Factors Associated with Malignancy in Hysteroscopically Resected Endometrial Polyps: a Systematic Review and Meta-Analysis

The objective of our study was to estimate the frequency of pre-malignant and malignant lesions in endometrial polyps and to evaluate associated clinical and demographic factors. A literature search was performed in major databases and the gray literature using the terms polyps OR endometrial polyp AND endometrial neoplasms OR endometrial cancer OR endometrial hyperplasia OR malignan*. Studies describing the frequency of pre-malignant and malignant lesions in endometrial polyps and any clinical or demographic factors associated with malignant lesions extracted using hysteroscopy were considered eligible. Independent investigators selected the studies and extracted the data. A meta-analysis was performed using a random-effects model and meta-regression. We identified 37 studies (21,057 patients) of endometrial polyps. The prevalence of pre-malignant and malignant lesions was 3.4% (95% confidence interval (CI):2.8-4.1, I2: 80.5%). Abnormal uterine bleeding (prevalence ratio (PR):1.47; 95% CI:1.27-1.69; I2:82.4%), menopausal status (PR:1.67; 95% CI:1.48-1.89; I2:78.4%), age >60 years (PR:2.41; 95% CI:1.84-3.16; I2:81.5%), diabetes mellitus (PR:1.76; 95% CI:1.43-2.16; I2:0.0%), systemic arterial hypertension (PR:1.50; 95% CI:1.20-1.88; I2:75.9%), obesity (PR:1.41; 95% CI:1.13-1.76; I2:41.2%) and tamoxifen use (PR:1.53; 95% CI:1.06-2.21; I2:0.0%) were associated with endometrial polyp malignancy. However, breast cancer (PR:0.83; 95% CI:0.44-1.57; I2:0.0%), hormonal therapy (PR:...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research

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Publication date: Available online 19 August 2019Source: Trends in Food Science &TechnologyAuthor(s): Qingying Fang, Jielun Hu, Qixing Nie, Shaoping NieAbstractBackgroundAs an important role of host homeostasis, the glycometabolism was closely related to the process and metabolic pathways of carbohydrates such as glycolysis, hexosamine biosynthetic pathway, and pentose phosphate in the host. Disorders of glycometabolism result in a series of metabolic diseases, such as diabetes, obesity, hypoglycemia, and etc.Scope and approachPolysaccharides, which were widely existing in daily diet and cannot be directly digested by ...
Source: Trends in Food Science and Technology - Category: Food Science Source Type: research
This study examines the extent to which data linkages between Indian Health Service, tribal data, and cancer registries affect cancer incidence rates among American Indians/Alaska Natives (AI/ANs) in Michigan. The incidence of tobacco- and alcohol-associated cancers for 1995-2012 was analyzed to compare rates of the Upper Peninsula (UP) and Lower Peninsula (LP) in Michigan and among AI/ANs and non-Hispanic Whites (NHWs). Complete linkage resulted in 1,352 additional AI/AN cases; 141 cases were linked via IHS records alone, while 373 were linked via tribal records alone; 838 were linked through both IHS and tribal records. ...
Source: Journal of Health Care for the Poor and Underserved - Category: International Medicine & Public Health Authors: Tags: J Health Care Poor Underserved Source Type: research
Abstract We conducted qualitative semi-structured telephone interviews with the directors of the 10 National Institutes of Health Centers for Population Health and Health Disparities (NIH/CPHHD) to identify factors that were associated with the sustainability of 19 interventions developed to address cancer disparities and 17 interventions developed to address cardiovascular disease disparities in the United States. Interview transcripts were analyzed using the constant comparative method of analysis to identify key themes and synthesize findings. Directors at NIH/CPHHD reported that barriers to sustainability incl...
Source: Journal of Health Care for the Poor and Underserved - Category: International Medicine & Public Health Authors: Tags: J Health Care Poor Underserved Source Type: research
This study applied the contemplation stage of the Trans-Theoretical Model of Behavioral Change (TTM-C) to evaluate health disparity-focused community interventions. Most of the 412 event participants self-identified as lower socioeconomic status (54%), overweight (74%), female (74%), and African American (83%). After event participation, stakeholders demonstrated significant improvement in overall TTM-C scores based on a standard t-test, where pre-event scores (M=30.8, SD=7.0) and post-event scores (M=32.3, SD=6.9) conditions t(346)=5.167, p=.001. For health disparity-related community events, underserved African American ...
Source: Journal of Health Care for the Poor and Underserved - Category: International Medicine & Public Health Authors: Tags: J Health Care Poor Underserved Source Type: research
CONCLUSIONS: Refugees had comparable burden of non-communicable diseases, but a greaterleast once during the study period proportion of refugees than of the U.S. population had uncontrolled conditions. Duration of follow-up, obesity, tobacco use, gender, age, and region of origin were risk factors for diagnosis. Culturally-tailored chronic disease management strategies are needed. PMID: 31422992 [PubMed - in process]
Source: Journal of Health Care for the Poor and Underserved - Category: International Medicine & Public Health Authors: Tags: J Health Care Poor Underserved Source Type: research
This study will evaluate the health care costs and utilization of individuals during their first year of enrollment in HOME and identify factors associated with higher cost and utilization. Secondary analysis of claims data were used to identify cost and utilization. Generalized linear regression and negative binomial regression were used to calculate utilization and cost. The mean total cost of care during the initial year of enrollment (n=239) per individual was $11,095.87, with $4,640.83 attributed to inpatient care. Those with diabetes (p=0.01), epilepsy (p=0.02), or mood disorders (p=0.03) were more likely to be admit...
Source: Journal of Health Care for the Poor and Underserved - Category: International Medicine & Public Health Authors: Tags: J Health Care Poor Underserved Source Type: research
ConclusionsUncommon Candida species frequently exhibit high rates of non-susceptibility to antifungals. Identification of all Candida isolates at the species level from blood samples is of value for treatment.
Source: Journal of Microbiology, Immunology and Infection - Category: Microbiology Source Type: research
CONCLUSION: Cannulation trauma at the initiation of haemodialysis could potentially be reduced with a strategy of incremental haemodialysis using single-needle treatment supported with duplex ultrasonography assessment to 'map' the vascular access as a guide for clinicians prior to cannulation initiation. PMID: 31423945 [PubMed - as supplied by publisher]
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
Authors: Idrees M, Suthananthan A, Pathmarajah T, Sieunarine K Abstract PURPOSE: To examine the feasibility of snuffbox arteriovenous fistula as a first option for haemodialysis. BACKGROUND: Snuffbox arteriovenous fistula is the most distal native anastomosis possible for haemodialysis access. It was described by Rassat et al. This systematic review evaluates all literature investigating the feasibility and efficiency of performing snuffbox arteriovenous fistula. METHODS: PubMed, Cochrane Library and Google Scholar were systematically searched for all English articles related to snuffbox arteriovenous fistu...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research
In this study, we aimed to estimate the frequency of premalignant and malignant lesions in endometrial polyps, and to evaluate associated clinical and demographic factors. A literature search was performed in major databases and the gray literature using the terms polyps OR endometrial polyp AND endometrial neoplasms OR endometrial cancer OR endometrial hyperplasia OR malignan*. Studies describing the frequency of premalignant and malignant lesions in endometrial polyps and any clinical or demographic factors associated with malignant lesions extracted using hysteroscopy were considered eligible. Independent investigators ...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
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