The present study examined the immunoexpression of the estrogen receptor (ER), the progesterone receptor (PR), B‑cell lymphoma 2 (Bcl‑2), cyclooxygenase‑2 (Cox‑2) and Ki67 in endometrial polyps and their association with obesity. In total, 515 premenopausal and postmenopausal females undergoing hysteroscopy with histological diagnosis of benign polyps were included. The immunohistochemical expression of the ER, PR, Bcl‑2, Cox‑2 and Ki67 was compared between obese and non‑obese females. The median final score demonstrated a higher PR expression in the stromal and glandular compartments of postmenopausal obese females as compared with no‑obese females. However, in this group, there was no difference in regard to the ER. No difference in hormone receptor expression was identified among premenopausal females. In postmenopausal females, the immunoexpression of Cox‑2 and Bcl‑2 in the glandular epithelium was higher in obese than in non‑obese females. Among premenopausal females, obese females demonstrated a higher Bcl‑2 expression in the glandular epithelium than non‑obese females. There were no differences in Ki67 expression between obese and non‑obese females. Polyps from obese females had a higher PR expression in the glandular and stromal compartments. The expression of Cox‑2 and Bcl‑2 was higher in the glandular compartment. These data suggested that the etiology and pathogenesis of polyps in obese females appear to be associated with the PR, the inhibition of apoptosis and cellular mechanisms linked with inflammation.
The aim of the present study was to evaluate estrogen receptor (ER) and progesterone receptor (PR) expression in the glandular epithelium and stroma of benign and malignant endometrial polyps of postmenopausal patients. A total of 1,050 females underwent surgical hysteroscopy at the Professor Dr José Aristodemo Pinotti Women’s Hospital, Center for Integral Attention to Women’s Health of the State University of Campinas, between January 1998 and December 2008. Of the total number, 390 postmenopausal females with endometrial polyps were included in the study. Polypoid lesions were histologically classified as benign lesions (endometrial polyps and polyps with non-atypical simple hyperplasia or non-atypical complex hyperplasia) and premalignant and malignant lesions (polyps with atypical simple hyperplasia or atypical complex hyperplasia and carcinomatous polyps). ER and PR expression was evaluated by immunohistochemistry according to cell staining, intensity of nuclear staining and final score. The final score for receptor expression was compared between the benign and premalignant/malignant polyps. The prevalence of malignancy in endometrial polyps was 7.1% and was associated with postmenopausal bleeding. Only the final score for ER expression in the stroma of endometrial polyps was higher in the benign group than in the premalignant/malignant group, and this difference was significant. However, no difference was identified in PR expression. In addition, the risk of malignancy in endometrial polyps was significantly higher when the expression of ER and PR was negative in the stromal component of the polyp (P<0.01). The malignancy of endometrial polyps was also associated with a low expression of stromal ER, however, PR expression did not show any association with the risk of malignancy.
A gestação gemelar de uma mola hidatiforme completa coexistindo com um feto vivo é uma entidade rara. Os poucos casos descritos na literatura mostram que, em geral, esse tipo de gestação cursa com risco aumentado de aborto espontâneo, parto prematuro, morte fetal intraútero, sangramento, préeclâmpsia e doença trofoblástica persistente. Neste artigo, descreveremos o caso de uma primigesta de 20 anos de idade que apresentou uma gestação gemelar de feto vivo com mola completa, a qual transcorreu sem intercorrências e complicações e cujo diagnóstico diferencial com degeneração da placenta foi feito com anatomopatológico. resumo unitermos Gestação gemelar Mola hidatiforme completa Feto vivo
A novel, simple, rapid, and cheap method using capillary electrophoresis with capacitively coupled contactless conductivity detection (CE-C4D) for determination of Na+, K+, Ca2+, and Mg2+ in virgin olive oils.
Background: Multiple gestation has a higher incidence of preterm
birth(PTB), especially in the presence of a short cervix. Objectives: To
perform a systematic review and network meta-analysis(NMA) evaluating
the effect of progesterone, cerclage, cervical pessary and their
combination as treatments for preventing PTB<34 weeks. Search
strategy: PubMed, MEDLINE, Cochrane Library, EMBASE, Web of Science,
BVS, Scopus, and grey literature were explored. Selection criteria: We
included randomized controlled trials that compared an intervention with
a control group or another intervention to prevent PTB in women with a
twin pregnancy and a short cervix<40mm. Data collection and
Analysis:Studies were checked for trustworthiness. We presented summary
relative effect sizes(Odds Ratios) for each possible pair of
interventions and we used the surface under the cumulative ranking
curves(SUCRA) to rank all interventions. Main Results: A total of 20
studies participated in NMA. We found no evidence that the combined
treatment of pessary and vaginal progesterone reduced the risk of
spontaneous PTB <34 weeks when compared to no intervention(OR
0.68; 95%CI 0.16 to 2.9). Also, pessary(OR 0.78; 95%CI 0.49 to 1.3),
vaginal progesterone(OR 0.79; CI95% 0.45 to 1.4) and injectable 17-OH
progesterone alone(OR 0.85; CI95% 0.26 to 2.8) did not show a
statistically significant reduction in spontaneous PTB. For overall
PTB<34 weeks, findings were similar. Conclusions: We found no
evidence that progesterone, cervical pessary, cerclage or their
combination reduce PTB<34 weeks. There is an urgent need for
randomized trials assessing these treatments in women with a multiple
pregnancy and a short cervix.
Objective: To identify the association between cervical length (CL) and
gestational age at birth. Design: Prospective cohort study. Setting:
Seventeen Brazilian reference hospitals. Population: A cohort of 3139
asymptomatic singleton pregnant women who participated in the screening
phase of a Brazilian multicenter randomized controlled trial (P5 trial).
Methods: Transvaginal ultrasound (TVU) to measure CL was performed from
18 to 22+6 weeks. Women with CL ≤ 30 mm received vaginal progesterone
(200 mg/day) until 36 weeks’ gestation. Main Outcome Measures: Area
under receive operating characteristic curve (AUC), sensitivity,
specificity, Kaplan-Meier curves for preterm birth (PTB), number needed
to screen (NNS). Results: CL ≤25mm was associated with extremely severe,
severe, moderate and late PTB, whereas a CL 25–30mm was directly
associated with late sPTB. The AUC to predict sPTB<28 weeks
was 0.82 and for sPTB<34 weeks was 0.67. Almost half of the
sPTB occurred in nulliparous women and CL ≤30mm was associated with sPTB
<37 weeks (OR = 7.84; 95%CI = 5.5–11.1). The NNS to detect
one sPTB <34 weeks in women with CL ≤25mm is 121 and 248
screening tests are necessary to prevent one sPTB <34 weeks
using vaginal progesterone prophylaxis. Conclusions: CL measured by TVU
is associated with sPTB <34 weeks. Women with CL ≤30mm are at
increased risk for late sPTB. Funding: Bill & Melinda Gates Foundation
[OPP1107597], the Brazilian Ministry of Health, and the Brazilian
National Council for Scientific and Technological Development (CNPq)
[401615/20138]. Keywords: cervical length; number needed to screen;
preterm birth; short cervix.
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