Tania Errasti

Saline infusion sonohysterography in endometrial cancer: assessment of malignant cells dissemination risk.

Background. To assess the risk of malignant cells dissemination in patients with endometrial cancer undergoing saline infusion sonohysterography (SIS).

Sonographic Features of Ovarian Cystadenofibromas Spectrum of Findings

To describe the sonographic characteristics of ovarian cystadenofibromas.

Assessment of a new logistic model in the preoperative evaluation of adnexal masses.

To assess a new logistic regression model developed to predict malignancy in adnexal masses.

Blood flow in functional cysts and benign ovarian neoplasms in premenopausal women.

To assess the value of transvaginal color Doppler sonography in the differentiation of functional cysts from benign ovarian neoplasms in premenopausal women, 100 premenopausal women with the diagnosis of adnexal mass were enrolled in a prospective study. All patients underwent transvaginal color Doppler sonography during the follicular phase. We evaluated 107 masses. Tumor volume and morphology were assessed, as were tumor blood flow location, the number of vessels, the resistive and pulsatility indices, and the peak systolic velocity. Patients were followed up after 8 to 10 weeks by transvaginal sonography. Functional cysts were considered when spontaneous resolution occurred. Surgery was performed if a tumor enlarged or persisted after two scans. Thirty‐nine (36.5%) cysts regressed spontaneously and 68 (63.5%) were removed surgically. Seven of the latter were follicular or luteal cysts and were considered to be functional cysts. No carcinoma was found. Arterial blood flow was detected in 28 (60.8%) functional cysts and in 42 (68.8%) benign neoplasms (P = 0.3446). The vessels were located peripherally in 27 (94.6%) functional cysts and in 37 (88.1%) benign neoplasms (P = 0.2226). No differences were found between functional cysts and benign neoplasms in mean resistive index (0.65, 95% confidence interval: 0.59 to 0.71 versus 0.64, 95% confidence interval: 0.60 to 0.69), mean pulsatility index (1.47, 95% confidence interval: 1.17 to 1.84 versus 1.57, 95% confidence interval: 1.26 to 1.86), number of vessels (1.1, 95% confidence interval: 0.7 to 1.3 versus 1.4, 95% confidence interval: 1.1 to 1.8), and peak systolic velocity (28.6 cm/s, 95% confidence interval: 24.7 to 34.2 versus 24.9 cm/s, 95% confidence interval: 21.6 to 28.3). We concluded that transvaginal color Doppler sonography is not useful to discriminate between functional ovarian cysts and benign ovarian neoplasms in premenopausal women.

Transvaginal color Doppler ultrasonography and CA‐125 in suspicious adnexal masses

Objective: To compare diagnostic performance of color Doppler ultrasound and CA‐125 in suspicious adnexal masses on B‐mode sonography. Materials and methods: Data on 94 patients (mean age: 47.4 years, range: 17–79 years. Fifty‐two (55.3%) premenopausal and 42 (44.7%) postmenopausal women) managed in our institution because of a suspicious adnexal mass were reviewed. All patients were evaluated by transvaginal color Doppler ultrasonography (CD) and serum CA‐125 level determination prior to surgery. Definitive histopathological diagnosis was obtained in each case. Sonographic morphology evaluation was suspicious in all cases. CD was considered as suspicious when flow was detected and the lowest RI found was ≤0.45. CA‐125 cut‐off was ≥35 UI/ml. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each method and compared. ROC analysis was performed for RI and CA‐125. Areas under curve (AUC) were calculated and compared. Results: Fifty‐six (59.6%) tumors were found to be malignant and 38 (40.4%) benign. Sensitivity, specificity, PPV and NPV for CD were 87.5% (95% CIs: 75.3–94.4), 84.2% (95% CIs: 68.7–94), 89.1% (95% CIs: 77.7–95.9) and 82.1% (95% CIs: 66.5–92.5), respectively. Sensitivity, specificity, PPV and NPV for CA‐125 were 83.9% (95% CIs: 71.7–92.4), 68.4% (95% CIs: 51.3–82.5), 79.7% (95% CIs: 66.2–89) and 74.3% (95% CIs: 56.7–87.5), respectively. Sensitivity, PPV and NPV were not statistically different. CD had higher specificity (P=0.01). AUC curve for Doppler (0.75) was significantly higher than for CA‐125 (0.61) (P=0.0002). Conclusions: Our results indicate that color Doppler ultrasound has a better diagnostic performance as compared with CA‐125, being significantly more specific.

Knowledge and beliefs about mechanism of action of birth control methods among European women

BACKGROUND Adequate knowledge is essential for making informed decisions. We attempted to determine the level of knowledge about mechanisms of action of birth control methods in five representative samples of European women. STUDY DESIGN Randomly selected women, aged 18-49 years, completed an anonymous survey in Germany, France, the UK, Sweden and Romania (N=1137). Participants were asked about how contraceptive methods work and if providers should inform them about this issue. Multiple linear regression was used to evaluate womens characteristics associated with their knowledge of mechanisms of action. RESULTS The majority of women identified the unequivocal mode of action of condoms, sterilization and abortion. Fewer than 2% identified all possible mechanisms of action of hormonal contraceptives and intrauterine devices. Highly educated women correctly identified the mechanism or mechanisms of action of more methods than less educated women (β=0.22, 95% confidence interval 0.01-0.43). Regardless of their sociodemographic characteristics and their belief about when human life begins, most women (75%) stated that the provider should inform them about possible postfertilization effects. CONCLUSIONS European women have low knowledge about mechanisms of action of several contraceptive methods. The majority want to be informed about possible postfertilization effects. Since adequate knowledge is essential for making informed decisions, providers are encouraged to inform women about all possible mechanisms of action of contraceptives.

Three-Dimensional Hysterosalpingo-Contrast-Sonography for the Assessment of Tubal Patency in Women with Infertility: A Systematic Review with Meta-Analysis

Background/Aims: We aimed at performing a systematic review to determine the diagnostic accuracy of three-dimensional (3D) hysterosalpingo-contrast-sonography (HyCoSy) for detecting tubal occlusion. Methods: A systematic review in Medline database search from January 1989 to October 2015 to identify relevant studies evaluating 3D-HyCoSy. Eligibility criteria were studies assessing the role of 3D-HyCoSy for diagnosing tubal occlusion in infertile women. Index test was 3D-HyCoSy. Reference standard was laparoscopy with dye test or X-ray hysterosalpingography. Quality was assessed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled sensitivity and specificity for the method were estimated. Results: A total number of 88 papers were identified. After exclusions, nine studies were ultimately included. Pooled estimated sensitivity was 98% (95% CI 91-100) with a moderate heterogeneity (I2: 64.8%, 95% CI 39.6-89.9; and Cochran Q 22.7, p < 0.001). Pooled estimated specificity was 90% (95% CI 83-95) with significant heterogeneity (I2: 80.3%, 95% CI 68.1-92.5; and Cochran Q 40.6, p < 0.001). Positive likelihood ratio was 10.3 (95% CI 5.6-18.7) and negative likelihood ratio was 0.02 (95% CI 0.00-0.21). Conclusion: 3D-HyCoSy is an accurate test for diagnosing tubal occlusion in women with infertility.

External validation of IOTA simple descriptors and simple rules for classifying adnexal masses

To assess the diagnostic performance of a three‐step strategy proposed by the International Ovarian Tumor Analysis (IOTA) Group for discriminating between benign and malignant adnexal masses.

Women's attitudes towards mechanisms of action of birth control methods: a cross-sectional study in five European countries

AIMS AND OBJECTIVES To assess womens attitudes towards the mechanisms of action of birth control methods. BACKGROUND When addressing womens knowledge of and attitudes towards birth control methods, researchers frequently focus on side effects, effectiveness or correct use. Womens opinions about mechanisms of action have been much less investigated, and research is usually concentrated on the EC pill. DESIGN Cross-sectional study. METHODS Women, aged 18-49, from Germany, France, the UK, Sweden and Romania were randomly selected (n = 1137). They were asked whether they would use a method that may work after fertilisation or after implantation and whether they would continue using it after learning it may have such effects. Logistic regression was performed to evaluate the influence of certain characteristics on womens attitudes. RESULTS Almost half of women in Romania and Germany would not use methods with postfertilisation effects, while the lowest percentages were found in Sweden and in France. Regarding methods with postimplantation effects, higher percentages were found in all the countries. Highly educated women and those using a highly effective method were more likely to use methods with postfertilisation effects. On the contrary, married women, those who stated that human life begins at fertilisation and women with middle/high religiosity were less likely to consider using methods that may act after fertilisation. CONCLUSIONS One-third of European women reported that they would not consider using a method that may have postfertilisation effects. RELEVANCE TO CLINICAL PRACTICE Given that postfertilisation effects may not be acceptable to some women, informing them of which methods may have these effects is essential to obtaining complete informed consent and to promoting womens autonomy.

Performance of three-dimensional power Doppler angiography as third-step assessment in differential diagnosis of adnexal masses

To evaluate the contribution of three‐dimensional (3D) power Doppler angiography (3D‐PDA) to the differential diagnosis of adnexal masses.