Uterine Artery Embolization Versus Hysterectomy in the Treatment of Symptomatic Adenomyosis: Protocol for the Randomized QUESTA Trial

Bruijn, Annefleur M. de; Lohle, Paul N.M.; Huirne, Judith A F; Vries, Jolanda De; Twisk, Moniek; Hehenkamp, Wouter J.K.

doi:10.2196/resprot.8512

Cited by 31 publications

(25 citation statements)

References 43 publications

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“…This important vascular network could improve circulation during arterial ligation, thus decreasing the production and accumulation of free radicals and other molecules from tissue pain. According to several authors, this type of vascularization could explain the tolerance of the uterus with respect to ischemia and paradoxically the destruction of certain myomas observed after myomectomies by arterial ligation [29]- [39] [58] [59] [60].…”

Section: Comparison Of Plasma Concentrations Of Gpx Cpk Ca 2+ K +mentioning

confidence: 99%

Uterine Reperfusion Ischemia and Use of Elastic Tourniquet

Essone¹,

Abessolo²,

Tsagoulela³

et al. 2019

JBM

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Introduction: In humans, it has not been established that the use of elastic tourniquet (ET) during myomectomies, whose delivery times do not exceed 90 minutes, which is responsible for ischemia reperfusion (I/R) systemic. Objectives: To study the plasma variations of markers of I/R during myomectomies performed with ET, whose exposure time does not exceed 90 minutes. Population and methods: Plasma créatinin phosphokinase kinase (CPK) and gluthatione peroxydase (GPX) levels of patients with ET myoma (M + G +, n = 19), taken before, during and after exposure, were compared to those of women operated on myoma without tourniquet (M + G −, n = 15), carriers of unoperated myomas (M + G0, n = 20) and controls (M0G0, n = 18). The duration of exposure of the ET was determined, and perioperative variations of GPX, Ca 2+ , K + and CPK between M + G + and others groups were analyzed (p < 0.005). Results: The average duration of exposure of the

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Section: Comparison Of Plasma Concentrations Of Gpx Cpk Ca 2+ K +mentioning

confidence: 99%

Uterine Reperfusion Ischemia and Use of Elastic Tourniquet

Essone¹,

Abessolo²,

Tsagoulela³

et al. 2019

JBM

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“…Yosra et al 21 designed a lightweight routing protocol for sharing bicycles based on the characteristics of DTN, achieving fast forwarding of information. Saeideh Rahim et al 22 proposed a hybrid geographic routing protocol.…”

Section: Related Workmentioning

confidence: 99%

An adaptive and secure traffic information forwarding mechanism in Internet of Vehicles

Fan

Duan

et al. 2020

Int J Communication

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SummaryTraffic information of disparate types in Internet of Vehicles (IoV) is the basis for supporting various IoV applications. Since traffic flows vary in real time, it is challenging to carry out efficient and reliable transfer of such information. Moreover, IoV is vulnerable to security threats due to its inherent properties such as dynamically changing topology and high‐speed motion of vehicles. Attacks, once launched successfully, would also disrupt message transmission between vehicles. We propose an adaptive traffic information forwarding mechanism, which divides traffic information in two categories, that is, early warning information and service information. The former is handled by selecting a relay node based on node connection stability evaluation, while the latter is handled by adopting an appropriate forwarding method according to the identified traffic flow density. Specifically, in a low‐density environment, we employ a broadcast method; while in a high‐density environment, we evaluate the cognitive interaction values of vehicle nodes and employ a cognitive interaction‐based method to select a relay node. Simulation results show that the proposed mechanism improves the forwarding efficiency of traffic information and yields satisfactory performance in mitigating black hole attacks.

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“…In many parts of the world, UAE is performed under conscious sedation. Vascular access is gained through a femoral or radial artery puncture using 4–6-French (F) arterial sheath for femoral [99, 101] and 4-F sheath for radial access [102]. Under fluoroscopic guidance, aortography is followed by selective and super selective arteriography using 4–5-F catheters for the internal iliac and 2–3-F microcatheters for the uterine artery and its branches respectively.…”

Section: Introductionmentioning

confidence: 99%

“…This multicenter non-blinded randomized controlled trial is currently ongoing in the Netherlands. It has started since November 2015, and its primary outcomes are expected by May 2020 [101]. The calculated sample size for this trial was 96 patients (divided into 52 embolization and 34 hysterectomy, including a 10% expected drop-out) made on assumptions from the embolization versus hysterectomy (EMMY) trial outcomes [111].…”

Section: Introductionmentioning

confidence: 99%

“…Following selection, TVUS and MRIs were performed to confirm the adenomyosis and eligible patients are informed of the trial. Patients with written informed consents were randomly allocated (in a 2:1 ratio) between both experimental intervention (UAE) and standard care control groups (hysterectomy), while patients refusing randomization are given the standard of care (hysterectomy) [101].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Management of uterine adenomyosis: current trends and uterine artery embolization as a potential alternative to hysterectomy

Dessouky

Gamil²,

Nada

et al. 2019

Insights Imaging

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Adenomyosis is a challenging clinical condition that is commonly being diagnosed in women of reproductive age. To date, many aspects of the disease have not been fully understood, making management increasingly difficult. Over time, minimally invasive diagnostic and treatment methods have developed as more women desire uterine preservation for future fertility or to avoid major surgery. Several uterine-sparing treatment options are now available, including medication, hysteroscopic resection or ablation, conservative surgical methods, and high-intensity focused ultrasound each with its own risks and benefits. Uterine artery embolization is an established treatment option for uterine fibroids and has recently gained ground as a safe and cost-effective method for treatment of uterine adenomyosis with promising results. In this review, we discuss current trends in the management of uterine adenomyosis with a special focus on uterine artery embolization as an alternative to hysterectomy.

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Uterine Artery Embolization Versus Hysterectomy in the Treatment of Symptomatic Adenomyosis: Protocol for the Randomized QUESTA Trial

Cited by 31 publications

References 43 publications

Uterine Reperfusion Ischemia and Use of Elastic Tourniquet

Uterine Reperfusion Ischemia and Use of Elastic Tourniquet

An adaptive and secure traffic information forwarding mechanism in Internet of Vehicles

Management of uterine adenomyosis: current trends and uterine artery embolization as a potential alternative to hysterectomy

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