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Uterine Fibroid

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141. Pregnancy outcomes in patients with uterine fibroids treated with ultrasound-guided high-intensity focused ultrasound. Full Text available with Trip Pro

Pregnancy outcomes in patients with uterine fibroids treated with ultrasound-guided high-intensity focused ultrasound. To investigate the effect of high-intensity focused ultrasound (HIFU) ablation for uterine fibroids on pregnancy.A retrospective observational study.Department of Gynaecology in a single centre in China.Patients with uterine fibroids who wish to become pregnant.Patients with uterine fibroids who wished become pregnant and have children, were treated using HIFU from April 2011 (...) -term normal deliveries, one patient planned to use contraception after complete curettage of the uterine cavity; and one patient had her labour induced (after 13-weeks pregnancy). The fetuses of all the patients developed well during both the pregnancy and child-bearing without uterine rapture or perinatal and postpartum complications.HIFU treatment can effectively treat patients with uterine fibroids who wish to have children; it could significantly reduce the preparation period for pregnancy

2017 BJOG

142. High-intensity focused ultrasound and laparoscopic myomectomy in the treatment of uterine fibroids: a comparative study. Full Text available with Trip Pro

High-intensity focused ultrasound and laparoscopic myomectomy in the treatment of uterine fibroids: a comparative study. To compare the clinical efficacies of high-intensity focused ultrasound (HIFU) and laparoscopic myomectomy (LM) in the treatment of uterine fibroids and their effects on patients' quality of life.A non-randomised control study.Gynaecological department in a university teaching hospital.Patients with uterine fibroids.From November 2014 to November 2015, 166 patients (...) with uterine fibroids were enrolled and underwent HIFU (n = 99) and LM (n = 67) surgeries, respectively. Clinical efficacy, postoperative complications and quality of life after treatment were evaluated using the SF-36 Scale to compare the differences in each variable at the 1-year follow up.Differences in efficacy, safety and quality of life between the patients treated with HIFU and LM.The 12-month follow-up results showed that the HIFU group had a total effective rate of 99%; only one patient underwent

2017 BJOG

143. Efficacy and safety of ultrasound-guided high intensity focused ultrasound ablation of symptomatic uterine fibroids in Black women: a preliminary study. Full Text available with Trip Pro

Efficacy and safety of ultrasound-guided high intensity focused ultrasound ablation of symptomatic uterine fibroids in Black women: a preliminary study. To evaluate the therapeutic effect and safety of ultrasound-guided high-intensity focused ultrasound (USgHIFU) treatment on symptomatic uterine fibroids in Black women.A feasibility study.Gynaecological department in a teaching hospital in South Africa.Premenopausal women with uterus fibroids.Twenty-six patients with 53 fibroids who underwent (...) USgHIFU treatment were enrolled. The USgHIFU treatment information was recorded, including treatment time, sonication time and total energy. Adverse events were also observed and recorded during and after treatment.Safety and efficacy of USgHIFU for the treatment of uterine fibroids in Black women.The median volume of fibroids was 52.7 (interquartile range, 18.6-177.4) cm3 . According to USgHIFU treatment plan, total energy of 298.6 ± 169.3 kJ (range, 76.0-889.2) within treatment time of 90.3 ± 43.3

2017 BJOG

144. Application of dexmedetomidine-remifentanil in high-intensity ultrasound ablation of uterine fibroids: a randomised study. Full Text available with Trip Pro

Application of dexmedetomidine-remifentanil in high-intensity ultrasound ablation of uterine fibroids: a randomised study. To compare the effects of dexmedetomidine-remifentanil with the traditional analgesia and sedation regimen midazolam-remifentanil during HIFU treatment of uterine fibroids.A randomised controlled trial.Department of Anesthesia in a single hospital.Patients with uterine fibroids.A total of 80 patients diagnosed with uterine fibroids and scheduled for selective HIFU treatment (...) in the evaluation of patient satisfaction, recovery score, and surgeon satisfaction (P < 0.05).Both dexmedetomidine-remifentanil and midazolam-remifentanil met the requirements and ensured the safety of HIFU treatment of uterine fibroids. However, compared with the traditional midazolam-remifentanil regimen, dexmedetomidine-remifentanil was associated with more stable sedation in patients, more efficient HIFU treatment and higher degree of patient comfort.Dexmedetomidine-remifentanil is associated with more

2017 BJOG Controlled trial quality: uncertain

145. The effect of exercise on high-intensity focused ultrasound treatment efficacy in uterine fibroids and adenomyosis: a retrospective study. Full Text available with Trip Pro

The effect of exercise on high-intensity focused ultrasound treatment efficacy in uterine fibroids and adenomyosis: a retrospective study. We conducted a retrospective study to evaluate whether exercise after high-intensity focused ultrasound (HIFU) treatment can improve the absorption of uterine fibroids and the relief of dysmenorrhea caused by adenomyosis.A retrospective study.Gynaecological department of a single centre in China.Patients with uterine fibroids and adenomyosis.From January (...) 2011 to August 2015,83 MRI-confirmed uterine fibroid patients and 102 adenomyosis patients who received HIFU treatment at Chongqing Haifu Hospital and attended the 1-year and 6-month follow up, respectively, were included in our retrospective study. Among the fibroid patients, 51 were assigned to the 'no exercise group' and 32 to the 'exercise group'. Among the adenomyosis patients, 45 were assigned to the 'no exercise group' and to the 57 'exercise group'.Symptom improvement, uterine fibroid

2017 BJOG

146. Economic impact of ulipristal acetate on surgical procedures for uterine fibroids in France. Full Text available with Trip Pro

Economic impact of ulipristal acetate on surgical procedures for uterine fibroids in France. To assess the budget impact of using ulipristal acetate (UPA) 5 mg to treat women with uterine fibroids (UF) causing moderate to severe symptoms.We modelled trends in the number of surgical procedures for symptomatic UF, with and without the use of UPA for preoperative or intermittent treatment and assessed the budget impact of UPA use from the French national healthcare insurance system perspective.A (...) French national hospital database (PMSI) that records admissions and relative procedures to public and private hospitals.Women eligible for surgical procedures for uterine fibroids.Economic impact of UPA treatment.This study based on observational retrospective data shows that the current use of UPA in its preoperative indication was associated with 5645 fewer surgeries from 2013 to 2015. Extrapolation suggests 17 885 fewer surgeries from 2016 to 2019. Overall, preoperative use of UPA results

2017 BMJ open

147. The current place of medical therapy in uterine fibroid management. (Abstract)

The current place of medical therapy in uterine fibroid management. Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Current management strategies mainly involve surgical interventions, but the choice of treatment is guided by patient's age and desire to preserve fertility or avoid "radical" surgery. Surgical and non-surgical approaches include hysterectomy myomectomy by hysteroscopy, myomectomy by laparotomy or laparoscopy, uterine artery (...) embolization, and magnetic resonance-guided focused ultrasound surgery. The need for alternatives to surgical intervention is very real, especially for women seeking to preserve their fertility. There is growing evidence of the crucial role of progesterone pathways in the pathophysiology of uterine fibroids, and the efficacy of long-term intermittent use of selective progesterone receptor modulators such as ulipristal acetate was recently demonstrated by randomized controlled studies.Copyright © 2017

2017 Best practice & research. Clinical obstetrics & gynaecology

148. Proteomic profiling of human uterine fibroids reveals upregulation of the extracellular matrix protein periostin. Full Text available with Trip Pro

Proteomic profiling of human uterine fibroids reveals upregulation of the extracellular matrix protein periostin. The central characteristic of uterine fibroids is excessive deposition of extracellular matrix (ECM), which contributes to fibroid growth and bulk-type symptoms. Despite this, very little is known about patterns of ECM protein expression in fibroids and whether these are influenced by the most common genetic anomalies, which relate to MED12. We performed extensive genetic (...) and proteomic analyses of clinically annotated fibroids and adjacent normal myometrium to identify the composition and expression patterns of ECM proteins in MED12 mutation-positive and mutation-negative uterine fibroids. Genetic sequencing of tissue samples revealed MED12 alterations in 39 of 65 fibroids (60%) from 14 patients. Using isobaric tagged-based quantitative mass spectrometry on three selected patients (n = 9 fibroids), we observed a common set of upregulated (>1.5-fold) and downregulated (<0.66

2017 Endocrinology

149. The past, present, and future of selective progesterone receptor modulators in the management of uterine fibroids. Full Text available with Trip Pro

The past, present, and future of selective progesterone receptor modulators in the management of uterine fibroids. Uterine fibroids are common in women of reproductive age and can have a significant impact on quality of life and fertility. Although a number of international obstetrics/gynecology societies have issued evidence-based clinical practice guidelines for the management of symptomatic uterine fibroids, many of these guidelines do not yet reflect the most recent clinical evidence (...) in uterine fibroids and other gynecologic conditions.Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

2017 American Journal of Obstetrics and Gynecology

150. Epidemiology and Risk Factors of Uterine Fibroids. (Abstract)

Epidemiology and Risk Factors of Uterine Fibroids. Risk factors, both modifiable and non-modifiable, are associated with the development of fibroids. These include age, race, endogenous and exogenous hormonal factors, obesity, uterine infection, and lifestyle (diet, caffeine and alcohol consumption, physical activity, stress, and smoking). Some of the epidemiological data were conflicting; consequently, further studies are needed to better understand the factors that influence fibroid

2017 Best practice & research. Clinical obstetrics & gynaecology

151. Uterine fibroids with positive 18F-FDG PET/CT image and significantly increased CA19-9: A case report. Full Text available with Trip Pro

Uterine fibroids with positive 18F-FDG PET/CT image and significantly increased CA19-9: A case report. Uterine fibroids are the most common pelvic solid tumors and common to 25% of women. F-fluorodexyglucose (F-FDG) is an energy metabolism tracer. Although FDG is generally concentrated in malignant lesions with high glucose metabolism, it can also accumulate in normal tissues, benign lesions, and inflammatory sites. The exact mechanism of FDG uptake by uterine fibroids is not clear. Here, we (...) report a case of uterine fibroids with positive F-FDG positron emission tomography/computed tomography (PET/CT) imaging and significantly increased CA19-9.The patient was a 43-year-old woman and admitted to our hospital because of "1-year-extended menstrual periods." At admission, she had normal CA125, AFP, and CEA level and CA19-9>1000.00 U/mL. Gynecological transvaginal ultrasound found enlarged uterus with an anterior hypoechoic area of 3.9 × 4.2 cm. CT and contrast-enhanced CT showed

2017 Medicine

152. Characterisation of Uterine Fibroid Tissue Stiffness

Characterisation of Uterine Fibroid Tissue Stiffness Characterisation of Uterine Fibroid Tissue Stiffness - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Characterisation of Uterine Fibroid Tissue Stiffness (...) Party): Dr. Linda McLean, University of Ottawa Study Details Study Description Go to Brief Summary: Uterine fibroids (leiomyomas, myomas, fibroids) are benign tumors of the uterus that can cause heavy menstrual bleeding, pain, and/or infertility. Fibroids can be managed with medication, surgery, or interventional radiology. While conservative methods that avoid surgical risks and complications are becoming more common, there are limitations to medical therapies including side effects, short

2017 Clinical Trials

153. Uterine fibroids: from observational epidemiology to clinical management. Full Text available with Trip Pro

Uterine fibroids: from observational epidemiology to clinical management. 28498567 2018 12 11 2018 12 11 1471-0528 124 10 2017 09 BJOG : an international journal of obstetrics and gynaecology BJOG Uterine fibroids: from observational epidemiology to clinical management. 1513 10.1111/1471-0528.14730 Vercellini P P Fondazione Ca' Granda Ospedale Maggiore Policlinico and Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. Frattaruolo M P MP (...) Fondazione Ca' Granda Ospedale Maggiore Policlinico and Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. eng Journal Article Comment 2017 06 22 England BJOG 100935741 1470-0328 AIM IM BJOG. 2017 Sep;124(10):1501-1512 28296146 Humans Leiomyoma epidemiology Uterine Neoplasms epidemiology 2017 5 13 6 0 2018 12 12 6 0 2017 5 13 6 0 ppublish 28498567 10.1111/1471-0528.14730

2017 BJOG

154. A case of disseminated peritoneal leiomyomatosis after two laparoscopic procedures due to uterine fibroids Full Text available with Trip Pro

A case of disseminated peritoneal leiomyomatosis after two laparoscopic procedures due to uterine fibroids Disseminated peritoneal leiomyomatosis (DPL) is a rare disorder characterized by the presence of multifocal nodules and tumors composed of proliferating smooth muscle tissue, spread throughout the peritoneum. Estrogens and progesterone are considered to be the main factors initiating the formation of disseminated leiomyomatosis. Disseminated peritoneal leiomyomatosis is often asymptomatic (...) , and acyclic vaginal bleeding or pain in the lower abdomen is associated with leiomyomatous rebuilt uterus corpus. Disseminated peritoneal leiomyomatosis can have other ambiguous presentation. The difficulty in DPL diagnosis is that it is not always accompanied by scattered leiomyomas and can occur after menopause. Some cases of DPL are associated with surgical procedures on uterine fibroids, especially with the use of a morcellator. We present the case of a 39-year-old woman with DPL who underwent

2017 Videosurgery and other Miniinvasive Techniques

155. Moderate-to-deep sedation technique, using propofol and ketamine, allowing synchronised breathing for magnetic resonance high-intensity focused ultrasound (MR-HIFU) treatment for uterine fibroids: a pilot study Full Text available with Trip Pro

Moderate-to-deep sedation technique, using propofol and ketamine, allowing synchronised breathing for magnetic resonance high-intensity focused ultrasound (MR-HIFU) treatment for uterine fibroids: a pilot study Magnetic resonance high-intensity focused ultrasound (MR-HIFU) treatment for uterine fibroids is rapidly gaining popularity as a treatment modality. This procedure is generally uncomfortable, painful, and requires minimal or absence of movement and an MR-HIFU synchronised breathing (...) patients were subjected to MR-HIFU treatment of uterine fibroids. Patients were deeply sedated using intravenous propofol and esketamine according to a standardised hospital protocol to allow synchronisation of the breathing pattern to the MR-HIFU. The quality of sedation for MR-HIFU and complications were recorded and analysed. The side effects of the sedation technique, the propofol and esketamine consumption rate, the duration of recovery, and patient satisfaction after 24 h were examined.A total

2017 Journal of therapeutic ultrasound

156. A randomized control trial to assess efficacy of Mifepristone in medical management of uterine fibroid Full Text available with Trip Pro

A randomized control trial to assess efficacy of Mifepristone in medical management of uterine fibroid Fibroids are the most common benign tumours of uterus. Heavy menstrual bleeding is the commonest concern for which medical attention is sought. Hysterectomies for leiomyoma constitute a third of all hysterectomies. Thus, healthcare cost to society due to uterine leiomyomas is of considerable importance.A prospective study was conducted at tertiary care hospital of armed forces. 120 women (...) in pre-menopausal age group with complaints of menorrhagia, Pictorial Bleeding Assessment Chart (PBAC) scoring ≥100 and at least one fibroid ≥2.5 cm in size were recruited in the study. Patients in Group 1 were given Tab Tranexemic acid (500 mg) and Tab Mefenemic acid (500 mg) three times a day during menstrual bleeding for a period of 6 months. Patients in Group 2 were given Tab Mifepristone 50 mg twice a week. They were followed up at 1, 3 and 6 months of starting the medicine. Results were

2017 Medical journal, Armed Forces India Controlled trial quality: uncertain

157. Uterine fibroid shrinkage after short-term use of selective progesterone receptor modulator or gonadotropin-releasing hormone agonist Full Text available with Trip Pro

Uterine fibroid shrinkage after short-term use of selective progesterone receptor modulator or gonadotropin-releasing hormone agonist The aim of this study was to evaluate the effect of short-term use of selective progesterone receptor modulator (SPRM) or gonadotropin-releasing hormone (GnRH) agonist on uterine fibroid shrinkage among Korean women.This retrospective study involved 101 women with symptomatic uterine fibroids who received ulipristal acetate (SPRM, n=51) and leuprolide acetate (...) (GnRH agonist, n=50) for 3 months between November 2013 and February 2015. The fibroid volume was measured both before and after treatment using ultrasonography, computed tomography, and magnetic resonance imaging. The outcomes were compared between the SPRM and GnRH agonist groups.The median rate of fibroid volume reduction after SPRM treatment was 12.4% (IQR -14.5% to 40.5%) which was significantly lower than the reduction rate observed after GnRH agonist treatment (median 34.9%, IQR 14.7% to 48.6

2017 Obstetrics & gynecology science

158. Usefulness of modified BRB technique in treatment to ablate uterine fibroids with magnetic resonance image-guided high-intensity focused ultrasound Full Text available with Trip Pro

Usefulness of modified BRB technique in treatment to ablate uterine fibroids with magnetic resonance image-guided high-intensity focused ultrasound If bowels and other structures are in the pathway of high-intensity focused ultrasound (HIFU) beam during magnetic resonance image-guided HIFU (MRgFUS) therapy, filling to the bladder and the rectum and then emptying the bladder (i.e., the BRB technique) is used to avoid them. A modified BRB technique might be useful method to using a uterine (...) elevator method or by inducing uterus downward traction to lower the position of the uterus.A total of 156 patients who had undergone MRgFUS surgery treatment for uterine fibroids from March 2015 to February 2016 were included in this retrospective study. Of the 156 patients, 40 were treated using a uterine elevator while 29 were treated using downward traction of uterus. HIFU was performed using Philips Achieva 1.5 Tesla MR and Sonalleve HIFU system.MRgFUS surgery was feasible with modified BRB

2017 Obstetrics & gynecology science

159. Repeated intermittent ulipristal acetate in the treatment of uterine fibroids: a cost-effectiveness analysis Full Text available with Trip Pro

Repeated intermittent ulipristal acetate in the treatment of uterine fibroids: a cost-effectiveness analysis There are limited treatment options available for women with moderate to severe symptoms of uterine fibroids (UFs) who wish to avoid surgery. For these women, treatment with standard pharmaceuticals such as contraceptives is often insufficient to relieve symptoms, and patients may require surgery despite their wish to avoid it. Clinical trials demonstrate that ulipristal acetate 5 mg

2017 ClinicoEconomics and Outcomes Research: CEOR

160. Burden of uterine fibroids in Italy: epidemiology, treatment outcomes, and consumption of health care resources in more than 5,000 women [Corrigendum] Full Text available with Trip Pro

Burden of uterine fibroids in Italy: epidemiology, treatment outcomes, and consumption of health care resources in more than 5,000 women [Corrigendum] [This corrects the article on p. 525 in vol. 9, PMID: 28919793.].

2017 ClinicoEconomics and Outcomes Research: CEOR

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