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Determining the relationship between gynecologic cancer awareness and health literacy among women of reproductive age: a descriptive study. 确定育龄妇女对妇科癌症的认识与健康知识之间的关系:一项描述性研究。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-04 DOI: 10.1007/s00404-024-07806-6
Fatma Nur Duman, Ayse Ozdemir, Zehra Golbasi

Purpose: To determine the relationship between gynecologic cancer awareness and health literacy among women of reproductive age.

Methods: This study was conducted in a descriptive design and involved 510 women. Data collection utilized the "Personal Information Form", "Gynecologic Cancer Awareness Scale (GCAS)" and "Health Literacy Scale (HLS)", gathered. Pearson correlation and linear regression analyses, independent samples t-test, one-way analysis of variance and post hoc analyses were employed for data analysis. Effect sizes were calculated using eta-squared (η2) coefficients.

Results: The mean total score of women on the GCAS was 154.42 ± 18.27, while the mean total score on the HLS was 57.07 ± 7.86. Significant differences were observed in women's GCAS total scores concerning age, perceived income status, and history of gynecological examination, whereas significant differences were noted in HLS total scores concerning age, educational status, marital status, and perceived income status. A weak positive correlation was detected betwixt women's GCAS and HLS total scores. It was determined that 20.8% of the total variation in gynecologic cancer awareness level was explained by health literacy.

Conclusion: Women exhibit an above-average level of awareness regarding gynecologic cancers. Health literacy level contributes to an increase in gynecologic cancer awareness.

目的:确定育龄妇女对妇科癌症的认识与健康知识之间的关系:本研究采用描述性设计,涉及 510 名妇女。数据收集采用了 "个人信息表"、"妇科癌症认知量表(GCAS)"和 "健康素养量表(HLS)"。数据分析采用了皮尔逊相关分析、线性回归分析、独立样本 t 检验、单因素方差分析和事后分析。效应大小用等方系数(η2)计算:女性在 GCAS 中的平均总分为(154.42 ± 18.27)分,而在 HLS 中的平均总分为(57.07 ± 7.86)分。妇女的 GCAS 总分在年龄、认为的收入状况和妇科检查史方面存在显著差异,而 HLS 总分在年龄、教育状况、婚姻状况和认为的收入状况方面存在显著差异。妇女的 GCAS 和 HLS 总分之间存在微弱的正相关。结论:妇女对妇科癌症的认知水平高于平均水平:结论:女性对妇科癌症的认知水平高于平均水平。健康素养水平有助于提高对妇科癌症的认识。
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引用次数: 0
Association of ovarian teratoma with anti-N-methyl-D-aspartate receptor encephalitis: a case report and narrative review. 卵巢畸胎瘤与抗 N-甲基-D-天冬氨酸受体脑炎的关系:病例报告和综述。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-04 DOI: 10.1007/s00404-024-07779-6
Konrad Joseph, Sarah van der Hock, Ishith Seth, Nipuni Hapangama, Lara Gibson, Roberto Cuomo, Warren M Rozen, Nita Dhupar

Background: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a potentially life-threatening autoimmune disorder which is strongly associated with ovarian teratomas in young female patients. The primary aim is to highlight the importance of considering NMDAR encephalitis in the differential diagnosis of young female patients presenting with acute or subacute neuropsychiatric symptoms, especially when accompanied by ovarian teratomas.

Case description: This case report and literature review detail the presentation, diagnosis, and treatment of a 35-year-old G4P3 Indigenous woman who initially presented with neuropsychiatric symptoms and fever, having a history of extensive drug and alcohol use. Misdiagnosed initially, the patient's lack of response to standard treatments led to further investigations, revealing paraneoplastic anti-NMDAR encephalitis secondary to a left ovarian teratoma. The report examines the treatment regimen followed, including prednisolone, intravenous immunoglobulin, rituximab injections, and laparoscopic bilateral salpingo-oophorectomy.

Conclusions: This case underscores the critical need for increased clinical vigilance for anti-NMDAR encephalitis in patients, particularly young females, presenting with neuropsychiatric symptoms and potential ovarian teratomas. The literature review accompanying the case report provides valuable insights into the presentation, diagnosis, and management of this complex condition. Lastly, this study emphasised the diagnostic challenges inherent in paraneoplastic neuropsychiatric syndromes, advocating for a multidisciplinary approach in similar clinical scenarios.

背景:抗 N-甲基-D-天冬氨酸受体(NMDAR)脑炎是一种可能危及生命的自身免疫性疾病,与年轻女性患者的卵巢畸胎瘤密切相关。主要目的是强调在对出现急性或亚急性神经精神症状的年轻女性患者进行鉴别诊断时考虑 NMDAR 脑炎的重要性,尤其是伴有卵巢畸胎瘤的患者:本病例报告和文献综述详细描述了一名 35 岁 G4P3 土著妇女的表现、诊断和治疗情况,该妇女最初出现神经精神症状和发热,有大量吸毒和酗酒史。该患者最初被误诊,但由于对标准治疗缺乏反应,医生对其进行了进一步检查,结果发现她患有继发于左侧卵巢畸胎瘤的副肿瘤性抗 NMDAR 脑炎。报告探讨了治疗方案,包括泼尼松龙、静脉注射免疫球蛋白、利妥昔单抗注射和腹腔镜双侧输卵管切除术:本病例强调,临床上需要提高对出现神经精神症状和潜在卵巢畸胎瘤的患者(尤其是年轻女性)抗 NMDAR 脑炎的警惕。该病例报告所附的文献综述为这一复杂病症的表现、诊断和处理提供了宝贵的见解。最后,本研究强调了副肿瘤性神经精神综合征固有的诊断难题,提倡在类似临床情况下采用多学科方法。
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引用次数: 0
Correlation of factor XIII subunit A with factor XIII activity in a population of parturient women. 产妇人群中因子 XIII 亚基 A 与因子 XIII 活性的相关性。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-04 DOI: 10.1007/s00404-024-07799-2
M L Frevert, J Bürgi, R Brun, T Hothorn, M Rösslein, N Ochsenbein-Kölble, C Haslinger, W Korte

Background: The role of factor XIII in acute bleeding situations is gaining more and more importance. It has previously been shown that prepartum factor XIII activity has a significant impact on postpartum blood loss. Whether factor XIII antigen behaves in a similar manner is unknown. As postpartum hemorrhage is one of the leading causes of maternal morbidity and mortality worldwide and factor XIII antigen determination might be available more readily in some centers as compared to factor XIII activity, this is an important question to answer, especially in the emergency situation of a postpartum hemorrhage.

Objective: To assess the correlation of prepartum factor XIII antigen with prepartum factor XIII activity and to evaluate the correlation between prepartum factor XIII antigen on measured postpartum blood loss.

Methods: This is a secondary analysis of a prospective cohort study which analyzed the impact of prepartum blood coagulation factor XIII activity on postpartum blood loss in 1300 women at the University Hospital Zurich, Switzerland between October 2015 and November 2016 ("PPH-1300 study"). Blood loss was quantified using a previously validated technique. The association of factor XIII activity and factor XIII antigen was assessed by means of a Spearman rank correlation and differences were displayed using Bland-Altman plot and Passing-Bablok regression. The effect of the prepartum factor XIII antigen on blood loss was estimated by continuous outcome logistic regression.

Results: Prepartum factor XIII activity significantly correlated with prepartum factor XIII antigen (Spearman rank correlation coefficient for prepartum values 0.89, p < 0.001 and postpartum values 0.902, p < 0.001). Elevated values of prepartum factor XIII antigen showed a trend toward lower measured postpartum blood loss.

Conclusion: The correlation of factor XIII activity with factor XIII antigen (subunit A) in a large real-world sample as well as an association of prepartum factor XIII antigen and postpartum blood loss is observed. Factor XIII antigen determination, a highly automatable test, could be useful in emergency situations such as a PPH (as well as other bleeding situations) if the determination of factor XIII activity is not possible. To evaluate whether FXIII replenishment reduces blood loss is the focus of ongoing studies.

背景:XIII 因子在急性出血情况中的作用越来越重要。以前的研究表明,产前 XIII 因子的活性对产后失血有重大影响。至于因子 XIII 抗原是否也有类似的作用,目前还不得而知。产后出血是全球孕产妇发病率和死亡率的主要原因之一,与 XIII 因子活性相比,XIII 因子抗原的测定在某些中心可能更容易获得,因此这是一个需要回答的重要问题,尤其是在产后出血的紧急情况下:评估产前 XIII 因子抗原与产前 XIII 因子活性的相关性,并评估产前 XIII 因子抗原与测量的产后失血量之间的相关性:这是一项前瞻性队列研究的二次分析,该研究分析了2015年10月至2016年11月期间瑞士苏黎世大学医院1300名产妇的产前血液凝固因子XIII活性对产后失血量的影响("PPH-1300研究")。失血量采用之前经过验证的技术进行量化。通过斯皮尔曼等级相关性评估了因子XIII活性和因子XIII抗原的关联性,并通过布兰德-阿尔特曼图和帕森-巴勃洛克回归显示了差异。产前因子 XIII 抗原对失血量的影响通过连续结果逻辑回归进行估计:结果:产前 XIII 因子活性与产前 XIII 因子抗原有明显相关性(产前值的 Spearman 等级相关系数为 0.89,p 结论:产前 XIII 因子活性与产前 XIII 因子抗原有明显相关性(产前值的 Spearman 等级相关系数为 0.89,p 结论):在大量实际样本中观察到因子 XIII 活性与因子 XIII 抗原(亚基 A)的相关性,以及产前因子 XIII 抗原与产后失血的相关性。因子 XIII 抗原测定是一种高度自动化的检测方法,在无法测定因子 XIII 活性的情况下,可用于 PPH 等紧急情况(以及其他出血情况)。评估补充 FXIII 是否能减少失血是目前研究的重点。
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引用次数: 0
Metabolomics for the identification of biomarkers in endometriosis. 用于鉴定子宫内膜异位症生物标志物的代谢组学。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-04 DOI: 10.1007/s00404-024-07796-5
Swarnima Pandey

Background: Endometriosis affects the quality of life in women during their reproductive years, causing immense pain and can result in infertility. It is characterized by inflammation and the growth of the endometrium outside the uterine cavity. Metabolomics has the potential to resolve the major bottleneck of endometriosis which is delay in diagnosis due to the invasive diagnostic approach.In this review, the author has summarized the identified biomarkers of endometriosis from different bodily fluids. Metabolomics promises a non-invasive diagnostic approach for endometriosis that could aid in earlier diagnosis and prognosis.

Methods: Patients with endometriosis keywords were searched in correspondence with the assigned keywords, including metabolomics from PubMed, from its inception to Dec 2023. The relevant studies from this search were extracted and included in the study.

Results: This article provides information regarding metabolomics studies in endometrisis.

Conclusions: We demonstrated that metabolomics is about to change the world of endometriosis by analyzing and detecting the diagnosis, prognosis, mortality and treatment response biomarkers.

背景:子宫内膜异位症影响育龄妇女的生活质量,给她们带来巨大的痛苦,并可能导致不孕。子宫内膜异位症的特点是炎症和子宫内膜在子宫腔外生长。在这篇综述中,作者总结了从不同体液中发现的子宫内膜异位症生物标志物。代谢组学有望成为子宫内膜异位症的非侵入性诊断方法,有助于早期诊断和预后:从 PubMed 开始到 2023 年 12 月,对子宫内膜异位症患者的关键词进行了检索,包括代谢组学。结果:本文提供了有关代谢组学的信息:本文提供了有关子宫内膜异位症代谢组学研究的信息:我们证明,代谢组学通过分析和检测诊断、预后、死亡率和治疗反应生物标志物,即将改变子宫内膜异位症的世界。
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引用次数: 0
Favorable outcome after fetal swallowing of a Somatex® intrauterine shunt. 胎儿吞咽 Somatex® 宫内分流器后的良好结果。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-02 DOI: 10.1007/s00404-024-07802-w
A Rejaey, I Gottschalk, E C Weber, A Messling, J Hubertus, C Berg

This report describes the ingestion of a dislodged Somatex Intrauterine Stent by the fetus. At 35 weeks one shunt was visualized in the fetal stomach, suggesting that the fetus had swallowed it. The shunt kept its position in the stomach until the last follow up scan at 37 weeks. At 38 weeks the patient went into spontaneous labor and vaginally delivered a boy weighting 3590 g. The first chest X-ray on the day of birth demonstrated the dislodged shunt in the duodenum while the other shunt drained the left kidney. The mother started breastfeeding. The x-ray on the second day of life was made after removal of the second shunt and the creation of a nephrostoma and demonstrated the dislodged shunt in the ileum. On the third day of life the shunt was found in the neonate's stool. The neonate was dismissed on day 7 with antibiotic prophylaxis. To our best knowledge this is the first report of an intrauterine ingestion of a Somatex Intrauterine Stent. It demonstrates that in the intrauterine period the shunt remains in the stomach and starts to pass the bowel after birth, probably prompted by breastfeeding. In our case the shunt was eventually excreted without any damage to the digestive system.

本报告描述了胎儿吞食脱落的 Somatex 宫内支架的情况。在 35 周时,胎儿胃部发现一个分流管,表明胎儿吞食了该分流管。直到 37 周的最后一次随访扫描时,分流管仍在腹中。出生当天的第一次胸部 X 光检查显示,十二指肠中的分流管移位,而另一个分流管则排出了左肾。母亲开始母乳喂养。出生后第二天的 X 光片是在移除第二个分流管并形成肾前列腺瘤后拍摄的,显示回肠中的分流管移位。出生后第三天,在新生儿粪便中发现了分流管。第 7 天,新生儿在抗生素预防治疗下出院。据我们所知,这是第一例宫内摄入 Somatex 宫内支架的报告。它表明,在宫内期间,分流管一直留在胃里,出生后才开始排出肠道,这可能是母乳喂养的结果。在我们的病例中,分流管最终被排出体外,没有对消化系统造成任何损害。
{"title":"Favorable outcome after fetal swallowing of a Somatex® intrauterine shunt.","authors":"A Rejaey, I Gottschalk, E C Weber, A Messling, J Hubertus, C Berg","doi":"10.1007/s00404-024-07802-w","DOIUrl":"https://doi.org/10.1007/s00404-024-07802-w","url":null,"abstract":"<p><p>This report describes the ingestion of a dislodged Somatex Intrauterine Stent by the fetus. At 35 weeks one shunt was visualized in the fetal stomach, suggesting that the fetus had swallowed it. The shunt kept its position in the stomach until the last follow up scan at 37 weeks. At 38 weeks the patient went into spontaneous labor and vaginally delivered a boy weighting 3590 g. The first chest X-ray on the day of birth demonstrated the dislodged shunt in the duodenum while the other shunt drained the left kidney. The mother started breastfeeding. The x-ray on the second day of life was made after removal of the second shunt and the creation of a nephrostoma and demonstrated the dislodged shunt in the ileum. On the third day of life the shunt was found in the neonate's stool. The neonate was dismissed on day 7 with antibiotic prophylaxis. To our best knowledge this is the first report of an intrauterine ingestion of a Somatex Intrauterine Stent. It demonstrates that in the intrauterine period the shunt remains in the stomach and starts to pass the bowel after birth, probably prompted by breastfeeding. In our case the shunt was eventually excreted without any damage to the digestive system.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Informed consent in gynecological oncology: a JAGO/NOGGO survey on real-world practices in daily clinical routine. 妇科肿瘤学中的知情同意:JAGO/NOGGO 对日常临床实践的调查。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-01 DOI: 10.1007/s00404-024-07776-9
M G Biersack, L L Volmer, C Geißler, J Fromme, S Fröhlich, K Pietzner, J Sehouli, M H Beck

Purpose: Informed consent is a quintessential element of contemporary medicine, reflecting the fundamental right of patients to participate in decision-making regarding their health. Despite its critical importance, there is a lack of data on real-world practices regarding patient informed consent in the context of modern, high-pressure medical environments.

Methods: We conducted a multinational multicentric survey from February 24, 2022, to September 14, 2022, investigating the practices and challenges surrounding informed consent in hospitals across Germany, Austria, and Switzerland with the use of a specifically developed questionnaire.

Results: Drawing on over 200 responses from gynecologists, the survey shows a critical need for structured training in conducting informed consent discussions with over 80% of participants expressing interest in courses addressing this aspect. Notably, a considerable portion of the physicians (59.9%) reported conducting discussions on procedures they had never personally witnessed. Significant disparities between types of hospitals and professional groups were observed in the frequency of informed consent discussions, with limitations arising from factors such as time constraints, language barriers, and insufficient resources for patient education. Moreover, the psychological burden experienced by physicians after informed-consent discussions underscores the need for systemic changes to alleviate concerns regarding patient safety, legal repercussions, and patient satisfaction.

Conclusion: This study serves as a call to action, emphasizing the need of enhancing resources and support for medical professionals to uphold the principles of empathic and comprehensive patient information and shared decision-making.

Trial registry: DRKS00028295, 25.07.2024.

目的:知情同意是当代医学的精髓,反映了患者参与有关其健康决策的基本权利。尽管知情同意至关重要,但在现代高压医疗环境下,患者知情同意的实际操作数据却十分匮乏:我们于 2022 年 2 月 24 日至 2022 年 9 月 14 日开展了一项跨国多中心调查,利用专门编制的问卷调查了德国、奥地利和瑞士各地医院在知情同意方面的做法和挑战:结果:从妇科医生的 200 多份回复中,调查显示,在进行知情同意讨论方面,对结构化培训的需求非常迫切,超过 80% 的参与者表示有兴趣参加这方面的课程。值得注意的是,相当一部分医生(59.9%)表示,他们从未亲眼目睹过就手术程序进行讨论。在知情同意讨论的频率方面,不同类型的医院和专业团体之间存在显著差异,时间限制、语言障碍和用于患者教育的资源不足等因素导致了讨论的局限性。此外,医生在知情同意讨论后所承受的心理负担凸显了系统性变革的必要性,以减轻对患者安全、法律后果和患者满意度的担忧:本研究呼吁采取行动,强调需要加强对医疗专业人员的资源和支持,以坚持移情、全面的患者信息和共同决策原则:DRKS00028295, 25.07.2024.
{"title":"Informed consent in gynecological oncology: a JAGO/NOGGO survey on real-world practices in daily clinical routine.","authors":"M G Biersack, L L Volmer, C Geißler, J Fromme, S Fröhlich, K Pietzner, J Sehouli, M H Beck","doi":"10.1007/s00404-024-07776-9","DOIUrl":"https://doi.org/10.1007/s00404-024-07776-9","url":null,"abstract":"<p><strong>Purpose: </strong>Informed consent is a quintessential element of contemporary medicine, reflecting the fundamental right of patients to participate in decision-making regarding their health. Despite its critical importance, there is a lack of data on real-world practices regarding patient informed consent in the context of modern, high-pressure medical environments.</p><p><strong>Methods: </strong>We conducted a multinational multicentric survey from February 24, 2022, to September 14, 2022, investigating the practices and challenges surrounding informed consent in hospitals across Germany, Austria, and Switzerland with the use of a specifically developed questionnaire.</p><p><strong>Results: </strong>Drawing on over 200 responses from gynecologists, the survey shows a critical need for structured training in conducting informed consent discussions with over 80% of participants expressing interest in courses addressing this aspect. Notably, a considerable portion of the physicians (59.9%) reported conducting discussions on procedures they had never personally witnessed. Significant disparities between types of hospitals and professional groups were observed in the frequency of informed consent discussions, with limitations arising from factors such as time constraints, language barriers, and insufficient resources for patient education. Moreover, the psychological burden experienced by physicians after informed-consent discussions underscores the need for systemic changes to alleviate concerns regarding patient safety, legal repercussions, and patient satisfaction.</p><p><strong>Conclusion: </strong>This study serves as a call to action, emphasizing the need of enhancing resources and support for medical professionals to uphold the principles of empathic and comprehensive patient information and shared decision-making.</p><p><strong>Trial registry: </strong>DRKS00028295, 25.07.2024.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can Ki-67 serve as a suitable marker to indicate the necessity of staging diagnostics in cases of low-risk breast cancer? 在低风险乳腺癌病例中,Ki-67 能否作为一种合适的标志物来指示分期诊断的必要性?
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-10-30 DOI: 10.1007/s00404-024-07753-2
Lisa Jung, Sarah Isabelle Huwer, Peter Jungmann, Markus Medl, Florin-Andrei Taran, Jakob Neubauer, Carolin Wilpert, Ingolf Juhasz-Böss, Carolin Müller

Background: For many years, staging tests have not been routinely employed for low-risk early breast cancer (EBC). However, the role of Ki-67 in determining the need for staging tests in low-risk EBC remains unclear. Our study aimed to assess the number and types of staging diagnostics, additional imaging, false-positive results, and rate of distant metastases in low-risk EBC with low and high Ki-67 (< / ≥ 25%).

Methods: This is a retrospective, single institution cohort study. All patients with newly diagnosed low-risk breast cancer at the University Medical Center in Freiburg in 2017 and 2021 were included. Low-risk was defined as clinical tumor stage T1/2, node negative (N0), hormone receptor positive, HER2 negative, asymptomatic EBC. Information on demographics, clinical and pathological characteristics, as well as number and type of performed staging diagnostics was obtained. Rate and type of additional imaging or follow-up diagnostics due to suspicious findings was analyzed. The patients were divided into two groups (Ki-67 < and ≥ 25%) and rates of distant metastases, performed staging diagnostics and false positive rates were compared.

Results: A total of 189 patients with low-risk EBC were identified, with 54% (n = 102) having Ki-67 < 25% and 46% (n = 87) having Ki-67 ≥ 25%. Risk for distant metastases was 0% in Ki-67 < 25% and 1.1% in patients with Ki-67 ≥ 25% (p = 0.46). Due to suspicious findings in the initial staging diagnostic, additional imaging was required for 11.8% (n = 12) of patients with Ki-67 < 25% compared to 19.5% (n = 17) of patients with Ki-67 ≥ 25% (p = 0.16). False positive rates did not differ significantly between the two groups (7.6% in Ki-67 < 25% vs. 9.8% in Ki-67 ≥ 25%; p = 0.55).

Conclusion: Distant metastases are rare in low-risk EBC. All in all, staging diagnostics should not be routinely employed in this patient population. Only patients with high Ki-67 developed distant metastases. In these cases, staging diagnostics may be discussed with the patient.

背景:多年来,低风险早期乳腺癌(EBC)一直没有常规采用分期检测。然而,Ki-67在确定是否需要对低风险EBC进行分期检测方面的作用仍不明确。我们的研究旨在评估 Ki-67 低和 Ki-67 高的低风险 EBC 的分期诊断数量和类型、额外的影像学检查、假阳性结果和远处转移率(方法:这是一项回顾性、单机构队列研究。纳入了弗莱堡大学医学中心在2017年和2021年新确诊的所有低危乳腺癌患者。低风险定义为临床肿瘤分期T1/2、结节阴性(N0)、激素受体阳性、HER2阴性、无症状EBC。研究人员收集了人口统计学、临床和病理学特征以及分期诊断的数量和类型等信息。此外,还分析了因可疑发现而进行额外成像或后续诊断的比例和类型。患者被分为两组(Ki-67 结果组和 Ki-67 结果组):共发现 189 例低风险 EBC 患者,54%(n = 102)的患者有 Ki-67 结论:低风险 EBC 患者很少发生远处转移:低危 EBC 很少发生远处转移。总而言之,分期诊断不应该在这一患者群体中常规使用。只有 Ki-67 偏高的患者才会发生远处转移。在这些病例中,可与患者讨论分期诊断。
{"title":"Can Ki-67 serve as a suitable marker to indicate the necessity of staging diagnostics in cases of low-risk breast cancer?","authors":"Lisa Jung, Sarah Isabelle Huwer, Peter Jungmann, Markus Medl, Florin-Andrei Taran, Jakob Neubauer, Carolin Wilpert, Ingolf Juhasz-Böss, Carolin Müller","doi":"10.1007/s00404-024-07753-2","DOIUrl":"https://doi.org/10.1007/s00404-024-07753-2","url":null,"abstract":"<p><strong>Background: </strong>For many years, staging tests have not been routinely employed for low-risk early breast cancer (EBC). However, the role of Ki-67 in determining the need for staging tests in low-risk EBC remains unclear. Our study aimed to assess the number and types of staging diagnostics, additional imaging, false-positive results, and rate of distant metastases in low-risk EBC with low and high Ki-67 (< / ≥ 25%).</p><p><strong>Methods: </strong>This is a retrospective, single institution cohort study. All patients with newly diagnosed low-risk breast cancer at the University Medical Center in Freiburg in 2017 and 2021 were included. Low-risk was defined as clinical tumor stage T1/2, node negative (N0), hormone receptor positive, HER2 negative, asymptomatic EBC. Information on demographics, clinical and pathological characteristics, as well as number and type of performed staging diagnostics was obtained. Rate and type of additional imaging or follow-up diagnostics due to suspicious findings was analyzed. The patients were divided into two groups (Ki-67 < and ≥ 25%) and rates of distant metastases, performed staging diagnostics and false positive rates were compared.</p><p><strong>Results: </strong>A total of 189 patients with low-risk EBC were identified, with 54% (n = 102) having Ki-67 < 25% and 46% (n = 87) having Ki-67 ≥ 25%. Risk for distant metastases was 0% in Ki-67 < 25% and 1.1% in patients with Ki-67 ≥ 25% (p = 0.46). Due to suspicious findings in the initial staging diagnostic, additional imaging was required for 11.8% (n = 12) of patients with Ki-67 < 25% compared to 19.5% (n = 17) of patients with Ki-67 ≥ 25% (p = 0.16). False positive rates did not differ significantly between the two groups (7.6% in Ki-67 < 25% vs. 9.8% in Ki-67 ≥ 25%; p = 0.55).</p><p><strong>Conclusion: </strong>Distant metastases are rare in low-risk EBC. All in all, staging diagnostics should not be routinely employed in this patient population. Only patients with high Ki-67 developed distant metastases. In these cases, staging diagnostics may be discussed with the patient.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A retrospective study on the effect of surgical approaches and uterine manipulators on the prognosis of cervical cancer. 关于手术方法和子宫操作器对宫颈癌预后影响的回顾性研究。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-10-30 DOI: 10.1007/s00404-024-07746-1
Xinmeng Guo, Jiangnan Song, Shuang Tian, Weiping Li, Jinning Zhang, Yuanqing Yao

Objective: Cervical cancer is a common gynecological malignancy. However, the optimal surgical approach and benefits of uterine manipulator use remain unclear in this context. This study aimed to compare patient outcomes among different surgical approaches including laparoscopic, combined vaginal and laparoscopic, abdominal, and robotic using the da Vinci surgical system. Moreover, we also aimed to examine the impact of uterine manipulator use in radical hysterectomy on the outcomes of patients with cervical cancer.

Methods: This retrospective study included data from 848 patients with cervical cancer stage IA2-IIA2 that underwent a radical hysterectomy and pelvic lymphadenectomy at the Chinese PLA General Hospital between 2009 and 2019. Patient demographic and clinical characteristics, perioperative findings, and postoperative outcomes were examined.

Results: Patient characteristics, including body mass index, age, FIGO stage, pathological type, and tumor differentiation status and size, were comparable. Five-year survival rates were comparable among the groups that underwent different types of surgery regardless of disease stage. Five-year survival rates were comparable between the groups that underwent surgery with and without the use of a uterine manipulator.

Conclusions: All surgical approaches examined in this study had comparable efficacy and safety profiles. The use of uterine manipulators during radical hysterectomy for cervical cancer does not increase the risk of death.

目的:宫颈癌是常见的妇科恶性肿瘤:宫颈癌是一种常见的妇科恶性肿瘤。然而,在这种情况下,最佳手术方法和使用子宫机械手的益处仍不明确。本研究旨在比较使用达芬奇手术系统的不同手术方法(包括腹腔镜、阴道镜和腹腔镜联合手术、腹腔镜和机器人手术)对患者的治疗效果。此外,我们还旨在研究在根治性子宫切除术中使用子宫操作器对宫颈癌患者预后的影响:这项回顾性研究纳入了 2009 年至 2019 年期间在中国人民解放军总医院接受根治性子宫切除术和盆腔淋巴结切除术的 848 例 IA2-IIA2 期宫颈癌患者的数据。研究了患者的人口统计学特征、临床特征、围手术期发现和术后结果:结果:包括体重指数、年龄、FIGO分期、病理类型、肿瘤分化状态和大小在内的患者特征具有可比性。无论疾病分期如何,接受不同类型手术的组别五年生存率相当。使用和不使用子宫操作器手术组的五年生存率相当:结论:本研究中的所有手术方法都具有可比的疗效和安全性。在宫颈癌根治性切除术中使用子宫操作器不会增加死亡风险。
{"title":"A retrospective study on the effect of surgical approaches and uterine manipulators on the prognosis of cervical cancer.","authors":"Xinmeng Guo, Jiangnan Song, Shuang Tian, Weiping Li, Jinning Zhang, Yuanqing Yao","doi":"10.1007/s00404-024-07746-1","DOIUrl":"https://doi.org/10.1007/s00404-024-07746-1","url":null,"abstract":"<p><strong>Objective: </strong>Cervical cancer is a common gynecological malignancy. However, the optimal surgical approach and benefits of uterine manipulator use remain unclear in this context. This study aimed to compare patient outcomes among different surgical approaches including laparoscopic, combined vaginal and laparoscopic, abdominal, and robotic using the da Vinci surgical system. Moreover, we also aimed to examine the impact of uterine manipulator use in radical hysterectomy on the outcomes of patients with cervical cancer.</p><p><strong>Methods: </strong>This retrospective study included data from 848 patients with cervical cancer stage IA2-IIA2 that underwent a radical hysterectomy and pelvic lymphadenectomy at the Chinese PLA General Hospital between 2009 and 2019. Patient demographic and clinical characteristics, perioperative findings, and postoperative outcomes were examined.</p><p><strong>Results: </strong>Patient characteristics, including body mass index, age, FIGO stage, pathological type, and tumor differentiation status and size, were comparable. Five-year survival rates were comparable among the groups that underwent different types of surgery regardless of disease stage. Five-year survival rates were comparable between the groups that underwent surgery with and without the use of a uterine manipulator.</p><p><strong>Conclusions: </strong>All surgical approaches examined in this study had comparable efficacy and safety profiles. The use of uterine manipulators during radical hysterectomy for cervical cancer does not increase the risk of death.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Family planning after transplantation: sex- and organ-related differences in the perception of medical counseling and social challenges. 移植后的计划生育:医疗咨询和社会挑战认知中与性别和器官有关的差异。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-10-29 DOI: 10.1007/s00404-024-07703-y
Nina Schirm, Lea Böhm, Tanja Zimmermann, Nadia Meyer, Frauke von Versen-Höynck

Purpose: Transplant patients are increasingly of childbearing age. Organ-related health as well as pregnancy-related risks require a standardized approach to family planning counseling. The aim of this study was to explore sex- and organ-related counseling differences and expectations in family planning to improve counseling services and reduce risks after transplantation.

Methods: The study was designed as a cross-sectional, multi-center cohort study. A total of 251 participants aged between 18 and 45 years with a visceral or thoracic transplant completed a questionnaire on their attitude toward family planning and experience with medical consultation.

Results: More female than male participants had a desire to have children. Males believed their transplantation-related medication had an influence on their fertility, while women worried it could harm their child. Contraceptive counseling was negated by 43.6% of the women and 73.4% of the men. Medical advice regarding family planning was highly requested by both sexes. Women felt more influenced in their family planning than men. Female thoracic organ recipients worried about a pregnancy more than visceral organ recipients. Women showed great awareness for pregnancy-related risks with the majority wanting to plan a pregnancy beforehand.

Conclusion: The findings revealed a lack of contraceptive counseling and a lack of family planning advice by physicians.

目的:移植患者越来越多地进入生育年龄。与器官相关的健康以及与妊娠相关的风险要求采用标准化的计划生育咨询方法。本研究旨在探讨与性别和器官相关的咨询差异以及对计划生育的期望,以改善咨询服务,降低移植后的风险:研究设计为横断面、多中心队列研究。共有 251 名年龄在 18 至 45 岁之间、接受过内脏或胸部移植手术的参与者填写了一份调查问卷,内容涉及他们对计划生育的态度和医疗咨询经验:结果:有生育意愿的女性参与者多于男性参与者。男性认为与移植相关的药物会影响他们的生育能力,而女性则担心药物会伤害孩子。43.6%的女性和 73.4%的男性拒绝接受避孕咨询。男女均强烈要求获得有关计划生育的医疗建议。与男性相比,女性在计划生育方面受到的影响更大。女性胸部器官接受者比内脏器官接受者更担心怀孕。女性对与怀孕相关的风险有很高的认识,大多数人都希望提前计划怀孕:研究结果表明,医生缺乏避孕咨询和计划生育建议。
{"title":"Family planning after transplantation: sex- and organ-related differences in the perception of medical counseling and social challenges.","authors":"Nina Schirm, Lea Böhm, Tanja Zimmermann, Nadia Meyer, Frauke von Versen-Höynck","doi":"10.1007/s00404-024-07703-y","DOIUrl":"https://doi.org/10.1007/s00404-024-07703-y","url":null,"abstract":"<p><strong>Purpose: </strong>Transplant patients are increasingly of childbearing age. Organ-related health as well as pregnancy-related risks require a standardized approach to family planning counseling. The aim of this study was to explore sex- and organ-related counseling differences and expectations in family planning to improve counseling services and reduce risks after transplantation.</p><p><strong>Methods: </strong>The study was designed as a cross-sectional, multi-center cohort study. A total of 251 participants aged between 18 and 45 years with a visceral or thoracic transplant completed a questionnaire on their attitude toward family planning and experience with medical consultation.</p><p><strong>Results: </strong>More female than male participants had a desire to have children. Males believed their transplantation-related medication had an influence on their fertility, while women worried it could harm their child. Contraceptive counseling was negated by 43.6% of the women and 73.4% of the men. Medical advice regarding family planning was highly requested by both sexes. Women felt more influenced in their family planning than men. Female thoracic organ recipients worried about a pregnancy more than visceral organ recipients. Women showed great awareness for pregnancy-related risks with the majority wanting to plan a pregnancy beforehand.</p><p><strong>Conclusion: </strong>The findings revealed a lack of contraceptive counseling and a lack of family planning advice by physicians.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does antenatal exercise shape labor and delivery outcomes? 产前锻炼会影响分娩和生产结果吗?
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-10-29 DOI: 10.1007/s00404-024-07801-x
Akanksha Chauhan, Anjali Gupta, Poonam Dhankher, Jagjit Singh Dalal, Nitika Jesingh, Savita Rani Singhal

Purpose: Incorporating regular physical activity into the lifestyle of a pregnant woman offers numerous health benefits and prepares her effectively for labor. This study was conducted to determine the impact of antenatal exercise on labor, delivery and perinatal outcome.

Methods: An interventional study was conducted including 200 women attending the antenatal clinic of Obstetrics and Gynaecology department of PGIMS Rohtak, India. The study subjects were randomly divided into two groups-exercise group and control group.

Results: The demographic profile of both the groups was similar. A higher proportion of patients in control group required labor induction compared to exercise group (33% vs 16%, P = 0.002). The rate of vaginal delivery was significantly higher in exercise group than in control group (71% vs 56%, P = 0.027). Additionally, women in exercise group had fewer assisted vaginal deliveries than control group (7% vs 20%, P = 0.007). Rates of cesarean section were comparable between both groups (P = 0.736). The mean duration of labor was significantly shorter in exercise group compared to control group (428.69 ± 131.242 min vs 516.91 ± 143.105 min, P < 0.0001). Mean Visual Analog Scale (VAS) score for pain was 6.38 ± 1.94 in exercise group compared to 7.89 ± 1.49 in control group (P < 0.0001). No significant difference was observed between the groups in birth weight and APGAR score of neonates.

Conclusion: A structured exercise program, practiced regularly during the antenatal period reduced the need for labor induction, shortened labor duration, increased the incidence of vaginal deliveries, and decreased pain perception during labor and delivery.

目的:将有规律的体育锻炼纳入孕妇的生活方式可为健康带来诸多益处,并为分娩做好有效准备。本研究旨在确定产前锻炼对分娩、生产和围产期结果的影响:方法:本研究对印度罗塔克 PGIMS 妇产科的 200 名产妇进行了干预性研究。研究对象被随机分为两组--运动组和对照组:两组的人口统计学特征相似。与运动组相比,对照组需要引产的患者比例更高(33% 对 16%,P = 0.002)。运动组的阴道分娩率明显高于对照组(71% 对 56%,P = 0.027)。此外,运动组产妇的阴道助产率低于对照组(7% 对 20%,P = 0.007)。两组的剖宫产率相当(P = 0.736)。运动组的平均产程明显短于对照组(428.69±131.242 分钟 vs 516.91±143.105 分钟,P 结论:运动组的平均产程明显短于对照组(428.69±131.242 分钟 vs 516.91±143.105 分钟,P = 0.007):在产前定期进行有组织的运动可减少引产的需要,缩短产程,增加阴道分娩的发生率,并降低分娩过程中的疼痛感。
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Archives of Gynecology and Obstetrics
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