The anti-Müllerian hormone: A useful tool for diagnosis of Polycystic Ovary Syndrome.

BACKGROUND: Polycystic Ovary Syndrome (PCOS) is the most frequent endocrine disorder that affects reproductive-age women with important long-term health implications. As such, the anti-Müllerian hormone (AMH) was proposed as a helpful test to identify women with PCOS. The aim of this study was to determine an AMH cut-off value for the diagnosis of PCOS. METHODS: This was a two-year cross-sectional study including women of reproductive age, diagnosed with PCOS according to Rotterdam criteria (2003). The control group of healthy women was age-matched. AMH was performed using an electrochemiluminescence immunoassay. AMH levels were compared and evaluated with the receiver operating characteristic curve analysis. RESULTS: A total of 130 women were enrolled in this study. Of these, 65 were diagnosed with PCOS, and 65 were healthy. No significant difference was detected in body mass index between the two groups. AMH levels were significantly higher in women with PCOS (p = < 0.001). No significant difference in AMH levels was detected between PCOS phenotypes. A cut-off of 25.1 pmol/L (3.5 ng/mL) could discriminate women with PCOS from controls with a sensitivity of 74% and specificity of 72.3%. The area under the curve was 0.811 (95% CI: 0.73-0.88). CONCLUSIONS: Our study suggests that AMH had good diagnostic potential as a complement to Rotterdam criteria for PCOS diagnosis in reproductive-age women of Tunisian origin.

[Predictive factors for anastomotic leakage after colon cancer surgery]. / Facteurs prédictifs de fistule anastomotique après colectomie pour cancer.

Introduction: in colon cancer surgery, anastomotic fistula (AF) is considered the most feared complication. The purpose of this study was to identify predictive factors associated with anastomotic fistula after colon cancer surgical resection and to describe the impact of this complication on mortality and postoperative length of stay. Methods: we conducted a retrospective, descriptive and analytical study in the Department of General Surgery at the Habib Bourguiba Hospital in Sfax, Tunisia from 1st January 2013 to 31 December 2020. Results: we collected data from the medical records of 163 patients who had undergone surgery for colon cancer. The average age of patients was 62.7 years with a sex ratio of 1.36. The postoperative course was uneventful in 64.4% of cases and complicated in 35.6% of cases. Surgical morbidity was mainly due to anastomotic fistulas (22 patients). This study demonstrated that predictors of the development of this complication were: diabetes p = 0.04, smoking p = 0.01, hypoalbuminaemia p = 0.01, preoperative haemoglobin less than 10g/dl, p < 0.01, anastomotic fistula located in the left colonic angle p = 0.02, perioperative transfusion p <0.01, and duration of surgery longer than 180 min p = 0.04. Moreover, the occurrence of anastomotic fistula was associated with specific mortality rate (9%) and significantly prolonged postoperative length of stay. Conclusion: the prevention of anastomotic fistulas should be part of a multimodal approach based on the correction of nutritional deficiencies and possible pre-operative anemia.

Concomitant primary angiosarcoma and invasive carcinoma of the breast: a case report.

Collision tumor is a rare entity composed of two different tumors that occur in close to one another and maintain distinct borders. Only few cases have been reported in the breast. We report the first case of concomitant and adjacent primary angiosarcoma (PBAS) and invasive carcinoma of the breast (IBC), in a 45-year-old patient which presented with a lump in her right breast. Biopsy revealed PBAS. She underwent mastectomy. Gross examination showed a hemorrhagic and spongy tumor in contact with a second small grayish-white mass. Histologically, the hemorrhagic tumor was consistent with a high grade (HG) PBAS; the second mass was consistent with an IBC with no images of histological admixture. The diagnosis of a collision tumor composed of HG PBAS and IBC was established. During follow-up, the patient developed ovarian angiosarcomatous metastasis. The diagnosis of breast collision tumor is very uncommon and hence is challenging for pathologist. Careful gross and microscopic examinations help in establishing the appropriate diagnosis.