Isolated port-site metastasis after laparoscopic surgery for endometrial cancer: A case report

► Isolated port-site metastasis is a rare event after laparoscopy in the surgical staging of endometrial cancer. ► More aggressive strategies in case of potentially increased risk for port-site metastasis are needed

Tibolone reverses the cognitive effects caused by leuprolide acetate administration, improving mood and quality of life in patients with symptomatic uterine leiomyomas

Objective: To investigate the effects of tibolone co-administration with GnRH agonist treatment in terms of cognition, mood, and quality of life.Design: Randomized, controlled, single blind, clinical trial.Setting: Department of gynecology and obstetrics at a university in Italy.Patient(s): One hundred ten premenopausal women with symptomatic uterine leiomyomas.Intervention(s): Six months of treatment with leuprolide acetate depot (11.25 mg IM, every 3 mo) associated with either tibolone (2.5 mg/d orally; group A) or placebo (1 tablet per d; group B).Main Outcome Measure(s): At baseline and after 6 months of treatment, uterine and leiomyoma sizes, leiomyoma-related symptoms, climacteric-like symptoms, cognition, mood, and quality of life.Result(s): At study entry, no difference was detected between groups in any parameters assessed. After treatment, the leiomyoma-related symptoms were significantly reduced in both groups, without any statistically significant differences between them. The Kupperman Index was statistically significantly higher in group B in comparison with baseline and group A. The cognition scores were statistically significantly different in comparison with baseline in group B, whereas no change was observed in group A. After treatment, mood and quality of life were statistically significantly improved in both groups, even though the improvement was significantly higher in group A than in group B.Conclusion(s): Tibolone administration reverses the deleterious effect on cognition that is caused by leuprolide acetate depot and improves mood and quality of life in patients who receive GnRH agonist for symptomatic uterine leiomyomas

Studio randomizzato controllato sul confronto tra due morcellatori tissutali: Gynecare Morcellex® versus Rotocut G1®

Obiettivo dello studio è quello di comparare la sicurezza e l’efficienza di due morcellatori tissutali, Gynecare Morcellex® e Rotocut G1®, per l’esecuzione di interventi di isterectomia sopracervicale e miomectomia per via laparoscopica. Si tratta di uno studio randomizzato controllato, svolto presso la Cattedra di Ginecologia e Ostetricia dell’Università “Magna Graecia” di Catanzaro. Sono state reclutate 74 donne con fibromi sintomatici e candidate per interventi di isterectomia sopracervicale o miomectomia per via laparoscopica, seguiti da morcellamento tissutale effettuato con Gynecare Morcellex® (gruppo sperimentale) o Rotocut G1® (gruppo controllo). Sono stati registrati per ogni paziente i parametri clinici, biochimici e chirurgici. Non sono state evidenziate differenze statisticamente significative tra i due gruppi di pazienti nel tempo operatorio totale (91.9±30.9 vs. 84.3±27.3, rispettivamente; P=0.264) e nel tempo di morcellamento (5.8±2.9 vs. 5.0±3.0 rispettivamente; P=0.281), mentre una differenza statisticamente significativa (P<0.05) è stata riscontrata nel grado di maneggevolezza del Morcellex® rispetto al Rotocut G1®. Tra i due gruppi non sono state registrate differenze in alcun altro parametro valutato. Concludendo, il Gynecare Morcellex® è uno strumento sicuro ed efficiente che potrebbe essere preferito da chirurghi con un minore grado di esperienza nel morcellamento elettronico di tessuti in corso di interventi laparoscopici

Effectiveness of risedronate in osteoporotic postmenopausal women with inflammatory bowel disease: A prospective, parallel, open-label, two-year extension study

Objective: To evaluate long-term efficacy of risedronate in osteoporotic postmenopausal patients with inflammatory bowel disease (IBD).Design: A prospective, parallel, open-label, 2-year extension study of a randomized, double-blind, 1-year clinical trial. Eighty-one osteoporotic postmenopausal women with IBD were treated with risedronate (n = 40) or placebo (n = 41). Bone mineral density (BMD), biochemical bone turnover markers, and vertebral and nonvertebral fractures were assessed throughout the study. Data were analyzed using the intent-to-treat principle.Results: Significant (P &lt; 0.05) differences were observed between risedronate and placebo groups at 1-, 2-, and 3-year follow-up visits in bone turnover markers and in lumbar spine, trochanter, and femoral neck BMD. In partcipants treated with risedronate, the percentage of changes from baseline in bone turnover markers and in lumbar spine, trochanter, and femoral neck BMD were significantly (P &lt; 0.05) higher at 2- and 3-year follow-up in comparison with baseline and 1-year follow-up, with a significant (P &lt; 0.05) difference between the 2- and 3-year follow-up visits. At the end of the study, the cumulative risk of vertebral and nonvertebral fractures was significantly (P &lt; 0.05) lower in the risedronate group than in the placebo group. The relative risk for new vertebral fractures was 0.456 (95% CI: 0.134-1.559, P = 0.211) and 0.296 (95% CI: 0.121-0.721, P = 0.007) and was 0.209 (95% CI: 0.023-1.867, P = 0.161) and 0.137 (95% CI: 0.030-0.620, P = 0.010), respectively, for new nonvertebral fractures after 2 and 3 years of risedronate treatment.Conclusions: In postmenopausal osteoporotic women with IBD, long-term treatment with risedronate is effective in increasing BMD and reducing vertebral and nonvertebral fracture risk

A randomized controlled trial comparing three single-incision minislings for stress urinary incontinence

Studies have observed a significant heterogeneity in efficacy data for single-incision minislings (SIMS) as surgical treatment for female urinary incontinence (UI). Our study aim was to test the hypothesis that different vaginal kits for SIMS have different long-term outcomes