Journal of Mid-life Health最新文献

{"title":"Vaginal Cellular Angiofibroma: Report of a Rare Case with Literature Review.","authors":"G Anju, Meenakshi Rao, Garima Yadav, Pratibha Singh","doi":"10.4103/jmh.jmh_186_23","DOIUrl":"10.4103/jmh.jmh_186_23","url":null,"abstract":"<p><p>Cellular angiofibroma (CA) is a relatively recently described, rare, benign soft tissue tumor that predominantly occurs in the vulvoperineal region. It was first described in 1997 as a mesenchymal-origin tumor composed of connective (fibrous) tissue and blood vessels. We report a case of vaginal CA in a 40-year-old woman who presented with pressure symptoms, incidentally diagnosed with a vaginal mass and clinically suspected as vaginal myoma. This case was diagnosed based on histomorphology and immunohistochemistry and underwent surgical treatment. This tumor was a diagnostic dilemma for other benign and aggressive spindle cell tumors in the same area, such as endometrial stromal nodule, spindle cell lipoma, solitary fibrous tumors, and mixed tumors of the vagina.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"15 3","pages":"213-216"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant Therapy for Endometrial Cancer in the Era of Molecular Classification.","authors":"Sumedha Gupta, Ratika Gupta, Varsha Motwani, Dheer Singh Kalwaniya","doi":"10.4103/jmh.jmh_88_24","DOIUrl":"10.4103/jmh.jmh_88_24","url":null,"abstract":"<p><p>Endometrial cancer primarily undergoes surgical intervention, with adjuvant treatments such as external beam pelvic radiotherapy, vaginal brachytherapy, chemotherapy, and combined therapy investigated in randomized trials. Treatment decisions hinge on clinicopathological risk factors. Low-risk cases usually require surgery alone, whereas high-intermediate risk often benefit from adjuvant vaginal brachytherapy for enhanced local control with minimal side effects. Recent trials advocate pelvic radiotherapy for high-risk cases, particularly in Stage I-II tumors with risk factors. Chemoradiation proves advantageous for serous cancers and Stage III disease, improving recurrence-free, and overall survival. Molecular studies, notably the Cancer Genome Atlas project, identified four distinct molecular classes, transcending stages, and histological types. These molecular subtypes exhibit a stronger prognostic impact than histopathological characteristics, heralding a shift toward molecular-integrated diagnostics and treatments. Incorporating molecular factors into adjuvant strategies, including targeted therapies, marks a new paradigm in endometrial cancer management, underpinning ongoing research, and clinical trials. This review outlines current adjuvant approaches, underscores the emergence of molecular-integrated risk profiling, and touches on developments in targeted therapy.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"15 3","pages":"142-152"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential Thrombocytosis in a Postmenopausal Female a Rare Cause of Aquagenic Pruritus.","authors":"Prabhat Agrawal, Ruchika Garg, Shiv Sagar Yadav, Sandipta Panda","doi":"10.4103/jmh.jmh_105_24","DOIUrl":"10.4103/jmh.jmh_105_24","url":null,"abstract":"<p><p>Essential thrombocytosis (ET) is a hematopoietic stem cell disorder in which the overproduction of platelets without a definable cause occurs. Its incidence is 1-2 per 100,000 population with female preponderance. These myeloproliferative disorders are associated with many dermatological manifestations such as pruritus and erythromelalgia. Here, we are reporting the case of a 61-year-old female with ET with aquagenic pruritus (AP), although AP is associated more with polycythemia vera.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"15 3","pages":"211-212"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unheard Variant of Leiomyoma Cotyledonoid Dissecting Leiomyoma: Case Report.","authors":"Alka Yadav, Sujata Raychauduri, Lakshinder Kaur, Ruchira Wadhwa, Minakshi Bhardwaj","doi":"10.4103/jmh.jmh_15_24","DOIUrl":"10.4103/jmh.jmh_15_24","url":null,"abstract":"<p><p>Leiomyomas are benign smooth muscle tumor of the uterus with varied morphology that are well known to undergo secondary changes. A variety of other unusual patterns of uterine leiomyoma have been described, such as parasitic leiomyoma, cellular leiomyoma, symplastic or bizarre leiomyoma, epithelioid leiomyoma, intravenous leiomyomatosis, and leiomyoma with secondary changes. Some cotyledonoid dissecting leiomyoma (CDL) appears as large fungating masses with widespread extension into the broad ligament and pelvic cavity. Due to its rarity and a clinician's lack of familiarity, such tumors are sometimes misdiagnosed as malignancies. We present a rare case report of CDL. It is a diagnostic challenge for clinicians, pathologists, and radiologists and can be confused with malignancy due to its large size. After extensive literature research, we found 28 case reports of this variant. Little is known in the literature about this entity. We present here a case report of a 65-year-old female emphasizing its clinical, radiological, gross, and microscopic findings. A total hysterectomy was performed on the patient. This tumor does not have malignant potential, but clinicians and pathologists must be aware of its existence to avoid over-treating patients as malignancy.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"15 3","pages":"197-200"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Efficacy and Cost-effectiveness of Outpatient Resection of Endometrial Pathologies in a University Hospital in the UK.","authors":"Kshitij Jamdade, PapaYaw Opokuansah, Sanjaya Kalkur","doi":"10.4103/jmh.jmh_73_24","DOIUrl":"10.4103/jmh.jmh_73_24","url":null,"abstract":"<p><strong>Objective: </strong>The objective of the study was to evaluate the efficacy of outpatient MyoSure procedures and their cost-effectiveness.</p><p><strong>Design: </strong>A retrospective analysis of patients who had outpatient MyoSure procedures from November 2019 to November 2020.</p><p><strong>Subjects and methods: </strong>Data were collected retrospectively from electronic patient records (hysteroscopy reports, clinic notes, clinic letters, and histopathology results) from November 2019 to November 2020 and analyzed using Microsoft Excel and SPSS software.</p><p><strong>Results: </strong>Fifty-eight outpatient MyoSure procedures were performed from November 2019 to November 2020. The mean age was 53.13 years (22-81 years) and the mean body mass index was 29.65 kg/m² (18-51 kg/m²). We found that our service has a success rate of 93.1% (54/58), a completion rate of 92.59% (50/58), and a discharge rate of 82.75% (48/58). The complete resection rate for polyps was 100% and for fibroids, it was 76.47%. When compared to the same procedure performed under general or regional anesthesia in a day surgery setting, an outpatient MyoSure procedure saves around 1117 GBP per procedure, for the Trust. We have compared data for the first 6 months to the following 6-month period. There were significant improvements in the success rate, completion rate, and discharge rate, also accompanied by a reduced complication rate. This is likely due to improved operators' experience in performing the procedure, and also the increased use of local anesthetic injection and cervical dilatation.</p><p><strong>Conclusions: </strong>Outpatient MyoSure procedures are feasible, efficacious, safe, acceptable, and cost-effective. The use of local anesthetic and cervical dilation has been associated with improved success rates.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"15 3","pages":"182-187"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological Characteristics of Multiple Primary Malignancies Involving Female Genital Tract at a Tertiary Cancer Institute of Northeast India.","authors":"Eshwarya Jessy Kaur, Debabrata Barmon, Upasana Baruah, Dimpy Begum","doi":"10.4103/jmh.jmh_55_24","DOIUrl":"10.4103/jmh.jmh_55_24","url":null,"abstract":"<p><strong>Background: </strong>The term \"Multiple Primary Malignant Neoplasms (MPMNs)\" refers to two or more unrelated primary malignant neoplasms that originate from single or different organs and occur in one patient. MPMNs have been divided into synchronous and metachronous based on time duration after first malignancy.</p><p><strong>Materials and methods: </strong>This was a hospital-based retrospective study conducted at a tertiary cancer institute in Northeast India. Clinicopathological factors of patients with multiple primary malignancies with at least one female genital tract malignancy attending the gynecological oncology outpatient department were observed. Those with ambiguous status of primary malignancy and incomplete treatment of first primary malignancy were excluded from the study.</p><p><strong>Results: </strong>A total of 57 patients with MPMN, including one case of triple primary malignancy, were included in the study. 59.18% of cases had metachronous, and 40.81% had synchronous malignancies. The median time to the development of second primary malignancy was 60 months. Among the first diagnosed malignancies, cervix was the most common site (26.5%), followed by endometrium (20.4%) and ovary (14.28%), whereas ovarian malignancy was more commonly diagnosed second malignancy (38.77%), followed by endometrium (14.28%) and cervix (10.2%). In an analysis of synchronous malignancies, the most common genital tract involvement was seen with endometrium and ovary, with a predominance of low-grade endometrioid histology in 75% of cases.</p><p><strong>Conclusions: </strong>As the cancer survivor population continues to increase in future, these patients must be comprehensively evaluated on follow-up, and a cognizance of prior treatment taken should be kept. In addition, it is vital that the clinicians keep a lookout for high-risk population in which genetic testing may be beneficial.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"15 3","pages":"161-166"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LeFort Colpocleisis: Unmet Expectations about Correction of Urinary Symptoms Are Related to Disappointment and Regret.","authors":"Themistoklis Mikos, Sofia Tsiapakidou, Matteo Lioupis, Christos Anthoulakis, Iakovos Theodoulidis, Grigoris F Grimbizis","doi":"10.4103/jmh.jmh_38_24","DOIUrl":"10.4103/jmh.jmh_38_24","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The aims of this study were to define long-term anatomic outcome, satisfaction rate, and reasons for disappointment and regret in a group of patients with advanced pelvic organ prolapse who underwent LeFort colpocleisis (LFC).</p><p><strong>Materials and methods: </strong>This was a retrospective, single-center, cohort study including consecutive patients who underwent LFC from 2007 to 2021. All patients had surgery involving vaginal hysterectomy and anti-incontinence procedure where clinically indicated. All patients were examined 3 months after surgery. A cross-sectional telephone survey was performed in 2022 using the Patient Global Impression of Severity (PGI-S), Patient Global Impression of Improvement (PGI-I), and Patient Global Impression of Change (PGI-C) questionnaires, as well as the Decision Regret Scale. Student's <i>t</i>-test, Fisher's Chi-square test, and univariable logistic regression analysis were carried out.</p><p><strong>Results: </strong>One hundred and forty-one patients (mean age 74.95 ± 6.25 years) were included. The mean preoperative POP Quantification C/D point was +6 (±2.7). In 86 (60.99%) patients, a hysterectomy and in 56 (39.71%), a mid-urethral synthetic sling was performed. At 3-month follow-up, there was one prolapse recurrence (0.71%) and no case of regret of sexual function loss. In the long term, 28 patients died, and 69 patients were interviewed through telephone (follow-up 61.65 months). The mean PGI-S, PGI-I, and PGI-C scores were 1.42 (±0.81), 1.93 (±1.45), and 5.91 (±1.69) respectively, and no patient declared regret about vaginal intercourse loss. Preoperative and postoperative persistent or <i>de novo</i> mixed UI appeared to be related to decreased satisfaction and regret post-LFC (<i>P</i> = 0.0021).</p><p><strong>Conclusion: </strong>LFC is a valuable, easy-to-perform technique with long-lasting results and decreased postoperative anti-incontinence rates. However, <i>de novo</i> or persistent urinary incontinence appears to be related to decreased satisfaction rates.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"15 3","pages":"153-160"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual Extension of Superficial Spreading Squamous Cell Carcinoma of Cervix to Uterus, Paraovarian, Paratubal Tissue, and Vaginal Surface: A Unique Case Report.","authors":"Naina Kumar, Immanuel Pradeep, Mishu Mangla, Annapurna Srirambhatla, Aparna Jarathi","doi":"10.4103/jmh.jmh_45_24","DOIUrl":"10.4103/jmh.jmh_45_24","url":null,"abstract":"<p><p>Superficial spreading cervical squamous cell carcinoma (SCC) is a rare phenomenon with few cases reported in the literature. The present case report briefs the findings of superficial spreading cervical SCC in postmenopausal women. A 65-year-old postmenopausal woman presented with bleeding per-vaginum for 1-2 months. On examination, the cervix was healthy with no visible growth. She was diagnosed with an endometrial malignancy on magnetic resonance imaging. On endometrial and cervical biopsy, histopathology revealed cervical intraepithelial neoplasia III in ectocervix with SCC in endocervical and endometrial curetting. The patient underwent modified radical hysterectomy with bilateral pelvic lymphadenectomy and histopathology revealed superficially spreading cervical SCC with tumor cells involving endometrium, myometrium, paratubal, paraovarian, vaginal margins without extending to pelvic, and para-aortic lymph nodes. The patient was further managed successfully with adjuvant chemoradiotherapy. Superficial spreading cervical SCC is very rare phenomenon. Its spread is not only limited to endometrium but can extend to involve myometrium, paratubal, paraovarian, and vaginal tissues.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"15 3","pages":"201-205"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopause and Oral Health: Clinical Implications and Preventive Strategies.","authors":"Sarita Shrivastava","doi":"10.4103/jmh.jmh_125_24","DOIUrl":"10.4103/jmh.jmh_125_24","url":null,"abstract":"<p><p>Menopause, occurring typically between the ages of 45 and 55 years, marks the end of a woman's reproductive years and is characterized by the cessation of menstruation and a significant decline in estrogen and progesterone production. These hormonal changes impact various aspects of health, including oral health. This review explores the clinical implications of menopause on oral health and outlines preventive strategies. Hormonal changes during menopause can lead to xerostomia (dry mouth), periodontal disease, burning mouth syndrome (BMS), oral mucosal changes, altered taste sensation, and osteoporosis-related oral health issues. Xerostomia results from decreased salivary flow, increasing the risk of dental caries and oral infections. Periodontal disease is exacerbated by estrogen deficiency, leading to bone loss and increased tooth mobility. BMS, characterized by a chronic burning sensation, and oral mucosal atrophy are linked to hormonal fluctuations. In addition, altered taste perception and osteoporosis further complicate oral health management. Effective prevention and management strategies include regular dental checkups, good oral hygiene practices, and tailored treatments such as fluoride treatments, saliva substitutes, and hormone replacement therapy. Nonpharmacological approaches such as stress management and lifestyle modifications also play a role. This review emphasizes the importance of a multidisciplinary approach, involving dental and medical professionals, to address the complex oral health challenges faced by menopausal women. Understanding the underlying mechanisms and implementing evidence-based preventive measures can significantly enhance the oral health and overall well-being of menopausal women.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"15 3","pages":"135-141"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering Precision Oncology: Advancing Cancer Research by Augmenting Single-cell RNA and Bulk RNA Sequencing for Confronting the Heterogeneity in Ovarian Cancer.","authors":"Muhammed Ali Siham, A Ashwin Prabahar","doi":"10.4103/jmh.jmh_93_23","DOIUrl":"10.4103/jmh.jmh_93_23","url":null,"abstract":"<p><p>Ovarian cancer presents significant challenges in clinical oncology due to its high prevalence, heterogeneity, and late-stage diagnosis. Our study explores the application of single-cell RNA sequencing (scRNA-Seq) and bulk RNA sequencing to enhance our understanding of ovarian cancer at the molecular level. We highlight the diagnostic strategies and emphasize the critical role of scRNA-Seq in unraveling the intricate cellular composition and phenotypic plasticity within ovarian tumors. We also discuss the identification of rare cell subtypes, characterization of distinct cell types, and elucidation of molecular features, signaling pathways, and dysregulated networks using scRNA-Seq. Furthermore, our study showcases how scRNA-Seq aids in the discovery of novel biomarkers for diagnosis, prognosis, and treatment response prediction, as well as identifying therapeutic targets and pathways associated with drug resistance.</p>","PeriodicalId":37717,"journal":{"name":"Journal of Mid-life Health","volume":"15 3","pages":"194-196"},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11601931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}