ABSTRACT
Aim of the Study: To evaluate the response of necrotic fibroids to UAE and to identify whether pre-UAE enhancement or other factors are predictors of fibroid shrinkage
Materials and methods: This is a retrospective review of all women who underwent UAE for symptomatic fibroids from January 2013 till July 2017, who experienced a follow-up MRI 5-6 months after UAE were included. There were 54 fibroids [37 non-enhancing and 17 enhancing] among 24 women with a mean age of 56 [range 40-59] years. All fibroids were assessed for size, position, enhancement on subtraction images, and Apparent Diffusion Constant [ADC]
Results: Enhancing fibroids had an average decrease in diameter by 23 +/- 6%, not significantly different compared to that non-enhancing fibroids which decreased by 19 +/- 3% [p=0.491]. Multiple linear regression with percent change in fibroid diameter as the dependent variable and patient age, fibroid position, and preUAE fibroid diameter, enhancement, and ADC as independent variables, showed that ADC [p<0.005] and pre-UAE diameter [p<0.005] were the only significant independent variables
Conclusion: Pre-UAE size and ADC, but not contrast enhancement, predicted fibroid diameter reduction. Enhancing and non-enhancing fibroids had similar size reduction after UAE. Non-enhancement should not be considered a contraindication to UAE
ABSTRACT
Purpose: To Compare tomosynthesis to mammography, ultrasound, MRI, and histology for the detection and staging of BI-RADS 4-5 anomalies, as a function of breast composition, histology, size, and lesion location
Materials and methods: 25 patients underwent tomosynthesis, MRI, mammography, and ultrasound. The diagnostic accuracy of the different examinations was compared
Results: The sensitivities for detection were as follows: 92.7% for MRI, 80.5% for ultrasound, 75.6% for tomosynthesis, and 61% for mammography. Tomosynthesis improves the sensitivity of mammography [P= 0.0001], but not the specificity. The detection of multifocality and multicentricity was improved, but not significantly. Tomosynthesis identified more lesions than mammography in 10% of cases and improved lesion staging irrespective of the density, but was still inferior to MRI. The detection of ductal neoplasia was superior with tomosynthesis Compared to mammography [P = 0.016], but this was not the case with lobular cancer. The visualization of masses was improved with tomosynthesis [P = 0.00012], but not with microcalcifications. Tomosynthesis was capable of differentiating lesions of all sizes, but the smaller lesions were easier to see. Lesion sizes measured with tomosynthesis, excluding the spicules, concurred with histological dimensions. Spicules lead to an overestimation of the size
Conclusion: In our series, tomosynthesis found more lesions than mammography in 10% of patients, resulting in an adaption of the surgical plan
ABSTRACT
Background: Menopause is the estimated end of reproductive life. Having a positive attitude towards it has been shown to outcome in a positive experience, whereas a negative attitude is connected with negative experiences and symptoms. Conventionally, women regularly abstain from sex after menopause
Purpose: The study aimed to determine the level of awareness and perceptions about the menopause and sex in perimenopausal women attending a general outpatient clinic
Methods: Women over 40 years were enlisted from the Family Medicine Department of King Abdulaziz Hospital, excluding those who were menopausal. Data analyses were done with chi-square test [P<0.05]. The study was done according to the ethical board of Umm Al Qura university
Results: Most [151; 85.8%] of the 176 surveyed participants were aware of the menopause. Only 36.1% anticipated associated symptoms. About half [55.68%] were indifferent to menopause onset, while 23.3% had a positive attitude and 21.11% had a negative attitude, respectively. Younger women were less likely to have a positive attitude to the menopause [P=0.04]. There were negative cultural beliefs towards sex. Sexual activity was low and declined with age [P<0.001]. Many women would like treatment to improve their sexual activity
Conclusion: Most participants had a favourable disposition towards the menopause, though sexual relationships suffer. Counselling and treatment should be offered
ABSTRACT
Elderly individuals are very vulnerable to influenza infection, and more prone to influenza-related morbidity and mortality. However, the prevalence of elderly persons receiving influenza vaccine remains low. Many factors have been proposed as the cause beyond this low prevalence, with knowledge and misconceptions about the vaccine on the top of the list
Objectives: the aim of this review is to assess the knowledge, attitude, and prevalence of flu vaccine and its effect among elderly
Methods: To achieve this aim, online database search was conducted to review articles stating knowledge, attitude, and incidence of flu vaccine and its effects among elderly. PubMed was searched for appropriately-related studies that address the studied parameters. PubMed search yielded 19 results, we quickly inspected the abstracts of these results to select those with most relevant data. Of 19 articles, 8 were chosen for review
Results: The prevalence of influenza vaccine ranged from 58% to 73%. Inadequate or lack of knowledge about the vaccine were common in over half of the elderly patients not receiving vaccine. The vast majority [>90%] of those received the vaccine did so after a clear recommendation by their physicians
Discussion: Inadequate knowledge and false beliefs about the influenza vaccines were the main cause of low vaccination rate among elderly. Physicians advice and health education were the most potent influencer on raising the prevalence of elderly immunization