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001-es BibID:	BIBFORM103390
035-os BibID:	(cikkazonosító)1132 (Wos)000846594700001 (Scopus)84897012855
Első szerző:	Buzzaccarini, Giovanni
Cím:	Pain Management during Office Hysteroscopy : an Evidence-Based Approach / Buzzaccarini Giovanni, Alonso Pacheco Luis, Vitagliano Amerigo, Haimovich Sergio, Chiantera Vito, Török Péter, Vitale Salvatore Giovanni, Lagana Antonio Simone, Carugno Jose
Dátum:	2022
ISSN:	1010-660X 1648-9144
Megjegyzések:	Background and Objectives: Hysteroscopy is a reliable technique which is highly useful for the evaluation and management of intrauterine pathology. Recently, the widespread nature of in-office procedures without the need for anesthesia has been requesting validation of practical approach in order to reduce procedure-related pain. In this regard, we performed a comprehensive review of literature regarding pain management in office hysteroscopic procedures. Materials and Methods: MEDLINE, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register), Global Health, Health Technology Assessment Database and Web of Science, other research registers (for example Clinical Trials database) were searched. We searched for all original articles regarding pain relief strategy during office hysteroscopy, without date restriction. Results have been collected and recommendations have been summarized according to the Appraisal of Guidelines for Research and Evaluation (AGREE) tool. Moreover, the strength of each recommendation was scored following the Grading of Recommendations Assessment (GRADE) system, in order to present the best available evidence. Results: Both pharmacological and non-pharmacological strategies for pain management are feasible and can be applied in office setting for hysteroscopic procedures. The selection of strategy should be modulated according to the characteristics of the patient and difficulty of the procedure. Conclusions: Accumulating evidence support the use of pharmacological and other pharmacological-free strategies for reducing pain during office hysteroscopy. Nevertheless, future research priorities should aim to identify the recommended approach (or combined approaches) according to the characteristics of the patient and difficulty of the procedure.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk anxiety office hysteroscopy outpatient hysteroscopy pain practical guidelines
Megjelenés:	Medicina. - 58 : 8 (2022), p. 1-14. -
További szerzők:	Alonso Pacheco, Luis Vitagliano, Amerigo Haimovich, Sergio Chiantera, Vito Török Péter (1975-) (szülész-nőgyógyász) Vitale, Salvatore Giovanni Laganà, Antonio Simone Carugno, Jose
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001-es BibID:	BIBFORM119026
035-os BibID:	(Scopus)85185787111
Első szerző:	Vitale, Salvatore Giovanni
Cím:	Risk of Endometrial Cancer in Asymptomatic Postmenopausal Women in Relation to Ultrasonographic Endometrial Thickness : Systematic Review and Diagnostic Test Accuracy Meta-analysis / Vitale Salvatore Giovanni, Riemma Gaetano, Haimovich Sergio, Carugno Jose, Pacheco Luis Alonso, Perez-Medina Tirso, Parry John Preston, Török Peter, Tesarik Jan, Corte Luigi Della, Cobellis Luigi, Sardo Attilio Di Spiezio, De Franciscis Pasquale
Dátum:	2024
ISSN:	0029-7828
Tárgyszavak:	Orvostudományok Klinikai orvostudományok hozzászólás folyóiratcikk
Megjelenés:	Obstetrical & Gynecological Survey. - 79 : 2 (2024), p. 94-96. -
További szerzők:	Riemma, Gaetano Haimovich, Sergio Carugno, Jose Pacheco, Luis Alonso Perez-Medina, Tirso Parry, John Preston Török Péter (1975-) (szülész-nőgyógyász) Tesarik, Jan Corte, Luigi Della Cobellis, Luigi Sardo, Attilio Di Spiezio De Franciscis, Pasquale
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001-es BibID:	BIBFORM110695
035-os BibID:	(cikkazonosító)102588 (Scopus)85153232429 (WoS)000990464300001
Első szerző:	Vitale, Salvatore Giovanni
Cím:	Endometrial Biopsy : Indications, Techniques and Recommendations. An Evidence-Based Guideline for Clinical Practice / Vitale Salvatore Giovanni, Buzzaccarini Giovanni, Riemma Gaetano, Pacheco Luis Alonso, Sardo Attilio Di Spiezio, Carugno Jose, Chiantera Vito, Török Peter, Noventa Marco, Haimovich Sergio, De Franciscis Pasquale, Perez-Medina Tirso, Angioni Stefano, Lagana Antonio Simone
Dátum:	2023
ISSN:	2468-7847
Megjegyzések:	This practice guideline provides updated evidence for the gynecologist who performs endometrial biopsy (EB) in gynecologic clinical practice. An international committee of gynecology experts developed the recommendations according to AGREE Reporting Guideline. An adequate tissue sampling is mandatory when performing an EB. Blind methods should not be first choice in patients with suspected endometrial malignancy. Hysteroscopy is the targeted-biopsy method with highest diagnostic accuracy and cost-effectiveness. Blind suction techniques are not reliable for the diagnosis of endometrial polyps. In low resources settings, and in absence of the capacity to perform office hysteroscopy, blind techniques could be used for EB. Hysteroscopic punch biopsy allows to collect only limited amount of endometrial tissue. grasp biopsy technique should be considered first choice in reproductive aged women, bipolar electrode chip biopsy should be preferred with hypotrophic or atrophic endometrium. EB is required for the final diagnosis of chronic endometritis. There is no consensus regarding which endometrial thickness cut-off should be used for recommending EB in asymptomatic postmenopausal women. EB should be offered to young women with abnormal uterine bleeding and risk factors for endometrial carcinoma. Endometrial pathology should be excluded with EB in nonobese women with unopposed hyperestrogenism. Hysteroscopy with EB is useful in patients with abnormal bleeding even without sonographic evidence of pathology. EB has high sensitivity for detecting intrauterine pathologies. In postmenopausal women with uterine bleeding, EB is recommended. Women with sonographic endometrial thickness > 4mm using tamoxifen should undergo hysteroscopic EB.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Hysteroscopy Practical guidelines Endometrium Endometrial biopsy
Megjelenés:	Journal of Gynecology Obstetrics and Human Reproduction. - 52 : 6 (2023), p. 1-7. -
További szerzők:	Buzzaccarini, Giovanni Riemma, Gaetano Pacheco, Luis Alonso Sardo, Attilio Di Spiezio Carugno, Jose Chiantera, Vito Török Péter (1975-) (szülész-nőgyógyász) Noventa, Marco Haimovich, Sergio De Franciscis, Pasquale Perez-Medina, Tirso Angioni, Stefano Laganà, Antonio Simone
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001-es BibID:	BIBFORM103064
035-os BibID:	(WoS)000911496500001 (Scopus)85136295331
Első szerző:	Vitale, Salvatore Giovanni
Cím:	Risk of endometrial cancer in asymptomatic postmenopausal women in relation to ultrasonographic endometrial thickness : systematic review and diagnostic test accuracy meta-analysis / Vitale Salvatore Giovanni, Riemma Gaetano, Haimovich Sergio, Carugno Jose, Pacheco Luis Alonso, Perez-Medina Tirso, Parry John Preston, Török Peter, Tesarik Jan, Della Corte Luigi, Cobellis Luigi, Di Spiezio Sardo Attilio, De Franciscis Pasquale
Dátum:	2023
ISSN:	0002-9378
Megjegyzések:	Objective: To evaluate the risk of endometrial carcinoma (EC) and atypical endometrial hyperplasia (AEH) in asymptomatic postmenopausal women in relation to the endometrial thickness (ET) measured by transvaginal ultrasonography (TVS) stratified by threshold categories used for performing subsequent endometrial sampling and histologic evaluation. Data sources: MEDLINE, Scopus, ClinicalTrials.gov, Scielo, EMBASE, the Cochrane Library at the CENTRAL Register of Controlled Trials, LILACS, conference proceedings and international controlled trials registries were searched without temporal or geographical or language restrictions. Study eligibility criteria: Studies were selected if they had a cross-over design evaluating the risk for AEH and EC in postmenopausal asymptomatic women and calculated the diagnostic accuracy of TVS thresholds (at least 3.0 mm) confirmed by histopathological diagnosis. Study appraisal and synthesis methods: We conducted a systematic review and diagnostic test accuracy meta-analysis according to PRISMA-DTA and SeDATE guidelines. ET thresholds were grouped as follows: from 3.0 mm to 5.9 mm; between 6.0 and 9.9 mm; between 10.0 and 13.9 mm; and equal or greater than 14.0 mm. Quality assessment was performed using QUADAS-2 tool. Publication bias was quantified by Deek funnel plot test. Co-primary outcomes were risk for AEH or EC according to ET and diagnostic accuracy of each threshold group. Results: A total of 18 studies provided the data of 10,334 women who were all included in the final analysis. Overall, at an ET threshold of at least 3.0 mm, the risk for AEH or EC was increased three-fold relative to women below the cut-off (relative risk (RR) 3.77, 95% confidence interval (CI) 2.26 to 6.32, I2=74%). Similar degrees of risk were reported for thresholds between 3.0 and 5.9 mm (RR 5.08, 95% CI 2.26 to 11.41, I2=0%), 6.0 and 9.9 mm (RR 4.34, 95% CI 1.68 to 11.23, I2=0%), 10.0 and 13.9 mm (RR 4.11, 95% CI 1.55 to 10.87, I2=86%) and over 14.0 mm (RR 2.53, 95% CI 1.04 to 6.16, I2=78%) with no significant difference among subgroups (p=0.885). Regarding diagnostic accuracy, the pooled sensitivity decreased from thresholds below 5.9 mm (0.81, 95% CI 0.49 to 0.85) to above 14.0 mm (0.28 95% CI 0.18 to 0.40) Meanwhile, specificity increased from 0.70 (95% CI 0.61 to 0.78) for ET between 3.0 mm and 5.9 mm to 0.86 (95% CI 0.71 to 0.94) when the ET is 14.0 mm or greater. For 3.0-5.9 mm and 10.0-13.9 mm thresholds, the highest diagnostic odds ratio of 10 (95% CI 3 to 41) and 11 (95% CI 2 to 49), with an area under curve of 0.81 (95% CI 0.77 to 0.84) and 0.82 (95% CI 0.79 to 0.86) respectively were retrieved. The summary point analysis revealed that, compared to the other subgroups, the 3.0-5.9 mm cut off point was placed higher in the summary receiver operator curve space, indicating increased EC or AEH diagnosis using these cut-offs. Conclusions: Both low and high ET thresholds in postmenopausal asymptomatic women seem equally effective in detecting EC and AEH. However, although using a 3.0 to 5.9 mm cut off results in lower specificity, the offsetting improvement in sensitivity may justify using this cut off for further endometrial evaluation in patients with suspected endometrial malignancy.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Atypical Endometrial Hyperplasia Cut-off Endometrial cancer Endometrial thickness Transvaginal ultrasonography
Megjelenés:	American Journal Of Obstetrics And Gynecology. - 228 : 1 (2023), p. 22-35.e2. -
További szerzők:	Riemma, Gaetano Haimovich, Sergio Carugno, Jose Pacheco, Luis Alonso Perez-Medina, Tirso Parry, John Preston Török Péter (1975-) (szülész-nőgyógyász) Tesarik, Jan Della Corte, Luigi Cobellis, Luigi Di Spiezio Sardo, Attilio De Franciscis, Pasquale
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