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Canadian Association of Radiologists... May 2015Whenever elevated signal intensity is displayed at magnetic resonance imaging (MRI) within an ovarian lesion on unenhanced T1-weighted sequences, some specific diagnoses... (Review)
Review
Whenever elevated signal intensity is displayed at magnetic resonance imaging (MRI) within an ovarian lesion on unenhanced T1-weighted sequences, some specific diagnoses should be considered because only 3 main components may be responsible for this T1-hyperintensity at MRI: fat, blood products, and proteinaceous or mucinous material. The associated clinical data and concomitant use of T2-weighted sequences and fat-saturation techniques is mandatory to make this tissue characterization possible. The goal of this pictorial review is to provide a simple radiologic reasoning and the differential diagnoses to consider in the presence of spontaneous elevated signal intensity on T1-weighted sequences within a cystic or solid ovarian tumour.
Topics: Abscess; Adipose Tissue; Cystadenoma, Mucinous; Diagnosis, Differential; Endometriosis; Female; Hematoma; Humans; Magnetic Resonance Imaging; Ovarian Cysts; Ovarian Neoplasms; Struma Ovarii; Teratoma
PubMed: 25578742
DOI: 10.1016/j.carj.2014.07.006 -
Journal of Cancer Research and... 2019The objectives of the present study were to demonstrate the influence of neutrophils, platelets, and neutrophil-lymphocyte ratio (NLR) in the ovarian cancer prognosis...
OBJECTIVE
The objectives of the present study were to demonstrate the influence of neutrophils, platelets, and neutrophil-lymphocyte ratio (NLR) in the ovarian cancer prognosis and to compare these parameters with benign ovarian neoplasms.
MATERIALS AND METHODS
Records of patients underwent surgery for ovarian cysts were evaluated. There were 72 malignant neoplasms and 213 benign neoplasms. Age, parity, histologic type, tumor stage, type of surgery performed, chemotherapy, disease-free survival, serum levels of tumor markers, neutrophils, lymphocytes, platelets, and NRL were recorded. The Mann-Whitney, the Chi-square test and multiple linear regression were used. A P-value < 0.05 was established as the significance level.
RESULTS
Higher values of platelets, neutrophils, and NLR were found in malignant tumors (P = 0.0132, P = 0.0208, and P < 0.0001, respectively), while lymphocytes values were higher in benign group (P < 0.0001). Preoperative platelet count 300,000/mm3 was related to less aggressive histological types (P = 0.0148). NLR <3 was related to the initial stages (P = 0.0053), and patients with disease-free survival >24 months had most often neutropenia during chemotherapy (P = 0.0482). After multivariate analysis, platelets, NLR, and serum levels of CA15.3 were considered independent variables related to tumor staging (P = 0.028, P = 0.028, and P = 0.035, respectively).
CONCLUSION
NLR and serum levels of platelets may represent potential prognostic factors in ovarian cancer, and they may also serve as therapeutic targets in the future treatment strategies.
Topics: Biomarkers; Clinical Decision-Making; Disease Management; Female; Humans; Leukocyte Count; Lymphocyte Count; Lymphocytes; Neoplasm Grading; Neoplasm Staging; Neutrophils; Ovarian Neoplasms; Platelet Count; Prognosis
PubMed: 31898652
DOI: 10.4103/jcrt.JCRT_304_17 -
Journal of Thrombosis and Haemostasis :... Dec 2022Congenital factor VII (FVII) deficiency is an inherited bleeding disorder, with heterogenous bleeding symptoms. Women with FVII deficiency face hemostatic challenges...
BACKGROUND
Congenital factor VII (FVII) deficiency is an inherited bleeding disorder, with heterogenous bleeding symptoms. Women with FVII deficiency face hemostatic challenges during menstruation, ovulation, and childbirth. This systematic review evaluated prevalence and management of bleeding symptoms associated with gynecological and obstetric issues in women with FVII deficiency.
METHODS
Databases (BIOSIS Previews, Current Contents Search, Embase, and MEDLINE) were searched for studies reporting FVII deficiency and gynecological or obstetric issues in women. Articles were screened using Joanna Briggs Institute checklists and relevant data extracted.
RESULTS
One hundred fourteen women were identified from 62 publications. Forty-six women had severe deficiency (FVII:C < 5% or <5 IU/dl). Heavy menstrual bleeding (HMB) was the most common bleeding symptom (n = 94; 82%); hospitalization and urgent medical/surgical interventions for acute HMB episodes were required in 16 women (14%). Seven women reported ovarian bleeding (6%); other bleeding symptoms varied. Patient management was inconsistent and included hemostatic and hormonal treatments. Only four women (7%) reporting vaginal bleeding during pregnancy. Postpartum hemorrhage (PPH) occurred following 12/45 deliveries (27%; 5 [42%] requiring blood transfusion) and was not necessarily prevented by prophylaxis (8 women).
CONCLUSION
Women with congenital FVII deficiency have an increased risk of HMB, ovarian bleeding, and PPH, impacting quality of life. Recognition of a bleeding disorder as the cause is often delayed. Management of bleeding complications is heterogeneous due to lack of treatment guidelines. Harmonizing severity classification of FVII deficiency may help standardize treatment strategies and development of specific guidelines for these women.
Topics: Pregnancy; Female; Humans; Factor VII Deficiency; Hemostatics; Quality of Life; Reproductive Health; Factor VII; Menorrhagia; Postpartum Hemorrhage
PubMed: 36073900
DOI: 10.1111/jth.15872 -
MAbs 2012Peptibodies or peptide-Fc fusions are an attractive alternative therapeutic format to monoclonal antibodies. They consist of biologically active peptides grafted onto an... (Review)
Review
Peptibodies or peptide-Fc fusions are an attractive alternative therapeutic format to monoclonal antibodies. They consist of biologically active peptides grafted onto an Fc domain. This approach retains certain desirable features of antibodies, notably an increased apparent affinity through the avidity conferred by the dimerization of two Fcs and a long plasma residency time. Peptibodies can be made in E. coli using recombinant technology. The manufacturing process involves fermentation and downstream processing, including refolding and multiple column chromatographic steps, that result in overall yields and quality suitable for commercial development. Romiplostim, marketed under the brand name Nplate®, is the first peptibody to be approved by the United States Food and Drug Administration and the European Medicines Agency and is indicated for the treatment of immune thrombocytopenic purpura. AMG 386, a peptibody antagonist to angiopoietins 1 and 2, is being evaluated in Phase 3 clinical testing in combination with chemotherapy in women with ovarian cancer. AMG 819, a peptibody targeting nerve growth factor for pain has also progressed to clinical trials. These peptibodies illustrate the versatility of the modality.
Topics: Clinical Trials as Topic; Female; Humans; Ovarian Neoplasms; Purpura, Thrombocytopenic, Idiopathic; Receptors, Fc; Recombinant Fusion Proteins; Thrombopoietin
PubMed: 22820181
DOI: 10.4161/mabs.21024 -
The British Journal of Radiology Jul 2018To assess the efficacy of uterine artery embolization (UAE) for the management of primary postpartum hemorrhage (PPH) and to determine the factors associated with...
OBJECTIVE
To assess the efficacy of uterine artery embolization (UAE) for the management of primary postpartum hemorrhage (PPH) and to determine the factors associated with clinical outcomes especially in relation to the ovarian artery.
METHODS
A retrospective analysis of 33 patients who underwent UAE for primary PPH was performed. Clinical data were used regarding maternal characteristics, cause of bleeding, mode of delivery, bleeding onset after delivery, risk factors for PPH, presence of coagulopathy, details regarding the UAE procedure, and types of ovarian artery flow. We defined two types of ovarian artery flow by initial aortography before UAE (Type A: ovarian artery flow arose directly from the aorta to the uterine artery; Type B: ovarian artery flow that did not obviously arise from the aorta). Clinical success was defined as cessation of bleeding after UAE without the need for hysterectomy. Univariate analysis was performed to determine factors related to clinical outcomes.
RESULTS
The major indication of UAE was uterine atony (82%; 27/33). Extravasation of contrast medium was observed in 15 (45%) patients. The clinical success rate was 85% (28/33). In five patients, embolization failed, and these patients were managed by hysterectomy. Univariate analysis showed that retained placental tissue (p < 0.001), type of ovarian artery (p < 0.001) and the existence of extravasation of contrast medium (p = 0.049) were related to the clinical success rate.
CONCLUSION
The clinical success rate was 85% (28/33), and some PPH patients were thought to need ovarian artery embolization in addition to UAE. Advances in knowledge: Initial aortography before UAE may be useful to predict the failure of UAE and the need of ovarian artery embolization. Obvious ovarian arterial blood flow to the uterus by aortography could be a warning sign.
Topics: Adult; Angiography, Digital Subtraction; Contrast Media; Extravasation of Diagnostic and Therapeutic Materials; Female; Humans; Hysterectomy; Postpartum Hemorrhage; Pregnancy; Radiography, Interventional; Retrospective Studies; Treatment Outcome; Uterine Artery Embolization
PubMed: 29641227
DOI: 10.1259/bjr.20180132 -
Fertility and Sterility Oct 2015The risk of pregnancy and neonatal complications in women with endometriosis and adenomyosis is debatable. A literature review looking at rates, presentation, and... (Review)
Review
The risk of pregnancy and neonatal complications in women with endometriosis and adenomyosis is debatable. A literature review looking at rates, presentation, and management of spontaneous hemoperitoneum, enlargement, abscess, and rupture of an endometrioma, uterine rupture, and bowel perforation in pregnant women with endometriosis was conducted. Moreover, studies addressing differences in early pregnancy (miscarriage), late pregnancy (gestational diabetes mellitus, preeclampsia, prematurity, placenta previa, placental abruption, cesarean section, hemorrhages) and neonatal outcomes (weight at birth) between endometriosis and adenomyosis patients versus control subjects were reviewed. The overall prevalence of endometriosis-related spontaneous hemoperitoneum in pregnancy is estimated to be ∼0.4%. Only four cases of endometrioma rupture in pregnancy have been reported. Although during pregnancy there is no way to anticipate the onset of complications from preexisting endometriosis, it is important, when a specific abdominal pain occurs, to suspect rare but potentially life-threating events. Population-based studies suggest a possible association of endometriosis with preterm birth and placenta previa. Limits of the published studies are noted and discussed.
Topics: Adenomyosis; Endometriosis; Female; Hemoperitoneum; Humans; Infant, Newborn; Infertility; Ovarian Diseases; Peritoneal Diseases; Postpartum Period; Pregnancy; Pregnancy Complications; Puerperal Disorders
PubMed: 26348274
DOI: 10.1016/j.fertnstert.2015.08.030 -
Biosensors Jun 2022Interleukin-6 (IL-6) is a biomarker of inflammation, the advanced stage of COVID-19, and several cancers, including ovarian cancer. Two biosensors for the determination...
Interleukin-6 (IL-6) is a biomarker of inflammation, the advanced stage of COVID-19, and several cancers, including ovarian cancer. Two biosensors for the determination of IL-6 in blood plasma by array SPRi have been developed. One of these biosensors consists of the mouse monoclonal anti-IL-6 antibody as the receptor immobilized via the cysteamine linker. The second contains galiellalactone as the receptor, being an inhibitor specific for IL-6, immobilized via octadecanethiol (ODM) as the linker. Both biosensors are specific for IL-6. The biosensor with the antibody as the receptor gives a linear analytical response between 3 (LOQ) and 20 pg mL and has a precision between 8% and 9.8% and recovery between 97% and 107%, depending on the IL-6 concentration. The biosensor with galiellalactone as the receptor gives a linear analytical response between 1.1 (LOQ) and 20 pg mL, and has a precision between 3.5% and 9.3% and recovery between 101% and 105%, depending on IL-6 concentration. Both biosensors were validated. Changes in IL-6 concentration in blood plasma before and after resection of ovarian tumor and endometrial cyst, as determined by the two developed biosensors, are given as an example of a real clinical application.
Topics: Animals; Biosensing Techniques; COVID-19; Female; Humans; Interleukin-6; Mice; Ovarian Neoplasms; Plasma
PubMed: 35735559
DOI: 10.3390/bios12060412 -
Women's Health (London, England) Jan 2009Bleeding into the corpus luteum following ovulation rarely has clinical significance in healthy women, but may lead to life-threatening hemorrhage in women with... (Review)
Review
Bleeding into the corpus luteum following ovulation rarely has clinical significance in healthy women, but may lead to life-threatening hemorrhage in women with congenital or acquired bleeding disorders. Women who are at an increased risk for corpus luteum hemorrhage (CLH) can be divided in two categories; first, those taking anticoagulants because of a thrombotic disorder; and second, women with congenital bleeding disorders. The management and prevention of CLH is still unsettled and the literature dealing with this problem is based on case reports only. This review focuses on the pathophysiology, clinical presentation, diagnosis and treatment options of an acute bleeding event and prevention modalities of CLH in women with bleeding disorders.
Topics: Anticoagulants; Blood Coagulation Disorders, Inherited; Contraceptives, Oral, Hormonal; Corpus Luteum; Diagnosis, Differential; Female; Hemorrhage; Humans; Ovarian Diseases; Premenopause
PubMed: 19102645
DOI: 10.2217/17455057.5.1.91 -
Cellular Physiology and Biochemistry :... 2017Published data on the prognostic role of neutrophil-to-lymphocyte ratio (NLR) in ovarian cancer are controversial. We conducted this meta-analysis to obtain a more... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
Published data on the prognostic role of neutrophil-to-lymphocyte ratio (NLR) in ovarian cancer are controversial. We conducted this meta-analysis to obtain a more accurate assessment of prognostic significance of NLR in ovarian cancer.
MATERIALS AND METHODS
We conducted a systematic literature search using the electronic databases PubMed, Web of Science, and Embase up to May 2016. Hazard ratio (HR) and odd ratio (OR) with 95% confidence interval (95% CI) were calculated. Subgroup analyses were carried out to explore the source of heterogeneity. Statistical analysis was performed using Stata 10.0.
RESULTS
A total of 12 studies, consisting of 3,854 patients, which met our criterion were selected in this meta-analysis. Our pooled results showed that high pre-treatment NLR level was significantly associated with poorer overall survival (OS) (HR: 1.69, 95% CI 1.29-2.22) and shorter progression free survival (PFS) (HR 1.63, 95% CI 1.27-2.09). Additionally, increased NLR was also significantly correlated with advanced FIGO stage (OR 2.32, 95% CI1.79-3.00), higher serum level of CA-125 (OR 3.33, 95% CI 2.43-4.58), more extensive ascites (OR 3.54, 95% CI 2.31-5.42) as well as less chemotheraputic response (OR 0.53, 95% CI 0.40-0.70). The findings from most of subgroup meta-analyses were consistent with those from the overall meta-analyses.
CONCLUSIONS
Elevated pre-treatment NLR could served as a predicative factor of poor prognosis for ovarian cancer patients.
Topics: CA-125 Antigen; Databases, Factual; Disease-Free Survival; Female; Humans; Lymphocytes; Neutrophils; Odds Ratio; Ovarian Neoplasms; Prognosis; Proportional Hazards Models
PubMed: 28467978
DOI: 10.1159/000475911 -
BMC Cancer Apr 2018The prognostic effect of elevated systemic inflammatory markers, including neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), remains controversial... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The prognostic effect of elevated systemic inflammatory markers, including neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), remains controversial in cancer patients. This meta-analysis was conducted to evaluate the predictive values of these markers for prognoses in ovarian cancer patients.
METHODS
Potentially relevant publications in PubMed, ISI Web of Science, and EBSCO were searched. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs) for overall survival (OS) and progression-free survival (PFS) were determined using a fixed or random effects model.
RESULTS
Ten studies involving 2919 patients were included in this meta-analysis. In multivariate analysis, the group with higher NLR had worse OS (HR = 1.34, 95% CI = 1.16-1.54) and shorter PFS (HR = 1.36, 95% CI = 1.17-1.57) than the control group. Furthermore, PLR values higher than the cut-off were associated with not only poorer OS (HR = 1.97, 95% CI = 1.61-2.40) but also more unfavorable PFS (HR = 1.79, 95% CI = 1.46-2.20). Univariate analysis also indicated the same results. Additionally, subgroup analysis showed that when the cut-off values for NLR and PLR were higher, their predictive effects became stronger.
CONCLUSION
This comprehensive meta-analysis suggested that the values of inflammatory markers such as NLR and PLR were associated with ovarian cancer survival. Therefore, inflammatory markers can potentially serve as prognostic biomarkers.
Topics: Biomarkers; Female; Humans; Inflammation Mediators; Leukocyte Count; Lymphocyte Count; Lymphocytes; Neutrophils; Ovarian Neoplasms; Platelet Count; Prognosis; Proportional Hazards Models; Publication Bias
PubMed: 29669528
DOI: 10.1186/s12885-018-4318-5