Purpose
Exploring potential risk factors for OMA recurrence, thereby contributing to the individual management of the disease and improving the patients’ prognosis.
Methods
Data sources PubMed, ...Embase, the Cochrane Library, CNKI, and Wanfang data were searched systematically before October 2020. We computed the pooled odd ratios or the standard mean difference with their corresponding 95% confidence interval to investigate the impact of involved risk factors on endometrioma recurrence.
Results
The pooled findings of this meta-analysis demonstrated that endometrioma relapse was closely related to age at surgery SMD (95% CI): − 0.28 (- − 0.38 to − 0.17),
P
< 0.00001, CA125 level SMD (95% CI): 0.51 (0.14–0.88),
P
= 0.007, cyst size SMD (95% CI): 0.35 (0.08–0.62),
P
= 0.01, dysmenorrhea OR (95% CI): 1.47 (1.07–2.02),
P
= 0.02, endometriosis-related surgery history OR (95% CI): 2.60 (1.84–3.67),
P
< 0.00001, pre-operative medication OR (95% CI): 2.13 (1.41–3.22),
P
= 0.0003, rASRM score SMD (95% CI): 0.33 (0.20–0.46),
P
< 0.00001. Furthermore, post-operative pregnancy was indicated a protective factor for preventing the OMA recurrence after surgery OR (95% CI): 0.22 (0.09–0.56),
P
= 0.001
Conclusion
Age at surgery, CA125 level, cyst size, dysmenorrhea, endometriosis-related surgery history, pre-operative medication, rASRM score were risk factors for endometrioma relapse. In addition, post-operative pregnancy was a protective factor for preventing recurrence after surgery. However, the effect of bilateral involvement, combination with adenomyosis, or post-operative medication on endometrioma relapse need further investigations.
Sentinel lymph node in colorectal cancer Bacalbasa, Nicolae; Balescu, Irina; Dimitriu, Mihai ...
Revista medicală Română,
03/2019, Letnik:
66, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Colorectal cancer represents one of the most encountered malignancies worldwide, with a high capacity of lymphatic spread. Therefore, the lymph node status plays a crucial role in order to tailor the ...adjuvant treatment and to decrease the recurrence rates. In consequence, performing the sentinel lymph node detection in colorectal cancer patients should orientate the surgeon’s attention on the lymphatic basins of drainage and, furthermore to orientate the lymph node dissection. However, the method has certain particularities in colorectal patients depending on the location of tumor, on the size and on the type of associated neoadjuvant therapy. This is a literature review of the most relevant studies conducted on this theme.
Abstract Foetus in fetu is a rare tumor of the child. CT and/or MRI suggest this diagnosis. Differential diagnosis with mature multicellular teratoma can be difficult. Here we reported the case of a ...girl born at 37 weeks, that presented a voluminous mastoïd mass on the left side treatment by initially by surgery. Until age of 9 years, she developed a tumor recurrence localized at the skull base near the left cerebello ponting angle requiring a neurosurgical approach with a good following. The pathology was finally a teratoma. Total removal must be a goal of the initial surgical treatment but a long term follow up is mandatory to avoid recurrence.
Les neuropathies optiques (NO) inflammatoires représentent une situation clinique fréquente en neurologie et en ophtalmologie. Lorsque les examens paracliniques sont négatifs (notamment l’IRM et la ...ponction lombaire) la NO est habituellement dite « idiopathique » suspectant un contexte viral. Cependant, dans un certain nombre de cas, malgré la normalité des examens complémentaires, celle-ci va récidiver ou être suivi d’une myélite. On parlera alors, dans le premier cas, de neuropathie optique inflammatoire récidivante (NOIR) ou, dans le second cas, de neuromyélite optique (NMO) de Devic. Les critères prédictifs d’une éventuelle récidive ou d’une extension de la maladie à la moelle sont encore mal établis en dehors peut être des anticorps anti-NMO qui semblent assez prédictifs d’une évolution ultérieure vers une NMO. Dans cette revue, nous étudierons successivement ces deux situations cliniques en essayant de trouver des critères diagnostiques et évolutifs les plus précis possibles.
Inflammatory optic neuritis (ON) represents a frequent clinical situation in neurology and ophthalmology. When MRI and CSF analysis are normal, ON is considered idiopathic with a suspected viral etiology. However, in several cases either a recurrence or a myelitis may occur. In the first case, it is relapsing inflammatory optic neuritis (RION) and in the second case it is neuromyelitis optica (NMO). Nevertheless, predictive criteria of a recurrence or an extension of the disease to spinal cord remains unknown, excepted for anti-NMO IgG antibodies which are probably highly specific for a future evolution to NMO. In the present paper, the authors successively present the two clinical situations (RION and NMO) and attempt to summarize diagnostic and prognostic criteria.
Objective The current methods of detection of recurrent colorectal cancer after surgical treatment are inaccurate using conventional imaging. This study set out to detect early recurrence by means ...of PET in patients treated surgically for colorectal cancer by curative resection.
Methods Thirty‐one disease‐free patients were recruited and underwent FDG‐PET. The results were verified by clinical, surgical and radiological follow up and/or biopsy to evaluate the accuracy for detecting recurrence.
Results PET detected 6 sites of increased activity in 5 patients. Three of these underwent surgery. One was false positive with no evident tumour and two underwent an hepatic resection with removal of a homental metastasis. The sensitivity was 100% and specificity 83.3%. Clinical management was altered in two cases (6.4%).
Conclusions This study demostrates that PET is more accurate than conventional imaging for the evaluation of recurrence in colorectal cancer patients. FDG‐PET should be considered in the follow‐up of patients after treatment for colorectal cancer in addition to other imaging methods.
Depression is a serious condition associated with a high rate of recurrence in all populations of depressed patients. Research studies in the past have focused more on the criteria for onset of ...depressive disorder than on consistent criteria for outcome. However, the issue of concern to the patient is whether their depression is a lifelong condition or a condition from which they can reasonably expect to make a complete recovery. The issues surrounding recovery from depression are reviewed in the following article. The lifetime prognosis of depression is examined with reference to the Zürich follow-up study, and outcome criteria and the importance of assessing recovery in terms of quality of life as well as symptomatic improvement are considered. The relevance of clinical trial results to the clinical management of depression is also addressed.
Making decisions about any modality of secondary prophylaxis in patients with venous thromobembolism (VTE) has to balance the risk of bleeding induced by anticoagulants against the benefit of ...reducing the risk of recurrent disease. It has to be kept in mind that the magnitude of risk is not only defined by the number of events per time period but also by the impact of the event on the fate of the patient. With standard intensity Vitamin K antagonists, the risk of bleeding is more closely related to comorbidities than to other factors, e.g. age. The risk of VTE recurrence differs largely between patient groups. The criterion of presence, or absence of a permanent or transient clinical trigger factor for the actual VTE episode has a greater impact than an abnormal result in thrombophilia testing. The standard period ofsecondary prophylaxis for proximal deep vein thrombosis and for pulmonary embolism is three to six months. The concept of prolonging this period for several months according to the risk of recurrence is seriously challanged by the observation that the prolongation period seems to delay recurrencies rather than truly avoiding them. For this reason, patients who clearly are threatened by recurrent episodes should receive indefinitive secondary prophylaxis. This is the case for cancer patients, patients with the antiphospholipid syndrome, and those who belong to families with severe and symptomatic protein C, protein S, or antithrombin deficiencies. Patients with recurrent VTE, with idiopathic VTE, or with combined thrombophilic conditions may only benefit from indefinitive secondary prophylaxis if the bleeding risk of the anticoagulant regimen under consideration is very low.
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