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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
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM113253
035-os BibID:	(scopus)85164501542 (WOS)001025575900001
Első szerző:	Vitale, Salvatore Giovanni
Cím:	Uterine cervical stenosis: from classification to advances in management. Overcoming the obstacles to access the uterine cavity / Vitale Salvatore Giovanni, De Angelis Maria Chiara, Della Corte Luigi, Saponara Stefania, Carugno Jose, Lagana Antonio Simone, Török Péter, Tinelli Raffaele, Pérez-Medina Tirso, Ertas Sinem, Urman Bulent, Angioni Stefano
Dátum:	2024
ISSN:	0932-0067 1432-0711
Megjegyzések:	Background To date hysteroscopy is the gold standard technique for the evaluation and management of intrauterine pathologies. The cervical canal represents the access route to the uterine cavity. The presence of cervical stenosis often makes entry into the uterine cavity difficult and occasionally impossible. Cervical stenosis has a multifactorial etiology. It is the result of adhesion processes that can lead to the narrowing or total obliteration of the cervical canal. Purpose In this review, we summarize the scientific evidence about cervical stenosis, aiming to identify the best strategy to overcome this challenging condition. Methods The literature review followed the scale for the quality assessment of narrative review articles (SANRA). All articles describing the hysteroscopic management of cervical stenosis were considered eligible. Only original papers that reported data on the topic were included. Results Various strategies have been proposed to address cervical stenosis, including surgical and non-surgical methods. Medical treatments such as the preprocedural use of cervical-ripening agents or osmotic dilators have been explored. Surgical options include the use of cervical dilators and hysteroscopic treatments. Conclusions Cervical stenosis can present challenges in achieving successful intrauterine procedures. Operative hysteroscopy has been shown to have the highest success rate, particularly in cases of severe cervical stenosis, and is currently considered the gold standard for managing this condition. Despite the availability of miniaturized instruments that have made the management of cervical stenosis more feasible, it remains a complex task, even for experienced hysteroscopists
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Cervical stenosis Hysteroscopy Infertility Therapy
Megjelenés:	Archives Of Gynecology And Obstetrics. - 309 : 3 (2024), p. 755-764. -
További szerzők:	De Angelis, Maria Chiara Della Corte, Luigi Saponara, Stefania Carugno, Jose Laganà, Antonio Simone Török Péter (1975-) (szülész-nőgyógyász) Tinelli, Raffaele Perez-Medina, Tirso Ertas, Sinem Urman, Bulent Angioni, Stefano
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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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
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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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
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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