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Effect of Surgical Specialty on Management of Adnexal Masses in Children and Adolescents: An 8-Year Single-Center Review.

外科专业对儿童和青少年附件肿块管理的影响: 8 年单中心综述。

  • 影响因子:1.96
  • DOI:10.1016/j.jpag.2019.06.007
  • 作者列表:"Peeraully R","Henderson K","Fairbrother K","Patel R","Fraser N","Shenoy M","Williams A
  • 发表时间:2020-02-01
Abstract

STUDY OBJECTIVE:Children with adnexal masses might be managed by pediatric surgeons, urologists or gynecologists, with the potential for different management strategies between specialties. In this study we compared ovarian conservation rates and surgical approach for adnexal masses in children and adolescents managed either by pediatric surgeons/urologists or gynecologists at a tertiary care institution. DESIGN:Retrospective cohort review. SETTING:Tertiary pediatric and adult university hospital. PARTICIPANTS:Patients younger than 18 years of age with an adnexal mass managed surgically with removal of histologically confirmed ovarian or fallopian tube tissue from 2008 to 2015. INTERVENTIONS:Laparoscopic or open procedure for adnexal mass. MAIN OUTCOME MEASURES:The primary outcome was rate of ovarian conservation relative to surgical specialty. The secondary outcome was surgical approach relative to surgical specialty. RESULTS:Forty-eight patients underwent surgery for adnexal masses; 26 (54%) under pediatric surgery/urology and 22 (46%) under gynecology care. Laparoscopy was performed in 5 (19%) pediatric and 19 (86%) gynecology cases (P = .000006). Of 24 patients older than 12 years of age with a benign tumor, 10 (42%) underwent procedures resulting in loss of an ovary with or without fallopian tube; 8 of these (80%) were under pediatric care. Of the remaining 14 (58%) who underwent ovarian conserving surgery, 12 (80%) were under gynecology care (P = .0027). CONCLUSION:Patients with a benign tumor were significantly more likely to undergo ovary-preserving surgery under gynecology care than under pediatric surgery/urology care. A multidisciplinary team approach involving gynecology and pediatric surgical specialties would be valuable in assessing the merits of ablative or conservative surgery in each case.

摘要

研究目的: 儿童附件包块可能由小儿外科医生、泌尿外科医生或妇科医生管理,有可能在不同专业之间采取不同的管理策略。在这项研究中,我们比较了由儿科外科医生/泌尿科医生或三级护理机构的妇科医生管理的儿童和青少年附件包块的卵巢保留率和手术方式。 设计: 回顾性队列研究。 单位: 三级儿科和成人大学医院。 对象: 2008 年至 2015 年手术切除组织学证实的卵巢或输卵管组织的附属器肿块小于 18 岁的患者。 干预: 腹腔镜或开腹手术治疗附件肿块。 主要观察指标: 主要结局为相对于手术专业的卵巢保守率。次要结局是手术入路相对于手术专业。 结果: 48 例患者因附件肿块行手术治疗; 26 例 (54%) 在小儿外科/泌尿外科,22 例 (46%) 在妇科护理。5 例 (19%) 小儿和 19 例 (86%) 妇科患者行腹腔镜手术 (P = .000006)。在 24 例年龄大于 12 岁的良性肿瘤患者中,10 例 (42%) 接受了手术,导致卵巢缺失,有或没有输卵管; 其中 8 例 (80%) 在儿科护理下。其余 14 例 (58%) 接受卵巢保护手术,12 例 (80%) 接受妇科治疗 (P = .0027)。 结论: 良性肿瘤患者在妇科护理下接受卵巢保留手术的可能性明显高于小儿手术/泌尿外科护理。涉及妇科和小儿外科专业的多学科团队方法将在评估每种情况下消融或保守手术的优点方面有价值。

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发表时间:2020-01-01
来源期刊:Clinical dysmorphology
DOI:10.1097/MCD.0000000000000272
作者列表:["Mbuyi-Musanzayi S","Kasamba EI","Revencu N","Lukusa PT","Kalenga PM","Tshilombo FK","Reychler H","Devriendt K"]

METHODS::Microdeletion of the entire interferon regulatory factory 6 (IRF 6) gene is a rare cause of Van der Woude syndrome (VDW) with only few cases reported in medical literature. Its occurrence in multiple affected members of a family is exceptional. The aim of this presentation was to describe a Central African family with typical VDW phenotype carrying an IRF6 gene deletion. Here we reported phenotype features of members of a Central African family with VDW syndrome consisting of labioalveolar cleft, depressions of the lower lip with labial fistulae (lip pits), submucosal clefts and cleft palate. Mutation analysis by means of multiplex ligation-dependent probe amplification and chromosomal microarray revealed a 374.070 kb, deletion encompassing the entire IRF6 gene in four affected family members. Microdeletion of the entire IRF6 gene causes the classical VDW syndrome phenotype.

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影响因子:2.42
发表时间:2020-02-01
DOI:10.1007/s12011-019-01715-5
作者列表:["Heidar Z","Hamzepour N","Zadeh Modarres S","Mirzamoradi M","Aghadavod E","Pourhanifeh MH","Asemi Z"]

METHODS::This study was performed to determine the effects of selenium supplementation on clinical symptoms and gene expression related to inflammatory markers in infertile women with polycystic ovary syndrome (PCOS) who were candidate for in vitro fertilization (IVF). Thirty-six women candidate for IVF were recruited in this randomized double-blinded, placebo-controlled trial. They (n = 18/group) were randomly assigned into intervention groups to take either 200 μg/day of selenium or placebo for 8 weeks. RT-PCR findings indicated that selenium supplementation downregulated gene expression of interleukin-1 (IL-1) (P < 0.004) and tumor necrosis factor alpha (TNF-α) (P = 0.02) in lymphocytes of patients with PCOS compared with the placebo. In addition, selenium supplementation upregulated gene expression of vascular endothelial growth factor (VEGF) (P = 0.001) in lymphocytes of patients with PCOS compared with the placebo. Selenium supplementation had no significant effect on clinical symptoms and gene expression of IL-8 (P = 0.10) and transforming growth factor beta (TGF-β) (P = 0.63). Overall, our findings documented that selenium supplementation for 8 weeks to infertile women candidate for IVF improved IL-1, TNF-α, and VEGF gene expression, though selenium had no effect on clinical symptoms and, IL-8 and TGF-β gene expression. Clinical trial registration number: http://www.irct.ir: IRCT20170513033941N23.

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影响因子:2.42
发表时间:2020-02-01
DOI:10.1007/s12011-019-01720-8
作者列表:["Jamilian M","Foroozanfard F","Kavossian E","Kia M","Aghadavod E","Amirani E","Asemi Z"]

METHODS::The primary aim of our study was to determine the influence of taking chromium plus carnitine on insulin resistance, with a secondary objective of evaluating the influences on lipid profiles and weight loss in overweight subjects with polycystic ovary syndrome (PCOS). In a 12-week randomized, double-blind, placebo-controlled clinical trial, 54 overweight women were randomly assigned to receive either supplements (200 μg/day chromium picolinate plus 1000 mg/day carnitine) or placebo (27/each group). Chromium and carnitine co-supplementation decreased weight (- 3.6 ± 1.8 vs. - 1.0 ± 0.7 kg, P < 0.001), BMI (- 1.3 ± 0.7 vs. - 0.3 ± 0.3 kg/m2, P < 0.001), fasting plasma glucose (FPG) (- 5.1 ± 6.0 vs. - 1.1 ± 4.9 mg/dL, P = 0.01), insulin (- 2.0 ± 1.4 vs. - 0.2 ± 1.2 μIU/mL, P < 0.001), insulin resistance (- 0.5 ± 0.4 vs. - 0.04 ± 0.3, P < 0.001), triglycerides (- 18.0 ± 25.2 vs. + 5.5 ± 14.4 mg/dL, P < 0.001), total (- 17.0 ± 20.3 vs. + 3.6 ± 12.0 mg/dL, P < 0.001), and LDL cholesterol (- 13.3 ± 19.2 vs. + 1.4 ± 13.3 mg/dL, P = 0.002), and elevated insulin sensitivity (+ 0.007 ± 0.005 vs. + 0.002 ± 0.005, P < 0.001). In addition, co-supplementation upregulated peroxisome proliferator-activated receptor gamma (P = 0.02) and low-density lipoprotein receptor expression (P = 0.02). Overall, chromium and carnitine co-supplementation for 12 weeks to overweight women with PCOS had beneficial effects on body weight, glycemic control, lipid profiles except HDL cholesterol levels, and gene expression of PPAR-γ and LDLR. Clinical trial registration number: http://www.irct.ir: IRCT20170513033941N38.

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囊肿方向

囊肿是一种良性疾病,它可以长在人体表面,也可以长在内脏里;囊肿就是长在体内某一脏器、囊状的良性包块,其内容物的性质是液态的。

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