Objective Notch signaling pathway is a vital parameter of the mammalian vascular system. In this review, the authors summarize the current knowledge about the impact of the Notch signaling pathway in breast cancer progression and the therapeutic role of Notch's inhibition. Methods The available literature in MEDLINE, PubMed, and Scopus, regarding the role of the Notch pathway in breast cancer progression was searched for related articles from about 1973 to 2017 including terms such as “Notch,” “Breast Cancer,” and “Angiogenesis.” Results. Notch signaling controls the differentiation of breast epithelial cells during normal development. Studies confirm that the Notch pathway has a major participation in breast cancer progression through overexpression and/or abnormal genetic type expression of the notch receptors and ligands that determine angiogenesis. The cross-talk of Notch and estrogens, the effect of Notch in breast cancer stem cells formation, and the dependable Notch overexpression during breast tumorigenesis have been studied enough and undoubtedly linked to breast cancer development. The already applied therapeutic inhibition of Notch for breast cancer can drastically change the course of the disease. Conclusion Current data prove that Notch pathway has a major participation and multiple roles during breast tumor progression. Inhibition of Notch receptors and ligands provides innovative therapeutic results and could become the therapy of choice in the next few years, even though further research is needed to reach safe conclusions.

AT-rich interaction domain 1A gene (ARID1A) encodes for a subunit of the switch/sucrose non-fermentable (SWI/SNF) complex, a chromatin remodeling complex, and it has been implicated in the pathogenesis of various cancer types. In this review, we discuss how ARID1A is linked to endometrial cancer and what molecular pathways are affected by mutation or inhibition of ARID1A. We also discuss the potential use of ARID1A not only as a prognostic biomarker, but also as a target for therapeutic interventions. The dynamic modification of chromatin structure in a temporal-and spatial-specific manner determines cell fate by regulating expression levels of specific genes. The complexity of this process is further highlighted when considering all the endogenous and exogenous signals received by each cell during development and throughout its life. Numerous molecules (proteins and RNA) and macromolecular complexes are responsible for the organization of nucleosomes (Figure 1), epigenetic modifications, the dynamic change between the 'relaxed' or 'tight' conformation of chromatin (euchromatin and heterochromatin, respectively) and the accessibility of gene promoters determining cellular activities such as gene transcription, DNA repair and cell differentiation. Thus, disruption of normal chromatin remodeling impairs cellular development and homeostasis, and it has been associated extensively with tumorigenesis [reviewed in (1)]. The switch/sucrose non-fermentable (SWI/SNF) complex is a nucleosome-remodeling factor found in both eukaryotes and prokaryotes. It is involved in gene expression through transcriptional regulation and plays a pivotal role in carcinogenesis (2). This complex changes the DNA conformation in nucleosomes, allowing recruitment of transcription factors or other complexes responsible for DNA repair, replication and proliferation. Thus, when the SWI/SNF complex is disrupted, aberrant cell cycling is observed, as well as a loss of control of proliferation (3). SWI/SNF is a multi-subunit complex and many of its subunits, such AT-rich interaction domain 1A (ARID1A), ARID1B, SWI/SNF related, matrix associated, actin dependent regulator of chromatin, subfamily A, member 2 (SMARCA2) and SMARCA4 (Figure 2), have been incriminated as driving mutations in various cancer types due to the high mutation frequencies observed (4). In particular, when considering human primary cancer cases with mutations in the SWI/SNF complex, most of the mutations seen are encountered in the gene encoding ARID1A (5-7). ARID1A and ARID1B genes encode DNA-targeting subunits, while SMARCA2 and SMARCA4 encode ATPase enzymes. The mutation frequency of these subunits in different cancer types seems to be tumor type-specific indicating that there is probably differential participation of the complex in gene regulation in different tissues (4). Loss of ARID1A has been shown in numerous human malignancies, such as uterine endometrioid carcinoma (8-10), ovarian endometrioid carcinoma (11), gastric cancer (12, 13), esophageal adenocarcinoma (14), pan...

Thromboembolic disease during pregnancy is a significant cause of maternal morbidity and mortality involving venous or arterial thrombosis and possible clinical manifestations like clinical symptoms of antiphospholipid antibody syndrome and hyperhomocysteinemia. For diminishing the prevalence of thromboembolic disease, the early identification of pregnant women with various risk factors for thrombosis without clinical symptoms is of great importance. However, the optimal management for asymptomatic pregnant women who have inherited thrombophilia is uncertain and recognized only due to pregnancy complications such as recurrent pregnancy loss and preeclampsia. The clinical approach to thromboembolism is the same in pregnant women with or without thrombophilia. Based on family history, clinical symptoms should begin with simple reliable inexpensive laboratory tests like prothrombin time and activated thromboplastin time to test the status. Early diagnosis and appropriate use of thromboprophylaxis lead to increasing better maternal and perinatal outcomes. Conclusively, it is important to recognize these patients in order to prevent all pregnancy complications.

Objective: Preterm labor is one of the most significant obstetric problems associated with high rate of actual and long-term perinatal complications. Despite the creation of scoring systems, uterine activity monitoring, cervical ultrasound and several biochemical markers, the prediction and prevention of preterm labor is still a matter of concern. The aim of this study was to examine cervical findings for the prediction and the comparative use of Arabin pessary or cerclage for the prevention of preterm birth in asymptomatic women with high risk factors for preterm labor. Material and methods: The study group was composed of singleton pregnancies (spontaneously conceived) with high risk factors for preterm labor. Cervical length, dilatation of the internal cervical os and funneling, were estimated with transvaginal ultrasound during the first and the second trimesters of pregnancy. Results: Cervical funneling, during the second trimester of pregnancy, was the most significant factor for the prediction of preterm labor. The use of Arabin cervical pessary was found to be more effective than cerclage in the prolongation of pregnancy. Conclusion: In women at risk for preterm labor, the detection of cervical funneling in the second trimester of pregnancy may help to predict preterm labor and to apply the appropriate treatment for its prevention. Although the use of cervical pessary was found to be more effective than cerclage, more studies are needed to classify the effectiveness of different methods for such prevention.

Adolescence is the transitional period between childhood and adulthood. Depending on female gonads' function and on hypothalamic-pituitary-ovarian axis activation, results in teenager's body growth, in secondary sex characteristics' development and finally in their reproductive potential. In adolescence, the negative feedback of gonadal steroids on gonadotropins is disturbed. Teenagers presenting with dysfunctional bleedings are usually suspected of hemorrhagic ovarian cysts or endometriosis and require gynecologic examination, evaluation, and hormone therapy. It is of great importance both for teenagers and their parents to understand that hormone therapy is the first line treatment for bleeding disorders in these ages. A detailed medical history is necessary to determine the appropriate treatment plan. Primary care includes the detection of adolescents with acute or chronic pelvic pain that may be associated with endometriosis or other pathologies like mullerian duct abnormalities, imperforate hymen, ovarian teratomas, ovarian torsion, and vaginal absence or atresia. Mullerian duct abnormalities are associated with increased rates of unexplained infertility, spontaneous abortions, and pathological conditions of pregnancy. Specialists, should help teenagers in getting familiar to their bodies, to their sexuality, inform them about the sexually transmitted diseases, and safety options including vaccination and guide them in contraception issues.

The cancer of the vulva is a rare disease with a positive association to poor developing countries. However, the incidence of vulvar cancer in situ nearly doubled in the last two decades and remained relatively stable. The main reason for this increased incidence of vulvar intraepithelial neoplasia (VIN) in women younger than 45 years is due to changes in sexual behavior, first intercourse at early age, multiple sexual partners, and sexually transmitted diseases that were increasing progressively. Furthermore, it is strongly associated with smoking and the increased incidence of HPV infection. The occurrence of early symptoms of VINlike pruritus vulvae, pain, and lichen sclerosus led to early diagnosis to perform the adequate treatment. VIN tends to appear multifocal, while most invasive cancers are unilateral located and appeared with well-circumscribed lesions.

The purpose of the present study was to describe the course of changes in laboratory inflammatory markers following bilateral uterine artery embolization (UAE) as a treatment for leiomyomas and adenomyosis. The body temperature was measured and blood samples were collected to determine white blood cell (WBC) count and C-reactive protein (CRP) levels in 270 patients on the day prior to UAE and for up to 4 days post-embolization. Aside from a single case with a non-inflammatory complication, none of the other cases had any complications. Post-UAE leukocytosis with a mean maximum value of 10.8±3.5x10 9 /l (range, 5.9-18.6x10 9 /l) was observed one-year post-intervention. The mean leukocyte numbers were indicated to be higher on day 3 post-UAE. The CRP level was also increased post-UAE, with a mean maximum value of 7.75±3.5 mg/dl. Maximum levels were reached in 8 patients on the 2nd and in 11 patients on the 3rd post-operative day. The maximum pain score was ~5.5 and reached its lowest level at the end of the 12th week post-intervention. The present study did not consider an association between the embolic material used or uterus size with the level of treatment success. No complications were observed post-UAE; however, a significant increase in the WBC count was observed within the first 3 days, indicating mild leukocytosis.

Background: According to data from World Health Organization, breast cancer constitutes the second most common diagnosed malignancy after lung cancer and the second leading cause of death among women in 2020, worldwide. The protective role of breastfeeding in the emergence of breast malignancy has been mentioned in several studies, indicating the important part it can have in the effort of reducing breast cancer’s incidence. Objective: To investigate a possible association between breastfeeding and breast cancer risk in Greek women. Methods: Totally, 391 women participated in our case-control retrospective study. In the case group included 238 women with breast cancer, while in control group 153 women without breast cancer who were enrolled in two breast clinics in Greece. All women were examined clinically and with breast ultrasound, while those older than 40 years old also with bilateral digital mammography. Results: The x 2 (chi-square) test found a statistically significant reverse correlation between breast cancer and breastfeeding ⩾12 months (cumulative) (p = 0.001). It was observed that the percentages of patients who breastfed ⩾12 months were lower than those of healthy women. Conclusion: Breastfeeding and particularly the cumulative period of ⩾12 months is related to the maximum of the protection from breast cancer.