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Zhang W, Chai N, Feng Y, Wang J, Wu Q, Liu Z, Linghu E. Cholangioscopy-assisted endoscopic mucosal resection for gallbladder polyp and stone extraction for cholecystocholedocholithiasis. Endoscopy 2024; 56:E303-E304. [PMID: 38569502 PMCID: PMC10990604 DOI: 10.1055/a-2281-9743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Affiliation(s)
- Wengang Zhang
- Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ningli Chai
- Department of Gastroenterology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yujie Feng
- Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
| | - Jiafeng Wang
- Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
| | - Qingzhen Wu
- Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
| | - Zhenyu Liu
- Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
| | - Enqiang Linghu
- Department of Gastroenterology, Chinese PLA General Hospital, Beijing, China
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Miller C, Whitney-Miller C, Ettel MG. Clinical Implications of Microscopic Colitis Isolated to Polyps. Int J Surg Pathol 2024; 32:456-461. [PMID: 37424329 DOI: 10.1177/10668969231185085] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Microscopic colitis is generally identified on random colon biopsies performed for chronic diarrhea, but rarely incidental polyps have histologic features of microscopic colitis. We compared patients with polypoid microscopic colitis to control patients with conventional polyps to determine the implications of polypoid microscopic colitis. Medical records were searched for patients without prior or concurrent microscopic colitis who were found to have polypoid microscopic colitis. For each patient with polypoid microscopic colitis, one patient with conventional polyps was selected as a control. We reviewed the histologic features of each polypoid microscopic colitis specimen, and evaluated endoscopic and clinical findings for polypoid microscopic colitis patients and controls. Twenty-six patients with polypoid microscopic colitis were identified with histologic features of collagenous colitis in 8 patients (31%) and lymphocytic colitis in 18 patients (69%). Polypoid microscopic colitis was unifocal in 14 patients (54%) and multifocal in 12 patients (46%). Patients with polypoid microscopic colitis were older than control patients (median age = 60 years vs 66 years, P = .04). On follow-up 7 patients with polypoid microscopic colitis (33%) developed chronic diarrhea compared to 3 (12%) controls (P = .16). Of patients with follow-up biopsies, 1 patient with polypoid microscopic colitis (13%) and no control patients developed microscopic colitis (P = 1). Polypoid microscopic colitis may be identified in asymptomatic patients and most patients do not develop chronic diarrhea, but some patients with polypoid microscopic colitis develop diarrhea (33% vs 12% in controls) or conventional microscopic colitis on follow-up. Thus pathologists should distinguish polypoid microscopic colitis from conventional microscopic colitis but may inform clinicians of the uncertain association with chronic diarrhea to guide decisions regarding follow-up.
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Affiliation(s)
- Caroline Miller
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Mark G Ettel
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
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Xiang Y, Qiu C, Hu H, Cai J, Da X, Kong X, Wang Y, He C, Zhang C, Yang Y. Age and incidence of occult pancreaticobiliary reflux in patients with benign gallbladder diseases. Scand J Gastroenterol 2024; 59:584-591. [PMID: 38318873 DOI: 10.1080/00365521.2024.2311358] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Occult pancreaticobiliary reflux (OPBR) has a significant correlation with diseases of the gallbladder and biliary system. This study examined the incidence of OPBR by age in patients with benign gallbladder diseases. METHODS We assessed 475 patients with benign gallbladder diseases who underwent surgery at Shanghai East Hospital from December 2020 to December 2021. Bile samples collected during surgery were tested for amylase. Patients with bile amylase >110 U/L (n = 64) were classified as the OPBR group; the rest (n = 411) as controls. RESULTS Of the participants, 375 had gallbladder stone (GS), 170 had gallbladder polyp (GP), and 49 had gallbladder adenomyomatosis (GA). The OPBR group was generally older, with OPBR incidence increasing with age, peaking post-45. Rates by age were: 4.9% (<35), 5.2% (35-44), 20.7% (45-54), 22.5% (55-64) and 17.6% (≥65), mainly in GS patients. ROC analysis for predicting OPBR by age yielded an area under the curve of 0.656, optimal cut-off at 45 years. Logistic regression indicated age > 45, GP, male gender, and BMI ≥ 24 kg*m-2 as independent OPBR predictors in GS patients. Based on these variables, a predictive nomogram was constructed, and its effectiveness was validated using the ROC curve, calibration curve and decision curve analysis (DCA). Further stratification revealed that among GS patients ≤ 45, concurrent GA was an OPBR risk; for > 45, it was GP and male gender. CONCLUSIONS The incidence of OPBR in GS patients is notably influenced by age, with those over 45, especially males without GP, being at heightened risk.
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Affiliation(s)
- Yukai Xiang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Chen Qiu
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Hai Hu
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Jingli Cai
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Xuanbo Da
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Xiangyu Kong
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Yubin Wang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Chuanqi He
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Cheng Zhang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Yulong Yang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
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Wang X, Ma R, Ma J, Tang N, Li R, Ma X. Endoscopic submucosal dissection for the treatment of a large inflammatory fibroid polyp in the gastric antrum prolapsing into the duodenum: A case report. Medicine (Baltimore) 2024; 103:e37877. [PMID: 38640263 PMCID: PMC11030001 DOI: 10.1097/md.0000000000037877] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/07/2024] [Accepted: 03/21/2024] [Indexed: 04/21/2024] Open
Abstract
RATIONALE Inflammatory fibroid polyp (IFP), also known as Vanek tumor, is a rare, benign gastrointestinal lesion characterized by its inflammatory and fibroid histological features. IFP is often discovered incidentally during endoscopic examinations. It is exceedingly rare for an IFP to prolapse into the duodenum and results in incomplete obstruction of the pylorus. PATIENT CONCERNS A 64-year-old male patient was admitted to the hospital with recurrent episodes of melena over a 6-month period, along with complaints of dizziness and fatigue in the past 10 days. DIAGNOSES Gastroscopy showed a giant polypoid mass on the posterior wall of the gastric antrum, prolapsing into the duodenum. Abdominal computer tomography (CT) confirmed the tumor protruding into the duodenum. Pathologic examination of the resected specimen confirmed the IFP diagnosis. INTERVENTIONS The giant tumor was completely and successfully excised using endoscopic submucosal dissection (ESD). After the surgery, the patient underwent acid suppression and fluid replenishment therapy. OUTCOMES The patient responded well to ESD and was discharged in stable condition. As of the submission of the case report, there has been no recurrence of the tumor after a 5-month follow-up, and the patient is still under follow-up. LESSONS While IFPs have traditionally been managed surgically, ESD demonstrates promising treatment outcomes, avoiding the need for surgical distal gastrectomy, and emerges as a safe and effective treatment option.
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Affiliation(s)
- Xiaoyun Wang
- Department of Gastroenterology, The First People’s Hospital of Shizuishan, Affiliated to Ningxia Medical University, Shizuishan, China
| | - Ru Ma
- Department of Gastroenterology, The First People’s Hospital of Shizuishan, Affiliated to Ningxia Medical University, Shizuishan, China
| | - Jizhou Ma
- Department of Pathology, The First People’s Hospital of Shizuishan, Affiliated to Ningxia Medical University, Shizuishan, China
| | - Na Tang
- Department of Gastroenterology, The First People’s Hospital of Shizuishan, Affiliated to Ningxia Medical University, Shizuishan, China
| | - Rui Li
- Department of Gastroenterology, The First People’s Hospital of Shizuishan, Affiliated to Ningxia Medical University, Shizuishan, China
| | - Xiaojin Ma
- Department of Gastroenterology, The First People’s Hospital of Shizuishan, Affiliated to Ningxia Medical University, Shizuishan, China
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Nian J, Zhu Y, Lv X, Zhang Y, Xue Z, Wu Z, Zhou Y, Liu Y. Expression levels of ADAMTS 5, 9, and 12 in endometrial polyps and their predictive value for the diagnosis and recurrence of endometrial polyps. Eur J Obstet Gynecol Reprod Biol 2024; 295:86-91. [PMID: 38340595 DOI: 10.1016/j.ejogrb.2024.02.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/30/2024] [Accepted: 02/04/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE Endometrial polyps (EPs) are common gynecological disorders for which no clear etiology has been found. ADAMTS have been associated with a variety of diseases. This study aimed to investigate the potential correlation between serologic levels of ADAMTS 5, 9, and 12 in patients with EPs. METHODS A total of 88 patients were categorized into two groups: the EPs group, consisting of recurrent EPs and first occurrence EPs, and a control group. The study compared the general information and serum levels of ADAMTS 5, 9, and 12 between the groups. RESULTS Regarding the general data, a statistically significant age difference (p < 0.05) was observed, while no significant differences were found in the other variables. After considering age as a confounding factor, the previously observed statistical significance in the differences of ADAMTS5 and 9 between the groups diminished. However, it was found that the concentrations of ADAMTS12 in both the EPs group and the recurrent EPs group were significantly higher compared to the control group and the first occurrence EPs group (p < 0.05). ROC curves were generated to determine the critical values of ADAMTS12 for predicting EPs and recurrent EPs, which were found to be 0.6962 ng/ml (sensitivity: 100 %, specificity: 39.5 %) and 0.8768 ng/ml (sensitivity: 75.0 %, specificity: 76.3 %), respectively. CONCLUSION Our findings revealed elevated serologic levels of ADAMTS12 in the EPs group, particularly in the recurrent EPs group. Furthermore, ADAMTS-12 was identified as a valuable biomarker for assisting in the diagnosis and prediction of EPs recurrence.
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Affiliation(s)
- Jiejie Nian
- Department of Gynecology and Obstetrics, Maternity and Child Healthcare Hospital Affiliated to Anhui Medical University, Hefei Maternal and Child Health Hospital, Hefei, Anhui 230001, China; Department of Gynecology and Obstetrics, The Fifth Clinical College of Anhui Medical University, Hefei, Anhui 230032, China
| | - Yuqing Zhu
- Department of Gynecology and Obstetrics, Maternity and Child Healthcare Hospital Affiliated to Anhui Medical University, Hefei Maternal and Child Health Hospital, Hefei, Anhui 230001, China; Department of Gynecology and Obstetrics, The Fifth Clinical College of Anhui Medical University, Hefei, Anhui 230032, China
| | - Xiaoli Lv
- Department of Gynecology and Obstetrics, Maternity and Child Healthcare Hospital Affiliated to Anhui Medical University, Hefei Maternal and Child Health Hospital, Hefei, Anhui 230001, China; Department of Gynecology and Obstetrics, The Fifth Clinical College of Anhui Medical University, Hefei, Anhui 230032, China
| | - Yue Zhang
- Department of Gynecology and Obstetrics, Xuancheng City People's Hospital, Xuancheng, Anhui, 242000, China
| | - Zhongkai Xue
- Department of Gynecology and Obstetrics, Maternity and Child Healthcare Hospital Affiliated to Anhui Medical University, Hefei Maternal and Child Health Hospital, Hefei, Anhui 230001, China; Department of Gynecology and Obstetrics, The Fifth Clinical College of Anhui Medical University, Hefei, Anhui 230032, China
| | - Zhongran Wu
- Department of Gynecology and Obstetrics, Maternity and Child Healthcare Hospital Affiliated to Anhui Medical University, Hefei Maternal and Child Health Hospital, Hefei, Anhui 230001, China
| | - Yujia Zhou
- Department of Gynecology and Obstetrics, Maternity and Child Healthcare Hospital Affiliated to Anhui Medical University, Hefei Maternal and Child Health Hospital, Hefei, Anhui 230001, China
| | - Yu Liu
- Department of Gynecology and Obstetrics, Maternity and Child Healthcare Hospital Affiliated to Anhui Medical University, Hefei Maternal and Child Health Hospital, Hefei, Anhui 230001, China; Department of Gynecology and Obstetrics, The Fifth Clinical College of Anhui Medical University, Hefei, Anhui 230032, China.
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Jang S, Hwang SO. The risk factors for premalignant and malignant endometrial polyps in premenopausal and postmenopausal women and trends over the past decade: A retrospective study in a single center, South Korea. Eur J Obstet Gynecol Reprod Biol 2024; 295:118-123. [PMID: 38354603 DOI: 10.1016/j.ejogrb.2024.01.033] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/09/2024] [Accepted: 01/24/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES To assess the prevalence and risk factors for premalignancy and malignancy in endometrial polyps and to evaluate trends over the past decade. STUDY DESIGN This was a retrospective study of patients who underwent hysteroscopic polypectomy at Inha University Hospital, South Korea between January 2013 and June 2023. The demographic and clinical characteristics of the patients reviewed to identify risk factors for premalignancy and malignancy in endometrial polyps included the following: age, parity, body mass index, menopausal status, abnormal uterine bleeding symptoms, diabetes mellitus, hypertension, polycystic ovarian syndrome, use of menopausal hormonal therapy or oral contraceptives, tamoxifen treatment in patients with breast cancer, and the number of polyps. RESULTS In total, 725 patients were enrolled, among whom 52 (7.2 %) had premalignant and malignant lesions. In logistic regression analysis, menopause (OR: 8.37, 95 % CI [3.33-21.04]), abnormal uterine bleeding (OR: 7.42, 95 % CI [2.13-25.86]), obesity (OR: 3.22, 95 % CI [1.53-6.77]), multiple polyps (OR: 2.86, 95 % CI [1.39-5.88]) and nulliparity (OR: 2.64, 95 % CI [1.13-6.19]) were significantly associated with premalignancy and malignancy in polyps. Annual trends during the study period showed an increase in the number of patients with three of the five risk factors (obesity, multiple polyps, and nulliparity) and an increase in the prevalence of premalignancy and malignancy in polyps. CONCLUSIONS Menopause, abnormal uterine bleeding, obesity, multiple polyps, and nulliparity increase the risk of premalignancy and malignancy in endometrial polyps. The prevalence of premalignant and malignant polyps has been increasing over the past decade. The risk factors that have contributed to this trend were obesity, nulliparity, and multiple polyps.
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Affiliation(s)
- Shina Jang
- Department of Obstetrics and Gynecology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea.
| | - Sung Ook Hwang
- Department of Obstetrics and Gynecology, Inha University Hospital, Inha University College of Medicine, Incheon, South Korea.
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Hamdan AL, Hosri J, Lechien JR. Office-based blue laser therapy for vocal fold polyps and Reinke's edema: a case study and review of the literature. Eur Arch Otorhinolaryngol 2024; 281:1849-1856. [PMID: 38170211 DOI: 10.1007/s00405-023-08414-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE To report the efficacy of blue laser in the treatment of vocal fold polyps and Reinke's edema in an office setting. METHODS The medical records and video-recordings of patients who underwent office-based blue laser therapy in a tertiary referral center for vocal fold polyps and/or Reinke's edema were reviewed. The primary outcome measures were the Voice Handicap Index-10 (VHI-10) score and disease regression. Acoustic and aerodynamic parameters were also analyzed. RESULTS Thirty-five patients (21 with vocal fold polyps and 14 with Reinke's edema) were included and a total of 47 lesions were treated. Out of the 35 patients, 7 patients were lost for follow-up. The mean VHI-10 score dropped significantly after surgery by 17.41 ± 8.67 points (p < 0.001). The endoscopic examinations of 38 lesions were reviewed (17 vocal fold polyps and 21 Reinke's edema) before and up to 6 months after laser therapy. In the subgroup with vocal fold polyps (N = 17), there was complete disease regression in 13 and partial in 4. In the subgroup with Reinke's edema (N = 21), there was complete disease regression in 7 and partial disease regression in 14. For patients with vocal fold polyp, there was a significant decrease in shimmer and a significant increase in maximum phonation time postoperatively. For patients with Reinke's edema, there was a significant decrease in shimmer and noise-to-harmonic ratio following treatment. CONCLUSION Office-based blue laser therapy is an effective treatment for vocal fold polyps and Reinke's edema leading to complete or partial disease regression. All patients had improvement in voice quality.
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Affiliation(s)
- Abdul-Latif Hamdan
- Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Riad El Solh, 11-0236, Beirut, 1107 2020, Lebanon.
| | - Jad Hosri
- Department of Otolaryngology-Head and Neck Surgery, American University of Beirut Medical Center, Riad El Solh, 11-0236, Beirut, 1107 2020, Lebanon
| | - Jerome R Lechien
- Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, University Paris Saclay, Paris, France
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Tao CP, Cao YS, Mao CK, Peng B. Laparoscopic treatment of pediatric duplicated kidney with ureteral fibroepithelial polyps: A case report. Asian J Surg 2024; 47:1499-1500. [PMID: 38065739 DOI: 10.1016/j.asjsur.2023.11.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 11/24/2023] [Indexed: 03/13/2024] Open
Affiliation(s)
- Cheng-Pin Tao
- Department of Urology, Anhui Provincial Children's Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Yong-Sheng Cao
- Department of Urology, Anhui Provincial Children's Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China.
| | - Chang-Kun Mao
- Department of Urology, Anhui Provincial Children's Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Bo Peng
- Department of Urology, Anhui Provincial Children's Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
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Cheung CMG. Macular neovascularization and polypoidal choroidal vasculopathy: phenotypic variations, pathogenic mechanisms and implications in management. Eye (Lond) 2024; 38:659-667. [PMID: 37803144 PMCID: PMC10920817 DOI: 10.1038/s41433-023-02764-w] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/07/2023] [Accepted: 09/18/2023] [Indexed: 10/08/2023] Open
Abstract
Advances in imaging have led to improved ability to characterize variations in clinical sub-phenotypes of macular neovascularization (MNV) in Age-related macular degeneration (AMD). Polypoidal choroidal vasculopathy (PCV) was initially described based on characteristic features observed in indocyanine green angiography (ICGA) and was thought to be a distinct entity from AMD. However, subsequent careful observations based on confocal scanning laser ophthalmoscopy-based ICGA, optical coherence tomography (OCT) and OCT angiography have led researchers to appreciate similarities between PCV lesion and type 1 MNV in typical neovascular AMD. Concurrently, clinical trials have shown that anti-VEGF monotherapy can achieve favourable visual outcome in the majority of eyes with PCV. These learnings have led to a shift in the way PCV is managed over the past decade. Recent studies have supported the use of non-ICGA based imaging modality to screen for PCV and the adoption of anti-VEGF monotherapy as initial therapy for PCV. A focus of recent research has been in the understanding of the role of choroidal alterations in the pathogenesis of PCV. The concept of pachychoroid in leading to outer retinal ischemia has garnered increasing support. Future research in this area should evaluate the potential of choroidal morphology in guiding personalized therapy in PCV.
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Affiliation(s)
- Chui Ming Gemmy Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore.
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Tao C, Cao Y, Mao C. Analysis of the Therapeutic Efficacy of Laparoscopic Treatment for Fibroepithelial Polyps of the Ureter in Children. J Endourol 2024; 38:219-227. [PMID: 38185850 DOI: 10.1089/end.2023.0360] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Objective: The aim of this study is to assess the efficacy and safety of laparoscopic surgery in the treatment of pediatric ureteral fibroepithelial polyp (FEP) patients. Our hypothesis is that laparoscopic surgery can effectively treat FEPs while minimizing patient discomfort and complications. Our research aims to evaluate the clinical outcomes of the surgery, including postoperative symptom relief, improvement in kidney function, and risk of postoperative complications. Methods: The clinical records of 34 patients who underwent ureteral polyp surgery at the Department of Urology at Anhui Provincial Children's Hospital between May 2014 and February 2023 were retrospectively analyzed. All patients underwent laparoscopic surgery. Among the 34 pediatric patients, there were 31 males and 3 females, with 2 on the right side and 32 on the left side. Of these cases, 24 polyps were located at the ureteropelvic junction, while seven were found in the upper segment of the ureter and three in its middle segment. Patients' ages ranged from 4 years and 3 months to 15 years, with a median age of 8 years and 6 months. All children presented with varying degrees of hydronephrosis, and preoperative clinical symptoms included ipsilateral flank or abdominal pain, hematuria, and other discomfort. Preoperative examinations mainly comprised ultrasound, intravenous pyelography, CT, or magnetic resonance urography imaging studies, as well as diuretic renography. All pediatric patients underwent laparoscopic excision of the polyp segment of the ureter, followed by renal pelvis ureteroplasty or ureter-to-ureter anastomosis. Results: All patients underwent surgery without conversion to open surgery. The surgical duration ranged from 72 to 313 minutes, with an average of 179.5 minutes. The average intraoperative blood loss was 14 mL. Postoperatively, one patient experienced leakage at the anastomotic site; however, no other significant complications occurred during or after the procedure. Postoperative histopathology confirmed the presence of FEPs in the ureter for all cases. All patients experienced a favorable postoperative recovery, with hospitalization periods ranging from 3 to 16 days and an average stay of 8.6 days. A Double-J stent was inserted in all patients for a duration of 1 to 2 months after surgery, and upon removal, follow-up color Doppler ultrasound revealed reduced hydronephrosis within 1 to 3 months. Follow-up examinations were conducted at intervals ranging from 3 to 108 months postsurgery, with an average follow-up time of 42.2 months, during which no recurrence of ureteral polyps or symptoms such as pain and hematuria was observed. Conclusions: The findings of this study demonstrate that laparoscopic excision of the polyp segment of the ureter, renal pelvis ureteroplasty, and ureter-to-ureter anastomosis represent safe and effective treatment modalities for pediatric FEPs in the ureters. This technique offers several advantages, including minimal invasiveness, rapid recovery, and definitive therapeutic efficacy, which effectively alleviate clinical symptoms and improve hydronephrosis.
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Affiliation(s)
- Chengpin Tao
- Department of Urology, Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - Yongsheng Cao
- Department of Urology, Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - Changkun Mao
- Department of Urology, Anhui Provincial Children's Hospital, Hefei, Anhui, China
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Wang Y, Zhang W, Yang J, Zhao X, Meng L, Chen Y, Zhang X. Evaluation of the First-Dose Anti-VEGF Anatomical Response in Polypoidal Choroidal Vasculopathy Patients: Correlation with the Third-Dose Response and Risk Factor Analysis. Ophthalmic Res 2023; 67:85-95. [PMID: 38109862 DOI: 10.1159/000534820] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/10/2023] [Indexed: 12/20/2023]
Abstract
INTRODUCTION The aims of the study were to investigate whether first-dose efficacy can predict third-dose anatomical response and analyze the risk factors for first-dose response of polypoidal choroidal vasculopathy (PCV) patients. METHODS We retrospectively reviewed patients' medical records from 27 centers of China PCV Research Alliance. PCV patients treated with intravitreal injections of conbercept (IVC) based on the 3+ pro re nata regimen (three initial monthly injections, followed by injections as needed) with complete 3-month injection data were included. Response correlations, risk factor associations, changes in central macular thickness (CMT) or best-corrected visual acuity (BCVA), and number of injections in the first year of follow-up were evaluated separately in the pachy-PCV and non-pachy-PCV phenotypes. RESULTS Overall, 165 eligible patients were included. There was a significant correlation between first-dose and third-dose anatomical response in pachy-PCV or non-pachy-PCV patients (rs = 0.611, p < 0.001; rs = 0.638, p < 0.001). Multivariate analysis revealed associations of good first-dose anatomical response in pachy-PCV patients with baseline CMT with a predicted area under the curve (AUC) of 0.847, while a good response in non-pachy-PCV patients was associated with baseline BCVA, baseline CMT, pigment epithelial detachment (PED) height, higher proportion of intraretinal fluid, and lower PED minimum diameter with a predicted AUC of 0.940. CMT in the good first-dose response group was significantly decreased from baseline at all first-year follow-up visits in both groups (p < 0.001), and mean BCVA was improved in the good versus poor first-dose anatomical response group (5.4 vs. 1.6 ETDRS letters in pachy-PCV, 10.6 vs. 7.4 letters in non-pachy-PCV) after the third injection. No significant difference was observed in the number of injections in the first year of follow-up between different response groups. CONCLUSION In PCV patients receiving IVC, the first- and third-dose responses are significantly correlated, and different factors influence the first-dose response in different subtypes of PCV.
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Affiliation(s)
- Yuelin Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China,
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China,
| | - Wenfei Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Jingyuan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinyu Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Lihui Meng
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiao Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China
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12
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Hu Y, Xiang Y, Huang W. Endometrial polyps effect on pregnancy outcomes in infertile women with minimal/mild endometriosis: A retrospective study. J Obstet Gynaecol Res 2023; 49:2946-2951. [PMID: 37723936 DOI: 10.1111/jog.15794] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE To assess the pregnancy outcomes and associated influencing factors of pregnancy after hysteroscopy combined with laparoscopy treatment in infertile patients with minimal/mild endometriosis. DESIGN A retrospective study. SETTING West China Second University Hospital of Sichuan University. PATIENTS We enrolled 898 infertile women who had their minimal/mild endometriosis lesions removed by laparoscopy, including 271 patients additionally diagnosed with endometrial polyps who also underwent hysteroscopic polypectomy. METHODS Based on the existence of endometrial polyps, patients with minimal/mild endometriosis were enrolled and divided into polyps group and non-polyps group. MAIN OUTCOME MEASURES Pregnancy outcomes. RESULTS A total of 271 women with minimal/mild endometriosis were included in polyps group while 491 women with minimal/mild endometriosis were included in non-polyps group. The pregnancy rate of polyps group was not statistically significant compared with non-polyp group (60.15% vs. 58.25%). The pregnancy rate was higher among patients with polyps ≥1 cm (76.06%, 54/71) than patients with polyps <1 cm (54.50%, 109/200) or patients without polyps (58.25%, 286/491) (p = 0.006). The pregnancy rate was higher for patients with multiple polyps (67.86%, 95/140) than for patients with single polyp (51.91%, 68/131) or without polyps (p = 0.025). CONCLUSIONS Among women with minimal/mild endometriosis, hysteroscopic polypectomy did significantly increase fertility in infertile patients with multiple polyps or size of polyp ≥1 cm compared with those without endometrial polyps, single polyp, and size of polyp <1 cm. The size and number of polyps were independently associated with the reproductive ability of women with minimal/mild endometriosis.
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Affiliation(s)
- Yuanyuan Hu
- Department of Obstetrics and Gynaecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, Sichuan, China
| | - Yingchun Xiang
- Department of Obstetrics and Gynecology, Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Clinical College of Wuhan University, Enshi, Hubei, China
| | - Wei Huang
- Department of Obstetrics and Gynaecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu, Sichuan, China
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13
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Rotenberg O, Doulaveris G, Fridman D, Renz M, Kaplan J, Xie X, Goldberg GL, Dar P. Risk of endometrial polyp and surgical intervention in postmenopausal women with proliferative endometrium. Maturitas 2023; 178:107847. [PMID: 37717294 DOI: 10.1016/j.maturitas.2023.107847] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/10/2023] [Accepted: 09/05/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE To study the long-term risks of postmenopausal women with proliferative endometrium developing benign uterine pathologies (endometrial polyps and uterine fibroids) and requiring future gynecological interventions, and to compare them with women with atrophic endometrium. DESIGN Retrospective cohort study of all women aged 55 or over who underwent endometrial biopsy between 1/1997 and 12/2008. Outcome data were available through to 2/2018. Women with proliferative endometrium were compared with those with atrophic endometrium for the presence of endometrial polyps, uterine fibroids, future endometrial biopsy for recurrent vaginal bleeding, and future hysteroscopy or hysterectomy. Logistic regression models were used to evaluate the association of endometrial histology and other covariates with the risk of morbidities. MAIN FINDINGS Postmenopausal women with proliferative endometrium are at higher risk of developing endometrial polyps, uterine fibroids and need for surgical intervention. Of 1808 women who underwent endometrial biopsy during the study period, 962 met inclusion criteria: 278 had proliferative and 684 had atrophic endometrium. Length of surveillance was similar in the two groups (11.9 vs. 11.5 years, p = 0.2). Compared with women with atrophic endometrium, women with proliferative endometrium had significantly higher rates of endometrial polyps (17.3 % vs 9.7 % p = 0.001). Multivariable logistic regression confirmed that women with proliferative endometrium had more fibroids on ultrasound (62.1 % vs 50.3 % 3 = 0.02), and had increased risks of developing endometrial polyps (aOR 1.9, 95 % CI 1.28-3.07, p = 0.002), repeat endometrial biopsy (34.9 % vs. 16.8%p < 0.001) and future hysterectomy or hysteroscopy (26.6 % vs 16.2 % p < 0.001). CONCLUSIONS In addition to the long-term increased risk of cancer, postmenopausal women with proliferative endometrium are more likely to have future bleeding, surgical interventions and diagnosis of endometrial polyps. Medical management to reduce estrogenic activity and associated risks may be considered in these cases.
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Affiliation(s)
- Ohad Rotenberg
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Canter, Bronx, NY, USA.
| | - Georgios Doulaveris
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Canter, Bronx, NY, USA
| | - Dmitry Fridman
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Canter, Bronx, NY, USA
| | - Malte Renz
- Department of Obstetrics & Gynecology, Gynecologic Oncology, Stanford University, Stanford, CA, USA
| | - Julie Kaplan
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Canter, Bronx, NY, USA
| | - Xianhong Xie
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Canter, Bronx, NY, USA
| | - Gary L Goldberg
- Department of Obstetrics & Gynecology, Gynecologic Oncology, Northwell Health, LIJ Medical Center, New Hyde Park, NY, USA
| | - Pe'er Dar
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Canter, Bronx, NY, USA
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14
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Lee Y, Park HJ, Bae IH, Kwon S, Kim G. The Usefulness of Multi Voice Evaluation for Measuring Voice Recovery After Endolaryngeal Phonomicrosurgery in Patients with Vocal Fold Polyps. J Voice 2023; 37:951-956. [PMID: 34312023 DOI: 10.1016/j.jvoice.2021.06.025] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of this study was to the usefulness of a five-variable model predicting perceived voice severity and incorporating acoustic analysis based on cepstral analysis and self-reported questionnaires, for measuring voice recovery after endolaryngeal phonomicrosurgery in patients with vocal fold polyps. METHODS In this study, 72 patients with vocal fold polyps were included. Two voice evaluations, including acoustic analysis, self-reported questionnaires, and auditory perceptual assessments for each patient, were implemented before and after endolaryngeal phonomicrosurgery. Using these evaluations, we compared the mean values of the perceptual evaluation of voice, acoustic analysis parameters, self-reported questionnaires, and the five-variable model estimated severity pre- and post-endolaryngeal phonomicrosurgery. RESULTS Various parameters related to acoustic analysis, self-reported questionnaires, and auditory perceptual assessments were useful for measuring voice recovery after endolaryngeal phonomicrosurgery. In particular, a five-variable model incorporating spectral/cepstral analyses and self-reported questionnaires was able to effectively track voice changes after endolaryngeal phonomicrosurgery. CONCLUSION We verified that most of the variables and the five-variable model were useful for measuring voice recovery in patients with vocal polyps after endolaryngeal phonomicrosurgery.
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Affiliation(s)
- YeonWoo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Hee J Park
- Deptartment of Speech and Hearing Therapy, Catholic University of Pusan, Busan, South Korea
| | - In Ho Bae
- Deptartment of Speech-Language Pathology, Kosin University, Busan, South Korea
| | - SoonBok Kwon
- Deptartment of Humanities, Language and Information, Pusan National University, Pusan, South Korea
| | - GeunHyo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.
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15
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Spielvogel R. A hypervascular placental polyp after complete abortion: a case report. BMC Womens Health 2023; 23:534. [PMID: 37817177 PMCID: PMC10566062 DOI: 10.1186/s12905-023-02672-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/22/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Placental polyps are rare complications of delivery or abortion. They are thought to complicate less than 0.25% of all pregnancies, although the actual incidence is unknown. While they typically occur within four weeks of delivery or abortion, they can have a variable presentation, which can lead to a delay in care. CASE PRESENTATION A 35-year-old G4P2012 patient presented at 9 weeks gestation for a medication abortion. Post-abortion ultrasound after one week confirmed the abortion was complete and her bleeding ceased. The patient then presented two months later with the new onset of worrisome bleeding. She was found on ultrasound to have a new hypervascular polypoidal mass in the endometrial cavity. She then underwent an in-office dilation and curettage with an electric vacuum aspirator, which was curative. A follow up ultrasound three months later demonstrated no recurrence. CONCLUSIONS Placental polyps are a rare complication following pregnancy and should be included in the differential when a patient presents with bleeding and a new mass in the endometrial cavity on ultrasound following a delivery or abortion, even when frankly retained products of conception had been ruled out at time of abortion.
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Affiliation(s)
- Ryan Spielvogel
- Department of Family Medicine, Sutter Medical Group, 1201 Alhambra Blvd. Ste 300, Sacramento, CA, 95816, USA.
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16
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Scarini JF, de Lima-Souza RA, Lavareze L, Emerick C, Miyaok RD, Kinasz LRS, Maunsell R, Egal ESA, Altemani A, Mariano FV. Oral Teratoma with Hairy Polyp-Like Features: A Brief Report of a Rare Presentation. Int J Surg Pathol 2023; 31:1122-1125. [PMID: 36325739 DOI: 10.1177/10668969221129889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
We present a 21-day-old female child presenting with a large oral epithelialized tumor implanted at the rhinopharynx and ethmoid plate through a cleft palate, associated with feeding and respiratory difficulties. The histopathological exam showed mature central adipose tissue, hair follicles, sebaceous glands, and neurovascular structures, lined by keratinized stratified squamous epithelium. Proliferative cartilaginous, glandular, lymphatic, bony, and immature myxoid tissue was seen at the posterior region and insertion. Despite the characterization of the tumor as a teratoma containing structures derived from the three embryonic leaflets, the anterior portion presented a microscopic bigeminal pattern fully compatible with hairy polyp.
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Affiliation(s)
- João Figueira Scarini
- Department of Pathology, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, São Paulo, Brazil
- Department of Oral Diagnosis, Piracicaba School of Dentistry, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Reydson Alcides de Lima-Souza
- Department of Pathology, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, São Paulo, Brazil
- Department of Oral Diagnosis, Piracicaba School of Dentistry, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Luccas Lavareze
- Department of Pathology, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, São Paulo, Brazil
- Department of Oral Diagnosis, Piracicaba School of Dentistry, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Carolina Emerick
- Department of Pathology, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, São Paulo, Brazil
- Department of Oral Diagnosis, Piracicaba School of Dentistry, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Rafaella Dini Miyaok
- Department of Pediatric Surgery, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Letícia Raysa Schiavon Kinasz
- Department of Otorhinolaryngology & Head & Neck Surgery, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Rebecca Maunsell
- Department of Otorhinolaryngology & Head & Neck Surgery, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Erika Said Abu Egal
- Department of Pathology, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, São Paulo, Brazil
- Department of Pathology, School of Medicine, University of Utah (UU), Salt Lake City, Utah, USA
| | - Albina Altemani
- Department of Pathology, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Fernanda Viviane Mariano
- Department of Pathology, Faculdade de Ciências Médicas, Universidade de Campinas (UNICAMP), Campinas, São Paulo, Brazil
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17
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Vaduva CC, Constantinescu C, Serbanescu M, Dara L, Oancea MD, Carp-Veliscu A. The association between endometrial polyps, chronic endometritis, and IVF outcomes. Eur Rev Med Pharmacol Sci 2023; 27:8895-8904. [PMID: 37782198 DOI: 10.26355/eurrev_202309_33810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Endometrial polyps (EPs) are one of the most common pathologies detected during the examination of the uterine cavity of infertile women. We aimed to demonstrate the relationship between EPs, chronic endometritis (CE) and in vitro fertilization (IVF) outcomes. PATIENTS AND METHODS This retrospective study was performed on 394 hysteroscopically examined infertility cases. We performed polyp resections (PR) and extensive biopsies of the endometrium to demonstrate the association with clinical pregnancy (CP) by IVF. We performed statistical analysis to compare these associations. RESULTS The incidence of CE was twice as high in the presence of EPs as in the absence of EPs. The associations between EPs and PR were found to be significant for positive CP outcomes. A significant difference in IVF outcome was found between the group with EPs and the group without EPs. All these associations were statistically significant (p < 0.05). CONCLUSIONS We found a frequent association between EPs and CE. The pregnancy rate obtained after IVF was negatively affected by the presence of EPs. Treatment of these pathologies improved IVF outcomes.
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Affiliation(s)
- C C Vaduva
- Department of Obstetrics and Gynaecology, University of Medicine and Pharmacy of Craiova, Filantropia Clinical Hospital, Craiova, Romania.
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18
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Kroupa R, Pavlik T, Konecny S, Packova B, Dastych M, Pavlovsky Z, Dolina J. The association between duration of and indications for proton pump inhibitor use and risk of gastric polyps. Eur J Gastroenterol Hepatol 2023; 35:829-835. [PMID: 37395234 DOI: 10.1097/meg.0000000000002587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
OBJECTIVES The development of fundic gland polyps (FGPs) is the most common side effect of long-term proton pump inhibitor (PPI) use; however, the effect of drug use characteristics and their impact on the risk of other gastric polyp development remain unclear. We aimed to identify the influence of PPI administration, as well as its duration and dose, in the development of gastric polyps. METHODS A prospective cohort study was conducted on consecutive patients who underwent gastroscopy between September 2017 and August 2019. Detailed characteristics of gastric polyps, Helicobacter pylori infection, and PPI use were analyzed. RESULTS Among the 2723 patients included, gastric polyps (75% FGPs, 22% hyperplastic) were detected in 16.4%, and 60% were prescribed PPI. The risk of FGPs and hyperplastic polyps according to the duration of PPI use were as follows: 2-5 years [odds ratio (95% confidence interval); 2.86 (2.00-4.11) and 2.82 (1.69-4.78)]; 6-9 years [7.42 (5.03-11.01) and 2.32 (1.05-4.78)]; ≥10 years [14.94 (10.36-21.80) and 3.52 (1.67-7.03)]. Multivariate analysis confirmed that the risk of FGPs was 17.16 (11.35-26.23) for ≥10 years of PPI use. Portal hypertension-related conditions were associated with hyperplastic polyps [4.99 (2.71-9.20)]. CONCLUSION Duration of and indications for PPI use are the most predictive factors for the development of gastric polyps. Prolonged PPI use increases the risk of polyp development and the number of patients with polyps, which may burden endoscopic practice. Highly selected patients may require particular care despite minimal risk of dysplasia and bleeding generally.
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Affiliation(s)
- Radek Kroupa
- Department of Internal Medicine and Gastroenterology, University Hospital Brno
| | - Tomas Pavlik
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno
- Institute of Health Information and Statistics of the Czech Republic, Prague
| | - Stefan Konecny
- Department of Internal Medicine and Gastroenterology, University Hospital Brno
| | - Barbora Packova
- Department of Internal Medicine and Gastroenterology, University Hospital Brno
| | - Milan Dastych
- Department of Internal Medicine and Gastroenterology, University Hospital Brno
| | - Zdenek Pavlovsky
- Department of Pathology, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Dolina
- Department of Internal Medicine and Gastroenterology, University Hospital Brno
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19
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Rodriguez-Guzman F, Ruas JN, Cabral JGGDAL, Micelli-Neto O, Venco FE, Ardengh JC. CHRONIC ANEMIA CAUSED BY GIANT AND SOLITARY PEUTZ-JEGHERS HAMARTOMATOUS POLYP TREATED BY ENDOSCOPIC RESECTION. Arq Gastroenterol 2023; 60:282-284. [PMID: 37556755 DOI: 10.1590/s0004-2803.20230222-155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/24/2023] [Indexed: 08/11/2023]
Abstract
•Giant and solitary polyps evolve with anemia. •EUS is an important tool for stage and manage this disease. •Endoscopic treatment is the best treatment choice. •Supplementary video available on this case report.
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Affiliation(s)
| | | | | | | | - Filadelfio Euclides Venco
- Faculdade de Medicina da Universidade de São Paulo, Departamento de Patología, São Paulo, SP, Brasil
| | - José Celso Ardengh
- Hospital Moriah, Serviço de Endoscopia Digestiva, São Paulo, SP, Brasil
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, SP, Brasil
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20
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Starkov YG, Dzhantukhanova SV, Zamolodchikov RD, Badakhova AB. [Hybrid laparo-endoscopic access for giant fibrovascular esophageal polyp: a case report]. Khirurgiia (Mosk) 2023:123-132. [PMID: 38010027 DOI: 10.17116/hirurgia2023111123] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Fibrovascular polyp is a rare non-epithelial esophageal tumor arising from submucosal layer and consisting of connective and adipose tissue, as well large number of vessels. Large tumors can cause dysphagia, vomiting, chest pain, shortness of breath and/or asthma, while giant neoplasms are potentially life threatening. Despite active introduction of minimally invasive treatment of patients with non-epithelial gastrointestinal tumors, there are still difficulties in surgical treatment of fibrovascular polyps. The patient with a giant fibrovascular esophageal polyp presented with cough, discomfort in the throat, impaired swallowing and episode of tumor migration into oropharynx. Examination confirmed giant highly vascularized esophageal fibrovascular polyp. A novel hybrid surgical technique (endoscopic submucosal dissection with laparoscopic removal of tumor) was applied. Eight-month follow-up revealed no complications. Favorable clinical result was achieved. A hybrid laparo-endoscopic approach in the treatment of patients with large fibrovascular polyps minimizes perioperative risks and improves postoperative outcomes.
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Affiliation(s)
- Yu G Starkov
- Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
| | | | - R D Zamolodchikov
- Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
| | - A B Badakhova
- Vishnevsky National Medical Research Center of Surgery, Moscow, Russia
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21
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Goto C, Okimoto K, Matsusaka K, Matsumura T, Akizue N, Ohta Y, Taida T, Saito K, Kato J, Kato N. Long-term vonoprazan administration causes gastric fundic gland-type hyperplastic polyps and chronic bleeding. Clin J Gastroenterol 2022; 16:159-163. [PMID: 36586091 DOI: 10.1007/s12328-022-01751-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/26/2022] [Indexed: 01/01/2023]
Abstract
A patient experienced gastric fundic gland-type hyperplastic polyps, consisting of foveolar epithelium and parietal cells, complicated with chronic bleeding due to long-term treatment with vonoprazan. The patient had progressive anemia, probably caused by bleeding from the polyps. After switching from vonoprazan to a histamine-2 (H2) receptor antagonist, the polyps markedly shrank and the anemia improved. Vonoprazan can produce reversible hyperplastic polyps and anemia. In case of anemia in patients receiving long-term vonoprazan, it is important to consider drug cessation or change to an H2 blocker.
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Affiliation(s)
- Chihiro Goto
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan
| | - Kenichiro Okimoto
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan.
| | | | - Tomoaki Matsumura
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan
| | - Naoki Akizue
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan
| | - Yuki Ohta
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan
| | - Takashi Taida
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan
| | - Keiko Saito
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan
| | - Jun Kato
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan
| | - Naoya Kato
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba, 260-8670, Japan
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22
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Thimmesch M, Corhay JL, Mutijima E, Piérart F, Schifflers S, Chantrain CF. Fibroepithelial Polyp as a Rare Cause of Bronchial Obstruction in a Child. J Bronchology Interv Pulmonol 2022; 29:e55-e57. [PMID: 35822741 DOI: 10.1097/lbr.0000000000000814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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23
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Nikaido M, Kumagai K, Ota Y. A hemorrhagic duodenal polyp disappeared with gastric polyps after discontinuation of proton pump inhibitor. Gastrointest Endosc 2022; 96:381-382. [PMID: 35489398 DOI: 10.1016/j.gie.2022.04.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/22/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Mitsuhiro Nikaido
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Gastroenterology, Hamamatsu Rosai Hospital, Shizuoka, Japan
| | - Ken Kumagai
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Gastroenterology, Hamamatsu Rosai Hospital, Shizuoka, Japan
| | - Yuji Ota
- Department of Gastroenterology, Hamamatsu Rosai Hospital, Shizuoka, Japan
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Hseu AF, Spencer GP, Jo S, Clark R, Nuss RC. Laryngeal pathologies in dysphonic children with Down Syndrome. Int J Pediatr Otorhinolaryngol 2022; 157:111118. [PMID: 35405441 DOI: 10.1016/j.ijporl.2022.111118] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/07/2022] [Accepted: 03/25/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Down syndrome is the most common chromosomal abnormality and is associated with a higher incidence of congenital heart defects, which often require surgery within the first year of life. Previous studies have found that children with Down syndrome are at higher risk for subglottic stenosis, vocal fold paralysis, and laryngomalacia. The goal of this study is to review children with Down syndrome presenting with dysphonia and to characterize their laryngeal pathologies. METHODS A retrospective review was performed of patients with Down syndrome seen at a tertiary pediatric hospital's department of otolaryngology from Jan. 2007-Jul. 2021 for voice-related concerns. Inclusion criteria included age less than 18 years, diagnosis of Trisomy 21, and complaint of dysphonia. The data extracted included history of dysphonia, co-morbidities, demographic information, age at presentation, perceptual voice assessments, voice quality of life scores, acoustic data, laryngoscopic and/or videostroboscopic exams, and surgical procedures. RESULTS Twenty-three total patients met the study criteria. Of these children, 13 (57%) were male and 10 (43%) were female. The mean age at first presentation was 4.08 years (range 12 days-16.3 years). Eleven of the 23 patients presented within the first 12 months of life. Sixteen patients were diagnosed with vocal fold immobility, 13 of which were left-sided unilateral immobility and the remaining 3 were bilateral immobility. 5 patients were diagnosed with vocal fold nodules. 12 children in the immobility group had a history of cardiothoracic surgery at our institution. Only 3 patients had Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) assessments, though all three showed overall dysphonia ratings of severely deviant, with roughness and strain scores being the most severe. DISCUSSION The most common etiology of dysphonia in our Down syndrome patient population was vocal fold immobility and hypomobility, as opposed to vocal fold nodules (which is the most common in the general pediatric population). The higher likelihood of cardiac surgery in patients with Trisomy 21 may result in the increased incidence of vocal fold immobility. There should be a low threshold to refer dysphonic patients with Down syndrome for laryngoscopic evaluation, as treatment options may be available.
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Affiliation(s)
- Anne F Hseu
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA, USA.
| | - Grant P Spencer
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Stacy Jo
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Roseanne Clark
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Roger C Nuss
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA, USA
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Rosenblum E, Wilkinson LD, Brady PH, Gin GT. Female Pelvic Conditions: Abnormal Uterine Bleeding. FP Essent 2022; 515:20-25. [PMID: 35420403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Abnormal uterine bleeding (AUB) is the term used to describe uterine bleeding that varies from the normal parameters of menstruation. This term replaces several previously used terms with less clear or conflicting definitions, including dysfunctional uterine bleeding, irregular menstrual bleeding, and menorrhagia. PALM-COEIN is a classification system for the etiologies of AUB in nongravid menstruating women. PALM refers to discrete structural entities (ie, polyp, adenomyosis, leiomyoma, malignancy and hyperplasia); COEIN refers to nonstructural etiologies (ie, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not yet classified). The prevalence of AUB is estimated to be 35% or higher. The history and physical examination are key in the evaluation of patients with AUB. Patients with symptomatic acute blood loss require urgent evaluation for potential hemodynamic instability. For women 45 years and younger with AUB, endometrial biopsy is indicated if specific risk factors for endometrial cancer are present. Endometrial biopsy is indicated for all patients with AUB who are older than 45 years or have postmenopausal bleeding. Management of AUB is determined by its etiology, and typically consists of medical therapy (ie, combination oral contraceptives, progestin-containing intrauterine devices, tranexamic acid, nonsteroidal anti-inflammatory drugs). Patients with structural lesions may require surgical procedures. Management should be individualized and patient desire for current or future fertility should be considered.
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Affiliation(s)
- Elizabeth Rosenblum
- Department of Family Medicine - University of California San Diego School of Medicine, 402 Dickinson St, San Diego, CA 92103
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Héroin L, Saviano A, Fenouil T, Sosa-Valencia L, Baumert TF, Habersetzer F, Mayer P. Differences between sporadic hyperplastic gastric polyps and portal hypertensive gastric polyps: a review. Eur J Gastroenterol Hepatol 2022; 34:260-266. [PMID: 34432677 DOI: 10.1097/meg.0000000000002278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Portal hypertension (PH) is one of the most severe complications of chronic liver diseases. It is defined as an increase in pressure in the portal venous system which results in a portosystemic gradient >5 mmHg. In the western world, cirrhosis is the most frequent cause of PH, mainly due to nonalcoholic fatty liver disease and alcoholic liver disease. Patients with PH have esophageal varices in 68-73% of cases, portal hypertensive gastropathy in 51-73% and hyperplastic polyps (HPs) in 0.9-2%. Recent studies have shown that HPs found in PH patients are different from classical HPs. They constitute a new entity called portal hypertensive polyps (PHPs). The main difference between sporadic HPs and PHP is the presence of larger and more numerous vascular capillaries in the lamina propria. The clinical course of PHPs is unknown. Their physiopathology seems different from HPs: the increased congestion caused by higher portal pressure in the stomach may induce capillaries proliferation and neoangiogenesis. PHPs may be responsible for symptoms, such as pyloric obstruction, iron deficiency and anemia. Their prevalence in portal hypertensive and cirrhotic patients is from 1% to 8%. PHPs can be single or numerous, in the antrum or the gastric corpus. Their size ranges from 2 to 3 cm. PHPs seem to disappear or shrink with the treatment of PH. They should be resected in case of symptom and if >10 mm, after Helicobacter pylori eradication if present. However, their recurrence is frequent (40-79%), thus surveillance endoscopy is mandatory, at the same time as esophageal varices.
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Affiliation(s)
- Lucile Héroin
- Gastroenterology and Hepatology Unit, Hôpitaux Universitaires de Strasbourg
| | - Antonio Saviano
- Gastroenterology and Hepatology Unit, Hôpitaux Universitaires de Strasbourg
- Université de Strasbourg
- Inserm, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg
| | - Tanguy Fenouil
- Institute of Pathology Est, Hospices Civils de Lyon, Lyon
| | | | - Thomas F Baumert
- Gastroenterology and Hepatology Unit, Hôpitaux Universitaires de Strasbourg
- Université de Strasbourg
- Inserm, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg
| | - François Habersetzer
- Gastroenterology and Hepatology Unit, Hôpitaux Universitaires de Strasbourg
- Université de Strasbourg
- Inserm, U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg
| | - Pierre Mayer
- Gastroenterology and Hepatology Unit, Hôpitaux Universitaires de Strasbourg
- Université de Strasbourg
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Izumi T, Koizumi H, Maruko I, Hasegawa T, Iida T. OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FINDINGS OF CLASSIC CHOROIDAL NEOVASCULARIZATION IN POLYPOIDAL CHOROIDAL VASCULOPATHY. Retina 2022; 42:123-128. [PMID: 34292224 DOI: 10.1097/iae.0000000000003264] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the flow signals in subretinal hyperreflective material (SHRM) that represents classic choroidal neovascularization (CNV) on fluorescein angiography in eyes with polypoidal choroidal vasculopathy. METHODS We retrospectively reviewed 20 eyes with polypoidal choroidal vasculopathy that appeared to have classic CNV on fluorescein angiography, accompanied by SHRM on optical coherence tomography (OCT) at the same location. Using OCT angiography (OCTA), we analyzed intrinsic flow signals in the SHRM (cross-sectional B-scans and en face). The possible association between pretreatment OCT angiography findings and fibrotic scar formation after antivascular endothelial growth factor (VEGF) treatment was evaluated. RESULTS Six of 20 eyes (30%) showed vascular SHRM; the remaining 14 eyes (70%) showed avascular SHRM at the classic CNV site at baseline. The SHRM corresponded with polypoidal lesions seen on indocyanine green angiography in 5 of 6 eyes with vascular SHRM and in all 14 eyes with avascular SHRM. After anti-VEGF treatment, all 6 eyes with vascular SHRM left a fibrotic scar, whereas all 14 eyes with avascular SHRM showed no scar formation (P < 0.001). CONCLUSION Using OCT angiography, we evaluated the flow signals in SHRM that represented classic CNV in eyes with polypoidal choroidal vasculopathy and successfully differentiated true Type 2 macular neovascularization from pseudo classic CNV.
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Affiliation(s)
- Takahiko Izumi
- Department of Ophthalmology, Tokyo Women's Medical University, Tokyo, Japan; and
| | - Hideki Koizumi
- Department of Ophthalmology, Tokyo Women's Medical University, Tokyo, Japan; and
- Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Ichiro Maruko
- Department of Ophthalmology, Tokyo Women's Medical University, Tokyo, Japan; and
| | - Taiji Hasegawa
- Department of Ophthalmology, Tokyo Women's Medical University, Tokyo, Japan; and
| | - Tomohiro Iida
- Department of Ophthalmology, Tokyo Women's Medical University, Tokyo, Japan; and
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Zhao XY, Luo MY, Meng LH, Zhang WF, Li B, Wang EQ, Liu SZ, Yu WH, Chen YX. THE INCIDENCE, CHARACTERISTICS, MANAGEMENT, PROGNOSIS, AND CLASSIFICATION OF BREAKTHROUGH VITREOUS HEMORRHAGE SECONDARY TO POLYPOIDAL CHOROIDAL VASCULOPATHY. Retina 2021; 41:1675-1685. [PMID: 33395221 DOI: 10.1097/iae.0000000000003098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe breakthrough vitreous hemorrhage secondary to polypoidal choroidal vasculopathy (PCV). METHODS Patients with the diagnosis of PCV from January 2005 to March 2020 at Peking Union Medical College Hospital were retrospectively reviewed, cases with breakthrough vitreous hemorrhage were analyzed. Subgroup analysis was conducted regarding pachychoroid PCV and nonpachychoroid PCV. RESULTS Among 722 PCV patients (834 eyes), 103 eyes with breakthrough vitreous hemorrhage (12.4%) were included. Pars plana vitrectomy and proper further interventions could significantly improve the best-corrected visual acuity from logMAR 2.15 ± 0.48 (Snellen 20/2825) to 1.65 ± 0.67 (20/893). Hemorrhagic retinal detachment, baseline central macular thickness, and best-corrected visual acuity were factors associated with final best-corrected visual acuity (P < 0.05). In the pachychoroid PCV group, patients were younger, all had hemorrhagic pigment epithelial detachment, with a higher prevalence of choroidal vascular hyperpermeability and hemorrhagic retinal detachment, thicker subfoveal choroidal thickness, and thinner central macular thickness; besides, the initial pars plana vitrectomy were more complicated, more additional surgeries had to be performed. More eyes in the nonpachychoroid PCV group had received anti-vascular endothelial growth factor or photodynamic therapy, mostly fibrovascular pigment epithelial detachment, the best-corrected visual acuity and the status of the fellow eye were significantly worse. For the final ocular status, more eyes in nonpachychoroid PCV group were taking anti-vascular endothelial growth factor monotherapy, whereas more eyes in pachychoroid PCV group were stable. The choroidal parameters of these two groups were all significantly different. CONCLUSION Breakthrough vitreous hemorrhage is a troublesome complication of PCV. Pars plana vitrectomy and additional interventions are required for better prognosis. Vitreous hemorrhage secondary to pachychoroid PCV or nonpachychoroid PCV have different characteristics and prognosis.
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Affiliation(s)
- Xin-Yu Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China; and
| | - Ming-Yue Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China; and
| | - Li-Hui Meng
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China; and
| | - Wen-Fei Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China; and
| | - Bing Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China; and
| | - Er-Qian Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China; and
| | - Sheng-Zhi Liu
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN
| | - Wei-Hong Yu
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China; and
| | - You-Xin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Lab of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, China; and
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Husain S, Al Hammad RS, Alduhaysh AK, AlBatly MM, Alrikabi A. Pathological spectrum of endometrial biopsies in Saudi women with abnormal uterine bleeding: A retrospective study of 13-years. Saudi Med J 2021; 42:270-279. [PMID: 33632905 PMCID: PMC7989265 DOI: 10.15537/smj.2021.42.3.20200814] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/08/2021] [Indexed: 12/09/2022] Open
Abstract
Objectives: To assess and age stratify the types and frequencies of endometrial pathologies in Saudi women with abnormal uterine bleeding (AUB) that underwent endometrial biopsies, at our hospital over a 13-year period. Methods: In a retrospective study, from 2006 to 2018, all endometrial biopsies from Saudi women with AUB, reported at the laboratory of King Saud University-Medical City, Riyadh, Saudi Arabia, were revisited and analyzed. The women were categorized into <40, between 40-55 and >55 years of age. Results: We analyzed 6458 biopsies. In <40 and 40-55 years’ groups cyclical endometrium was most common followed by endometrial polyps and disordered proliferative endometrium. In the >55 years’ group, atrophic endometrium was most common followed by endometrial polyps. The hyperplasias and malignancies together accounted for 7.2% of the study, majority in the >55 years’ group. Simple hyperplasia without atypia was the most common (3.9%), followed by malignancies (1.9%), complex atypical hyperplasia (0.7%), complex hyperplasia without atypia (0.4%), and simple atypical hyperplasia (0.3%). Conclusion: Awareness of the probable spectrum of endometrial histopathologies in the various ages is useful in guiding management. Endometrial biopsies are valuable in early detection of precancerous and cancerous endometrial lesions especially in women over 40 years.
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Affiliation(s)
- Sufia Husain
- From the Department of Pathology (Husain, Alrikabi), Department of Obstetrics and Gynecology (Al Hammad), Department of Pediatrics Neurology (Alduhaysh), College of Medicine (AlBatly), King Saud University; and from the Department of Pathology (Husain), Department of Obstetrics and Gynecology (Al Hammad), Department of Pediatrics Neurology (Alduhaysh), King Saud University-Medical City, Riyadh, Kingdom of Saudi Arabia.
- Address correspondence and reprint request to: Dr. Sufia Husain, Associate Professor, Department of Pathology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: https://orcid.org/0000-0003-3486-9356
| | - Reema S. Al Hammad
- From the Department of Pathology (Husain, Alrikabi), Department of Obstetrics and Gynecology (Al Hammad), Department of Pediatrics Neurology (Alduhaysh), College of Medicine (AlBatly), King Saud University; and from the Department of Pathology (Husain), Department of Obstetrics and Gynecology (Al Hammad), Department of Pediatrics Neurology (Alduhaysh), King Saud University-Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Aljawhara K. Alduhaysh
- From the Department of Pathology (Husain, Alrikabi), Department of Obstetrics and Gynecology (Al Hammad), Department of Pediatrics Neurology (Alduhaysh), College of Medicine (AlBatly), King Saud University; and from the Department of Pathology (Husain), Department of Obstetrics and Gynecology (Al Hammad), Department of Pediatrics Neurology (Alduhaysh), King Saud University-Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Mada M. AlBatly
- From the Department of Pathology (Husain, Alrikabi), Department of Obstetrics and Gynecology (Al Hammad), Department of Pediatrics Neurology (Alduhaysh), College of Medicine (AlBatly), King Saud University; and from the Department of Pathology (Husain), Department of Obstetrics and Gynecology (Al Hammad), Department of Pediatrics Neurology (Alduhaysh), King Saud University-Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Ammar Alrikabi
- From the Department of Pathology (Husain, Alrikabi), Department of Obstetrics and Gynecology (Al Hammad), Department of Pediatrics Neurology (Alduhaysh), College of Medicine (AlBatly), King Saud University; and from the Department of Pathology (Husain), Department of Obstetrics and Gynecology (Al Hammad), Department of Pediatrics Neurology (Alduhaysh), King Saud University-Medical City, Riyadh, Kingdom of Saudi Arabia.
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Giordano MV, Alvarenga TF, Bastos Júnior CDS, Giordano MG, Baracat EC, Soares Júnior JM. Does obesity modify the expression of cyclin D1 and pten in endometrial polyps in postmenopausal women? Gynecol Endocrinol 2021; 37:467-470. [PMID: 33345649 DOI: 10.1080/09513590.2020.1862787] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
To assess cyclin D1 and PTEN immunoexpression in benign endometrial polyps (EPs) in asymptomatic postmenopausal women and its correlation with obesity. Methods: This was a cross-sectional study based on data from a sample of 52 patients diagnosed with EP between February 2018 and January 2019. The women included in this study were amenorrheal for at least 1 year and were asymptomatic (no postmenopausal bleeding). Obesity defined by body mass index (BMI) was investigated for correlation with Cyclin-D1 and PTEN gene expression (immunohistochemistry) in glandular and stromal compartments of polyps. Results: No significant differences among groups were identified in any clinical and epidemiological parameter (age, age of menopause, time since menopause, number of gestations, polyp size, leucocyte count, fasting blood glucose and basic pathologies), except for BMI. Body mass index did not alter PTEN or Cyclin D1 immunoexpression. Conclusion: Our study shows that obesity does not appear to be a relevant factor in the immunoexpression of PTEN and Cyclin D1 in benign EP, in either the stromal or glandular compartments.
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Affiliation(s)
| | | | | | | | - Edmund Chada Baracat
- Department of Obstetrics and Gynecology, Laboratory of Structural and Molecular Gynecology (LIM 58), Universidade de São Paulo Hospital das Clínicas, Sao Paulo, Brazil
| | - José Maria Soares Júnior
- Department of Obstetrics and Gynecology, Laboratory of Structural and Molecular Gynecology (LIM 58), Universidade de São Paulo Hospital das Clínicas, Sao Paulo, Brazil
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Di Serio M, Capozzi VA, Berretta R, Marcato C, Dall'Asta A, Frusca T. Conservative treatment for hypervascularised placental polyp with secondary haemoperitoneum: a case report. Acta Biomed 2021; 92:e2021157. [PMID: 33944840 PMCID: PMC8142775 DOI: 10.23750/abm.v92is1.9559] [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] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We describe the first case to our knowledge of Hypervascularised placental polyp (HPP) presenting with acute pelvic pain and hemoperitoneum. CASE REPORT A 33 years-old woman with a history of medical abortion three months earlier came to our attention complaining acute pelvic pain and vaginal bleeding. Transvaginal (TV) and transabdominal (TA) ultrasound (US) demonstrated a highly vascular intrauterine lesion and intra-abdominal free fluid consistent with a diagnosis of haemoperitoneum. Emergency laparoscopy yielded no intra-abdominal bleeding and was followed by bilateral selective embolization of the uterine arteries due to persistent vaginal bleeding. Hysteroscopy and pathology findings were consistent with a final diagnosis of HPP. CONCLUSION HPP may occur months or years after pregnancy or abortion and the clinical picture of abnormal vaginal bleeding associated with acute abdominal pain and haemoperitoneum should warrant to consider HPP among the differential diagnosis. Clinical and imaging findings need to be considered when planning the conservative management of HPP. Our experience suggests that uterine artery embolization is a safe and effective for the conservative treatment of highly vascularized HPP.
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Affiliation(s)
- Maurizio Di Serio
- Department of Medicine and Surgery, Unit of Surgical Sciences, Obstetrics and Gynecology, University of Parma.
| | - Vito Andrea Capozzi
- Department of Medicine and Surgery, Unit of Surgical Sciences, Obstetrics and Gynecology, University of Parma.
| | - Roberto Berretta
- Department of Medicine and Surgery, Unit of Surgical Sciences, Obstetrics and Gynecology, University of Parma.
| | - Carla Marcato
- Department of Radiology, University Hospital of Parma.
| | - Andrea Dall'Asta
- Department of Medicine and Surgery, Unit of Surgical Sciences, Obstetrics and Gynecology University of Parma.
| | - Tiziana Frusca
- Department of Medicine and Surgery, Unit of Surgical Sciences, Obstetrics and Gynecology University of Parma.
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Inayat F, Ur Rahman A, Wahab A, Riaz A, Zahid E, Bejarano P, Pimentel R. Gastric Inflammatory Fibroid Polyp: A Rare Cause of Occult Upper Gastrointestinal Bleeding. J Investig Med High Impact Case Rep 2021; 8:2324709620936840. [PMID: 32602395 PMCID: PMC7328486 DOI: 10.1177/2324709620936840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Inflammatory fibroid polyps (IFPs) are rare mesenchymal lesions that can arise
throughout the gastrointestinal tract. These tumors represent less than 0.1% of
all gastric polypoid lesions and are frequently found incidentally on endoscopic
evaluation. While presenting symptoms depend on the location of the tumor,
gastric polyps commonly present with epigastric pain and early satiety. We
hereby delineate the case of a middle-aged female who presented with chronic
iron deficiency anemia and a positive fecal occult blood test. She underwent an
upper endoscopy, which revealed an actively oozing umbilicated lesion in the
gastric antrum. Endoscopic ultrasound divulged the submucosal origin of the
lesion. It was subsequently excised using endoscopic mucosal resection.
Pathologic examination of the resected specimen confirmed the diagnosis of
gastric IFP. Furthermore, we conducted a systematic literature search of the
MEDLINE database centered on gastric IFPs from January 2000 till March 2020. The
data on patient demographics, clinical features, endoscopic findings, lesion
site and size, and treatment approaches were collected and analyzed. This
article illustrates the overarching need for clinicians to be vigilant of
gastric IFPs presenting with initial clinical symptoms suggestive of occult
upper gastrointestinal bleeding. Prompt diagnosis and management of gastric IFPs
carry paramount importance to combat chronic unexplained iron deficiency anemia
following occult bleeding in such patients. A concoction of endoscopy, biopsy,
and immunohistochemical examination can be employed toward their prompt
detection. Although gastric IFPs have conventionally been treated with surgery,
endoscopic resection is now emerging as a safe and efficient therapeutic
modality.
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Affiliation(s)
| | | | - Ahsan Wahab
- Baptist Medical Center South, Montgomery, AL, USA
| | - Amir Riaz
- Cleveland Clinic Florida, Weston, FL, USA
| | - Effa Zahid
- Services Institute of Medical Sciences, Lahore, Pakistan
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Ulmer K, Powers J, Alrwashdeh A, Hardy-Fairbanks A. Metastatic malignant melanoma in an endometrial polyp. Dermatol Online J 2021; 27:13030/qt9m97010n. [PMID: 33999583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023] Open
Abstract
Melanocytic metastasis to gynecologic organs is rare with most metastases to the ovaries. Metastases to the uterus, or in this case report, a uterine polyp, is exceedingly rare with only 17 cases reported in the literature. Post-menopausal bleeding is the most common presentation of metastatic melanoma in the endometrium, followed by uterine bleeding or abnormal postnatal bleeding in the premenopausal population. We present an 81-year-old woman with metastatic melanoma confined to an endometrial polyp leading to the diagnosis of widespread dissemination of the patient's acral melanoma resected 6 years prior. Although rare, metastatic melanoma should be considered as a cause for abnormal bleeding, especially in the post-menopausal patient with a history of melanoma.
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Wong M, Thanatsis N, Amin T, Bean E, Madhvani K, Jurkovic D. Ultrasound diagnosis of endometrial cancer by subjective pattern recognition in women with postmenopausal bleeding: prospective inter-rater agreement and reliability study. Ultrasound Obstet Gynecol 2021; 57:471-477. [PMID: 32621381 DOI: 10.1002/uog.22141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/15/2020] [Accepted: 06/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To assess the inter-rater agreement and reliability of using subjective pattern recognition for diagnosing endometrial cancer (EC) on ultrasound in women with postmenopausal bleeding (PMB). METHODS This was a prospective cross-sectional study conducted at a gynecological rapid-access clinic, between October 2016 and December 2017, in which consecutive women with PMB and endometrial thickness of ≥ 4.5 mm on transvaginal ultrasound examination were included. Women on hormone replacement therapy or tamoxifen and those with a history of primary gynecological malignancy were excluded. Two raters independently performed ultrasound examinations, blinded to each other's findings, and classified women as having uniformly thickened endometrium, benign endometrial polyp or EC, using subjective pattern recognition. Inter-rater reliability of ultrasound diagnosis was assessed using Cohen's kappa (κ) statistic. All women subsequently underwent either outpatient endometrial biopsy, hysteroscopy or hysterectomy. RESULTS Forty women were included in the study, with a median age of 61 (interquartile range (IQR), 57-69) years and a median endometrial thickness of 11.0 (IQR, 6.2-20.3) mm. Final histological analysis confirmed 16 (40%) women with EC, 16 (40%) with benign endometrial polyp, four (10%) with atrophic endometrium, three (8%) with proliferative endometrium and one (3%) with endometrial hyperplasia. Inter-rater agreement for the ultrasound diagnoses of uniformly thickened endometrium, benign endometrial polyp and EC was 14/16 (87.5%), 22/30 (73.3%) and 28/34 (82.4%), respectively; inter-rater reliability was good (κ = 0.69; 95% CI, 0.49-0.88). When the ultrasound diagnoses were grouped as either cancer or no cancer, inter-rater agreement was 85% and inter-rater reliability was good (κ = 0.78; 95% CI, 0.61-0.95). Rater A correctly identified 14/16 cases of EC and Rater B identified 15/16. EC was misdiagnosed as benign polyps on ultrasound in two women by Rater A and in one woman by Rater B. The overall accuracies of Rater A and Rater B in differentiating between benign endometrial pathologies and malignancy were 90% and 90%, respectively. CONCLUSIONS Our results show good inter-rater reliability of subjective pattern recognition in diagnosing uniformly thickened endometrium, benign endometrial polyp and EC on ultrasound in women with PMB. Our findings should facilitate wider use of subjective pattern recognition in routine clinical practice. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M Wong
- Institute for Women's Health, University College London Hospital, London, UK
| | - N Thanatsis
- Institute for Women's Health, University College London Hospital, London, UK
| | - T Amin
- Institute for Women's Health, University College London Hospital, London, UK
| | - E Bean
- Institute for Women's Health, University College London Hospital, London, UK
| | - K Madhvani
- Department of Gynaecology, Poole Hospital, Dorset, UK
| | - D Jurkovic
- Institute for Women's Health, University College London Hospital, London, UK
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Abstract
Endometrial polyps are one of the common reasons of abnormal uterine bleeding in women. Industrialisation, urbanisation and increased air pollution cause increased heavy metal exposure. Heavy metals that have oestrogenic effects in human body are named as metalloestrogens. The aim of this study was to investigate the serum metalloestrogen levels such as copper (Cu), zinc (Zn), aluminium (Al), lead (Pb), nickel (Ni) and Cu/Zn ratio and their possible relationship with the occurrence of endometrial polyps. Eighty women with abnormal uterine bleeding were divided into two groups: 40 women diagnosed with endometrial polyp (study group) and 40 women without endometrial polyp (control group). Ages, body mass indices, smoking behaviours, drinking water choices, chronic diseases and intrauterine device histories were noted for all patients. Blood levels of Cu, Zn, Al, Pb, Ni and Cu/Zn ratio were analysed by inductively coupled plasma-mass spectrometry method for both groups. No statistically significant differences were observed in terms of serum median levels of Cu and Pb between the study and the control groups. The serum median levels of Zn, Ni and Al were found to be statistically lower in the study group when compared with the control group. The Cu/Zn ratio was statistically higher in the study group. High Cu/Zn ratio, as a biomarker of oxidative stress, suggests the role of oxidative stress in etiopathogenesis of endometrial polyps.IMPACT STATEMENTWhat is already known on this subject? Studies demonstrate that oestrogen and progesterone play an important role in pathogenesis of endometrial polyps. Inorganic heavy metal ions that bind and activate oestrogen receptors are referred to as 'metalloestrogens'. Apart from toxic effects, metalloestrogens have been linked to the aetiology of oestrogen-dependent diseases such as breast and endometrium cancer and endometriosis. However, serum levels of heavy metals were not investigated in a large group of endometrial polyp patients.What do the results of this study add? This is the first study investigating the serum levels of heavy metals in a large group of endometrial polyp patients. We did not observe any increased serum levels of heavy metals in endometrial polyp patients. Our results might suggest that oestrogenic heavy metal exposure has no role in the appearance of endometrial polyps. However, increased Cu/Zn ratio due to low serum levels zinc suggests oxidative stress might play a role in endometrial polyps.What are the implications of these findings for clinical practice and/or further research? Further research of heavy metals in endometrial polyps with simultaneous blood and tissue samples could show the precise effect of environmental exposure of metalloestrogens in aetiopathogenesis of endometrial polyps.
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Affiliation(s)
- Betül Kalkan Yılmaz
- Zekai Tahir Burak Women's Health Education and Research Center, Department of Obstetrics and Gynecology, University of Health Sciences, Ankara, Turkey
| | - Özlem Evliyaoğlu
- Zekai Tahir Burak Women's Health Education and Research Center, Department of Obstetrics and Gynecology, University of Health Sciences, Ankara, Turkey
| | - Ayçağ Yorgancı
- Zekai Tahir Burak Women's Health Education and Research Center, Department of Obstetrics and Gynecology, University of Health Sciences, Ankara, Turkey
| | - Şebnem Özyer
- Zekai Tahir Burak Women's Health Education and Research Center, Department of Obstetrics and Gynecology, University of Health Sciences, Ankara, Turkey
| | - Yaprak Engin Üstün
- Zekai Tahir Burak Women's Health Education and Research Center, Department of Obstetrics and Gynecology, University of Health Sciences, Ankara, Turkey
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Heller Murray ES, Segina RK, Woodnorth GH, Stepp CE. Relative Fundamental Frequency in Children With and Without Vocal Fold Nodules. J Speech Lang Hear Res 2020; 63:361-371. [PMID: 32073342 PMCID: PMC7210445 DOI: 10.1044/2019_jslhr-19-00058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Purpose Relative fundamental frequency (RFF) is an acoustic measure that is sensitive to functional voice differences in adults. The aim of the current study was to evaluate RFF in children, as there are known structural and functional differences between the pediatric and adult vocal mechanisms. Method RFF was analyzed in 28 children with vocal fold nodules (CwVN, M = 9.0 years) and 28 children with typical voices (CwTV, M = 8.9 years). RFF is the instantaneous fundamental frequency (f 0) of the 10 vocalic cycles during devoicing (vocal offset) and 10 vocalic cycles during the revoicing (vocal onset) of the vowels that surround a voiceless consonant. Each cycle's f 0 was normalized to a steady-state portion of the vowel. RFF values for the cycles closest to the voiceless consonant, that is, Offset Cycle 10 and Onset Cycle 1, were examined. Results Average RFF values for Offset Cycle 10 and Onset Cycle 1 did not differ between CwVN and CwTV; however, within-subject variability of Offset Cycle 10 was decreased in CwVN. Across both groups, male children had lower Offset Cycle 10 RFF values as compared to female children. Additionally, Onset Cycle 1 values were decreased in younger children as compared to those of older children. Conclusions Unlike previous work with adults, CwVN did not have significantly different RFF values than CwTV. Younger children had lower RFF values for Onset Cycle 1 than older children, suggesting that vocal onset f 0 may provide information on the maturity of the laryngeal motor system.
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Affiliation(s)
- Elizabeth S. Heller Murray
- Department of Speech, Language & Hearing Sciences, Boston University, MA
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, MA
| | - Roxanne K. Segina
- Department of Speech, Language & Hearing Sciences, Boston University, MA
| | | | - Cara E. Stepp
- Department of Speech, Language & Hearing Sciences, Boston University, MA
- Department of Otolaryngology—Head & Neck Surgery, Boston University School of Medicine, MA
- Department of Biomedical Engineering, Boston University, MA
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Al Nemer AM, Al Bayat MI, Al Qahtani NH. The accuracy of endometrial sampling for the diagnosis of patterns of endometrial pathology in women presenting with abnormal uterine bleeding. More conservative therapeutic approaches. Saudi Med J 2020; 40:815-819. [PMID: 31423519 PMCID: PMC6718861 DOI: 10.15537/smj.2019.8.24449] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objectives: Abnormal uterine bleeding (AUB) is a leading cause of hysterectomies, the cause of which is usually diagnosed with preoperative endometrial sampling. We planned this study to assess the accuracy of diagnosing the histologic patterns of endometrium in the preoperative sample in reference to the final histologic diagnosis in hysterectomy. Methods: We retrospectively reviewed medical charts between January 2011 and December 2015 at a tertiary hospital in Saudi Arabia and identified 43 cases of AUB with complete documentation. The histologic diagnoses were classified into normal and benign pathology group (N/B), or carcinoma and hyperplasia category (Ca/H). Measures of validity were used to compare endometrial sampling histological diagnoses to diagnoses following hysterectomy and Cohen’s kappa to assess for agreement between the 2 modalities. Results: The median age of all patients was 49 years. Preoperative histologic examination showed 53.8% sensitivity, 90% specificity, 70% positive predictive values and 81.8% negative predictive values, 30.1% false positive rates and 18.2% false negative rates. The agreement between preoperative and postoperative histologic diagnoses was moderate (79.1%, k=0.469). Conclusion: The accuracy of preoperative histologic examination was moderate. Our findings recommend cautious clinical decision making and limiting hysterectomy to women who do not respond to other therapeutic measures.
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Affiliation(s)
- Areej M Al Nemer
- Pathology Department, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia. E-mail.
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Abstract
Endometrial polyps, adenomyosis, and leiomyomas are commonly encountered abnormalities frequently found in both fertile women and those with infertility. The clinician is frequently challenged to determine which of these entities, when found, is likely to impair fertility, and which are "innocent bystanders" unrelated to the problem at hand. Although removing an endometrial polyp may be seen as a relatively benign and safe intervention, myomectomy, and in particular adenomyomectomy, can be substantive surgical procedures, associated with their own potential for disrupting fertility. One of the mechanisms thought to be involved when these entities are contributing to infertility is an adverse impact on endometrial receptivity. Indeed polyps, adenomyosis, and leiomyomas have all been associated with an increased likelihood of abnormal endometrial molecular expressions thought to impair implantation and early embryo development. This review is designed to examine the relationship of these common entities to endometrial receptivity and to identify evidence gaps that should be considered when strategizing research initiatives. It is apparent that we have the tools necessary to fill these gaps, but it will be necessary to approach the issue in a strategic and coordinated fashion. It is likely that we will have to recognize the limitations of imaging alone and look to the evidence-based addition of molecular analysis to provide the individualized phenotyping of disease necessary for patient-specific treatment decisions.
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Affiliation(s)
- Malcolm G Munro
- Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, California; Department of Obstetrics and Gynecology, Kaiser-Permanente, Los Angeles Medical Center, Los Angeles, California.
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McGrath M, Jegatheeswaran K, Braga LH. Medusa's Curls: Ureteropelvic Junction Obstruction Secondary to Multiple Long Intraluminal Polyps. Urology 2019; 130:138-141. [PMID: 31063764 DOI: 10.1016/j.urology.2019.04.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/17/2019] [Accepted: 04/23/2019] [Indexed: 11/16/2022]
Abstract
Fibroepithelial polyps represent a rare cause of intrinsic ureteropelvic junction obstruction in the pediatric population, accounting for less than 5% of cases. Herein, we present this peculiar case of a 10-year-old boy with multiple large intraluminal FEPs resembling Medusa's hair and the challenges associated with its subsequent treatment plan.
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Affiliation(s)
- Melissa McGrath
- McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Ontario, Canada; Division of Urology, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Kizanee Jegatheeswaran
- McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Ontario, Canada
| | - Luis H Braga
- McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Ontario, Canada; Division of Urology, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada.
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40
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Khoramshahi H, Khatoonabadi AR, Khoddami SM, Dabirmoghaddam P, Ansari NN. Responsiveness of Persian Version of Consensus Auditory Perceptual Evaluation of Voice (CAPE-V), Persian Version of Voice Handicap Index (VHI), and Praat in Vocal Mass Lesions with Muscle Tension Dysphonia. J Voice 2018; 32:770.e21-770.e30. [PMID: 29029830 DOI: 10.1016/j.jvoice.2017.08.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 05/16/2017] [Revised: 08/07/2017] [Accepted: 08/09/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study was aimed at determining the internal and external responsiveness of the Persian version of the Consensus Auditory-Perceptual Evaluation of Voice (called ATSHA), Persian version of the Voice Handicap Index (VHI), and Praat scales among patients with vocal mass lesions and secondary muscle tension dysphonia. STUDY DESIGN Prospective, within-participant repeated measures. METHOD Thirty patients with vocal fold nodules, polyps, and cysts related to secondary muscle tension dysphonia participated in the study. The measures of interest and videostroboscopy examination were used before and after treatment. The Global Perceived Effect questionnaire was used to separate those improved (moderately or greatly improved) and stable (slightly improved) patients. RESULTS The mean standardized response, standardized effect size, and Guyatt analyses indicated high internal responsiveness for the all target parameters of the ATSHA, total score of the VHI, and two parameters of the Praat (0.8<). There was poor correlation between the videostroboscopy and the other target scales (r Pearson = -0.1-0.1). The receiver operating characteristic analysis indicated that all the target scales did not significantly separate those improved and stable subjects (area under the curve = 0), except for the overall severity and roughness parameters of the ATSHA scale (area under the curve = 1). CONCLUSION This study recommends both the Consensus Auditory-Perceptual Evaluation of Voice and the VHI scales to show voice therapy changes. The target voice scale changes were not able to predict the videostroboscopy changes as external standard. Furthermore, we recommend that the overall severity and roughness may properly classify those improved and stable patients.
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Affiliation(s)
- Hassan Khoramshahi
- Tehran University of Medical Sciences, School of Rehabilitation, Speech Therapy Department, Tehran, Iran
| | - Ahmad Reza Khatoonabadi
- Tehran University of Medical Sciences, School of Rehabilitation, Speech Therapy Department, Tehran, Iran.
| | - Seyyedeh Maryam Khoddami
- Tehran University of Medical Sciences, School of Rehabilitation, Speech Therapy Department, Tehran, Iran
| | - Peyman Dabirmoghaddam
- Tehran University of Medical Sciences, School of Rehabilitation, Speech Therapy Department, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran; Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran; Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
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Abstract
The author reports the case of a patient with a tuberculosis-associated endobronchial inflammatory polyp. Acid-fast bacillus (AFB) staining and culturing of sputum and bronchial washing fluid specimens were negative on three occasions. Biopsy results twice showed chronic inflammation. The patient was finally diagnosed with Mycobacterium tuberculosis based on a polymerase chain reaction (PCR) of a biopsy tissue specimen, along with the finding of chronic granulomatous inflammation. The author herein reports a rare case of a tuberculosis-associated endobronchial inflammatory polyp that was AFB smear- and culture-negative and the patient's clinical course after treatment.
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Affiliation(s)
- Eun Jin Kim
- Department of Internal Medicine, Daegu Catholic University Medical Center, Korea
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42
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Köklü S, Guler G. An unusual cause of anemia : familial hyperplastic gastric polyposis. Acta Gastroenterol Belg 2018; 81:445-446. [PMID: 30350540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- S Köklü
- Professor of Gastroenterology, Ortadogu 19 Mayis Hospital, Dikmen, Cankaya, Ankara, Turkey
| | - G Guler
- Professor of Pathology, Hekim Center, Cankaya, Ankara, Turkey
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Ekici U, Yilmaz S, Tatli F. Ileocecal invagination due to an inflammatory fibroid polyp. A case report. Ann Ital Chir 2018; 89:347-349. [PMID: 30337504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The invagination develops as a result of the dislocation of proximal bowel segment within the following distal portion. It is rarely seen in adult population. It generally develops as a result of intestinal wall neoplasia in the adult patients. Only 3-6% of gastrointestinal system tumors are seen to be localized to small bowels. Inflammatory fibroid polyp is a rarely seen benign tumor in gastrointestinal system. We present the case of 47 year-old female with ileo-cecal invagination caused by Inflammatory fibroid polyp in ileum. KEY WORDS: Invagination, Intusseption, Inflamaotry Fibroid Polyp.
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Noguerón García A, Hernán Calvo F, Viguera Garrido L, Abizanda Soler P. [Gastrointestinal bleeding secondary to cholesterol embolus polyp as the first manifestation of primary biliary cirrhosis in an older adult]. Rev Esp Geriatr Gerontol 2017; 52:288-290. [PMID: 28457688 DOI: 10.1016/j.regg.2017.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 03/04/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Alicia Noguerón García
- Servicio de Geriatría, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - Félix Hernán Calvo
- Servicio de Digestivo, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - Legna Viguera Garrido
- Servicio de Anatomía Patológica, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - Pedro Abizanda Soler
- Servicio de Geriatría, Complejo Hospitalario Universitario de Albacete, Albacete, España.
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Bittencourt CA, Dos Santos Simões R, Bernardo WM, Fuchs LFP, Soares Júnior JM, Pastore AR, Baracat EC. Accuracy of saline contrast sonohysterography in detection of endometrial polyps and submucosal leiomyomas in women of reproductive age with abnormal uterine bleeding: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2017; 50:32-39. [PMID: 27862503 DOI: 10.1002/uog.17352] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 10/27/2016] [Accepted: 10/28/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To analyze the diagnostic accuracy of two- (2D) and three- (3D) dimensional saline contrast sonohysterography (SCSH) in the detection of endometrial polyps and submucosal uterine leiomyomas in women of reproductive age with abnormal uterine bleeding compared with gold standard hysteroscopy. METHODS A systematic review of diagnostic studies that compared 2D- and/or 3D-SCSH with hysteroscopy and anatomopathology was conducted according to PRISMA and SEDATE recommendations. The databases MEDLINE, EMBASE and The Cochrane Library were searched electronically using specific terms with no restriction on language or publication year. Quality assessment of included studies was performed using the QUADAS-2 tool. Meta-analysis was performed with the Meta-DiSk program and data presented as forest plots and summary receiver-operating characteristics (SROC) curves. Pooled sensitivity, specificity and positive (LR+) and negative (LR-) likelihood ratios of SCSH in the detection of uterine cavity abnormalities were calculated. RESULTS A total of 1398 citations were identified and five studies were included in the systematic review and meta-analysis. Pooled sensitivity and specificity of 2D-SCSH in detecting endometrial polyps were 93% (95% CI, 89-96%) and 81% (95% CI, 76-86%), respectively, with pooled LR+ of 5.41 (95% CI, 2.60-11.28) and LR- of 0.10 (95% CI, 0.06-0.17). In the detection of submucosal uterine leiomyomas, pooled sensitivity and specificity were 94% (95% CI, 89-97%) and 81% (95% CI, 76-86%), respectively, with pooled LR+ of 4.25 (95% CI, 2.20-8.21) and LR- of 0.11 (95% CI, 0.05-0.22). 2D-SCSH had good accuracy in detecting endometrial polyps and submucosal uterine leiomyomas, with areas under the SROC curves of 0.97 ± 0.02 and 0.97 ± 0.03, respectively. Studies that analyzed the diagnostic accuracy of 3D-SCSH could not be compared due to high heterogeneity related to menopausal status, type of technique used and primary outcome being investigation of infertility. CONCLUSIONS 2D-SCSH proved to be a highly sensitive method for detection of endometrial polyps and submucosal uterine leiomyomas, making it a potential first-line diagnostic method in the work-up for women with abnormal uterine bleeding. More studies are needed on 3D-SCSH in women of reproductive age. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- C A Bittencourt
- Disciplina de Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - R Dos Santos Simões
- Disciplina de Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - W M Bernardo
- Disciplina de Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - L F P Fuchs
- Disciplina de Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - J M Soares Júnior
- Disciplina de Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - A R Pastore
- Disciplina de Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - E C Baracat
- Disciplina de Ginecologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Takeda T, Asaoka D, Tajima Y, Matsumoto K, Takeda N, Hiromoto T, Okubo S, Saito H, Aoyama T, Shibuya T, Sakamoto N, Hojo M, Osada T, Nagahara A, Yao T, Watanabe S. Hemorrhagic polyps formed like fundic gland polyps during long-term proton pump inhibitor administration. Clin J Gastroenterol 2017; 10:478-484. [PMID: 28660530 PMCID: PMC5606985 DOI: 10.1007/s12328-017-0756-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 06/13/2017] [Indexed: 01/15/2023]
Abstract
We report a rare case of hemorrhagic gastric polyps resulting in anemia during long-term proton pump inhibitor (PPI) administration that endoscopically looked like a fundic gland polyp (FGP). A 44-year-old man presented complaining of anemia and tarry stools. Esophagogastroduodenoscopy (EGD) demonstrated multiple white edematous polyps in the corpus and antrum, which were considered to be FGPs. We attempted endoscopic hemostasis but hemorrhaging increased because of hemorrhagic polyps and vulnerable gastric mucosa. Re-bleeding occurred several times. Polyp resection was performed at 24 polyp sites. We also ceased the administration of PPI. Microscopically, polyps showed characteristics of hyperplasia in the foveolar epithelium, extensions of fundic glands, and edema of the stroma. The proliferation of parietal and chief cells was also observed. Immunohistochemically, aquaporin-4 (AQP4) and KCNQ1-positive parietal cells and dilated mucous glands were found from the basal side to the apical side of the mucosa. These findings were compatible with the development of lesions associated with the long-term administration of PPI. EGD revealed an improvement in the vulnerability of gastric mucosa and the development of polyps, with no further gastric polyps observed 1 year after discharge. Bleeding from polyps resembling FGPs is generally rare, with indications that long-term PPI administration may induce such bleeding.
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Affiliation(s)
- Tsutomu Takeda
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan.
| | - Daisuke Asaoka
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuzuru Tajima
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
- Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan
| | - Kenshi Matsumoto
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Naoto Takeda
- Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Takahumi Hiromoto
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shoki Okubo
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Tomonori Aoyama
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Tomoyoshi Shibuya
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Naoto Sakamoto
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Mariko Hojo
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Taro Osada
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Akihito Nagahara
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Takashi Yao
- Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan
| | - Sumio Watanabe
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
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Hirten R, Cohen BL, Colombel JF. Colonic Pseudopolyps Resulting in Iron Deficiency Anemia. Clin Gastroenterol Hepatol 2017; 15:A27. [PMID: 28110094 PMCID: PMC6692070 DOI: 10.1016/j.cgh.2017.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 01/10/2017] [Accepted: 01/10/2017] [Indexed: 02/07/2023]
Affiliation(s)
- Robert Hirten
- Division of Gastroenterology, Icahn School of Medicine at The Mount Sinai Hospital, New York, New York
| | - Benjamin L Cohen
- Division of Gastroenterology, Icahn School of Medicine at The Mount Sinai Hospital, New York, New York
| | - Jean-Frederic Colombel
- Division of Gastroenterology, Icahn School of Medicine at The Mount Sinai Hospital, New York, New York
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48
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Affiliation(s)
- Jordan Axelrad
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York
| | - Mark Lebwohl
- Department of Dermatology, the Icahn School of Medicine at Mount Sinai, New York, New York
| | - Oscar Lebwohl
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York
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49
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Abstract
Cap polyposis is extremely rare in children. We report a case of an 11-month-old male infant who visited our hospital because of rectal prolapse and small amount of hematochezia lasting several days. He also had an epidermal nevus in the sacral area. Colonoscopy showed erythematous, multilobulated, circumferential, polypoid lesions with mucoid discharge from the rectum. He was diagnosed with cap polyposis by endoscopy and histologic examination. He was treated with surgical resection, and was closely followed up. In the relevant literature, there is no report of cap polyposis in an infant. We report the first case of cap polyposis in the youngest infant.
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Affiliation(s)
- Soon Chul Kim
- Department of Pediatrics, Chonbuk National University Medical School, Chonbuk National University Hospital, Jeonju, Korea
- Research Institute of Clinical Medicine-Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea
| | - Myoung Jae Kang
- Department of Pathology, Chonbuk National University Medical School, Chonbuk National University Hospital, Jeonju, Korea
| | - Yeon Jun Jeong
- Division of Pediatric Surgery, Chonbuk National University Medical School, Chonbuk National University Hospital, Jeonju, Korea
| | - Pyoung Han Hwang
- Department of Pediatrics, Chonbuk National University Medical School, Chonbuk National University Hospital, Jeonju, Korea
- Research Institute of Clinical Medicine-Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.
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50
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Pasman EA, Heifert TA, Nylund CM. Esophageal squamous papillomas with focal dermal hypoplasia and eosinophilic esophagitis. World J Gastroenterol 2017; 23:2246-2250. [PMID: 28405153 PMCID: PMC5374137 DOI: 10.3748/wjg.v23.i12.2246] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 02/24/2017] [Accepted: 03/06/2017] [Indexed: 02/06/2023] Open
Abstract
Focal dermal hypoplasia (FDH) is a rare disorder of the mesodermal and ectodermal tissues. Here we present an eight-year-old female known to have FDH who presents with poor weight gain and dysphagia. She was diagnosed with multiple esophageal papillomas and eosinophilic esophagitis. She was successfully treated with argon plasma coagulation and ingested fluticasone propionate, which has not been described previously in a child.
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