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1.
Retina ; 44(1): 47-55, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37657069

RESUMO

PURPOSE: To investigate the characteristics and natural history of treatment-naive nonexudative polypoidal choroidal vasculopathy (PCV) and to determine biomarkers predicting exudative conversion. METHODS: Patients diagnosed with nonexudative PCV based on indocyanine green angiography and optical coherence tomography were included. Incidence of exudative conversion in nonexudative PCV patients and cumulative estimates for overall risk were assessed. Indocyanine green angiography and optical coherence tomography imaging-based features were analyzed to identify risk factors for exudative conversion. RESULTS: The study included 42 eyes of 40 patients with nonexudative PCV. The mean follow-up duration was 54.3 ± 35.5 months. Of the 42 eyes with nonexudative PCV, exudative conversion developed in 23 eyes (54.8%) after 42.2 ± 28.3 months (range, 8-103 months). Kaplan-Meier analysis showed that the exudation-free survival at 5 years after baseline was estimated to be 53.6%. Multivariate regression analysis showed that sequentially increased protrusion of retinal pigment epithelium in the polyp area was a significant risk factor for exudation in nonexudative PCV (odds ratio = 10.16; 95% CI 1.78-57.81; P = 0.01). CONCLUSION: Exudative conversion has been noted in nearly half of the nonexudative PCV cases in 5 years. The progressive protrusion of polypoidal lesions on optical coherence tomography examination may be a significant biomarker for predicting the near-term onset of exudation.


Assuntos
Doenças da Coroide , Neovascularização de Coroide , Pólipos , Humanos , Verde de Indocianina , Corioide , Vasculopatia Polipoidal da Coroide , Angiofluoresceinografia/métodos , Tomografia de Coerência Óptica/métodos , Pólipos/diagnóstico , Pólipos/epidemiologia , Neovascularização de Coroide/diagnóstico , Estudos Retrospectivos , Doenças da Coroide/diagnóstico , Doenças da Coroide/epidemiologia
2.
J Gastroenterol Hepatol ; 38(12): 2247-2253, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37926936

RESUMO

BACKGROUND AND AIM: We aimed to determine the risk and predictors of gallbladder cancer in all individuals with gallbladder polyps (GP) including those who did not have cholecystectomy. METHODS: The STROCSS guideline was followed to conduct a retrospective cohort study. All individuals with GP between 2010 and 2019 were followed up to determine the risk and predictors of gallbladder cancer. The primary outcomes were gallbladder cancer and gallbladder dysplasia, and the secondary outcomes included polyp growth rate and polyp disappearance rate. Binary logistic regression analysis and receiver operating characteristic curve analysis were conducted to evaluate the outcomes. RESULTS: Analysis of 438 patients showed risk of gallbladder cancer was 0.7% in all polyps (0% in polyps < 10 mm; 5.9% in polyps ≥ 10 mm). The risk of gallbladder dysplasia or cancer was 1.1% in all polyps (0% in polyps < 10 mm; 10% in polyps ≥ 10 mm). The polyp size (P = 0.0001) was predictor of cancer; however, patient's age (P = 0.1085), number of polyps (P = 0.9983), symptomatic polyps (P = 0.3267), and change in size (P = 0.9012) were not. Size of 21 mm was cut-off for risk of cancer (area under the curve [AUC]: 0.995, P < 0.001) and 11.8 mm for risk of dysplasia or cancer (AUC: 0.986, P < 0.001). The mean polyp growth rate was 0.3 mm/year and polyp disappearance rate was 16%. CONCLUSIONS: The GP size remains the only predictor of malignant changes regardless of patient's age, patient's symptoms and number of polyps. The polyp growth rate is unremarkable, and a significant proportion disappears during follow-up. We changed our follow-up protocol with reduced number of scans and early discharge policy.


Assuntos
Carcinoma in Situ , Doenças da Vesícula Biliar , Neoplasias da Vesícula Biliar , Neoplasias Gastrointestinais , Pólipos , Humanos , Neoplasias da Vesícula Biliar/epidemiologia , Neoplasias da Vesícula Biliar/etiologia , Neoplasias da Vesícula Biliar/diagnóstico , Vesícula Biliar/patologia , Estudos Retrospectivos , Doenças da Vesícula Biliar/cirurgia , Colecistectomia , Carcinoma in Situ/patologia , Pólipos/epidemiologia , Pólipos/patologia , Neoplasias Gastrointestinais/patologia , Ultrassonografia
3.
Korean J Intern Med ; 38(6): 844-853, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37848340

RESUMO

BACKGROUND/AIMS: We aimed to determine whether hepatitis B virus (HBV) or hepatitis C virus (HCV) infection remains an important risk factor for gallbladder polyps (GBPs) in the current context of reduced prevalence of these infections. METHODS: The cohort included 392,913 asymptomatic adults who underwent abdominal ultrasonography (US). RESULTS: The prevalence of GBP sized ≥ 5 mm, ≥ 10 mm, and overall (< 5, 5-9 and ≥ 10 mm) was 2.9%, 0.1%, and 12.8%, respectively. The prevalence of hepatitis B surface antigen (HBsAg), hepatitis B core antibody (HBcAb), and hepatitis C antibody (anti-HCV) positivity was 3.2%, 26.7%, and 0.1%, respectively. The GBP risk was significantly increased in HBsAg-positive individuals, with an adjusted odds ratio of 1.66 (95% confidence interval, 1.49-1.85) for GBP ≥ 5 mm, 2.39 (1.53-3.75) for GBP ≥ 10 mm, and 1.49 (1.41-1.59) for overall, whereas there was no significant association between anti-HCV positivity and GBP risk. The GBP risk did not increase significantly in individuals who tested negative for HBsAg but positive for HBcAb. CONCLUSION: The presence of HBsAg may be an independent risk factor for GBP development in the current context of a indecreasing prevalence of HBsAg positivity. A more comprehensive evaluation of GBP during abdominal US surveillance of HBsAg-positive individuals may be necessary.


Assuntos
Doenças da Vesícula Biliar , Hepatite B , Hepatite C , Pólipos , Adulto , Humanos , Vírus da Hepatite B , Antígenos de Superfície da Hepatite B , Estudos de Coortes , Hepatite B/complicações , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Hepatite C/complicações , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Anticorpos Anti-Hepatite B , Hepacivirus , Doenças da Vesícula Biliar/diagnóstico por imagem , Doenças da Vesícula Biliar/epidemiologia , Pólipos/epidemiologia
4.
Eur Rev Med Pharmacol Sci ; 27(18): 8895-8904, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37782198

RESUMO

OBJECTIVE: Endometrial polyps (EPs) are one of the most common pathologies detected during the examination of the uterine cavity of infertile women. We aimed to demonstrate the relationship between EPs, chronic endometritis (CE) and in vitro fertilization (IVF) outcomes. PATIENTS AND METHODS: This retrospective study was performed on 394 hysteroscopically examined infertility cases. We performed polyp resections (PR) and extensive biopsies of the endometrium to demonstrate the association with clinical pregnancy (CP) by IVF. We performed statistical analysis to compare these associations. RESULTS: The incidence of CE was twice as high in the presence of EPs as in the absence of EPs. The associations between EPs and PR were found to be significant for positive CP outcomes. A significant difference in IVF outcome was found between the group with EPs and the group without EPs. All these associations were statistically significant (p < 0.05). CONCLUSIONS: We found a frequent association between EPs and CE. The pregnancy rate obtained after IVF was negatively affected by the presence of EPs. Treatment of these pathologies improved IVF outcomes.


Assuntos
Endometrite , Infertilidade Feminina , Pólipos , Gravidez , Feminino , Humanos , Endometrite/epidemiologia , Endometrite/complicações , Endometrite/patologia , Infertilidade Feminina/terapia , Estudos Retrospectivos , Histeroscopia , Endométrio/patologia , Fertilização In Vitro/efeitos adversos , Doença Crônica , Pólipos/epidemiologia , Pólipos/complicações , Pólipos/patologia
5.
Eur J Gastroenterol Hepatol ; 35(8): 829-835, 2023 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-37395234

RESUMO

OBJECTIVES: The development of fundic gland polyps (FGPs) is the most common side effect of long-term proton pump inhibitor (PPI) use; however, the effect of drug use characteristics and their impact on the risk of other gastric polyp development remain unclear. We aimed to identify the influence of PPI administration, as well as its duration and dose, in the development of gastric polyps. METHODS: A prospective cohort study was conducted on consecutive patients who underwent gastroscopy between September 2017 and August 2019. Detailed characteristics of gastric polyps, Helicobacter pylori infection, and PPI use were analyzed. RESULTS: Among the 2723 patients included, gastric polyps (75% FGPs, 22% hyperplastic) were detected in 16.4%, and 60% were prescribed PPI. The risk of FGPs and hyperplastic polyps according to the duration of PPI use were as follows: 2-5 years [odds ratio (95% confidence interval); 2.86 (2.00-4.11) and 2.82 (1.69-4.78)]; 6-9 years [7.42 (5.03-11.01) and 2.32 (1.05-4.78)]; ≥10 years [14.94 (10.36-21.80) and 3.52 (1.67-7.03)]. Multivariate analysis confirmed that the risk of FGPs was 17.16 (11.35-26.23) for ≥10 years of PPI use. Portal hypertension-related conditions were associated with hyperplastic polyps [4.99 (2.71-9.20)]. CONCLUSION: Duration of and indications for PPI use are the most predictive factors for the development of gastric polyps. Prolonged PPI use increases the risk of polyp development and the number of patients with polyps, which may burden endoscopic practice. Highly selected patients may require particular care despite minimal risk of dysplasia and bleeding generally.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Pólipos , Neoplasias Gástricas , Humanos , Inibidores da Bomba de Prótons/efeitos adversos , Infecções por Helicobacter/complicações , Infecções por Helicobacter/tratamento farmacológico , Estudos Prospectivos , Neoplasias Gástricas/induzido quimicamente , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/complicações , Pólipos/induzido quimicamente , Pólipos/epidemiologia , Pólipos/complicações , Gastroscopia
6.
Surg Endosc ; 37(10): 7563-7572, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37438481

RESUMO

BACKGROUND: The likelihood of recurrence of gastric hyperplastic polyps (GHPs) following endoscopic resection and the need for long-term follow-up remain unknown. We, therefore, aimed to investigate the factors associated with the recurrence and cumulative incidence of GHPs over a 10-year period. METHODS: Between May 1995 and December 2020, 1,018 GHPs > 1 cm were endoscopically resected from 869 patients. Medical records of these patients were retrospectively reviewed and their clinical features and outcomes were assessed. Groups of GHPs with recurrence and those without recurrence group were compared, and univariate and multivariable analyses were performed to identify the potential risk factors for GHP recurrence. RESULTS: A total of 104 (12.0%) patients who underwent endoscopic removal of GHPs experienced recurrence. Compared to patients without recurrent GHPs, those with recurrent GHPs showed considerably larger median polyp size (28 mm vs. 14 mm, P < 0.001), a higher proportion of multiple polyps (41.3% vs. 29.3%, P = 0.020), polyps with lobulation (63.5% vs. 40.3%, P = 0.001), and exudate (63.5% vs. 46.8%, P = 0.001). Compared to the local recurrence (n = 52) group, the metachronous recurrence (n = 52) group had larger median polyp size (20 mm vs. 16 mm, P = 0.006) as well as higher rates of polyp lobulation (86.5% vs. 40.4%, P < 0.001) and exudate (82.7% vs. 44.4%, P = 0.001). After primary GHP excision, the cumulative incidence of recurrence was 7.2%, 12.7%, and 19.6% at 2 years, 5 years, and 10 years, respectively. CONCLUSION: The incidence of GHP recurrence following endoscopic excision increased as the follow-up period increased, especially in patients whose GHPs were large-sized, multiple, or characterized by surface exudates/lobulations.


Assuntos
Pólipos Adenomatosos , Pólipos do Colo , Pólipos , Humanos , Estudos Retrospectivos , Pólipos Adenomatosos/epidemiologia , Pólipos Adenomatosos/cirurgia , Pólipos/epidemiologia , Pólipos/cirurgia , Fatores de Risco , Pólipos do Colo/cirurgia
7.
J Am Coll Radiol ; 20(10): 1031-1041, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37406750

RESUMO

OBJECTIVE: Incidentally detected gallbladder polyps are commonly encountered when performing upper abdominal ultrasound. Our purpose was to estimate the life expectancy (LE) benefit of ultrasound-based gallbladder surveillance in patients with small (6-7 to <10 mm), incidentally detected gallbladder polyps, accounting for patient sex, age, and comorbidity level. METHODS: We developed a decision-analytic Markov model to evaluate hypothetical cohorts of women and men with small gallbladder polyps, with varying age (66-80 years) and comorbidity level (none, mild, moderate, severe). Drawing from current evidence, in the base case, we assumed no increased risk of gallbladder cancer in patients with small gallbladder polyps. To estimate maximal possible LE gains from surveillance, we assumed perfect cancer control consequent to 5 years of surveillance. We varied key assumptions including cancer risk and test performance characteristics in sensitivity analysis. RESULTS: Projected LE gains from surveillance were <3 days across most cohorts and scenarios evaluated. For 66- and 80-year-olds with no comorbidities, LE gains were 1.46 and 1.45 days, respectively, for women, and 0.67 and 0.75 days for men. With 10 years of surveillance, LE gains increased to 2.94 days for 66-year-old women with no comorbidities (men: 1.35 days). If we assumed a 10% increase in gallbladder cancer risk among individuals with polyps, LE gains increased slightly to 1.60 days for 66-year-old women with no comorbidities (men: 0.74 days). Results were sensitive to test performance and surgical mortality. DISCUSSION: Even under unrealistic, optimistic assumptions of cancer control, ultrasound surveillance of incidentally detected small gallbladder polyps provided limited benefit.


Assuntos
Neoplasias da Vesícula Biliar , Pólipos , Masculino , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Lactente , Neoplasias da Vesícula Biliar/diagnóstico por imagem , Neoplasias da Vesícula Biliar/epidemiologia , Neoplasias da Vesícula Biliar/cirurgia , Pólipos/diagnóstico por imagem , Pólipos/epidemiologia , Pólipos/cirurgia , Ultrassonografia , Comorbidade
8.
Artigo em Inglês | MEDLINE | ID: mdl-37174173

RESUMO

BACKGROUND: Sulcus vocalis (SV) is a longitudinal groove in the free edge of the true vocal cord. It may impair phonation with incomplete glottic closure, phonasthenia and hoarseness. This study aims to detect a correlation between benign vocal cord lesions and the incidence of the SV. METHODS: A retrospective study was carried out on patients who underwent transoral surgery due to benign vocal fold lesions and were selected according to strict criteria. Patients were divided into a group with sulcus vocalis (Group wSV) and a group without sulcus vocalis (Group w/oSV). The possible correlations between variables were assessed by the Pearson chi-square test (p < 0.05). RESULTS: The study included 232 vocal cord lesions in 229 patients: 62.88% were females whose mean age was 46.61 ± 14.04. The most frequent diseases were polyps (37.94%), nodules (18.53%) and Reinke's edema (21.12%). Statistically significant relationships were found between age and SV (p-value 0.0005) and between mild dysplasia and SV (p-value 0.03). CONCLUSIONS: This study did not detect a cause-effect relationship between SV and benign vocal fold lesions. SV within vocal fold lesions is more common in younger patients, suggesting a congenital nature of SV. In conclusion, in the case of a benign vocal fold lesion, a possible SV should be considered and researched to provide the patient the best healthcare.


Assuntos
Doenças da Laringe , Pólipos , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Prega Vocal/patologia , Prega Vocal/cirurgia , Doenças da Laringe/epidemiologia , Doenças da Laringe/patologia , Doenças da Laringe/cirurgia , Estudos Retrospectivos , Fonação , Pólipos/epidemiologia , Pólipos/patologia , Pólipos/cirurgia
9.
Sci Rep ; 13(1): 6168, 2023 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-37061587

RESUMO

Non-gastric upper gastrointestinal system polyps are detected rarely and mostly incidentally during upper gastrointestinal endoscopy. While the majority of lesions are asymptomatic and benign, some lesions have the potential to become malignant, and may be associated with other malignancies. Between May 2010 and June 2022, a total of 127,493 patients who underwent upper gastrointestinal endoscopy were retrospectively screened. Among these patients, those who had polyps in the esophagus and duodenum and biopsied were included in the study. A total of 248 patients with non-gastric polyps were included in this study. The esophageal polyp detection rate was 80.00/100,000, while the duodenal polyp detection rate was 114.52/100,000. In 102 patients (41.1%) with esophageal polyps, the mean age was 50.6 ± 15.1, and 44.1% (n = 45) were male. The most common type of polyps was squamous papilloma (n = 61, 59.8%), followed by inflammatory papilloma (n = 18, 17.6%). In 146 patients (58.9%) with duodenal polyps, the mean age of patients was 58.3 ± 16.5, and 69.8% (n = 102) were male. Brunner's gland hyperplasia, inflammatory polyp, ectopic gastric mucosa, and adenomatous polyp were reported to be the most prevalent types of polyps in the duodenum overall (28.1%, 27.4%, 14.4%, and 13.7%, respectively). It is crucial to identify rare non-gastric polyps and create an effective follow-up and treatment plan in the era of frequently performed upper gastrointestinal endoscopies. The epidemiological assessment of non-gastric polyps, as well as a follow-up and treatment strategy, are presented in this study.


Assuntos
Pólipos Adenomatosos , Duodenopatias , Pólipos , Humanos , Masculino , Feminino , Estudos Retrospectivos , Duodeno/patologia , Pólipos/epidemiologia , Pólipos/patologia , Pólipos Intestinais/epidemiologia , Pólipos Adenomatosos/diagnóstico , Pólipos Adenomatosos/epidemiologia , Pólipos Adenomatosos/patologia
10.
BMC Womens Health ; 23(1): 127, 2023 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-36964546

RESUMO

BACKGROUND: Polycystic ovary syndrome (PCOS) is characterized by anovulation, insufficient progesterone, hyperandrogenism, and insulin resistance. These factors can disrupt the endometrium of PCOS patients and can lead to chronic low-grade inflammation in the endometrium, endometrial hyperplasia, or even endometrial cancer. OBJECTIVE: The aim of this study was to investigate the prevalence of premalignant and malignant endometrial polyps in premenopausal women and to further explore whether PCOS is associated with premalignant and malignant changes in endometrial polyps. METHODS: This study was conducted by retrieving the medical data of 4236 premenopausal women who underwent hysteroscopic polypectomies between January 2015 and December 2021. Demographic and clinical data regarding age, height, weight, parity, hormone replacement therapy, oral contraceptives, abnormal uterine bleeding, hypertension, diabetes mellitus, PCOS, number of polyps, and size of polyps were collected, and their associations with premalignant and malignant changes in endometrial polyps were analysed. RESULT: Among the endometrial polyps removed by hysteroscopic polypectomy in premenopausal women, the prevalence of premalignant and malignant polyps was 2.15%, which comprised hyperplasia with atypia at 1.13% and endometrial carcinoma at 1.02%. PCOS was associated with a higher risk of premalignant and malignant endometrial polyps in premenopausal women after adjustment for potential confounding factors. CONCLUSION: PCOS is associated with a higher risk of premalignant and malignant endometrial polyps in premenopausal women. Therefore, it is important to evaluate the endometrium in PCOS patients with ultrasonography or hysteroscopy, and active management involving hysteroscopic polypectomy should be offered to PCOS patients diagnosed with endometrial polyps regardless of symptoms.


Assuntos
Neoplasias do Endométrio , Síndrome do Ovário Policístico , Pólipos , Lesões Pré-Cancerosas , Doenças Uterinas , Neoplasias Uterinas , Gravidez , Humanos , Feminino , Estudos Retrospectivos , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/epidemiologia , Neoplasias Uterinas/patologia , Doenças Uterinas/complicações , Doenças Uterinas/epidemiologia , Doenças Uterinas/patologia , Neoplasias do Endométrio/epidemiologia , Neoplasias do Endométrio/patologia , Lesões Pré-Cancerosas/epidemiologia , Endométrio/patologia , Histeroscopia , Hospitais de Ensino , Pólipos/epidemiologia
11.
Sci Rep ; 13(1): 4800, 2023 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-36959460

RESUMO

We describe the clinical characteristics of treatment-naïve polypoidal choroidal vasculopathy (PCV) in three tertiary clinic settings in 2 cities (Chicago in the USA and Nishinomiya in Japan). This cohort study was a retrospective, multicenter, consecutive case series. A total of 126 patients with treatment-naïve PCV-46 in Chicago and 80 in Nishinomiya-were identified. The proportion of PCV in patients with neovascular age-related macular degeneration was lower in Chicago (10.8% vs. 36.9%). Patients in Chicago had a significantly higher prevalence of soft drusen (50.0% vs 25.0%, p = 0.006) and intra-retinal cyst (37.0% vs 15.0%, p = 0.008), and a significantly lower prevalence of pachyvessels (41.3% vs 62.5%, p = 0.03). At baseline, presenting vision for patients in Chicago was worse than in Nishinomiya (mean log MAR: 0.609 vs. 0.312, p < 0.001). Ninety-five eyes were followed for more than one year. The Nishinomiya group received a higher rate of combination therapy (61.0%) compared to the Chicago group (5.3%). Vision and central foveal thickness at month 12 were significantly improved from baseline in both Chicago (p = 0.009 and p = 0.01) and Nishinomiya groups (both p < 0.001). Our study highlights interesting differences in the proportion of PCV, clinical findings and treatment responses of PCV, that need to be further evaluated in larger, epidemiologic cohorts.


Assuntos
Doenças da Coroide , Neovascularização de Coroide , Pólipos , Drusas Retinianas , Humanos , Doenças da Coroide/tratamento farmacológico , Corioide/irrigação sanguínea , Estudos de Coortes , Estudos Retrospectivos , Vasculopatia Polipoidal da Coroide , Japão/epidemiologia , Angiofluoresceinografia , Drusas Retinianas/patologia , Tomografia de Coerência Óptica , Pólipos/diagnóstico , Pólipos/epidemiologia , Pólipos/patologia , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/epidemiologia , Neovascularização de Coroide/tratamento farmacológico
12.
Dig Liver Dis ; 55(9): 1201-1207, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-36858908

RESUMO

BACKGROUND: Gastric polyps represent an abnormal proliferation of the gastric mucosa. Chronic atrophic autoimmune gastritis (CAAG) targets parietal cells and results in hypo-achlorhydria and hypergastrinemia, which exerts a proliferative effect on the gastric mucosa. AIMS: We investigate the incidence of gastric polyps in CAAG patients. METHODS: This is a single-center retrospective study examining patients with confirmed CAAG from January 1990 until June 2022. Demographic, clinical, biochemical, and serological data were collected for each included patient. The histopathological characteristics of the detected polyps were recorded. RESULTS: A total of 176 CAAG patients were included. Eighty-nine (50.5%) had 163 incidental polyps. Seventy-six patients (85%) had 130 non-endocrine lesions, among which 118 (90.7%) were inflammatory, 6 (4.6%) adenomatous, and 4 (3%) fundic; 33 patients (37%) had gastric neuroendocrine neoplasms (gNENs), and 21 (23.6%) both; one had MALToma and one gastric adenocarcinoma. Higher circulating levels of gastrin and chromogranin A were observed among patients with polyps (median 668 vs 893 pg/ml p = 0.0237, 146 vs 207 ng/ml p = 0.0027, respectively). CONCLUSION: CAAG implies a high incidence of gNENs and exocrine lesions. Gastrin plays a possible trophic role on the mucosa. Further evidence is needed to validate its predictive role for increased polyp risk in CAAG.


Assuntos
Doenças Autoimunes , Gastrite Atrófica , Gastrite , Pólipos , Lesões Pré-Cancerosas , Neoplasias Gástricas , Humanos , Gastrinas , Estudos Retrospectivos , Doenças Autoimunes/complicações , Doenças Autoimunes/epidemiologia , Doenças Autoimunes/patologia , Gastrite/complicações , Gastrite/epidemiologia , Gastrite/patologia , Gastrite Atrófica/complicações , Gastrite Atrófica/epidemiologia , Mucosa Gástrica/patologia , Neoplasias Gástricas/patologia , Lesões Pré-Cancerosas/patologia , Pólipos/epidemiologia
13.
J Obstet Gynaecol Res ; 49(2): 658-664, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36448572

RESUMO

AIMS: Previous studies have shown an association between chronic endometritis and endometrial polyps, and only one study in infertile women reported an association between tubal obstruction and polyps. This study aimed to compare the prevalence of endometrial polyps in two groups of women with tubal factor infertility and male factor infertility to assess if is there any association between tubal factor infertility and endometrial polyps. METHODS: This case-control study was performed on infertile women. The case group included women with tubal factor infertility and the control group included all women with male factor infertility. In all patients, vaginal ultrasound was performed between days 8 and 12 of the menstrual cycle to diagnose endometrial polyp, its size, and number. Demographic and obstetrics variables were recorded. Patients underwent hysteroscopy and polypectomy and the diagnosis of the polyp was confirmed by pathology report. RESULT: In the present study, 245 people participated in two groups. There was a statistically significant difference between the two groups in terms of demographic and obstetric characteristics like type of infertility, duration of infertility, and gravidity. The prevalence of polyps in the tubal factor group was higher than in the male factor group (63 [60%] vs. 12 [9.8%]), and this difference was statistically significant (p = 0.0001). In addition, the prevalence of chronic endometritis in the tubal factor group was higher than in the male factor group (19 [18.8%] vs. 4 [3.3%]), and this difference was statistically significant (p = 0.001). CONCLUSIONS: In the present study, a strong association was observed between endometrial polyps and tubal obstruction, and considering that the most common cause of tubal obstruction is pelvic and genital infections, after confirmation with more studies, it may be possible to consider antibiotic treatment in these patients, especially in patients with recurrent polyps.


Assuntos
Endometrite , Doenças das Tubas Uterinas , Infertilidade Feminina , Pólipos , Gravidez , Humanos , Feminino , Masculino , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/etiologia , Infertilidade Feminina/diagnóstico , Endometrite/complicações , Estudos de Casos e Controles , Prevalência , Histeroscopia/efeitos adversos , Doenças das Tubas Uterinas/complicações , Doenças das Tubas Uterinas/epidemiologia , Pólipos/complicações , Pólipos/epidemiologia , Pólipos/diagnóstico
16.
Biomark Med ; 17(21): 881-887, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-38230984

RESUMO

Aim: We studied the association of estrogen receptor (ER) and progesterone receptor (PR) with endometrial polyp (EP) formation. Methods: A total of 129 EP patients and an equal number of disease-free women were evaluated for ER and PR expression in endometrial tissues. Correlation with EP incidence was analyzed, as well as diagnostic value via receiver operating characteristic curve. Results: ER expression was higher and PR was lower in patients than in controls (p < 0.01). ER levels positively correlated with EP incidence, and PR negatively (p < 0.01). Receiver operating characteristic curves gave ER an area under the curve of 0.6168 (95% CI: 0.5479-0.6856; p < 0.0001) and PR 0.739 (95% CI: 0.6776-0.8003; p < 0.0001). Conclusion: Imbalance in ER and PR expression associates with EPs formation, offering clinical insights into EP pathology.


Assuntos
Neoplasias do Endométrio , Pólipos , Humanos , Feminino , Progesterona/metabolismo , Receptores de Progesterona/genética , Receptores de Progesterona/metabolismo , Endométrio/metabolismo , Endométrio/patologia , Incidência , Receptores de Estrogênio/metabolismo , Estrogênios/metabolismo , Pólipos/epidemiologia , Pólipos/metabolismo , Pólipos/patologia , Neoplasias do Endométrio/epidemiologia , Neoplasias do Endométrio/genética , Neoplasias do Endométrio/metabolismo
17.
JAMA Netw Open ; 5(11): e2243951, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36441547

RESUMO

Importance: The association of tamoxifen use with the risk of uterine diseases, such as endometrial cancer, in premenopausal women with breast cancer remains controversial. However, many studies have reported an increased risk of uterine disease among postmenopausal tamoxifen users. Objective: To investigate the association of tamoxifen use with the risk of endometrial cancer and other uterine diseases in premenopausal women with breast cancer. Design, Setting, and Participants: A nationwide, population-based, retrospective longitudinal cohort study with an 18-year study period was conducted using data obtained from the Korean National Health Insurance Service. Participants included premenopausal women aged 20 to 50 years with breast cancer diagnoses between January 2003 and December 2018. Data were analyzed from April to December 2021. Exposures: Tamoxifen treatment. Main Outcomes and Measures: The incidence of uterine diseases, including endometrial cancer, hyperplasia, polyps, and other uterine cancers, was identified in the study cohort using insurance claim codes. The incidence of uterine diseases per 1000 person-years was compared between women receiving tamoxifen and those not treated with adjuvant hormone therapy. Multivariable Cox proportional hazard regression analysis was performed to determine the risk of each uterine disease. Results: Among 78 320 female participants with a mean (SD) age of 42.1 (6.1) years, 34 637 (44.2%) were categorized into the tamoxifen group and 43 683 (55.8%) were categorized into the control group. Among tamoxifen users, during the mean (SD) follow-up duration of 6.13 (4.15) years, the incidence of newly diagnosed endometrial polyps was 20.13 cases per 1000 person-years, that of endometrial hyperplasia was 13.49 cases per 1000 person-years, that of endometrial cancer was 2.01 cases per 1000 person-years, and that of other uterine cancers was 0.45 cases per 1000 person-years. The risk of endometrial cancer was higher in the tamoxifen group than in the control group (hazard ratio, 3.77; 95% CI, 3.04-4.66) after adjusting for age, body mass index, history of diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, gonadotropin-releasing hormone agonist treatment, and trastuzumab treatment. Conclusions and Relevance: In this longitudinal cohort study, premenopausal Korean women with breast cancer who received tamoxifen as adjuvant hormone therapy had a significantly increased risk of endometrial hyperplasia, polyps, carcinoma, and other uterine cancers compared with those who were not treated with adjuvant hormone therapy. These findings suggest that clinicians should consider the risk of uterine disease among tamoxifen users, including premenopausal women.


Assuntos
Neoplasias da Mama , Carcinoma , Hiperplasia Endometrial , Neoplasias do Endométrio , Pólipos , Doenças Uterinas , Feminino , Humanos , Tamoxifeno/efeitos adversos , Hiperplasia , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Hiperplasia Endometrial/induzido quimicamente , Hiperplasia Endometrial/epidemiologia , Estudos Retrospectivos , Estudos Longitudinais , Pólipos/induzido quimicamente , Pólipos/epidemiologia , Hormônios
18.
Turk J Ophthalmol ; 52(5): 338-341, 2022 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-36317811

RESUMO

Objectives: To determine the prevalence of polypoidal choroidal vasculopathy (PCV) in intravitreal (IV) anti-vascular endothelial growth factor (anti-VEGF)-resistant neovascular age-related macular degeneration (nvAMD) cases. Materials and Methods: Eyes that were diagnosed as having active and treatment-naive nvAMD in the Ege University Ophthalmology Department, Retina Unit in 2011-2018, were non-responsive to IV anti-VEGF treatment, and for which indocyanine angiography (ICGA) could be obtained were included in the study. Active nvAMD was defined as the presence of fresh hemorrhage on clinical examination or findings of subretinal, intraretinal, or sub-retinal pigment epithelial fluid on spectral domain optical coherence tomography and accompanying fluorescein dye leakage in fluorescein angiography. Eyes that had activation findings despite at least 6 consecutive intravitreal anti-VEGF injections were defined as non-responders and underwent ICGA to assess for PCV. The diagnosis of PCV was based on the Everest II study criterion. Results: A total of 97 eyes of 88 patients were included in the study. Of 88 patients, 44 (50%) were female, 44 (50%) were male, and the mean age was 75.9±8.3 years (range: 59-93). The mean number of anti-VEGF injections until the time of ICGA was 7.3±2.2 (range: 6-15). PCV was detected in 62 eyes (63.9%) on ICGA. Conclusion: The prevalence of PCV is quite high among eyes with IV anti-VEGF treatment-resistant nvAMD in Turkey (63.9%). ICGA evaluation for PCV should be conducted for all nvAMD cases that are non-responsive to IV anti-VEGF treatment, both to shed light on the reason for resistance and to modify treatment as necessary.


Assuntos
Neovascularização de Coroide , Degeneração Macular , Pólipos , Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/tratamento farmacológico , Neovascularização de Coroide/epidemiologia , Pólipos/diagnóstico , Pólipos/tratamento farmacológico , Pólipos/epidemiologia , Prevalência , Inibidores da Angiogênese
19.
Am J Ophthalmol ; 244: 58-67, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35952753

RESUMO

PURPOSE: To determine prevalence of probable polypoidal choroidal vasculopathy (PCV) among White patients with neovascular age-related macular degeneration (nAMD) using non-indocyanine green angiography (ICGA) criteria DESIGN: Multicenter, multinational, retrospective, cross-sectional study. METHODS: A total of 208 treatment-naive eyes from Hispanic and non-Hispanic White individuals diagnosed with nAMD were included. All underwent color fundus photography (CFP), optical coherence tomography (OCT), and fluorescein angiography (FFA). De-identified images of study eyes were sent to 2 groups of graders. Group 1 reviewed CFP, OCT, and FFA to confirm nAMD diagnosis. Group 2 reviewed CFP and OCT to determine highly suggestive features for PCV. Probable PCV diagnosis defined as the presence of ≥2 of 4 highly suggestive features for PCV: notched or fibrovascular pigment epithelial detachment (PED) on CFP, sharply-peaked PED, notched PED, and hyperreflective ring on OCT. RESULTS: Eleven eyes were excluded because of poor image quality (6) or non-nAMD diagnosis (5). Of 197 eligible eyes (197 patients), the mean age (SD) was 78.8 years (8.9), 44.2% were men, 26.4% were Hispanic, and 73.6% were non-Hispanic White individuals; 41.1%, 23.4%, 9.1%, and 2.5% had ≥1, ≥2, ≥3, and 4 highly suggestive features. Results showed that 23.4% (95% CI, 17.6%-29.9%) had probable PCV diagnosis. Predominantly occult CNV was more frequently found in probable PCV than nAMD subgroup (84.8% vs 64.9%, P = .01). Hispanic White individuals had a lower prevalence of probable PCV than non-Hispanic White individuals (9.6% vs 28.2%, P = .006) CONCLUSIONS: These findings suggest that probable PCV occurs between 17.6% and 29.9% in White individuals with nAMD, and more commonly in non-Hispanic than in Hispanic White individuals.


Assuntos
Neovascularização de Coroide , Degeneração Macular , Pólipos , Descolamento Retiniano , Masculino , Humanos , Idoso , Feminino , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/epidemiologia , Estudos Retrospectivos , Estudos Transversais , População Branca , Angiofluoresceinografia/métodos , Tomografia de Coerência Óptica/métodos , Pólipos/diagnóstico , Pólipos/epidemiologia , Corioide/irrigação sanguínea
20.
Medicine (Baltimore) ; 101(30): e29643, 2022 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-35905261

RESUMO

CONCLUSION: FLD, older age group, and alcohol consumption are major risk factors of GBP formation in Taiwanese population. The presence of GBPs might be revealed in second-look examinations of abdominal sonographies.


Assuntos
Doenças da Vesícula Biliar , Neoplasias da Vesícula Biliar , Neoplasias Gastrointestinais , Hepatopatias , Pólipos , Idoso , Doenças da Vesícula Biliar/complicações , Neoplasias Gastrointestinais/complicações , Humanos , Hepatopatias/complicações , Pólipos/diagnóstico por imagem , Pólipos/epidemiologia , Fatores de Risco
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