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1.
BMC Ophthalmol ; 24(1): 441, 2024 Oct 08.
Article in English | MEDLINE | ID: mdl-39379869

ABSTRACT

BACKGROUND: This study aims to evaluate the two-year outcomes of polypoidal choroidal vasculopathy (PCV) treated with conbercept and to investigate the predictive response factors. METHODS: Consecutive patients with PCV who received three-loading intravitreal conbercept, followed by as-needed reinjections, were studied retrospectively. The best corrected visual acuity (BCVA), central retinal thickness (CRT) and polyps were evaluated. Patients who achieved dry maculae in month 6 were categorised into the dry group, or otherwise, into the non-dry group. The predictive factors for a dry macula were evaluated. RESULTS: A total of 25 eyes from 25 patients (17 males; mean age: 62.8 ± 6.4 years) were included. At month 24, the average BCVA increased significantly from 49.9 ± 15.0 letters to 57.2 ± 16.0 letters (p = 0.040); the average CRT decreased significantly from 430.16 ± 166.55 µm to 278.31 ± 157.34 µm (p = 0.00), and 88% of the eyes achieved dry maculae. The number of polyps changed from 55 to 20 (fading rate: 63.6%; p < 0.001). The mean number of intravitreal injections was 8.6 ± 5.4. The dry group (10 eyes, 40%) was more likely to have higher branching vascular network vessel density (BVN VD; p = 0.021), submacular haemorrhages (p = 0.011) but lack polyp-related serous pigmented epithelial detachment (PED) (p = 0.037). CONCLUSIONS: Conbercept was effective in eyes with PCV at maintaining functional and anatomical improvement. Baseline characteristics, including BVN VD, the presence of polyps with serous PED and submacular haemorrhage, seemed to be related to the response to conbercept.


Subject(s)
Fluorescein Angiography , Intravitreal Injections , Polyps , Recombinant Fusion Proteins , Tomography, Optical Coherence , Visual Acuity , Humans , Male , Female , Middle Aged , Retrospective Studies , Recombinant Fusion Proteins/administration & dosage , Recombinant Fusion Proteins/therapeutic use , Visual Acuity/physiology , Polyps/drug therapy , Polyps/diagnosis , Polyps/physiopathology , Aged , Tomography, Optical Coherence/methods , Fluorescein Angiography/methods , Choroid/blood supply , Angiogenesis Inhibitors/administration & dosage , Angiogenesis Inhibitors/therapeutic use , Choroid Diseases/drug therapy , Choroid Diseases/diagnosis , Choroid Diseases/physiopathology , Follow-Up Studies , Treatment Outcome , Choroidal Neovascularization/drug therapy , Choroidal Neovascularization/physiopathology , Choroidal Neovascularization/diagnosis , Fundus Oculi , Polypoidal Choroidal Vasculopathy
3.
Sci Rep ; 14(1): 23382, 2024 10 08.
Article in English | MEDLINE | ID: mdl-39379452

ABSTRACT

The rise of object detection models has brought new breakthroughs to the development of clinical decision support systems. However, in the field of gastrointestinal polyp detection, there are still challenges such as uncertainty in polyp identification and inadequate coping with polyp scale variations. To address these challenges, this paper proposes a novel gastrointestinal polyp object detection model. The model can automatically identify polyp regions in gastrointestinal images and accurately label them. In terms of design, the model integrates multi-channel information to enhance the ability and robustness of channel feature expression, thus better coping with the complexity of polyp structures. At the same time, a hierarchical structure is constructed in the model to enhance the model's adaptability to multi-scale targets, effectively addressing the problem of large-scale variations in polyps. Furthermore, a channel attention mechanism is designed in the model to improve the accuracy of target positioning and reduce uncertainty in diagnosis. By integrating these strategies, the proposed gastrointestinal polyp object detection model can achieve accurate polyp detection, providing clinicians with reliable and valuable references. Experimental results show that the model exhibits superior performance in gastrointestinal polyp detection, which helps improve the diagnostic level of digestive system diseases and provides useful references for related research fields.


Subject(s)
Algorithms , Humans , Image Interpretation, Computer-Assisted/methods , Polyps/diagnosis , Polyps/pathology , Colonic Polyps/diagnosis , Colonic Polyps/pathology
4.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 38(10): 935-939;946, 2024 Oct.
Article in Chinese | MEDLINE | ID: mdl-39390933

ABSTRACT

Objective:To explore the differences in clinical presentation and therapeutic outcomes between vocal fold fibrocystic degeneration and other common benign lesions, such as vocal fold polyp and cyst. Methods:Vocal function was assessed before and after surgery in 10 cases of vocal fold fibrocystoids, 30 cases of vocal fold polyps and 10 cases of vocal fold cysts at Department of Voice Medicine, Xiamen University Zhongshan Hospital. The voice Assessments included GRBAS(G-scale), VHI-10 scale, Reflux Symptom Index(RSI) scale, stroboscope, acoustic objective analysis, and aerodynamics measurements. The acoustice analysis parameters included fundamental frequency(F0), fundamental frequency perturbation(Jitter), amplitude perturbation(Shimmer) and voice disturbance severity index(DSI), while the maximum phonation time(MPT) was assessed for aerodynamics. Stroboscopic parameters included vocal fold straightness, vocal fold color, glottic closure and mucosal wave. All three groups underwent phonomicrosurgery and a follow-up review was conducted one month later. Pre-and post-operative function assessment parameters were compared across the three groups. Results:Significant differences were founded in the G grade, Jitter, Shimmer, DSI, glottic closure and mucosal wave between the vocal fold fibrocystic degeneration group and the vocal fold polyp and vocal fold cyst group(P<0.05). Most voice function parameters in all three groups showed significant improvement after surgery(P<0.05). The improvement of VHI(10), RSI and mucosal wave scores in the vocal fold fibrocystic lesion group was significantly different from that of the vocal fold polyp group(P<0.05). Conclusion:Vocal fold fibrocystic degeneration is a more severe than that of vocal fold polyps and cysts, which are two common benign vocal fold lesions. Phonomicrosurgery is an effective treatment for vocal fold fibrocystic degeneration, but its curative effect are less favorable compared to those for vocal fold polyps and vocal fold cysts. Therefore, a detailed preoperative evaluation is essential for predicting surgical outcomes.


Subject(s)
Cysts , Laryngeal Diseases , Vocal Cords , Voice Quality , Humans , Vocal Cords/surgery , Vocal Cords/pathology , Cysts/surgery , Laryngeal Diseases/surgery , Female , Male , Polyps/surgery , Middle Aged , Adult , Treatment Outcome
5.
Ceska Gynekol ; 89(4): 269-277, 2024.
Article in English | MEDLINE | ID: mdl-39242201

ABSTRACT

OBJECTIVE: Endometrial polyp (EP) is a type of pathology that is quite common in clinical practice. Although its exact etiology is not fully known, there is evidence to support that it is sensitive to hormonal stimuli. We aimed to investigate the relationship between kisspeptin (KP) and EP by comparing the genetic (tissue-blood) and immunohistochemical (IHC) expression of KP in EP lesions in patients with normal endometrial findings. MATERIALS AND METHODS: A prospective case-control study of 50 patients with EP (N = 25) and normal endometrial findings (N = 25) on biopsy and/or excision material was performed. Blood and biopsy samples obtained from all patients were stored at -80 °C. KP gene expression levels were determined from paraffin blocks, and peripheral venous blood samples obtained from biopsy specimens and IHC-H-score analysis were performed from paraffin blocks. EP and matched controls were compared for KP. RESULTS: After IHC, the KP H-score of the control group was higher than the EP group, and this difference was statistically significant; H-score: control: 5 (++; 1-15); polyp: 1 (+; 0-12) (P < 0.05). Although KP expression in both tissue and blood was higher in the control group than in the EP group, this difference was not statistically significant (P > 0.05). No significant correlation was found between IHC H-score and KP expression levels in tissue and blood. According to the ROC analysis, the tissue and blood KP expression cut-off value and area under the curve (AUC) predicting the likelihood of developing EP were not significant (tissue KP: 1.04, AUC: 0.570, P = 0.388, sensitivity 56%, specificity 60%, Blood KP: 1.06, AUC: 0.569, P = 0.401, sensitivity 80%, specificity 40%). CONCLUSIONS: Decreased KP expression level in EP lesions may predict the diagnosis of EP, and in the future, KP may have therapeutic potential for benign gynecological pathologies such as polyps.


Subject(s)
Immunohistochemistry , Kisspeptins , Polyps , Humans , Female , Polyps/genetics , Polyps/metabolism , Polyps/pathology , Kisspeptins/genetics , Kisspeptins/metabolism , Case-Control Studies , Uterine Diseases/genetics , Uterine Diseases/metabolism , Uterine Diseases/pathology , Uterine Diseases/blood , Prospective Studies , Adult , Endometrium/metabolism , Endometrium/pathology , Middle Aged
6.
Zhonghua Yi Xue Za Zhi ; 104(35): 3342-3346, 2024 Sep 10.
Article in Chinese | MEDLINE | ID: mdl-39266499

ABSTRACT

To analyze the clinical characteristics of appendiceal orifice polyps and the effect of endoscopic super minimally invasive treatment. A retrospective analysis was conducted on the general situation (age and sex), the classification of appendiceal orifice polyps, the treatment method under endoscope, postoperative pathology and postoperative complications in patients who underwent resection of appendiceal orifice polyps at the Peking University First Hospital and the First Medical Center of the PLA General Hospital from January 1, 2022, to December 31, 2023. A total of 47 patients were included, consisting of 28 males and 19 females, with 35-86 (61±12) years. Appendiceal orifice polyps were classified into four types: type 0 (14 cases), type 1 (15 cases), type 2 (12 cases), and type 3 (6 cases). Among the endoscopic morphologies, 22 cases were granular laterally spreading tumors. Endoscopic mucosal dissection was performed in 37 cases. Postoperative appendiceal stent placement was performed in 1 case. The pathological types of polyps included adenoma in 15 cases, high-grade intraepithelial neoplasia in 10 cases, intramucosal carcinoma in 4 cases, submucosal carcinoma in 5 cases, inflammatory polyps in 1 cases, and sessile serrated lesion in 12 cases. Curative resection was performed in 44 cases. There were no postoperative complications such as bleeding, perforation, or acute appendicitis. The pathology of appendiceal polyps is mostly precancerous lesions, and the treatment scheme of endoscopic super minimally invasive resection is both safe and effective.


Subject(s)
Appendix , Humans , Male , Female , Middle Aged , Retrospective Studies , Adult , Aged , Appendix/surgery , Aged, 80 and over , Minimally Invasive Surgical Procedures , Polyps/surgery , Endoscopic Mucosal Resection/methods , Appendiceal Neoplasms/surgery , Appendiceal Neoplasms/pathology , Postoperative Complications , Adenoma/surgery , Adenoma/pathology , Endoscopy/methods
7.
J Zoo Wildl Med ; 55(3): 838-842, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39255229

ABSTRACT

Gastric and intestinal mucosal hyperplasia and polyps are identified as a cause of morbidity and mortality in moray eels. This report describes the clinical presentations, diagnostic procedures, and therapeutic interventions in eight moray eels diagnosed with gastric polypoid hyperplasia. All described cases were humanely euthanized or found deceased, and multifocal adenomatous hyperplasia and polyps extending from the gastric mucosal epithelium were identified in all cases. The moray eels diagnosed with adenomatous hyperplasia and polyps often exhibited anorexia, regurgitation, and occasional changes in buoyancy, and supportive care was unsuccessful in alleviating or resolving these signs.


Subject(s)
Eels , Hyperplasia , Animals , Hyperplasia/veterinary , Hyperplasia/pathology , Female , Male , Fish Diseases/pathology , Fish Diseases/diagnosis , Polyps/veterinary , Polyps/pathology , Polyps/diagnosis , Stomach Diseases/veterinary , Stomach Diseases/pathology , Stomach Diseases/diagnosis
8.
Sci Rep ; 14(1): 22446, 2024 09 28.
Article in English | MEDLINE | ID: mdl-39341964

ABSTRACT

The influence of metabolic dysfunction-associated steatotic liver disease (MASLD) on gallbladder polyp development in both sexes remains elusive. Therefore, to clarify the role of MASLD in gallbladder polyp development, we investigated the longitudinal association between MASLD and gallbladder polyps. In this observational study, we included 5,527 gallbladder polyp-free patients who underwent > 2 health check-ups over > 2 years. Generalized estimation equations were used to analyze associations between MASLD and gallbladder polyp development according to repeated measures at baseline and the most recent stage. Gallbladder polyp development rates in men and women were 7.5% and 5.6% (p < 0.01), respectively. MASLD was not significantly correlated with gallbladder polyp development. Regarding the association between gallbladder polyp development (men: ≥6 mm and women: ≥5 mm) and the number of MASLD components following lifestyle habits, men and women with ≥ 4 MASLD components had odds ratios of 3.397 (95% confidence interval: 1.096-10.53) and 5.338 (1.054-27.04), respectively. Higher nonalcoholic fatty liver disease fibrosis scores were associated with significant risk of gallbladder polyp development in women (1.991, 1.047-3.785). Although MASLD influence on gallbladder polyp development differs by sex, close monitoring of patients with an increasing number of MASLD components is essential to prevent gallbladder polyp development. Specifically, men with ≥ 4 MASLD components should be monitored for gallbladder polyps measuring ≥ 6 mm.


Subject(s)
Gallbladder Diseases , Polyps , Humans , Male , Female , Middle Aged , Polyps/pathology , Gallbladder Diseases/pathology , Gallbladder Diseases/metabolism , Gallbladder Diseases/epidemiology , Gallbladder Diseases/complications , Adult , Risk Factors , Gallbladder/pathology , Gallbladder/metabolism , Non-alcoholic Fatty Liver Disease/complications , Non-alcoholic Fatty Liver Disease/pathology , Non-alcoholic Fatty Liver Disease/metabolism , Fatty Liver/pathology , Fatty Liver/complications , Fatty Liver/metabolism , Aged
9.
J Med Case Rep ; 18(1): 466, 2024 Sep 27.
Article in English | MEDLINE | ID: mdl-39334512

ABSTRACT

INTRODUCTION AND IMPORTANCE: Fibroepithelial polyps are rare benign lesions with uncertain origins. They are commonly found in the skin and genitourinary system. Fibroepithelial polyps in the external auditory canal are infrequent. CASE PRESENTATION: We report a 60-year-old Persian woman with an incidentally discovered painless fibroepithelial polyp in the right external auditory canal. Microscopic transcanal surgery confirmed the diagnosis after temporal computed tomography imaging showed a soft tissue mass. CLINICAL DISCUSSION: Fibroepithelial polyps have an uncertain etiology and are typically asymptomatic. Surgical resection is the preferred treatment, and the prognosis following resection is generally favorable, with low recurrence rates. CONCLUSION: This case highlights the rarity of fibroepithelial polyps in the external auditory canal and underscores the importance of considering them in the differential diagnosis of external auditory canal lesions.


Subject(s)
Ear Canal , Polyps , Tomography, X-Ray Computed , Humans , Female , Middle Aged , Ear Canal/pathology , Ear Canal/diagnostic imaging , Ear Canal/surgery , Polyps/pathology , Polyps/surgery , Polyps/diagnostic imaging , Ear Neoplasms/pathology , Ear Neoplasms/surgery , Ear Neoplasms/diagnostic imaging , Ear Neoplasms/diagnosis , Neoplasms, Fibroepithelial/pathology , Neoplasms, Fibroepithelial/surgery , Neoplasms, Fibroepithelial/diagnosis , Diagnosis, Differential , Incidental Findings
10.
Front Immunol ; 15: 1431990, 2024.
Article in English | MEDLINE | ID: mdl-39346904

ABSTRACT

Background: Previous research has demonstrated an association between gut microbiota and immune status with the development of several diseases. However, whether these factors contribute to polyps remains unclear. This study aims to use Mendelian randomization (MR) to investigate the causal relationship between gut microbiota and 4 types of polyps (nasal, gallbladder, colon, and gastric polyps), as well as to analyze the mediating role of immune traits. Methods: This study utilized large-scale GWAS meta-analyses of gut microbiota (MiBioGen Consortium), 731 immune traits, and 4 types of polyps (one from the FinnGen Consortium and three from the NBDC Human Database). Univariate MR with the inverse variance weighted (IVW) estimation method was employed as the primary analytical approach. A two-step MR analysis was performed to identify potential mediating immune traits. Additionally, multivariable MR approach based on Bayesian model averaging (MR-BMA) was employed to further prioritize gut microbiota and immune traits associated with polyp development. Results: Based on IVW method in univariate MR analysis, we identified 39 gut microbial taxa and 135 immune traits significantly causally associated with at least one type of polyp. For nasal polyps, 13 microbial taxa and 61 immune traits were causally associated. After false discovery rate (FDR) correction, CD3 on Central Memory CD8+ T cells and CD3 on CD4 regulatory T cells remained significant. MR-BMA identified 4 gut microbial taxa and 4 immune traits as high priority. For gallbladder polyps, 9 microbial taxa and 30 immune traits were causally associated. MR-BMA identified 8 microbial taxa and 6 immune traits as higher importance. For colon polyps, 6 microbial taxa and 21 immune traits were causally associated. MR-BMA identified 4 microbial taxa and 3 immune traits as higher importance. For gastric polyps, 12 microbial taxa and 33 immune traits were causally associated. Actinobacteria remained significant after FDR correction, and MR-BMA identified 7 gut microbial taxa and 6 immune traits as high priority. We identified 16 causal pathways with mediator directions consistent with the direction of gut microbiome-polyp association. Of these, 6 pathways were associated with the mechanism of nasal polyps, 1 with gallbladder polyps, 2 with colon polyps, and 7 with gastric polyps. Conclusions: Our findings shed light on the causal relationships between gut microbiota, immune traits, and polyp development, underscoring the crucial roles of gut microbiota and immune status in polypogenesis. Furthermore, these findings suggest potential applications in polyp prevention, early screening, and the development of effective strategies to reduce polyp risk.


Subject(s)
Gastrointestinal Microbiome , Genome-Wide Association Study , Mendelian Randomization Analysis , Humans , Gastrointestinal Microbiome/immunology , Polyps/immunology , Polyps/microbiology , Genetic Predisposition to Disease
11.
Int J Biol Macromol ; 279(Pt 4): 135405, 2024 Nov.
Article in English | MEDLINE | ID: mdl-39245110

ABSTRACT

The use of submucosal injection is crucial for satisfactory submucosal elevation in the early resection of flat polyps originating from the gastrointestinal tract (GIT). Injectable hydrogels derived from natural polypeptides are attractive candidates due to their excellent biocompatibility and easy gelation properties. However, most of the reported hydrogels are not the class of catheter delivery materials due to quick gelation, high inherent viscosity, and injection clogging. This study presents a novel injectable shear-thinning hydrogel platform of small molecules (nonanal) modified gelatin polymer, which offers a promising submucosal injection for effective removal of polyps from GIT. Physicochemical characterizations of hydrogel demonstrate the suitable features as an effective submucosal injection, including shear thinning property, self-assembly, methylene blue dye encapsulation, flow behavior, stability, syringeability (18 G, 21 G, and 24 G needles) and fibrous morphology. Ex vivo investigations of developed submucosal formulation on goat intestines demonstrate the enhanced visibility of cushions and the ability to produce stable, long-lasting cushions of about 8.07 mm up to ∼60 min of submucosal injection. The rapid blood clotting behavior of hydrogel was observed in about 120 s without compromising hemocompatibility with the hemolysis of about 3.77 % only. In vitro biocompatibility of the hydrogel was also verified using the HepG2 and nHDF cells. In vivo study depicts desirable biocompatibility, a non-toxic organ profile, and optimal cushion height in mice models. Studies established the foundation of novel submucosal fluid to improve the therapeutic outcomes of early resection for gastrointestinal polyps.


Subject(s)
Gelatin , Hydrogels , Animals , Hydrogels/chemistry , Humans , Gelatin/chemistry , Mice , Injections , Hep G2 Cells , Polyps/surgery , Polyps/pathology , Biocompatible Materials/chemistry , Goats
12.
Turk J Gastroenterol ; 35(9): 681-689, 2024 Sep 02.
Article in English | MEDLINE | ID: mdl-39344501

ABSTRACT

Acute cholecystitis, cholelithiasis, and gallbladder polyps represent the most gallbladder benign diseases. Endoscopic approaches for the management of these diseases were an alternative to standard laparoscopic cholecystectomy. These endoscopic approaches include transpapillary approaches via endoscopic retrograde cholangiopancreatography, transmural access approaches via endoscopic ultrasound, and endoscopic surgical approaches using natural orifice transluminal endoscopic surgery approaches. However, it's still uncertain which approach is associated with the superior clinical outcomes due to the lack of high-level evidence. Our review provides new insight into the endoscopic approaches for the management of gallbladder benign diseases, with the latest evidence included.


Subject(s)
Cholangiopancreatography, Endoscopic Retrograde , Cholelithiasis , Gallbladder Diseases , Polyps , Humans , Gallbladder Diseases/surgery , Cholangiopancreatography, Endoscopic Retrograde/methods , Polyps/surgery , Cholelithiasis/surgery , Endosonography/methods , Natural Orifice Endoscopic Surgery/methods , Cholecystitis, Acute/surgery , Cholecystectomy, Laparoscopic/methods
13.
JAAPA ; 37(10): 1-3, 2024 Oct 01.
Article in English | MEDLINE | ID: mdl-39316005

ABSTRACT

ABSTRACT: Patients with vocal cord polyps commonly present with symptoms of hoarseness. Although rare, large polyps can cause shortness of breath and stridor and should be included in the differential for patients with airway obstruction. Dysphonia or hoarseness can be a symptom of underlying disease, such as head and neck cancer. This case illustrates the importance of prompt and accurate diagnosis in a patient with persistent symptoms and a history of smoking. Obtaining a laryngoscopy is crucial to appropriately evaluate the larynx. Proper visualization of the laryngeal structures will help direct patient care toward further diagnostic imaging and medical or surgical intervention if indicated.


Subject(s)
Airway Obstruction , Laryngoscopy , Polyps , Vocal Cords , Humans , Polyps/complications , Polyps/diagnosis , Airway Obstruction/etiology , Airway Obstruction/diagnosis , Vocal Cords/diagnostic imaging , Male , Hoarseness/etiology , Laryngeal Diseases/diagnosis , Laryngeal Diseases/complications , Laryngeal Diseases/etiology , Middle Aged , Dysphonia/etiology , Diagnosis, Differential , Female
14.
Zhonghua Yi Xue Za Zhi ; 104(34): 3171-3174, 2024 Sep 03.
Article in Chinese | MEDLINE | ID: mdl-39193604

ABSTRACT

Gallbladder polyp is a common disease of gallbladder, the incidence of gallbladder polyp in China is about 5%~10%, and the trend is increasing year by year. The patients with gallbladder polyps had no obvious clinical symptoms, which was more than that found by ultrasonography during physical examination. At present, the diameter of gallbladder polyps>10 mm is still used by clinicians as the main surgical indication for cholecystectomy. According to the data, about 80% to 90% of gallbladder polyps are cholesterol type polyps and benign gallbladder polyps. For these patients whose gallbladder is removed due to benign gallbladder polyps, we consider that we can continue to observe or retain the gallbladder, without having to bear the adverse consequences that may be caused by gallbladder removal. Based on the literature analysis at home and abroad, this paper discusses the surgical treatment of gallbladder polyps and the results of postoperative pathological diagnosis, and reminds the majority of clinicians to be careful when removing gallbladder polyps.


Subject(s)
Cholecystectomy , Gallbladder Diseases , Polyps , Humans , Polyps/surgery , Gallbladder Diseases/surgery , Gallbladder/surgery , Gallbladder Neoplasms/surgery
15.
World J Gastroenterol ; 30(31): 3640-3653, 2024 Aug 21.
Article in English | MEDLINE | ID: mdl-39192997

ABSTRACT

Gastric polyps (GPs) are increasingly common. On upper endoscopy, they should be examined with white light and occasionally chromoendoscopy, and their morphology classified according to the Paris classification. Most GPs have a typical endoscopic appearance and can be associated with diseases like Helicobacter pylori infection. Histological examination is necessary for an accurate diagnosis. While most polyps are non-neoplastic and do not require treatment, some carry a risk of malignancy or are already malignant. Therefore, understanding the diagnosis, classification, and management of GPs is crucial for patient prognostication. Our new classification categorizes GPs into "good", "bad", and "ugly" based on their likelihood of becoming malignant. We aim to provide descriptions of the endoscopic appearance, pathology, treatment, and follow-up for different GPs, as well as clinical management flowcharts.


Subject(s)
Helicobacter Infections , Stomach Neoplasms , Humans , Stomach Neoplasms/classification , Stomach Neoplasms/pathology , Helicobacter Infections/diagnosis , Helicobacter Infections/microbiology , Helicobacter Infections/pathology , Helicobacter Infections/complications , Gastroscopy , Helicobacter pylori/isolation & purification , Prognosis , Polyps/classification , Polyps/pathology , Polyps/diagnosis , Adenomatous Polyps/pathology , Adenomatous Polyps/classification
16.
Ann Med ; 56(1): 2393273, 2024 Dec.
Article in English | MEDLINE | ID: mdl-39189520

ABSTRACT

BACKGROUND: Polypoidal choroidal vasculopathy (PCV) is a hemorrhagic fundus disease that can lead to permanent vision loss. Predicting the treatment response to anti-VEGF monotherapy in PCV is consistently challenging. We aimed to conduct a prospective multicenter study to explore and identify the imaging biomarkers for predicting the anti-VEGF treatment response in PCV patients, establish predictive model, and undergo multicenter validation. METHODS: This prospective multicenter study utilized clinical characteristics and images of treatment naïve PCV patients from 15 ophthalmic centers nationwide to screen biomarkers, develop model, and validate its performance. Patients from Peking Union Medical College Hospital were randomly divided into a training set and an internal validation set. A nomogram was established by univariate, LASSO regression, and multivariate regression analysis. Patients from the other 14 centers served as an external test set. Area under the curve (AUC), sensitivity, specificity, and accuracy were calculated. Decision curve analysis (DCA) and clinical impact curve (CIC) were utilized to evaluate the practical utility in clinical decision-making. FINDINGS: The eye distribution for the training set, internal validation set, and external test set were 66, 31, and 71, respectively. The 'Good responder' exhibited a thinner subfoveal choroidal thickness (SFCT) (230.67 ± 61.96 vs. 314.42 ± 88.00 µm, p < 0.001), lower choroidal vascularity index (CVI) (0.31 ± 0.08 vs. 0.36 ± 0.05, p = 0.006), fewer choroidal vascular hyperpermeability (CVH) (31.0 vs. 62.2%, p = 0.012), and more intraretinal fluid (IRF) (58.6 vs. 29.7%, p = 0.018). SFCT (OR 0.990; 95% CI 0.981-0.999; p = 0.033) and CVI (OR 0.844; 95% CI 0.732-0.971; p = 0.018) were ultimately included as the optimal predictive biomarkers and presented in the form of a nomogram. The model demonstrated AUC of 0.837 (95% CI 0.738-0.936), 0.891 (95% CI 0.765-1.000), and 0.901 (95% CI 0.824-0.978) for predicting 'Good responder' in the training set, internal validation set, and external test set, respectively, with excellent sensitivity, specificity, and practical utility. INTERPRETATION: Thinner SFCT and lower CVI can serve as imaging biomarkers for predicting good treatment response to anti-VEGF monotherapy in PCV patients. The nomogram based on these biomarkers exhibited satisfactory performances.


Subject(s)
Angiogenesis Inhibitors , Biomarkers , Tomography, Optical Coherence , Vascular Endothelial Growth Factor A , Humans , Male , Female , Prospective Studies , Aged , Middle Aged , Angiogenesis Inhibitors/therapeutic use , Angiogenesis Inhibitors/administration & dosage , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Choroid/blood supply , Choroid/diagnostic imaging , Choroidal Neovascularization/drug therapy , Choroidal Neovascularization/diagnostic imaging , Treatment Outcome , Nomograms , Polyps/drug therapy , Polyps/diagnostic imaging , Polyps/diagnosis , Fluorescein Angiography/methods , Choroid Diseases/drug therapy , Choroid Diseases/diagnostic imaging , Choroid Diseases/diagnosis , Polypoidal Choroidal Vasculopathy
17.
Arch Gynecol Obstet ; 310(4): 1945-1950, 2024 10.
Article in English | MEDLINE | ID: mdl-39103619

ABSTRACT

PURPOSES: This study aims to assess the effectiveness and safety of cervical polypectomy performed via vaginoscopy in pregnant women. METHODS: Pregnant patients diagnosed with cervical polyps were retrospectively included in Beijing Tiantan Hospital between April 2017 and April 2023. Group A underwent cervical polypectomy using a vaginoscopy technique without speculum, cervical forceps and anesthesia, while Group B received conservative management. The incidence of spontaneous abortion, preterm birth, preterm rupture of membranes (PROM), visual analog scale (VAS) scores, timing and method of delivery, and neonatal outcomes were analyzed. RESULTS: Of 90 pregnant patients included in the study, 48 patients receiving polypectomy under vaginoscopy were included into group A while 42 patients receiving conservative treatment were assigned into group B. At baseline, group A exhibited higher rates of vaginal bleeding pre-operation, as well as larger cervical polyp dimensions compared to group B. The median interval between vaginal bleeding and polypectomy was 3.5 weeks, with the median procedure typically performed at gestational week 19 in group A. There was no significant difference in the incidence of spontaneous abortion between the two groups (4.2% vs. 4.8%, p = 1.000). However, group A showed a significantly lower frequency of preterm birth (4.2% vs. 21.4%, p = 0.030) and premature rupture of membranes (PROM) (18.8% vs. 45.2%, p = 0.025) compared to group B. No disparities were observed in the timing, mode of delivery, and neonatal outcomes between the two groups. CONCLUSIONS: The utilization of vaginoscopy for cervical polypectomy has been shown to decrease the likelihood of preterm delivery and premature rupture of membranes in pregnant women with symptomatic cervical polyps. Therefore, performing cervical polypectomy via vaginoscopy without anesthesia provide a feasible and optimal ways in the management of this population.


Subject(s)
Fetal Membranes, Premature Rupture , Polyps , Humans , Female , Pregnancy , Adult , Retrospective Studies , Polyps/surgery , Fetal Membranes, Premature Rupture/etiology , Premature Birth/prevention & control , Premature Birth/etiology , Premature Birth/epidemiology , Cervix Uteri/surgery , Abortion, Spontaneous/epidemiology , Abortion, Spontaneous/etiology , Uterine Cervical Diseases/surgery , Uterine Hemorrhage/etiology , Treatment Outcome , Colposcopy/methods , Colposcopy/adverse effects
18.
J Coll Physicians Surg Pak ; 34(8): 885-890, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39113504

ABSTRACT

OBJECTIVE: To assess the efficacy of mechanical resection through TruClear™ hysteroscopy in patients with endometrial polyps and submucosal fibroids. STUDY DESIGN: Descriptive study. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Shifa International Hospital, Islamabad, Pakistan, from June 2018 to 2022. METHODOLOGY: Patients diagnosed with endometrial polyps and submucosal fibroids confirmed by abdominal or transvaginal ultrasonography were included. Patients having a history of congestive cardiac failure, chronic kidney disease, and bleeding diathesis were excluded from the study. Data about the complete removal of pathology (endometrial polyps and submucosal fibroids), mean operating time, and postoperative complications such as bleeding and perforation were extracted. The follow-up was set up to 6 months after the procedure. RESULTS: The average age of the 45 patients was 35.62 ± 7.46 years. Heavy menstrual bleeding was the most prevalent symptom, seen in 73.3% of cases, followed by irregular vaginal bleeding (IVB) in 11.1% of cases. The most frequent disease identified by sonography was a polyp in 21 (47%) instances, followed by submucosal fibroids in 12 (27%) cases, mixed pathology in 10 (22%), and malignancy in 2 (4%) cases. The overall average operative time was 36.46 ± 24.94 minutes. A hundred percent removal of lesions was observed in this study. Persistent symptoms were observed in 13% of patients after the surgery so they were treated with other interventions. The most common intervention was an intrauterine hormonal device. Intraoperative bleeding was observed in only one patient and was managed by intraoperative intrauterine balloon insertion. The recurrence rate was 8.9% (4/45). CONCLUSION: TruClear™ hysteroscopy showed a major advantage in the successful and complete removal of the pathology, low operation time, and complications. KEY WORDS: Fibroids, Hysteroscopy, Polyps, Endometrial resection, Menstrual bleeding.


Subject(s)
Hysteroscopy , Leiomyoma , Polyps , Uterine Neoplasms , Humans , Female , Hysteroscopy/methods , Leiomyoma/surgery , Leiomyoma/pathology , Polyps/surgery , Adult , Middle Aged , Treatment Outcome , Uterine Neoplasms/surgery , Uterine Neoplasms/pathology , Pakistan/epidemiology , Operative Time , Menorrhagia/surgery , Uterine Diseases/surgery , Postoperative Complications/epidemiology , Uterine Hemorrhage/surgery
19.
Georgian Med News ; (350): 120-126, 2024 May.
Article in English | MEDLINE | ID: mdl-39089283

ABSTRACT

The relationship between Helicobacter pylori infection and gallbladder diseases, particularly cholecystitis and gallbladder polyps, remains unclear. This study aimed to investigate the presence of H. pylori in gallbladder tissues and its potential role in gallbladder pathologies, as well as to examine the expression of chemokines CXCL2 and CXCL5 in these conditions. MATERIAL AND METHODS: A total of 137 laparoscopically excised gallbladders were analysed through histological examination, PCR for H. pylori-specific DNA, and quantitative real-time PCR for CXCL2 and CXCL5 gene expression. The study cohort included patients with acute calculous cholecystitis, chronic calculous cholecystitis, and gallbladder polyps. RESULTS: H. pylori was detected in 30.7% of cases by histological methods and 42.3% by PCR. Elevated expression of CXCL2 and CXCL5 was observed in 62% and 57.7% of cases, respectively, with a higher prevalence in acute cholecystitis compared to chronic conditions. However, no statistically significant association was found between H. pylori presence and the forms of cholecystitis, as well as between H. pylori presence and chemokine expression in gallbladder. CONCLUSIONS: The study did not establish a direct link between the presence of H. pylori infection and forms of gallbladder pathologies. The findings suggest that other factors other than H. pylori may contribute to the upregulation of CXCL2 and CXCL5 in gallbladder diseases. Further research is needed to elucidate the complex interactions between H. pylori, chemokines, and gallbladder pathologies.


Subject(s)
Chemokine CXCL2 , Chemokine CXCL5 , Gallbladder , Helicobacter Infections , Helicobacter pylori , Humans , Helicobacter pylori/isolation & purification , Helicobacter pylori/pathogenicity , Helicobacter Infections/microbiology , Helicobacter Infections/pathology , Helicobacter Infections/complications , Helicobacter Infections/genetics , Male , Gallbladder/microbiology , Gallbladder/pathology , Gallbladder/surgery , Female , Middle Aged , Chemokine CXCL5/genetics , Chemokine CXCL5/metabolism , Chemokine CXCL2/genetics , Chemokine CXCL2/metabolism , Adult , Cholecystitis/microbiology , Cholecystitis/pathology , Cholecystitis/surgery , Polyps/microbiology , Polyps/pathology , Gallbladder Diseases/microbiology , Gallbladder Diseases/pathology , Gallbladder Diseases/surgery , Aged
20.
J Vis Exp ; (210)2024 Aug 02.
Article in English | MEDLINE | ID: mdl-39158302

ABSTRACT

Endometrial polyps commonly contribute to female infertility, and hysteroscopic resection is the established surgical approach for their treatment. Numerous resection methods are available, with the most used and cost-effective options being cold resection employing micro-scissors or hot resection using an electric loop. However, both methods involve sharp resection, posing a challenge in achieving complete polyp removal while avoiding damage to the uterine endometrium. To address this issue, this study proposes an innovative approach: the combined use of the 6 Fr micro-scissors and forceps under hysteroscopy. The method entails utilizing 6 Fr micro-scissors to initially remove large polyps, followed by using 6 Fr micro-forceps to extract the remaining polyp tissue expeditiously and bluntly near the basal layer of the endometrium. This approach not only prevents surgical damage to the basal layer of the endometrium but also mitigates the risk of residual polyps resulting from incomplete resection. This method is particularly suitable for women with fertility requirements, offering additional considerations for the selection of treatment options for endometrial polyp resection.


Subject(s)
Hysteroscopy , Polyps , Female , Hysteroscopy/methods , Hysteroscopy/instrumentation , Polyps/surgery , Humans , Uterine Diseases/surgery , Surgical Instruments , Endometrium/surgery , Endometrium/pathology
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