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Thanh Ha Nguyen M, Varma N, Lan Cheong Wah D, Chew R, Botha T, Kouloyan-Ilic S, Paiva J. Performance of contrast-enhanced mammography for detecting multifocal and multicentric breast cancer and evaluating tumour size, and implications for surgical management: Early experience in a tertiary centre. J Med Imaging Radiat Oncol 2023. [PMID: 38146085 DOI: 10.1111/1754-9485.13616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/14/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION To compare diagnostic accuracy of contrast-enhanced mammography (CEM) with standard 2D digital mammography (equivalent to low-energy image; LEM) for detection of multifocal and multicentric breast cancer and evaluation of tumour size and disease extent for preoperative planning. METHODS Biopsy proven breast cancer patients who underwent CEM preoperatively between January 2021 and January 2023 were included in this study. CEM and LEM images were independently reviewed by at least two blinded readers. Lesion location, number, size (maximal diameter) and extension across the midline and/or nipple invasion were recorded. Tumour number and size estimated on imaging were compared with final operative histology, which served as the gold standard. RESULTS Forty-nine patients (48 females and 1 male) and 50 cases (one patient had bilateral breast lesions) were included in the analysis. Median patient age was 60 (IQR 51, 69). CEM had significantly higher lesion detection rate compared with LEM, with sensitivities of 78% for LEM and 92% for CEM for the index tumour and 15% for LEM and 100% for CEM for multicentric and multifocal cancer. We found no statistically significant difference in median tumour size measurements on CEM and final surgical specimen (P value = 0.97); however, a significant difference was identified in the tumour size measured on LEM and surgical specimen (P value < 0.001). CONCLUSION CEM is superior to standard 2D digital mammography for detection of multifocal and multicentric breast cancer and is a reliable and more accurate method for estimating tumour size.
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Affiliation(s)
- Margaret Thanh Ha Nguyen
- Department of Medical Imaging, Western Health - Sunshine Hospital, Melbourne, Victoria, Australia
| | - Nisha Varma
- Department of Medical Imaging, Western Health - Sunshine Hospital, Melbourne, Victoria, Australia
| | - David Lan Cheong Wah
- Department of Breast Surgery, Western Health - Sunshine Hospital, Melbourne, Victoria, Australia
| | - Renny Chew
- Department of Medical Imaging, Western Health - Sunshine Hospital, Melbourne, Victoria, Australia
| | - Tanita Botha
- Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Susan Kouloyan-Ilic
- Department of Medical Imaging, Western Health - Sunshine Hospital, Melbourne, Victoria, Australia
| | - Joseph Paiva
- Department of Medical Imaging, Western Health - Sunshine Hospital, Melbourne, Victoria, Australia
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Ge C, Shen Z, Lu Y, Liu X, Tong Y, Zhang M, Liu Y, Shen H, Zhu L. Propensity score analysis the clinical characteristics of active distal and extensive ulcerative colitis: a retrospective study. Front Physiol 2023; 14:1136659. [PMID: 37457023 PMCID: PMC10349330 DOI: 10.3389/fphys.2023.1136659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/24/2023] [Indexed: 07/18/2023] Open
Abstract
Background and Objectives: Ulcerative Colitis (UC) subtypes defined by disease extent and shared pathophysiology are important. Analyzing the clinical characteristics of UC with different disease extent and optimizing clinical typing are conducive to the pathogenesis research, disease monitoring and precise treatment. Methods: 188 patients with active UC were divided into distal and extensive colitis. The clinical characteristics of the two groups were analyzed by propensity score. Spearman is used for correlation analysis, and receiver operating characteristic (ROC) curve was used to evaluate the ability of clinical indicators to predict Mayo endoscopic subscore (MES). Results: Compared with distal colitis, extensive colitis had more severe disease activity, younger age, higher utilization rate of corticosteroids and incidence of extra intestinal manifestations (EIMs), and clinical indicators were differentially expressed in the two groups. After using propensity score, the incidence of EIMs in the extensive colitis was still higher than that in distal colitis. Inflammation, coagulation and immune indicators like CRP, FC, IL-10, D-D and α1-MG are higher in extensive colitis, and metabolic indicators like LDL-C, HDL-C, TC, GSP and albumin are higher in distal colitis. The correlation between clinical indicators and MES is affected by disease extent. The area under curve (AUC) of CRP + D-D + α2-MG for predicting distal colitis MES3 was 0.85, and the AUC of IL-6+ GSP+ α1-MG predicted extensive colitis MES3 can reach 0.82. Conclusion: Differential clinical indicators can become potential markers for predicting disease progression and prognosis, and have significance for UC mechanism research and drug development. We can select biomarkers according to lesion site.
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Affiliation(s)
| | | | | | | | | | | | | | - Hong Shen
- *Correspondence: Hong Shen, ; Lei Zhu,
| | - Lei Zhu
- *Correspondence: Hong Shen, ; Lei Zhu,
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Montanari E, Bokor A, Szabó G, Kondo W, Trippia CH, Malzoni M, Di Giovanni A, Tinneberg HR, Oberstein A, Rocha RM, Leonardi M, Condous G, Alsalem H, Keckstein J, Hudelist G. Comparison of #Enzian classification and revised American Society for Reproductive Medicine stages for the description of disease extent in women with deep endometriosis. Hum Reprod 2022; 37:2359-2365. [PMID: 36066464 DOI: 10.1093/humrep/deac187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/01/2022] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION How is endometriosis extent described by the #Enzian classification compared to the revised American Society for Reproductive Medicine (rASRM) stages in women undergoing radical surgery for deep endometriosis (DE)? SUMMARY ANSWER The prevalence and severity grade of endometriotic lesions and adhesions as well as the total number of #Enzian compartments affected by DE increase on average with increasing rASRM stage; however, DE lesions are also present in rASRM stages 1 and 2, leading to an underestimation of disease severity when using the rASRM classification. WHAT IS KNOWN ALREADY Endometriotic lesions can be accurately described regarding their localization and severity by sonography as well as during surgery using the recently updated #Enzian classification for endometriosis. STUDY DESIGN, SIZE, DURATION This was a prospective multicenter study including a total of 735 women between January 2020 and May 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS Disease extent in women undergoing radical surgery for DE at tertiary referral centers for endometriosis was intraoperatively described using the #Enzian and the rASRM classification. MAIN RESULTS AND THE ROLE OF CHANCE A total of 735 women were included in the study. Out of 31 women with rASRM stage 1, which is defined as only minimal disease, 65% (i.e. 20 women) exhibited DE in #Enzian compartment B (uterosacral ligaments/parametria), 45% (14 women) exhibited DE in #Enzian compartment A (vagina/rectovaginal septum) and 26% (8 women) exhibited DE in #Enzian compartment C (rectum). On average, there was a progressive increase from rASRM stages 1-4 in the prevalence and severity grade of DE lesions (i.e. lesions in #Enzian compartments A, B, C, FB (urinary bladder), FU (ureters), FI (other intestinal locations), FO (other extragenital locations)), as well as of endometriotic lesions and adhesions in #Enzian compartments P (peritoneum), O (ovaries) and T (tubo-ovarian unit). In addition, the total number of #Enzian compartments affected by DE lesions on average progressively increased from rASRM stages 1-4, with a maximum of six affected compartments in rASRM stage 4 patients. LIMITATIONS, REASONS FOR CAUTION Interobserver variability may represent a possible limitation of this study. WIDER IMPLICATIONS OF THE FINDINGS The #Enzian classification includes the evaluation of DE in addition to the assessment of endometriotic lesions and adhesions of the ovaries and tubes and may therefore provide a comprehensive description of disease localization and extent in women with DE. STUDY FUNDING/COMPETING INTEREST(S) No funding was received for this study. All authors declare that they have no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Eliana Montanari
- Department of Gynecology, Center for Endometriosis, Hospital St. John of God, Vienna, Austria.,Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria
| | - Attila Bokor
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Gábor Szabó
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - William Kondo
- Department of Gynecology and Minimally Invasive Unit, Vita Batel Hospital, Curitiba, Brazil
| | | | - Mario Malzoni
- Endoscopica Malzoni, Centre for Advanced Pelvic Surgery, Avellino, Italy
| | | | | | - Anna Oberstein
- Department of Obstetrics and Gynecology, Nordwest Hospital, Frankfurt, Germany
| | - Rodrigo Manieri Rocha
- Acute Gynecology, Early Pregnancy and Advanced Endoscopy Surgery Unit, Nepean Hospital, Kingswood, NSW, Australia.,Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
| | - Mathew Leonardi
- Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia.,Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
| | - George Condous
- Acute Gynecology, Early Pregnancy and Advanced Endoscopy Surgery Unit, Nepean Hospital, Kingswood, NSW, Australia.,Sydney Medical School Nepean, University of Sydney, Sydney, NSW, Australia
| | - Hanan Alsalem
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
| | - Joerg Keckstein
- Stiftung Endometrioseforschung (SEF), Westerstede, Germany.,Gynecological Clinic Drs Keckstein, Villach, Austria
| | - Gernot Hudelist
- Department of Gynecology, Center for Endometriosis, Hospital St. John of God, Vienna, Austria.,Stiftung Endometrioseforschung (SEF), Westerstede, Germany.,Rudolfinerhaus Private Clinic, Vienna, Austria
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Sood A, Singh A, Mahajan R, Midha V, Kaur K, Singh D, Bansal N, Dharni K. Clinical Predictors of response to Faecal Microbiota Transplantation in patients with active ulcerative colitis. J Crohns Colitis 2020; 15:jjaa163. [PMID: 32772093 DOI: 10.1093/ecco-jcc/jjaa163] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Fecal Microbiota Transplantation (FMT) has been shown to be effective for induction of remission in patients with active ulcerative colitis (UC). At present, clinical factors impacting the response to FMT in UC remain unclear. METHODS Patients with active UC treated with multisession FMT via colonoscopy at weeks 0, 2, 6, 10, 14, 18, and 22, were analysed. Response to FMT was defined as achievement of corticosteroid free clinical remission at week 30. Patient and disease characteristics were evaluated to determine the predictors of response to FMT. RESULTS Out of 140 patients with active UC treated with FMT, 93 patients [mean age 34.96±11.27 years, 62.36% males (n=58), mean Mayo clinic score 8.07±2.00] who completed the multi-session FMT protocol were analysed. Fifty-seven (61.29%) patients achieved clinical remission. Younger age (OR for age 0.93, 95% CI 0.89-0.97, p=0.001), moderate (Mayo clinic score 6-9) disease severity (OR 3.01, 95% CI 1.12 to 8.06, p=0.025) and endoscopic Mayo score 2 (OR 5.55, 95% CI 2.18-14.06, p<0.001) were significant predictors of remission on univariate analysis. Younger age, disease extent E2 and endoscopic mayo score 2 (OR 0.925, 95% CI 0.88-0.97, p=0.002; OR 2.89, 95% CI 1.01-8.25, p=0.04 and OR 8.43, 95% CI 2.38-29.84, p=0.001, respectively) were associated with clinical remission on multivariate logistic regression. A mathematical model (nomogram) was developed for estimating the probability of remission with FMT protocol. CONCLUSION Younger age, disease extent E2, and endoscopic mayo score 2 significantly predict achievement of clinical remission with FMT in active UC. The prediction model can help in selecting individuals for FMT. Validation in larger cohorts is needed.
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Affiliation(s)
- Ajit Sood
- Internal Medicine, DM Gastroenterology, Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Arshdeep Singh
- Internal Medicine, DM Gastroenterology, Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Ramit Mahajan
- Internal Medicine, DM Gastroenterology, Department of Gastroenterology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Vandana Midha
- Internal Medicine, Department of Internal Medicine, Dayanand Medical College, Ludhiana, Punjab, India
| | - Kirandeep Kaur
- Pharmacology, Department of Pharmacology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Dharmatma Singh
- CRC, Research and Development Centre, Dayanand Medical College, Ludhiana, Punjab, India
| | - Namita Bansal
- Statistician, Research and Development Centre, Dayanand Medical College, Ludhiana, Punjab, India
| | - Khushdeep Dharni
- School of Business Studies, Punjab Agricultural University, Ludhiana, Punjab, India
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Tot T, Gere M, Hofmeyer S, Bauer A, Pellas U. The clinical value of detecting microcalcifications on a mammogram. Semin Cancer Biol 2019; 72:165-174. [PMID: 31733292 DOI: 10.1016/j.semcancer.2019.10.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 10/30/2019] [Indexed: 12/22/2022]
Abstract
Many breast lesions are associated with microcalcifications that are detectable by mammography. In most cases, radiologists are able to distinguish calcifications usually associated with benign diseases from those associated with malignancy. In addition to their value in the early detection of breast carcinoma and accurate radiological diagnosis, the presence of microcalcifications often affects the extent of surgical intervention. Certain types of microcalcifications are associated with negative genetic and molecular characteristics of the tumor and unfavorable prognosis. Microcalcifications localized in the larger ducts (duct-centric, casting-type microcalcifications) represent an independent negative prognostic marker compared to lesions containing other types of microcalcifications and to non-calcified lesions. In this review, we summarize the theoretical and methodological background for understanding the clinical impact and discuss the diagnostic and prognostic value of microcalcifications detected in the breast by mammography.
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Affiliation(s)
- Tibor Tot
- Pathology & Cytology Dalarna, County Hospital Falun and Center for Clinical Research Dalarna, Falun, Sweden.
| | - Maria Gere
- Pathology & Cytology Dalarna, County Hospital Falun, Falun, Sweden
| | - Syster Hofmeyer
- Pathology & Cytology Dalarna, County Hospital Falun, Falun, Sweden
| | - Annette Bauer
- Pathology & Cytology Dalarna, County Hospital Dalarna, Falun, Sweden
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Burisch J, Ungaro R, Vind I, Prosberg MV, Bendtsen F, Colombel JF, Vester-Andersen MK. Proximal Disease Extension in Patients With Limited Ulcerative Colitis: A Danish Population-based Inception Cohort. J Crohns Colitis 2017; 11:1200-1204. [PMID: 28486626 PMCID: PMC6279091 DOI: 10.1093/ecco-jcc/jjx066] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 05/06/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Disease extent in ulcerative colitis [UC] is dynamic and can progress over time. Little is known about risk factors for UC extension in the era of biologics. We investigated the risk of UC extension and subsequent risk of surgery in a Danish population-based cohort. METHODS All incident UC cases in a strictly defined Copenhagen area between 2003 and 2004 were followed prospectively through 2011. Disease extension was defined as patients with limited UC [E1 or E2] at diagnosis having progressed from the initial extent by colonoscopy or surgery to E2 or extensive colitis [E3]. Associations between progression or colectomy and multiple covariates were analysed by Cox regression analysis. RESULTS Of 300 UC patients, 220 [73%] had E1 or E2 at diagnosis. During follow-up, 50 [23%] patients with E1/E2 progressed to E3, and 22 [10%] with E1 progressed to E2. Disease extent at diagnosis was the sole predictor of extension to E3. A total of 18 [8%] patients with E1/E2 at diagnosis had a colectomy. Progression from E1/E2 to E3, female gender and a history of smoking were risk factors for colectomy. CONCLUSION After 7 years of follow-up, 33% of patients with limited UC experienced disease extension. Only extent at diagnosis was a clinical predictor for disease extension. The risk of colectomy was increased in former smokers and patients who progressed to extensive colitis. This highlights the need to prevent disease progression in patients with limited UC, and to identify new histological or molecular markers that might help stratify risks for disease progression.
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Affiliation(s)
- Johan Burisch
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark,Corresponding author: Johan Burisch, MD, PhD, Gastrounit, Medical Division, Copenhagen University Hospital, Hvidovre, Kettegård Allé 30, 2750 Hvidovre, Denmark.
| | - Ryan Ungaro
- Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Ida Vind
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Michelle V Prosberg
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Flemming Bendtsen
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Jean-Frederic Colombel
- Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Marianne K. Vester-Andersen
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark,Department of Internal Medicine, Zealand University Hospital, Køge, Denmark
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Abstract
Scientific and clinical communities produce ever increasing amounts of data and details about health and disease. Our ability to understand and utilize this information is limited because of imprecise language and lack of well-defined concepts. This problem involves also the principal concepts of health, disease, and pathogenicity. Here, a systematic model is presented for pathogenicity, as well as for health and disease. It has three components: extent, modulation, and severity, which jointly define the continuum of pathogenicity. The model is population based, and once implemented, it can be used for numerous purposes such as diagnosis, patient stratification, prognosis, finding phenotype-genotype correlations, or explaining adverse drug reactions. The new model has several benefits including health economy by allowing evidence-based personalized/precision medicine.
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Affiliation(s)
- Mauno Vihinen
- Department of Experimental Medical Science, Lund University, BMC B13, Lund, SE-22184, Sweden
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Abstract
The anatomic disease extent or tumour stage of a cancer at diagnosis as a determinant of prognosis is discussed. The importance of cancer stage in individual patient prognosis and determination of treatment is reviewed as well as its value in research and cancer control activities. The conflict between the need for stability of cancer stage definitions over time and the need to evolve with advances in medicine are examined. The ecancer elearning modules on Cancer Stage are introduced.
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Affiliation(s)
- James Brierley
- Department of Radiation Oncology, University of Toronto, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
| | - Mary Gospodarowicz
- Department of Radiation Oncology, University of Toronto, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
| | - Brian O'Sullivan
- Department of Radiation Oncology, University of Toronto, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
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Lobatón T, Bessissow T, De Hertogh G, Lemmens B, Maedler C, Van Assche G, Vermeire S, Bisschops R, Rutgeerts P, Bitton A, Afif W, Marcus V, Ferrante M. The Modified Mayo Endoscopic Score (MMES): A New Index for the Assessment of Extension and Severity of Endoscopic Activity in Ulcerative Colitis Patients. J Crohns Colitis 2015; 9:846-52. [PMID: 26116558 DOI: 10.1093/ecco-jcc/jjv111] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/01/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIMS Current endoscopic activity scores for ulcerative colitis (UC) do not take into account the extent of mucosal inflammation. We have developed a simple endoscopic index for UC that takes into account the severity and distribution of mucosal inflammation. METHODS In this multicentre trial, UC patients undergoing colonoscopy were prospectively enrolled. For the Modified Score (MS), the sum of Mayo Endoscopic Subscores (MESs) for five colon segments (ascending, transverse, descending, sigmoid and rectum) was calculated. The Extended Modified Score (EMS) was obtained by multiplying the MS by the maximal extent of inflammation. The Modified Mayo Endoscopic Score (MMES) was obtained by dividing the EMS by the number of segments with active inflammation. Colon biopsies were obtained from the rectum and sigmoid, as well as from all inflamed segments, by standard methods. Clinical activity was scored according to the Partial Mayo Score (PMS). Biological activity was scored according to C-reactive protein (CRP) and faecal calprotectin (FC) levels. Histological activity was scored according to the Geboes Score (GS). RESULTS One hundred and seventy-one UC patients (38% female, median age 47 years, median disease duration 13 years) were included. The MMES correlated significantly with the PMS (r = 0.535), CRP (r = 0.238), FC (r = 0.730) and GS (r = 0.615) (all p < 0.001). Median MMES scores were significantly higher in patients with clinical, biological or histological activity (all p ≤ 0.001) CONCLUSIONS: The MMES is an easy to use endoscopic index for UC that combines the severity analysis of the MES with disease extent, and correlates very well with clinical, biological and histological disease activity.
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Affiliation(s)
- Triana Lobatón
- Department of Gastroenterology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Talat Bessissow
- Department of Gastroenterology, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Gert De Hertogh
- Department of Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Bart Lemmens
- Department of Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Chelsea Maedler
- Department of Pathology, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Gert Van Assche
- Department of Gastroenterology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Séverine Vermeire
- Department of Gastroenterology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Raf Bisschops
- Department of Gastroenterology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Paul Rutgeerts
- Department of Gastroenterology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Alain Bitton
- Department of Gastroenterology, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Waqqas Afif
- Department of Gastroenterology, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Victoria Marcus
- Department of Pathology, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Marc Ferrante
- Department of Gastroenterology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
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Gospodarowicz M, Brierley J, O'Sullivan B. Principles of Cancer Staging for Clinical Obstetrics and Gynecology. Best Pract Res Clin Obstet Gynaecol 2015; 29:767-75. [PMID: 26231930 DOI: 10.1016/j.bpobgyn.2015.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 05/20/2015] [Indexed: 01/14/2023]
Abstract
Cancer represents a complex group of diseases characterized by uncontrolled growth and the ability to metastasize. Cancer may affect any part of the body, and within the female reproductive systems, there exist a variety of cancers each associated with different presenting symptoms, clinical course, etiology, and natural history of disease. The essential features of each cancer include the presenting site of disease (topography), the histopathologic (morphology), molecular and genetic tumor profile, and the anatomic disease extent (stage). Without knowing these features, it is impossible to discuss investigation, treatment, and prognosis in cancer.
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Affiliation(s)
| | - James Brierley
- Radiation Oncology, University of Toronto, Toronto, ON, Canada
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11
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Deckers IE, van der Zee HH, Boer J, Prens EP. Correlation of early-onset hidradenitis suppurativa with stronger genetic susceptibility and more widespread involvement. J Am Acad Dermatol 2015; 72:485-8. [PMID: 25582541 DOI: 10.1016/j.jaad.2014.11.017] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/11/2014] [Accepted: 11/15/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND The reported mean age of onset of hidradenitis suppurativa (HS) is between 20 and 24 years. Prepubertal onset is thought to be rare. OBJECTIVE We sought to determine the prevalence of early-onset HS and to compare clinical characteristics between early-onset and normal-onset HS in a retrospective study. METHODS Data were collected from 855 patients with HS. Early-onset HS was defined as onset before the thirteenth birthday. Clinical characteristics were analyzed in relation to the age of onset. RESULTS In all, 66 patients (7.7%) reported early-onset HS. A family history for HS was significantly higher in early-onset patients (55.6% vs 34.2%; odds ratio 2.1, 95% confidence interval 1.2-3.6, P = .006). They developed inflammatory lesions at more body sites than patients with normal-onset HS (odds ratio 3.0, 95% confidence interval 1.8-4.9, P < .001). Distribution of the Hurley stages of severity showed no differences between the 2 groups (odds ratio 1.1, 95% confidence interval 0.7-1.8, P = .72). LIMITATIONS Some data were based on patient-reported information. CONCLUSION Early-onset HS occurs more frequently than previously believed. Patients with early-onset HS often report a family history for HS and develop lesions at more body sites.
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Affiliation(s)
- Inge E Deckers
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Hessel H van der Zee
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jurr Boer
- Department of Dermatology, Deventer Hospital, Deventer, The Netherlands
| | - Errol P Prens
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Immunology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Chung KP, Chen JY, Lee CH, Wu HD, Wang JY, Lee LN, Yu CJ, Yang PC. Trends and predictors of changes in pulmonary function after treatment for pulmonary tuberculosis. Clinics (Sao Paulo) 2011; 66:549-56. [PMID: 21655745 PMCID: PMC3095809 DOI: 10.1590/s1807-59322011000400005] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Accepted: 12/17/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The present study aimed to investigate the trends in changes in pulmonary function and the risk factors for pulmonary function deterioration in patients with pulmonary tuberculosis after completing treatment. INTRODUCTION Patients usually have pulmonary function abnormalities after completing treatment for pulmonary tuberculosis. The time course for changes in pulmonary function and the risk factors for deterioration have not been well studied. METHODS A total of 115 patients with 162 pulmonary function results were analyzed. We retrieved demographic and clinical data, radiographic scores, bacteriological data, and pulmonary function data. A generalized additive model with a locally weighted scatterplot smoothing technique was used to evaluate the trends in changes in pulmonary function. A generalized estimating equation model was used to determine the risk factors associated with deterioration of pulmonary function. RESULTS The median interval between the end of anti-tuberculosis treatment and the pulmonary function test was 16 months (range: 0 to 112 months). The nadir of pulmonary function occurred approximately 18 months after the completion of the treatment. The risk factors associated with pulmonary function deterioration included smear-positive disease, extensive pulmonary involvement prior to anti-tuberculosis treatment, prolonged anti-tuberculosis treatment, and reduced radiographic improvement after treatment. CONCLUSIONS After the completion of anti-tuberculosis TB treatment, several risk factors predicted pulmonary function deterioration. For patients with significant respiratory symptoms and multiple risk factors, the pulmonary function test should be followed up to monitor the progression of functional impairment, especially within the first 18 months after the completion of anti-tuberculosis treatment.
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Affiliation(s)
- Kuei-Pin Chung
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
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