=2.08,17.60), woman educational status (AOR=4.4, 95%CI=1.47,13.42), husband educational status (AOR=4, 95%CI=1.43,11.60), two or more ANC visits (AOR=4, 95%CI=1.95,8.52), and accessibility to vehicle transportation (AOR=2.8, 95%CI=1.23,6.46). Conclusion. Preferring health facility as the birthplace in this study seems relatively better compared to other studies. It is shown that both mothers and their husbands attending secondary and greater educational level, history of obstetric difficulties, two or more ANC visits, and physical accessibility to health care facility have influenced mothers to prefer a health institution as the childbirth place. Therefore, any programs aimed at increasing the choice of institutional delivery should work on increasing ANC attendance and transportation facilities in the study area.


Ból ◽  
2020 ◽  
Vol 20 (3) ◽  
pp. 51-59
Author(s):  
Marcin Kopka

Low back pain (LBP) is the third most common disorder presenting in the neurology outpatient clinic. It is usually defined as acute (less than 4 weeks), subacute (4–8 weeks) and chronic (more than 12 weeks). It is estimated that lifetime prevalence of up to 84 %. LBP is the most common cause of disability. LBP is divided into musculoskeletal and neurologic low back pain. In 90% of patients under the age of 65 the cause of pain is nerve root compression caused by disk herniation. Although serious spinal pathology is rare (less than 1%), the identification of red flags remains key in the evaluation of patients with LBP. A prior history of cancer, even in the absence of other red flags, has the highest predictive value for detection of malignancy. In conjunction with the history, a careful neurologic examination can help establish the presence and localize the lesion. According to guidelines imaging studies should not be obtained in patients with LBP of less than 6 weeks duration in the absence of red flags. Magnetic resonance imaging is the study of choice in patients with LBP. It allows for optimal visualization of the spinal cord, nerve roots and intervertebral discs. The results of MRI should be interpreted with caution because incidental degenerative spine changes unrelated to the pain are commonly seen in MRI. The main goals of treatment the patients presenting with acute LBP are reduction of pain and preservation of sensory and motor function. In the absence of red flags, for most cases conservative management will be appropriate. Prognosis are favorable, although recurrence rates range from 23% to 80%.


Blood ◽  
2012 ◽  
Vol 120 (2) ◽  
pp. 275-284 ◽  
Author(s):  
Francesco Passamonti

Abstract Polycythemia vera (PV) is a clonal disorder characterized by unwarranted production of red blood cells. In the majority of cases, PV is driven by oncogenic mutations that constitutively activate the JAK-STAT signal transduction pathway, such as JAK2 V617F, or exon 12 mutations or LNK mutations. Diagnosis of PV is based on the WHO criteria. Diagnosis of post-PV myelofibrosis is established according to the International Working Group for Myeloproliferative Neoplasms Research and Treatment criteria. Different clinical presentations of PV are discussed. Prognostication of PV is tailored to the most frequent complication during follow-up, namely, thrombosis. Age older than 60 years and prior history of thrombosis are the 2 main risk factors for disease stratification. Correlations are emerging between leukocytosis, JAK2(V617F) mutation, BM fibrosis, and different outcomes of PV, which need to be confirmed in prospective studies. In my practice, hydroxyurea is still the “gold standard” when cytoreduction is needed, even though pegylated IFN-alfa-2a and ruxolitinib might be useful in particular settings. Results of phase 1 or 2 studies concerning these latter agents should however be confirmed by the ongoing randomized phase 3 clinical trials. In this paper, I discuss the main problems encountered in daily clinical practice with PV patients regarding diagnosis, prognostication, and therapy.


2017 ◽  
Vol 30 (2) ◽  
pp. 265-271 ◽  
Author(s):  
Silvia Maffoni ◽  
Rachele De Giuseppe ◽  
Fatima Cody Stanford ◽  
Hellas Cena

AbstractSeveral studies have described a positive association between elevated BMI and birth defects risk. Data on plasma concentration of folate in pregnant women with obesity have shown values far below those recommended, regardless of diet, while folate levels should increase before pregnancy to reduce neural tube defects. We report a descriptive review of the most recent studies (from 2005 to 2015) to evaluate folate status through a population of women of childbearing age affected by obesity. The literature contains few studies, which present conflicting results regarding folate status in non-pregnant women of childbearing age affected by obesity, and it appears that there is a modification in folate metabolism, with a reduction in plasma folate levels and an increase in erythrocyte folate uptake. In conclusion, the folate status in women of childbearing age should be assessed by both plasma and erythrocyte levels to start a personalised and more adequate supplementation before conception. Further studies need to be conducted in a larger population, which take into account variables that can affect folate metabolism, such as dietary intake, lifestyle and genetic factors, oral contraceptives or other drug use, previous weight-loss programmes, or a history of bariatric surgery.


2019 ◽  
Author(s):  
Tariku Tesfaye Bekuma ◽  
Belaynesh Firrisa ◽  
Melese Girmaye ◽  
Haile Bikila ◽  
Gemechu Kejela

Abstract Background: Maternal death is the most extreme consequence of poor maternal health. More than 30 million women in developing regions suffer from serious diseases and disabilities due to inadequate care during pregnancy and delivery. Access to proper medical attention and hygienic conditions during delivery can reduce the risk of complications and infections that may lead to death or serious illness for the mother, baby, or both. In Ethiopia, the high maternal mortality rate with delivery by unskilled birth attendants shows low utilization of maternal health services.Objective: This study was aimed to assess factors determining the choice of childbirth place among women of childbearing age in Jimma Arjo District.Method A cross-sectional study design was conducted in Jimma Arjo District East Wollega Zone, Ethiopia, from March 20 to April 20, 2018. Multistage sampling technique was used to select a total sample of 506 participants. Data were collected using structured questionnaires to interview women of childbearing age. It was entered into Epi-Info and was exported to SPSS software version 20 for analysis. Data was checked for its completeness, cleaned, entered and analyzed accordingly. Bivariate and Multivariable data analysis was used to examine the association between dependent and independent variables. Result: A total of 506 women participated in this study, giving a response rate of 97.8%. This study has investigated that home delivery was found to be 200(39.5%) whereas institutional delivery was 306(60.5%) in the study area. Factors found to be statistically associated with choice of institutional delivery at p<0.05 were; history of obstetric difficulties (AOR=6, 95% CI= (2.08, 17.60)), women educational status(AOR = 4.4, 95% CI= (1.47, 13.42)), husband educational status (AOR=4, 95% CI= (1.43, 11.60)), having 2-3 ANC Visits (AOR=4, 95%CI= (1.95, 8.52)), and accessing vehicle transportation (AOR = 2.8, 95% CI= (1.23, 6.46)).Conclusion: Preferring health facility as birth place in this study seems relatively better compared to other studies. It’s shown that attending secondary and more educational level in both mothers’ and their husbands’, history of obstetric difficulties, history of ANC attendance, having 2-3 ANC visits, and accessing facilty nearby have influenced mothers to prefer health institution as childbirth place. Therefore, any programs aimed at increasing choice of institutional delivery should first work on education, ANC follow up and transportation facilities in the study area.


2021 ◽  
Vol 14 (5) ◽  
pp. e241597
Author(s):  
Harkirat Singh Talwar ◽  
Vikas Kumar Panwar ◽  
Rudra Prasad Ghorai ◽  
Ankur Mittal

Urolithiasis is the most common non-obstetric complication in pregnancy and has the potential to cause grave consequences resulting in pregnancy loss. We present two such cases. First, a 24-year-old woman, 5 weeks pregnant with a history of urolithiasis presented with right flank pain and fever. She was found to have a right perinephric collection and during the course of her treatment suffered an abortion. The second case was a 25-year-old woman who presented in septic shock. She underwent emergency lower segment caesarean section elsewhere 10 days ago for intrauterine death at 38 weeks of gestation. On evaluation, she was found to have bilateral stone disease with a left subcapsular haematoma. Both the cases were managed conservatively and are planned for definitive management. Thus, women of childbearing age with diagnosed urolithiasis should get themselves evaluated and be free of stone disease before planning a family to prevent increased obstetric complications during pregnancy.


Author(s):  
Karla L. Thompson ◽  
William Filer ◽  
Matthew Harris ◽  
Michael Y. Lee

Traumatic brain injury (TBI) is a leading cause of death and disability throughout the world, particularly among young adults, affecting untold numbers of women of childbearing age. TBIs can disrupt almost any aspect of physical, cognitive, and/or emotional functioning, potentially complicating a woman’s ability to conceive, carry, and deliver a healthy child. For women who are already pregnant and sustain a TBI, medical stabilization of the mother and management of risk of further injury to the fetus are priorities. For women with a previous history of TBI, comprehensive assessment and optimal management of common sequelae of TBI (eg, seizures, endocrine dysfunction, physical and cognitive impairments, and neuropsychiatric symptoms) are essential to maximizing outcomes for both mother and child. Consultation with physiatry and neuropsychology, utilization of rehabilitation therapies to maximize the mother’s functional recovery, and consistent communication among all medical team members throughout pregnancy are essential.


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