Objectives: This study aimed to evaluate the diagnostic performances of the Copenhagen Index (CPH-I) and Risk of Ovarian Malignancy Algorithm (ROMA) in the preoperative prediction of ovarian cancer.Methods: In a prospective cohort study, data were collected from 475 patients with ovarian masses who were hospitalized at the Departments of Obstetrics and Gynecology, Hue Central Hospital and Hue University of Medicine and Pharmacy Hospital, Vietnam, between January 2018 and June 2020. ROMA and CPH-I were included for the women who had measurements of serum carbohydrate antigen (CA-125) and human epididymis protein (HE4). Matching these values to postoperative histopathology resulted in the preoperative prediction values. The final diagnosis was based on clinical features, histologic, radiologic findings, and the International Federation of Gynecology and Obstetrics (FIGO) 2014 stages of ovarian cancer were recorded.Results: Among the 475 women, 408 had benign tumors, 5 had borderline tumors and 62 had malignant tumors. The two indices showed similar discriminatory performances with no significant differences (p > 0.05). At an optimal cut-off, the sensitivities/specificities of ROMA and CPH-I for ovarian cancer diagnosis were 76.1% and 87.0%, 83.6% and 78.7%, respectively. The optimal cut-off for CPH-I was 1.89%. The areas under the ROC curves (AUCs) of ROMA and CPH-I were 0.860 (95%CI: 0.825 – 0.890) and 0.868 (95%CI: 0.833 – 0.896), respectively.Conclusions: The introduction of the Copenhagen Index to help stratify the malignancy risk of ovarian tumor, irrespective of menopausal status might be applied as a simple alternative with a similar efficacy to ROMA in clinical practice.
Copenhagen Index (CPH-I) can help stratify the risk of ovarian tumor malignancy.• CPH-I is similarly accurate to but simpler than ROMA.• CPH-I could replace ROMA in clinical practice.
♦ Background: Widespread Al toxicity is unusual today. In 2005, Canadian peritoneal dialysis (PD) centers reported widespread hyperaluminemia in patients using dialysates from one specific manufacturer. Our objectives were to evaluate risk factors related to Al accumulation and to assess its clinical consequences in patients from 2 centers. ♦ Methods: A retrospective closed cohort study was conducted in patients treated with PD in May 2005. A multivariate linear regression model was constructed to identify variables associated with a higher serum Al level in the exposed group at the moment of solution change. Using appropriate statistical methods, anemia and bone metabolism parameters were compared between the exposed and unexposed groups. Time to first peritonitis was estimated by the Kaplan-Meier method. ♦ Results: The study cohort included 87 Al-exposed patients and 95 unexposed patients. In the exposed group, serum Al at the moment of solution change was influenced by the length of exposure to Al-containing dialysates and by PD creatinine clearance; serum Al was inversely correlated with renal creatinine clearance. No consequences of Al accumulation were observed. No difference was observed in the time to first peritonitis between patients who switched manufacturers and those who remained with the original manufacturer. ♦ Conclusions: Our results suggest that hyperaluminemia is directly related to the length and extent of exposure to Alcontaining dialysates; residual renal function is protective against Al accumulation. Because the problem was detected rapidly, no clinical consequences of hyperaluminemia were observed in the study cohort.
Objectives: This study aims to determine the abnormal rate and the diagnostic validity of VIA and Pap-smear in screening of cervical pre-invasive lesions and invasive cancer in community health facilities. Subjects and Methods: Cross-sectional description on 977 women aged of 21 – 70 years in 5 communes in two districts Huong Tra, Huong Thuy of Thua Thien Hue province during the time from December 2011 to October 2012. Women were concurrently examined by gynecologic examination, screened for cervical lesions with Pap’s smear and VIA. Cervical smears were processed by using Papanicolaou staining, and classified according to Bethesda 2001 nomenclature. VIA was carried out and results classified according to 2011Guidelines of the Ministry of Health. Women whose VIA or papsmears appeared abnormal will be invited for re-examination at the Hospital for colposcopy and biopsy if indicated. The study parameters include the abnormal rate of pap-smear and VIA and the diagnostic value of VIA and cytology. Results: The mean age of screened women was 38.9±9.5. Rate of positive Pap’s smear increased with age and number of pregnancies. Abnormal VIA results were recorded in 20 cases (2.0%). Detection rate of cervical pre-cancerous lesions by Pap-smear was 7.6%, in which the diagnosis of ASCUS/ H was 3.0%, AGUS 2.9%, LSIL 1.6% and HSIL 0.1%. Concordancerate of VIA and Pap’s smear was 92.2%. Diagnostic value of VIA had a sensitivity of 75%; specificity of 99.16%; Diagnostic value of cervical pap-smear had a sensitivity of 81.25%; specificity of 93.65%. Conclusion: Detection rate of cervical pre-cancerous lesions by Pap’s smear was 7.6%. The concordance rate of VIA and Pap’s smear was quitehigh, at 92.2%, Diagnostic value of VIA had a sensitivity of 75%; specificity of 99.16%; Diagnostic value of cervical pap-smear had a sensitivity of 81.25%; specificity of 93.65%. However, if possible performing a biopsy all patients were screened, the research results will be more accurate. Key words: Cervical pre-invasive lesions and invasive cancer
Objectives: (1) To determine the prevalence, agents of RTIs among married women of the reproductive age group in A Luoi, Thua Thien Hue; (2) Tosurvey some factors influencing the occurrence of the disease. Methods: A cross-sectional study of 460 married women of the productive age group (18 – 49 years) in A Luoi district from 5/2015 to 5/2016. This was followed by interview, clinical examination and collection of samples for laboratory tests. Results: The prevalence of RTIs among the reproductive age group women was 37.6%, of which vaginitis 26.1%, vaginitis & cervicitis 11.5%. Pathogenic agents included: Bacteria 32.4%, Gardnerella vaginosis 35.3%, Candida 17.3%, Candida& bacteria 7.5%, pus-forming bacteria 7.5%. There was no case of Trichomonas Vaginalis. There is a link between RTIs and abortion history and sexual hygiene practices. Conclution: The prevalence of RTIs was 37.6%. The causative agent is Gardnerella vaginosis 35.3%, Candida infection 17.3%. There is a link between RTIs and abortion history and sexual hygiene practices. Key words: RTIs (Reproductive Tract Infections), A Luoi
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