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  1. Article: Breast cancer screening in women taking hormone replacement therapy needs updating.

    Koninckx, P R / Ussia, A / Page, G

    Facts, views & vision in ObGyn

    2024  Volume 16, Issue 1, Page(s) 5–8

    Abstract: Breast cancer screening by mammography is widely used. The diagnostic accuracy is limited, with a positive predictive value of 16%. Therefore, a stepwise investigation, with repeat mammography and confirmation by pathology, is usually proposed. Although ... ...

    Abstract Breast cancer screening by mammography is widely used. The diagnostic accuracy is limited, with a positive predictive value of 16%. Therefore, a stepwise investigation, with repeat mammography and confirmation by pathology, is usually proposed. Although this stepwise investigation intends to avoid overtreatment, the many false positives result in unnecessary fear and diagnostic surgery in many women. The false negatives are not known since these women have not been investigated. Given the estimated low risk of missing breast cancer and the slow growth, repeating a screening mammography every two years is sufficient. The false positive screening results, increase with breast density, and breast density increases when hormone replacement therapy (HRT) is given. It, therefore, is suggested to use clinical judgment and stop HRT for 3 to 6 months before repeating the mammography instead of starting immediately a stepwise investigation in all women.
    Language English
    Publishing date 2024-03-29
    Publishing country Belgium
    Document type Journal Article
    ZDB-ID 2701574-9
    ISSN 2032-0418 ; 2684-4230
    ISSN 2032-0418 ; 2684-4230
    DOI 10.52054/FVVO.16.1.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: The glass ceiling of endometriosis surgeons is research.

    Koninckx, P R / Ussia, A / Guo, S W / Saridogan, E

    Facts, views & vision in ObGyn

    2024  Volume 16, Issue 1, Page(s) 1–3

    Language English
    Publishing date 2024-03-29
    Publishing country Belgium
    Document type Journal Article
    ZDB-ID 2701574-9
    ISSN 2032-0418 ; 2684-4230
    ISSN 2032-0418 ; 2684-4230
    DOI 10.52054/FVVO.16.1.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Letter to the Editor.

    Koninckx, P R / Ussia, A / Gordts, S

    Facts, views & vision in ObGyn

    2023  Volume 14, Issue 4, Page(s) 357

    Language English
    Publishing date 2023-02-01
    Publishing country Belgium
    Document type Journal Article
    ZDB-ID 2701574-9
    ISSN 2032-0418 ; 2684-4230
    ISSN 2032-0418 ; 2684-4230
    DOI 10.52054/FVVO.14.4.052
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: En bloc resection of giant retroperitoneal liposarcoma involving the right colon - a video vignette.

    Tonini, V / Ussia, A / Cervellera, M

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2020  Volume 22, Issue 11, Page(s) 1772–1773

    MeSH term(s) Colon ; Humans ; Liposarcoma/diagnostic imaging ; Liposarcoma/surgery ; Retroperitoneal Neoplasms/diagnostic imaging ; Retroperitoneal Neoplasms/surgery
    Language English
    Publishing date 2020-06-14
    Publishing country England
    Document type Letter ; Video-Audio Media
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.15163
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5799: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article: The severity and frequency distribution of endometriosis subtypes at different ages: a model to understand the natural history of endometriosis based on single centre/single surgeon data.

    Koninckx, P R / Ussia, A / Wattiez, A / Adamyan, L / Martin, D C / Gordts, S

    Facts, views & vision in ObGyn

    2021  Volume 13, Issue 3, Page(s) 209–219

    Abstract: Background and objective: to study the natural history of endometriosis.: Materials and methods: the analysis of all women (n=2086) undergoing laparoscopy for pelvic pain and endometriosis between 1988 and 2011 at University Hospital Gasthuisberg.: ...

    Abstract Background and objective: to study the natural history of endometriosis.
    Materials and methods: the analysis of all women (n=2086) undergoing laparoscopy for pelvic pain and endometriosis between 1988 and 2011 at University Hospital Gasthuisberg.
    Main outcome measures: the severity of subtle, typical, cystic and deep endometriosis in adult women, with or without a pregnancy, as estimated by their pelvic area and their volume.
    Results: the number of women undergoing a laparoscopy increased up to 28 years of age and decreased thereafter. Between 24 and 44 years, the severity and relative frequencies of subtle, typical, cystic and deep lesions did not vary significantly. The number of women younger than 20 years was too small to ascertain the impression of less severe lesions. The severity of endometriosis lesions was not less in women with 1 or more previous pregnancies or with previous surgery. There was no bias over time since the type and severity of endometriosis lesions remained constant between 1988 and 2011.
    Conclusions: severity of endometriosis does not increase between 24 and 44 years of age, suggesting that growth is limited by intrinsic or extrinsic factors. Severity was not lower in women with a previous pregnancy.
    What is new: considering the time needed for lesions to become symptomatic together with the diagnostic delay, the decreasing number of laparoscopies after age 28 is compatible with a progressively declining risk of initiating endometriosis lesions after menarche, the remaining women being progessively less susceptible.
    Language English
    Publishing date 2021-06-10
    Publishing country Belgium
    Document type Journal Article
    ZDB-ID 2701574-9
    ISSN 2032-0418 ; 2684-4230
    ISSN 2032-0418 ; 2684-4230
    DOI 10.52054/FVVO.13.3.028
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Reconsidering evidence-based management of endometriosis.

    Koninckx, P R / Ussia, A / Alsuwaidi, S / Amro, B / Keckstein, J / Adamyan, L / Donnez, J / Martin, M C / Wattiez, A

    Facts, views & vision in ObGyn

    2022  Volume 14, Issue 3, Page(s) 225–233

    Abstract: Background: Without an adequate animal model permitting experiments the pathophysiology of endometriosis remains unclear and without a non-invasive diagnosis, information is limited to symptomatic women. Lesions are macroscopically and biochemically ... ...

    Abstract Background: Without an adequate animal model permitting experiments the pathophysiology of endometriosis remains unclear and without a non-invasive diagnosis, information is limited to symptomatic women. Lesions are macroscopically and biochemically variable. Hormonal medical therapy cannot be blinded since recognised by the patient and the evidence of extensive surgery is limited because of the combination of low numbers of interventions of variable difficulty with variable surgical skills. Experience is spread among specialists in imaging, medical therapy, infertility, pain and surgery. In addition, the limitations of traditional statistics and p-values to interpret results and the complementarity of Bayesian inference should be realised.
    Objectives: To review and discuss evidence in endometriosis management.
    Materials and methods: A PubMed search for blinded randomised controlled trials in endometriosis.
    Results: Good-quality evidence is limited in endometriosis.
    Conclusions: Clinical experience remains undervalued especially for surgery.
    What is new?: Evidence-based medicine should integrate traditional statistical analysis and the limitations of P-values, with the complementary Bayesian inference which is predictive and sequential and more like clinical medicine. Since clinical experience is important for grading evidence, specific experience in the different disciplines of endometriosis should be used to judge trial designs and results. Finally, clinical medicine can be considered as a series of experiments controlled by the outcome. Therefore, the clinical opinion of many has more value than an opinion.
    Language English
    Publishing date 2022-10-06
    Publishing country Belgium
    Document type Journal Article
    ZDB-ID 2701574-9
    ISSN 2032-0418 ; 2684-4230
    ISSN 2032-0418 ; 2684-4230
    DOI 10.52054/FVVO.14.3.033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Swab test in biological fluids as predictor of COVID-19 transmission risk during surgery: a prospective cross-sectional study from an Italian COVID center.

    Fabbri, N / Pesce, A / Ussia, A / D'Urbano, F / Pizzicotti, S / Greco, S / Feo, C V

    BMC surgery

    2022  Volume 22, Issue 1, Page(s) 119

    Abstract: Background: The contamination of body fluids by Severe Acute Respiratory Syndrome Coronavirus 2 during surgery is current matter of debate in the scientific literature concerning CoronaVIrus Disease 2019. Surgical guidelines were published during the ... ...

    Abstract Background: The contamination of body fluids by Severe Acute Respiratory Syndrome Coronavirus 2 during surgery is current matter of debate in the scientific literature concerning CoronaVIrus Disease 2019. Surgical guidelines were published during the first wave of the COVID-19 pandemic and recommended to avoid laparoscopic surgery as much as possible, in fear that the chimney effect of high flow intraperitoneal gas escape during, and after, the procedure would increase the risk of viral transmission.
    Aim: The aim of this study was to evaluate the possibility of SARS-CoV-2 transmission during surgery by searching for viral RNA in serial samplings of biological liquids.
    Methods: This is a single center prospective cross-sectional study. We used a real-time reverse transcriptase (RT) polymerase chain reaction (PCR) test to perform swab tests for the qualitative detection of nucleic acid from SARS-CoV-2 in abdominal fluids, during emergency surgery and on the first post-operative day. In the case of thoracic surgery, we performed a swab test of pleural fluids during chest drainage placement as well as on the first post-operative day.
    Results: A total of 20 samples were obtained: 5 from pleural fluids, 13 from peritoneal fluids and two from biliary fluid. All 20 swabs performed from biological fluids resulted negative for SARS-CoV-2 RNA detection.
    Conclusion: To date, there is no scientific evidence of possible contagion by laparoscopic aerosolization of SARS-CoV-2, neither is certain whether the virus is effectively present in biological fluids.
    MeSH term(s) COVID-19/diagnosis ; COVID-19/epidemiology ; Cross-Sectional Studies ; Humans ; Pandemics ; Prospective Studies ; RNA, Viral/analysis ; RNA, Viral/genetics ; SARS-CoV-2
    Chemical Substances RNA, Viral
    Language English
    Publishing date 2022-03-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050442-1
    ISSN 1471-2482 ; 1471-2482
    ISSN (online) 1471-2482
    ISSN 1471-2482
    DOI 10.1186/s12893-022-01571-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Laparoscopic Surgery: A Systematic Review of Loop and Knot Security, Varying with the Suture and Sequences, Throws, Rotation and Destabilization of Half-Knots or Half-Hitches.

    Koninckx, Philippe R / Ussia, Anastasia / Wattiez, Arnaud / Kondo, William / Romeo, Armando

    Journal of clinical medicine

    2023  Volume 12, Issue 19

    Abstract: Surgical knots are sequences of half-knots (H) or half-hitches (S), defined by their number of throws, by an opposite or similar rotation compared with the previous one, and for half-hitches whether they are sliding (s) or blocking (b). Opposite rotation ...

    Abstract Surgical knots are sequences of half-knots (H) or half-hitches (S), defined by their number of throws, by an opposite or similar rotation compared with the previous one, and for half-hitches whether they are sliding (s) or blocking (b). Opposite rotation results in (more secure) symmetric (s) knots, similar rotation in asymmetric (a) knots, and changing the active and passive ends has the same effect as changing the rotation. Loop security is the force to keep tissue together after a first half-knot or sliding half-hitches. With polyfilament sutures, H2, H3, SSs, and SSsSsSs have a loop security of 10, 18, 28, and 48 Newton (N), respectively. With monofilament sutures, they are only 7, 16, 18, and 25 N. Since many knots can reorganize, the definition of knot security as the force at which the knot opens or the suture breaks should be replaced by the clinically more relevant percentage of clinically dangerous and insecure knots. Secure knots with polyfilament sutures require a minimum of four or five throws, but the risk of destabilization is high. With monofilament sutures, only two symmetric+4 asymmetric blocking half-hitches are secure. In conclusion, in gynecology and in open and laparoscopic surgery, half-hitch sequences are recommended because they are mandatory for monofilament sutures, adding flexibility for loop security with less risk of destabilization.
    Language English
    Publishing date 2023-09-24
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12196166
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: How organoids from endometrium and endometriosis could help to understand the pathogenesis of endometriosis.

    Koninckx, Philippe R / Ussia, Anastasia / Martin, Dan C

    Fertility and sterility

    2021  Volume 115, Issue 1, Page(s) 78–79

    MeSH term(s) DNA Methylation ; Endometriosis/metabolism ; Endometrium/metabolism ; Epigenesis, Genetic ; Female ; Genes, Homeobox ; Humans ; Organoids
    Language English
    Publishing date 2021-01-04
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 80133-1
    ISSN 1556-5653 ; 0015-0282
    ISSN (online) 1556-5653
    ISSN 0015-0282
    DOI 10.1016/j.fertnstert.2020.11.022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 73: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  10. Article: Correction: Heterogeneity of endometriosis lesions requires individualisation of diagnosis and treatment and a different approach to research and evidence based medicine.

    Koninckx, P R / Ussia, A / Adamyan, L / Wattiez, A / Gomel, V / Martin, D C

    Facts, views & vision in ObGyn

    2020  Volume 11, Issue 3, Page(s) 263

    Abstract: Statistical significance is used to analyse research findings and is together with biased free trials the cornerstone of evidence based medicine. However traditional statistics are based on the assumption that the population investigated is homogeneous ... ...

    Abstract Statistical significance is used to analyse research findings and is together with biased free trials the cornerstone of evidence based medicine. However traditional statistics are based on the assumption that the population investigated is homogeneous without smaller hidden subgroups. The clinical, inflammatory, immunological, biochemical, histochemical and genetic-epigenetic heterogeneity of similar looking endometriosis lesions is a challenge for research and for diagnosis and treatment of endometriosis. The conclusions obtained by statistical testing of the entire group are not necessarily valid for subgroups. The importance is illustrated by the fact that a treatment with a beneficial effect in 80% of women but with exactly the same but opposite effect, worsening the disease in 20%, remains statistically highly significant. Since traditional statistics are unable to detect hidden subgroups, new approaches are mandatory. For diagnosis and treatment it is suggested to visualise individual data and to pay specific attention to the extremes of an analysis. For research it is important to integrate clinical, biochemical and histochemical data with molecular biological pathways and genetic-epigenetic analysis of the lesions.
    Language English
    Publishing date 2020-01-24
    Publishing country Belgium
    Document type Editorial ; Corrected and Republished Article
    ZDB-ID 2701574-9
    ISSN 2684-4230 ; 2032-0418 ; 2032-0418
    ISSN (online) 2684-4230 ; 2032-0418
    ISSN 2032-0418
    Database MEDical Literature Analysis and Retrieval System OnLINE

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