Biomedical subjects

Moty Pansky

Publications and source records attributed to Moty Pansky.

5 recordsLinked to original sources

PubMed2006

Adnexal torsion involving hydatids of Morgagni: a rare cause of acute abdominal pain in adolescents.

OBJECTIVE: Hydatids of Morgagni are common embryonal remnants of the müllerian duct and among the infrequent causes of adnexal torsion. The purpose of this study was to investigate the occurrence of adnexal torsion involving hydatids of Morgagni, as well as its possible mechanisms. METHODS: A database search was conducted for cases of adnexal torsion treated in our institution from January 2002 to July 2005. These cases were analyzed, focusing on a subgroup of adolescents with adnexal torsion involving the hydatids of Morgagni. RESULTS: There were 76 patients with adnexal torsion. The rate of hydatid of Morgagni torsion was 26% (4 of 15 cases, 95% confidence interval [CI] 0.15-0.51) in the adolescent subgroup (10-19 years old), compared with 0% (0 of 61 cases, 95% CI 0-0.048) in the adult subgroup. The difference between the hydatid torsion rates in the two subgroups was statistically significant (P = .01, 95% CI 0.001-0.532). The four patients with hydatid torsion (postmenarchal girls, aged 13-18 years) were managed with laparoscopic adnexal detorsion and cystectomy of the affected hydatid of Morgagni. At surgery, we noted three different mechanisms of hydatid torsion: torsion of the adnexa together with torsion of the hydatid of Morgagni, torsion of the hydatid of Morgagni with intact adnexa (n = 2), and entanglement of the hydatid's pedicle around the distal fallopian tube. The hydatids of Morgagni were observed on the preoperative transabdominal ultrasonogram in only one patient and appeared as a simple cyst. CONCLUSION: Adnexal torsion involving the hydatids of Morgagni appears to be more common in adolescents than previously thought. LEVEL OF EVIDENCE: III.

Abdominal Pain↗

PubMed2004

The major histopathologic characteristics in the vulvar vestibulitis syndrome.

OBJECTIVE: In order to better understand the etiology of the vulvar vestibulitis syndrome, we examined the histopathologic parameters in vestibular mucosa, and compared the findings in specimens obtained from women with vulvar vestibulitis with those obtained from the control group. STUDY DESIGN: Specimens of vestibulitis were obtained from 24 patients, undergoing circumferential vestibulectomy under general anesthesia due to the symptoms and signs consistent with vulvar vestibulitis. Control specimens were obtained from 16 women, without symptoms or signs of vulvar vestibulitis, undergoing reconstructive introital surgery due to roomy vagina, rectocele or painful episiotomy. All vestibular tissue specimens were examined for intensity of inflammation, extension of inflammatory cells into the epithelium, vascular proliferation, the presence of mast cells and proliferation of peripheral nerve bundles. RESULTS: No significant difference was found regarding the degree of inflammation, the extension of inflammatory cells into the epithelium, the vascular proliferation and the presence of mast cells while comparing the study and the control groups. The only histopathologic feature, differentiating the patients with vulvar vestibulitis from the control group, was the proliferation of peripheral nerve bundles found in 19 out of 24 (79.1%) specimens expressing vestibulitis and in none of 16 control specimens (p < 0.0001). CONCLUSION: Our results, therefore, support the existence of peripheral nerve hyperplasia in vestibular tissue obtained from patients with vulvar vestibulitis, and exclude the role of active inflammation or mast cells as probable etiologies for the vulvar vestibulitis syndrome.

Adult↗

PubMed2004

A comparison of the incidence, presentation, and management of ovarian pregnancies between two periods of time.

STUDY OBJECTIVE: To compare the prevalence, presentation diagnostic modalities, and management of 37 ovarian pregnancies in one institution during two time periods. DESIGN: A retrospective study (Canadian Task Force classification II-2). SETTING: Department of Gynecology in a university-affiliated hospital. PATIENTS: Twenty patients with ovarian pregnancy between 1971-1989 compared with 17 patients with ovarian pregnancy between 1990-2000. MEASUREMENTS AND MAIN RESULTS: Seventeen ovarian pregnancies, diagnosed between 1990-2000, comprised 2.6% (17/634) of all ectopic pregnancies, 1:3500 of all live births leading to a mean ovarian pregnancy rate per year of 1.5, as opposed to 3.1% (20/647) of all ectopic pregnancies, 1:3600 of all live births, and a mean ovarian pregnancy rate per year of 1.1 in the previous period. Circulatory collapse was present in 4/17 (23%) patients in the 1990-2000 time period and in 6/20 (30%) in the previous period. Culdocentesis for diagnostic purposes was practically abandoned in the recent decade. Wedge resection by laparotomy was the treatment of choice in the past, and after 1997, it was performed exclusively by laparoscopy. When an ovarian pregnancy was diagnosed, an intrauterine device (IUD) was present in 65% of all patients and in 73% of women who had previously conceived in the 1999-2000 time period, compared with higher rates in the previous period (90% and 100%, respectively). CONCLUSION: The absolute number of ovarian pregnancies in the last 11 years increased when compared with the previous 19 years; however, the prevalence rate per delivery was stable. Patients still experienced circulatory collapse despite modern diagnostic modalities. Culdocentesis for diagnostic purposes has become an unnecessary procedure. Laparoscopic wedge resection was the treatment of choice. The relationship between IUD use and ovarian pregnancies was still strong.

Adult↗

PubMed2004

Improved patient compliance using pediatric cystoscope during office hysteroscopy.

STUDY OBJECTIVE: To evaluate the use of a pediatric cystoscope in office diagnostic hysteroscopy. DESIGN: Retrospective review (Canadian Task Force classification II-2). SETTING: Maccabi Outpatient Women's Health Center. PATIENTS: One thousand three hundred and thirty-five women; 959 (71.8%) premenopausal and 376 (28.2%) menopausal. INTERVENTION: Office diagnostic hysteroscopy using 2.3-mm diameter pediatric cystoscope, without premedication or anesthesia. MEASUREMENTS AND MAIN RESULTS: Hysteroscopy was successfully completed in 1298 patients (97.3%). The main reason for failure was cervical stenosis. Menopausal status was the only statistically significant factor correlating with increased failure rate. The analysis demonstrates that for every year of age, the OR for success decreases by 0.965, and success rises by 1.29 for every delivery the woman had. In menopausal women, the OR for success decreases by 0.45. Dilatation of the cervix was required in six women (0.46%), and local anesthesia was needed in only two women. One uterine perforation was recorded, and eight women (0.006%) developed vasovagal reflex or severe abdominal cramps. Post procedural oral analgesia was needed in 108 (8%) of the women. CONCLUSION: The combination of a very small diameter continuous flow pediatric cystoscope, together with its ability to deliver high-quality images of the uterine cavity, make this instrument an excellent option for office diagnostic hysteroscopy.

Adolescent↗

PubMedDate not supplied

Diagnostic hysteroscopy as a primary tool in a basic infertility workup.

OBJECTIVE: To assess the value of diagnostic hysteroscopy in a primary workup of infertility. METHODS: We performed a retrospective analysis (Canadian Task Force Classification II-2) of 221 infertile patients referred to the Outpatient Center for Uterine Cavity Evaluation and the Tel-Aviv University affiliated Assaf Harofe Medical Center for evaluation of the uterine cavity. Patients underwent a diagnostic office hysteroscopy. RESULTS: Hysteroscopy revealed an abnormal uterine cavity in 30% of women evaluated for either primary or secondary infertility. No significance was found regarding the total number of intrauterine pathologies when comparing the groups of primary versus secondary infertility. CONCLUSION: Routine diagnostic hysteroscopy should be part of an infertility workup in primary and secondary infertility.

Adolescent↗