Objective: The aim of the study was to evaluate the pregnancy outcomes of women who underwent conservative management of adenocarcinoma in situ (AIS).
Materials And Methods: We conducted a retrospective chart review of patients diagnosed with AIS at a single tertiary institution between January 1, 1991, and December 31, 2019. We collected demographic data, AIS-specific information, and fertility outcomes and performed bivariate analyses to compare demographic characteristics and AIS-specific information between patients with and without hysterectomy after diagnosis. Patients with conservative management who achieved pregnancy were described.
Results: Among 87 patients with AIS, 38 (44%) underwent a hysterectomy within 6 months of diagnosis and 49 (56%) underwent conservative management. Six of 19 patients (32%) had residual AIS despite undergoing definitive management after an excisional procedure with negative margins and negative endocervical curettage (ECC). Nine of 19 patients (47%) had residual AIS after an excisional procedure with positive margins and/or a positive ECC. Patients who opted for conservative management were younger (median = 31.6 [interquartile range = 27.4-34.9] vs 38.5 y [32.3-44.8 y], p < .001) and nulligravid. Among patients with conservative management, there were 15 pregnancies and 14 live births (29%). Seven were preterm, although 2 were for medical indications.
Conclusions: Residual AIS in patients with negative margins and ECC leading to definitive hysterectomy (32%) and the rate of preterm birth (36%) were higher than previous reports and nationally reported rates. However, only 1 patient had a preterm birth before 34 weeks. These findings reflect important information for counseling patients who elect for conservative management of AIS.
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http://dx.doi.org/10.1097/LGT.0000000000000621 | DOI Listing |
BMC Oral Health
January 2025
Associate Professor of Operative Dentistry, Conservative Dentistry Department, Faculty of Oral and Dental Medicine Badr University in Cairo, Cairo, Egypt.
Background: Endodontic treatment aims in the preservation of extremely carious primary teeth. For root canal therapy to be successful, root canals must be properly prepared and effectively irrigated .Therefore, it is necessary to select the proper root canal disinfection method to preserve the primary tooth.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA, USA.
Post-dural puncture headache (PDPH) is a debilitating complication of neuraxial anesthesia, particularly prevalent in obstetric patients, usually characterized by a postural headache. PDPH is hypothesized to result from cerebrospinal fluid leakage through a dural puncture, triggering symptoms like neck stiffness and subjective hearing changes. While conservative measures are common for treatment, more refractory cases may require invasive interventions such as an epidural blood patch (EBP).
View Article and Find Full Text PDFJ Anxiety Disord
January 2025
School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, China. Electronic address:
Anxiety symptoms are among the most prevalent mental health disorders in adolescents, highlighting the need for scalable and accessible interventions. As anxiety often co-occurs with perceived stress during adolescence, stress interventions may offer a promising approach to reducing anxiety. Previous stress interventions have largely focused on the view that stress is harmful, aiming to manage and mitigate its negative effects.
View Article and Find Full Text PDFClin Genitourin Cancer
December 2024
Department of Urology, Mie University hospital, Tsu, Japan.
Objective: To evaluate the oncological outcomes of selective bladder preservation therapy, comprising maximal TURBT plus neoadjuvant chemotherapy (NAC) followed by 2nd-TURBT.
Methods: From 2012 to 2022, 110 localized muscle-invasive bladder cancer patients who desired bladder preservation (BP) received maximal TURBT plus NAC followed by restaging (CT scan+ 1st-TURBT) and 2nd-TURBT. Sixty-one patients with pure urothelial carcinoma of the urinary bladder (PUCUB) who achieved noninvasive downstaging (NID) after NAC and had no residual tumor at 2nd-TURBT underwent conservative treatment (BP group).
Eur J Orthop Surg Traumatol
January 2025
Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Purpose: A prospective longitudinal cohort study was performed to gain insight into the course of recovery in terms of pain, opioid consumption, and mobility in patients with a lateral compression (LC) pelvic injury.
Methods: Adult patients with an LC injury, without any cognitive disorders or limited mobility and who could communicate in Dutch were asked to participate. Pain in terms of NRS (numeric rating scale, range 0-10), opioid use and mobility were recorded at eight time points: at hospital admission, and three days, one week, six weeks, three months, six months, one year and two years after the injury.
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