Histological assessment of endometrial polyps resected by hysteroscopy.

OBJECTIVE: This study aimed to analyze the clinical data and pathologic aspects of endometrial polyps (EMPs) excised completely during surgical hysteroscopy and assess the connection between premalignant and malignant EMPs. PATIENTS AND METHODS: This retrospective study includes 489 participants who underwent hysteroscopy due to endometrial polyps, and the clinical features and histological findings of the resected polyps analyzed. RESULTS: Participants with EMPs were divided into six groups according to histologic findings. The histologic finding of most cases was simple benign endometrial polyp [397 patients (81.2%)]. Malignant polyp was detected in 3 patients (0.6%). The histologic findings according to age, menopausal status, and menstrual bleeding patterns at the time of presentation to the outpatient clinic were compared; however, no significant difference was observed. 237 patients were observed to have menometrorrhagia, which was the most prevalent symptom reported. The distribution of polyp sizes observed at hysteroscopy according to histologic findings was compared, but no significant difference was observed. CONCLUSIONS: EMPs are often benign but can include premalignant or malignant tissue changes. Hysteroscopy is used for direct observation of the uterine cervix and resection of existing polyps, considering the increasing frequency of its use as a diagnostic and treatment tool.

Activities of daily living in Alzheimer's disease: neuropsychiatric, cognitive, and medical illness influences.

Using a retrospective data analysis, the authors investigated the relationships between instrumental activities of daily living (IADLs) and neuropsychiatric symptoms, cognitive impairment, and medical illness burden in patients with Alzheimer's disease (AD). One hundred forty-three patients fulfilling the clinical criteria for probable or possible AD in an outpatient clinic were assessed for IADLs, neuropsychiatric symptoms, cognitive impairment, and medical illness burden with the Functional Activities Questionnaire (FAQ), Neuropsychiatric Inventory (NPI), Mini-Mental State Exam (MMSE), and Cumulative Illness Rating Scale-Geriatric (CIRS-G). Both MMSE and NPI scores related significantly to IADLs as measured by the FAQ. Several psychiatric symptoms were correlated significantly with IADLs. FAQ scores had no correlation with CIRS-G. Neuropsychiatric findings also were associated significantly with MMSE and had a weak correlation with CIRS-G scores. IADLs changed with cognition and neuropsychiatric disturbances in AD. Medical illness burden had little influence on functional status and a limited impact on neuropsychiatric symptoms.

Assessment of thyroid nodules by technetium-99m-tetrofosmin scintigraphy.

Thyroid nodularity is a common finding. The incidence of thyroid cancer in the general population is estimated at 0.1%. Thyroid nodules are evaluated by palpation, ultrasonography, radionuclide scintigraphy and fine-needle aspiration cytology. Routine thyroid scintigraphy is made by using Tc-99m-pertechnetate or the I-131 and I-123 scintigraphic method. Tc-99m-tetrofosmin accumulates in the myocardium, skeletal muscle, liver, spleen breast tissue, kidney and normal and pathological thyroid tissue. We investigated 36 patients (28 females and 8 males) with solitary and/or multiple thyroid nodules. All the patients were euthyroid, and their thyroid nodules were diagnosed by palpation and ultrasound examination. Thyroid scintigraphy was applied by Tc-99m-pertechnetate, then thyroid fine-needle aspiration biopsy was performed. Finally, Tc-99m-tetrofosmin scintigraphy was carried out. Five patients (14.8%) had differential thyroid carcinoma, 23 (63.8%) had thyroid adenoma, 1 (0.02%) had Riedel's thyroiditis and 7 (19.4%) had follicular cyst. We detected 80% uptake in the early phase and 100% in the late phase by Tc-99m-tetrofosmin scintigraphy in the differentiated thyroid carcinoma group. In summary, we claim that Tc-99m-tetrofosmin may be an important scintigraphic method to identify thyroid malignancy from benign thyroid pathologies.