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Sample records for incident primary endometrial

  1. Endometrial and cervical cancer: incidence and mortality among women in the Lodz region

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    Beata Leśniczak

    2015-09-01

    Full Text Available Introduction: By the early 21st century the most common cancer of female genitals in Poland was cervical cancer. Now endometrial cancer ranks first. The aim of this study was to analyse the incidence and mortality of endometrial and cervical cancer among women in the Lodz region. Material and methods: Data on the incidence and mortality of endometrial and cervical cancer among inhabitants of the Lodz region were obtained from the National Cancer Registry and Bulletin of Cancer Cases in the Lodz region. The analysis covered ten consecutive years beginning in 2001. Results : The number of new cases reported in 2010 exceeded that observed in 2001 by 181. The standardized incidence rate of endometrial cancer increased by 6.3, while the standardized incidence rate of cervical cancer decreased by 1.4. Conclusions : In the years 2001-2010, the incidence of endometrial cancer increased by 88.3% and that of cervical cancer decreased by 6.5% among inhabitants of the Lodz region. In the years 2001-2010, mortality of endometrial cancer increased by 24.5% and that of cervical cancer decreased by 12.6%. In 2010, the highest crude incidence rates in the Lodz region of both endometrial and cervical cancer at 39.1 were recorded in the district town of Piotrków.

  2. Whole grain, dietary fiber, and incidence of endometrial cancer in a Danish cohort study

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    Aarestrup, Julie; Kyrø, Cecilie; Christensen, Jane

    2012-01-01

    Whole grains and dietary fiber might be inversely associated with endometrial cancer risk through their effects on sex hormone metabolism and body fat. We investigated whether a higher intake of whole grains and dietary fiber was associated with a lower incidence of endometrial cancer in the Diet...... included as cohort members, 217 had a diagnosis of endometrial cancer. No clear associations were found between intake of whole grains or dietary fiber and the incidence of endometrial cancer......., Cancer and Health cohort of 29,875 women aged 50-64 years at enrollment in 1993-1997. Information on diet and lifestyle was derived from self-administered questionnaires. The incidence rate ratios and 95% confidence intervals were estimated based on a Cox proportional hazards model. Of the 24,418 women...

  3. A new afterloading applicator for primary brachytherapy of endometrial cancer

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    Bauer, M.; Schulz-Wendtland, R.

    1993-01-01

    The authors describe and have used a new afterloading applicator in six patients for primary radiation therapy of endometrial cancer. The first introduction of the applicator was done under general anaesthesia. Dilating the cervical canal to Heger 9 made insertion easier. Prior to application it is advisable to probe the lumen of the uterine cavity with a tube or curette to estimate how far the applicator must be spread open. For brachytherapy it is advantageous to remove necrotic tumour portions. This requires experienced hands to avoid perforation of the uterus. The new afterloading applicator is easy to use, and permits direct contact between the six tubes and the tumour. In conjunction with careful planning with the help of MRI, it provides an optimal system for the treatment of endometrial cancer. (Author)

  4. Reproductive factors and incidence of endometrial cancer in U.S. black women.

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    Sponholtz, Todd R; Palmer, Julie R; Rosenberg, Lynn; Hatch, Elizabeth E; Adams-Campbell, Lucile L; Wise, Lauren A

    2017-06-01

    Previous studies have shown that reproductive history is a strong determinant of endometrial cancer risk among white women. Less is known about how reproductive history affects endometrial cancer risk among black women, whose incidence and mortality differ from white women. We investigated the associations of age at menarche, parity, timing of births, and menopausal age with endometrial cancer in the Black Women's Health Study, a prospective cohort study. Every 2 years from 1995 to 2013, 47,555 participants with intact uteri at baseline in 1995 completed questionnaires on reproductive and medical history, and lifestyle factors. Self-reported cases of endometrial cancer were confirmed by medical record, cancer registry, or death certificate when available. Cox proportional hazards regression was used to estimate multivariable incidence rate ratios (IRR) and 95% confidence intervals (CI). During 689,501 person-years of follow-up, we identified 300 incident cases of endometrial cancer. The strongest associations with endometrial cancer were found for early age at menarche (black women were generally consistent with those in studies of white women.

  5. Computed tomography of primary, persistent, and recurrent endometrial malignancy

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    Walsh, J.W.; Goplerad, D.R.

    1982-01-01

    For 45 months, 24 patients with primary endometrial malignancy, 12 patients with suspected persistent tumor, and 29 patients with suspected recurrent tumor were evaluated with computed tomography (CT). In staging primary tumors, CT could not differentiate stage IA, IB, and II lesions and showed extrauterine tumor in only one (7%) of 15 clinical stage I-II tumors. CT was valuable in clinical state III tumors by showing both parametrial extension and extrapelvic metastases. CT-surgical stage comparison showed an 83% accuracy in showing tumor confined to the uterus and an 86% accuracy in showing extrauterine tumor spread. CT did not detect microscopic pelvic node metastases or microscopic bladder involvement. In persistent and recurrent tumors, CT was sensitive in detecting both pelvic tumor and lymphatic, peritoneal, and mesenteric metastases. These data were supplemental to clinical assessment in choosing among surgical, radiation, or chemotherapy treatment. Vaginal recurrences were best evaluated by clinical examination and cytology

  6. Incidence of nodal metastasis and isolated aortic metastases in patients with surgically staged endometrioid endometrial cancer.

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    Sautua, Rubén Ruiz; Goiri, Kostantze; Calle, Marisa Avila; Marin, Ibon Jaunarena; Artola, Arantza Lekuona

    2015-06-01

    To describe the incidence of lymph node metastasis in patients with surgically staged endometrioid-type endometrial cancer in Donostia University Hospital and evaluate the presence of isolated aortic metastasis. Using a prospectively maintained database, we recorded all cases of endometrioid endometrial cancer that underwent lymph node dissection and determined the rate and location (pelvic or para-aortic) of lymph node metastasis. A total of 212 patients with endometrioid type endometrial cancer were surgically treated at our institution from May 2008 to June 2013. Ninety underwent pelvic and para-aortic lymphadenectomy. Thirteen had positive nodes upon pathological examination. Six (6.6%) of 90 patients had positive para-aortic nodes with negative pelvic nodes. In our series, the incidence of isolated aortic nodal metastasis is high compared with other published reports. Performing aortic lymphadenectomy only in case of positive pelvic nodes would have underdiagnosed 6 (46%) of 13 stage IIIC cancers.

  7. Plasma enterolactone and incidence of endometrial cancer in a case-cohort study of Danish women

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    Aarestrup, Julie; Kyrø, Cecilie; Knudsen, Knud Erik Bach

    2013-01-01

    The phyto-oestrogen enterolactone has been hypothesised to protect against hormone-dependent cancers, probably through its anti-oestrogenic potential. We investigated whether a higher level of plasma enterolactone was associated with a lower incidence of endometrial cancer in a case-cohort study ...

  8. The impact of histological subtype in developing both ovarian and endometrial cancer: A longstanding nationwide incidence study.

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    van Niekerk, Catharina C; van Dijck, Jos A A M; Verbeek, André L M

    2018-02-01

    To estimate the incidence of ovarian cancer (OC) and endometrial cancer (EC) separately, as well as double cancers diagnosed in the same calendar year, and to relate the occurrences to histological subtype. All cases of epithelial OC and EC diagnosed in the Netherlands in 1989-2009 were related to population data. Histologically specific associations were made using the ratio of observed and expected incidence numbers, calculated with age-specific incidence rates. 25,489 OC and 32,729 EC were analyzed, and 649 OC/EC. Life-time risks for OC and EC were 1.8% and 2.4%. Among OC, adenocarcinoma (18%) and serous cancers (33%) were the most prevalent subtypes. In EC, adenocarcinoma (39%) and endometrioid cancer (37%) were highest, with hardly any serous cancers. The observed incidence of OC/EC was 50-fold higher than expected (95% CI, 46-54). For patients aged <55years, the O/E ratio was 274, for the elderly 32, both findings are significant. Of the 2345 OC endometrioid subtype, 294 had EC (12.5%), whereas 1.1 was expected. In EC patients, no particular histological subtype was distinguished with a highly elevated occurrence of OC. The 680 serous EC patients had 11 double cancers (1.6%), of which 8 with the ovarian serous subtype. Strong relationships exist between malignancies in the ovary and a second primary malignancy in the endometrium, especially for the endometrioid subtype of ovarian cancer. Viewed from the endometrial site, no special subtype was noted, and the influence of endometrial serous adenocarcinoma in developing serous OC is not plausible. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Sensitivity of endometrial cancer cells from primary human tumor samples to new potential anticancer peptide lactaptin

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    Olga A Koval

    2015-01-01

    Conclusions: Our results indicate that the recombinant analog of lactaptin, RL2, exerts cytotoxic effects against primary hormone-dependent endometrial tumor cells in vitro with features of apoptosis.

  10. Can routine gynecologic examination contribute to the diagnosis of cervical involvement by primary endometrial cancer?

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    Pristauz, G; Winter, R; Fischerauer, E; Haas, J; Bjelic-Radisic, V; Bader, A A; Petru, E

    2009-01-01

    There are few data in the literature as to whether findings at routine preoperative gynecologic examination of patients with primary endometrial cancer including cervical cytology, colposcopy and rectovaginal bimanual pelvic exam could predict cervical extension of the disease. The present retrospective study was undertaken to preoperatively identify potential clinical parameters associated with the histological diagnosis of cervical involvement by primary endometrial cancer in the hysterectomy specimen. We reviewed the records of 104 patients with Stage II endometrial cancer treated at our institution between 1985 and 2005 by simple or radical abdominal hysterectomy with special emphasis on cervical Pap smear, colposcopy, cervical palpation as well as rectal parametrial assessment. Patients with Stage I disease operated on before and after each study patient were selected as controls (n = 208). Patients with more advanced disease were excluded. Overall, 312 records of patients with primary endometrial cancer were reviewed. Patients with Stage II disease had a significantly lower prevalence (p examination are significantly more often pathologic in patients with Stage II than in Stage I disease. The majority of patients with Stage II disease had at least one of these tests positive. Thus they may be useful to preoperatively detect cervical involvement by primary endometrial cancer.

  11. International Patterns and Trends in Endometrial Cancer Incidence, 1978-2013.

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    Lortet-Tieulent, Joannie; Ferlay, Jacques; Bray, Freddie; Jemal, Ahmedin

    2017-10-16

    Cancers of the corpus uteri-primarily of the endometrium-rank as the sixth most common neoplasm in women worldwide. Analyses of the global patterns and trends of uterine cancer rates are needed in view of the ongoing obesity epidemic, a major risk factor for the disease. Data on endometrial cancer (ICD-10 C54) incidence from population-based cancer registries in 43 populations, published in CI5plus or by registries, were extracted for 1978 to 2013. Age-standardized incidence rates were computed for all ages and for pre- (25-49 years) and postmenopausal ages (50 years and older). Temporal trends were assessed with Joinpoint analysis, and the effects of birth cohort and year of diagnosis on the overall trends were examined using age-period-cohort modeling. In 2006 to 2007, rates varied 10-fold across countries. The highest rates were in North America, Eastern and Northern Europe (19 cases per 100 000 among whites in the United States, 95% confidence interval [CI] = 18 to 20, and in Slovakia, 95% CI = 18 to 21), and the lowest rates were in middle-income countries (South Africa 1, 95% CI = 0 to 3, and India 3, 95% CI = 3 to 4). Rates during the most recent 10 data years increased in 26 of the 43 populations considered in this study, with South Africa and several countries in Asia showing the largest increase. The risk of endometrial cancer increased both in consecutive generations and over time in 11 of 23 populations, with the increases more pronounced in Japan, the Philippines, Belarus, Singapore, Costa Rica, and New Zealand. Endometrial cancer incidence rates increased over time and in successive generations in several countries, especially in those countries with rapid socioeconomic transitions. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  12. Time trends in the incidence of hysterectomy-corrected overall, type 1 and type 2 endometrial cancer in Denmark 1978-2014

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    Faber, Mette Tuxen; Frederiksen, Kirsten; Jensen, Allan

    2017-01-01

    OBJECTIVE: To investigate time trends in the incidence of overall, type 1 and type 2 endometrial cancer in Denmark 1978-2014, correcting for hysterectomy. METHODS: Based on the Danish Cancer Registry and the Danish National Patient Registry we calculated hysterectomy-corrected incidence rates...... of overall, type 1 and type 2 endometrial cancer. Separate analyses for women ...-linear Poisson models were used to estimate annual percentage change (APC) in incidence with 95% confidence intervals (CI). RESULTS: The overall incidence of endometrial cancer decreased slightly from 1978 to 1995, but in the last two decades of the study period the incidence has been stable (APC=0.16; 95% CI...

  13. Incidence of and risk factors for surgical site infections in women undergoing hysterectomy for endometrial carcinoma.

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    Tuomi, Taru; Pasanen, Annukka; Leminen, Arto; Bützow, Ralf; Loukovaara, Mikko

    2016-04-01

    The purpose of this study was to determine the incidence of, and risk factors for, surgical site infections in a contemporary cohort of women with endometrial carcinoma. We retrospectively studied 1164 women treated for endometrial carcinoma by hysterectomy at a single institution in 2007-2013. In all, 912 women (78.4%) had minimally invasive hysterectomy. Data on surgical site infections were collected from medical records. Univariate and multivariate analyses were used to identify risk factors for incisional and organ/space infections. Ninety-four women (8.1%) were diagnosed with a surgical site infection. Twenty women (1.7%) had an incisional infection and 74 (6.4%) had an organ/space infection. The associations of 17 clinico-pathologic and surgical variables were tested by univariate analyses. Those variables that were identified as potential risk factors in univariate analyses (p infections as dependent variables. Obesity (body mass index ≥ 30 kg/m(2)), diabetes, and long operative time (>80th centile) were independently associated with a higher risk of incisional infection, whereas minimally invasive surgery was associated with a smaller risk. Smoking, conversion to laparotomy, and lymphadenectomy were associated with a higher risk of organ/space infection. Organ/space infections comprised the majority of surgical site infections. Risk factors for incisional and organ/space infections differed. Minimally invasive hysterectomy was associated with a smaller risk of incisional infections but not of organ/space infections. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  14. The End of the Hysterectomy Epidemic and Endometrial Cancer Incidence: What Are the Unintended Consequences of Declining Hysterectomy Rates?

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    Temkin, Sarah M; Minasian, Lori; Noone, Anne-Michelle

    2016-01-01

    Population-level cancer incidence rates are one measure to estimate the cancer burden. The goal is to provide information on trends to measure progress against cancer at the population level and identify emerging patterns signifying increased risk for additional research and intervention. Endometrial cancer is the most common of the gynecologic malignancies but capturing the incidence of disease among women at risk (i.e., women with a uterus) is challenging and not routinely published. Decreasing rates of hysterectomy increase the number of women at risk for disease, which should be reflected in the denominator of the incidence rate calculation. Furthermore, hysterectomy rates vary within the United States by multiple factors including geographic location, race, and ethnicity. Changing rates of hysterectomy are important to consider when looking at endometrial cancer trends. By correcting for hysterectomy when calculating incidence rates of cancers of the uterine corpus, many of the disparities that have been assumed for this disease are diminished.

  15. Endometrial Hyperplasia

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    ... Patients Search FAQs Endometrial Hyperplasia Page Navigation ▼ ACOG Pregnancy Book Endometrial Hyperplasia Patient Education FAQs Endometrial Hyperplasia Patient Education Pamphlets - Spanish Endometrial ...

  16. Lumbee Native American ancestry and the incidence of aggressive histologic subtypes of endometrial cancer

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    Chelsea Zhang

    2015-08-01

    Conclusion: In this retrospective cohort analysis, Lumbee Native American ancestry was not a significant independent predictor of rates of high-risk histological subtypes of endometrial cancer or poor survival outcomes.

  17. A systematic review of tests for lymph node status in primary endometrial cancer

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    Zamora Javier

    2008-05-01

    Full Text Available Abstract Background The lymph node status of a patient is a key determinate in staging, prognosis and adjuvant treatment of endometrial cancer. Despite this, the potential additional morbidity associated with lymphadenectomy makes its role controversial. This study systematically reviews the accuracy literature on sentinel node biopsy; ultra sound scanning, magnetic resonance imaging (MRI and computer tomography (CT for determining lymph node status in endometrial cancer. Methods Relevant articles were identified form MEDLINE (1966–2006, EMBASE (1980–2006, MEDION, the Cochrane library, hand searching of reference lists from primary articles and reviews, conference abstracts and contact with experts in the field. The review included 18 relevant primary studies (693 women. Data was extracted for study characteristics and quality. Bivariate random-effect model meta-analysis was used to estimate diagnostic accuracy of the various index tests. Results MRI (pooled positive LR 26.7, 95% CI 10.6 – 67.6 and negative LR 0.29 95% CI 0.17 – 0.49 and successful sentinel node biopsy (pooled positive LR 18.9 95% CI 6.7 – 53.2 and negative LR 0.22, 95% CI 0.1 – 0.48 were the most accurate tests. CT was not as accurate a test (pooled positive LR 3.8, 95% CI 2.0 – 7.3 and negative LR of 0.62, 95% CI 0.45 – 0.86. There was only one study that reported the use of ultrasound scanning. Conclusion MRI and sentinel node biopsy have shown similar diagnostic accuracy in confirming lymph node status among women with primary endometrial cancer than CT scanning, although the comparisons made are indirect and hence subject to bias. MRI should be used in preference, in light of the ASTEC trial, because of its non invasive nature.

  18. Endometrial and cervical metastases leading to the diagnosis of a primary breast cancer: A case report

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    E Chupryna

    2017-10-01

    Full Text Available Breast cancer can metastasize to a vast array of organs, but in rare cases cancer can form secondary lesions in the uterus and cervix. In our case report we have a 56 years old female with gynaecologic bleeding, bloating, and difficulty in breathing, fatigue, weakness and polyuria. After performing of dilatation and curettage the result was endometrial and cervical metastases which show histopathological and immunohistochemical results suggesting invasive lobular carcinoma of the breast that leads to primary breast cancer. The treatment was estimated on the basis of her status.

  19. Primary Endometrial Squamous Cell Carcinoma In Situ; Report of a rare disease

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    Sujata Jetley

    2015-11-01

    Full Text Available Squamous cell carcinoma (SCC of the endometrium, whether primary or secondary to cervical cancer, is a rare entity. Primary endometrial squamous cell carcinoma in situ is even more uncommon; it usually occurs in postmenopausal women and has a strong association with pyometra. We report a 60-year-old multiparous postmenopausal woman who presented to the Hakeem Abdul Hameed Centenary Hospital, New Delhi, India, in May 2014 with a lower abdominal swelling corresponding in size to a pregnancy of 26 gestational weeks and vaginal discharge of one year’s duration. A total abdominal hysterectomy with a bilateral salpingooophorectomy was performed, which revealed an enlarged uterus with pyometra. Histopathology showed that the entire endometrial lining had been replaced with malignant squamous cells without invasion of the myometrium. Immunohistochemistry revealed that the tumour cells were positive for p63 with a high Ki-67 labelling index. No adjuvant therapy was required and the patient was disease-free at a seven-month follow-up.

  20. Antioxidant ameliorating effects against H2O2-induced cytotoxicity in primary endometrial cells.

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    Zal, F; Khademi, F; Taheri, R; Mostafavi-Pour, Z

    2018-02-01

    Oxidative stress and a disrupted antioxidant system are involved in a variety of pregnancy complications. In the present study, the role of vitamin E (Vit E) and folate as radical scavengers on the GSH homeostasis in stress oxidative induced in rat endometrial cells was investigated. Primary endometrial stromal cell cultures treated with 50 and 200 µM of H 2 O 2 and evaluated the cytoprotective effects of Vit E (5 µM) and folate (0.01 µM) in H 2 O 2 -treated cells for 24 h. Following the exposure of endometrial cells to H 2 O 2 alone and in the presence of Vit E and/or folate, cell survival, glutathione peroxidase (GPx) and glutathione reductase activities and the level of reduced glutathione (GSH) were measured. Cell adhesions comprise of cell attachment and spreading on collagen were determined. Flow cytometric analysis using annexin V was used to measure apoptosis. H 2 O 2 treatment showed a marked decrease in cell viability, GPx and GR activities and the level of GSH. Although Vit E or folate had some protective effect, combination therapy with Vit E and folate attenuated all the changes due to H 2 O 2 toxicity. An increasing number of alive cells was showed in the cells exposed to H 2 O 2 (50 µM) accompanied by co-treatment with Vit E and folic acid. The present findings indicate that co-administration of Vit E and folate before and during pregnancy may maintain a viable pregnancy and contribute to its clinical efficacy for the treatment of some idiopathic infertility.

  1. Incidence of childhood primary immune thrombocytopenic purpura.

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    Higashigawa, Masamune; Maeyama, Takatoshi; Yoshino, Ayako; Matsuda, Kazuyuki; Ito, Mitsue; Maji, Tomoaki; Ichimi, Ryouji

    2015-10-01

    There is a discrepancy in the reported incidence of childhood immune thrombocytopenic purpura (ITP) between Europe (2.9-5.3 per 100 000 persons) and Japan (1.91). Ise district is a suitable area in which to conduct epidemiological study because there is little fluctuation in the sociodemographic factors. We performed a retrospective population-based study to clarify the incidence of primary childhood ITP. We calculated person-years for children aged <15 years based on the Ise district demographics between 2002 and 2012. The calculated person-years were 298 533. The number of hospitalized patients in Ise district was 25 (M/F, 14/11) during the study period. The calculated incidence was therefore 8.4 per 100 000 person-years. It is possible that the difference in incidence between the present calculation and that of the European studies is due to variation in accuracy and/or registration criteria between the studies. © 2015 Japan Pediatric Society.

  2. Prognostic value of lymph node-to-primary tumor standardized uptake value ratio in endometrioid endometrial carcinoma

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    Chung, Hyun Hoon; Kim, Jae-Weon; Park, Noh-Hyun; Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Cheon, Gi Jeong [Seoul National University College of Medicine, Department of Nuclear Medicine, Cancer Research Institute, Seoul (Korea, Republic of)

    2018-01-15

    To determine whether the relative metabolic activity of pelvic or para-aortic LN compared with that of primary tumor measured by preoperative [{sup 18}F]FDG PET/CT scan has prognostic value in patients with endometrioid endometrial carcinoma. We retrospectively reviewed patients with endometrioid endometrial carcinoma who underwent preoperative [{sup 18}F]FDG PET/CT scans. Prognostic values of PET/CT-derived metabolic variables such as maximum standardized uptake value (SUV) of the primary endometrial carcinoma (SUV{sub Tumor}) and LN (SUV{sub LN}), and the LN-to-endometrial carcinoma SUV ratio (SUV{sub LN} / SUV{sub Tumor}) were assessed. Clinico-pathological data, imaging data, and treatment results were reviewed for 107 eligible patients. Median post-surgical follow-up was 23 months (range, 6-60), and 7 (6.5%) patients experienced recurrence. Regression analysis showed that SUV{sub LN} / SUV{sub Tumor} (P < 0.001), SUV{sub LN} (P = 0.003), International Federation of Gynecology and Obstetrics (FIGO) stage (P = 0.006), and tumor grade (P = 0.011) were risk factors of recurrence. Multivariate regression analysis revealed that FIGO stage (P = 0.034) was the independent risk factor of recurrence. SUV{sub LN} / SUV{sub Tumor} showed significant correlation with FIGO stage (P < 0.001), LN metastasis (P < 0.001), lymphovascular space invasion (P < 0.001), recurrence (P = 0.001), tumor grade (P < 0.001), and deep myometrial invasion of tumor (P = 0.022). Patient groups categorized by SUV{sub LN} / SUV{sub Tumor} showed significant difference in progression-free survival (Log-rank test, P = 0.001). Preoperative SUV{sub LN} / SUV{sub Tumor} measured by [{sup 18}F]FDG PET/CT was significantly associated with recurrence, and may become a novel prognostic factor in patients with endometrioid endometrial carcinoma. (orig.)

  3. High-throughput interrogation of PIK3CA, PTEN, KRAS, FBXW7 and TP53 mutations in primary endometrial carcinoma.

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    Garcia-Dios, Diego A; Lambrechts, Diether; Coenegrachts, Lieve; Vandenput, Ingrid; Capoen, An; Webb, Penelope M; Ferguson, Kaltin; Akslen, Lars A; Claes, Bart; Vergote, Ignace; Moerman, Philippe; Van Robays, Johan; Marcickiewicz, Janusz; Salvesen, Helga B; Spurdle, Amanda B; Amant, Frédéric

    2013-02-01

    Endometrial cancer patients may benefit from systemic adjuvant chemotherapy, alone or in combination with targeted therapies. Prognostic and predictive markers are needed, however, to identify patients amenable for these therapies. Primary endometrial tumors were genotyped for >100 hot spot mutations in genes potentially acting as prognostic or predictive markers. Mutations were correlated with tumor characteristics in a discovery cohort, replicated in independent cohorts and finally, confirmed in the overall population (n=1063). PIK3CA, PTEN and KRAS mutations were most frequently detected, respectively in 172 (16.2%), 164 (15.4%) and 161 (15.1%) tumors. Binary logistic regression revealed that PIK3CA mutations were more common in high-grade tumors (OR=2.03; P=0.001 for grade 2 and OR=1.89; P=0.012 for grade 3 compared to grade 1), whereas a positive TP53 status correlated with type II tumors (OR=11.92; P<0.001) and PTEN mutations with type I tumors (OR=19.58; P=0.003). Conversely, FBXW7 mutations correlated with positive lymph nodes (OR=3.38; P=0.045). When assessing the effects of individual hot spot mutations, the H1047R mutation in PIK3CA correlated with high tumor grade and reduced relapse-free survival (HR=2.18; P=0.028). Mutations in PIK3CA, TP53, PTEN and FBXW7 correlate with high tumor grade, endometrial cancer type and lymph node status, whereas PIK3CA H1047R mutations serve as prognostic markers for relapse-free survival in endometrial cancer patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Outcomes in patients with primary breast cancer and a subsequent diagnosis of endometrial cancer : comparison of cohorts treated with and without tamoxifen.

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    Saadat, Mandana; Truong, Pauline T; Kader, Hosam A; Speers, Caroline H; Berthelet, Eric; McMurtrie, Elissa; Olivotto, Ivo A

    2007-07-01

    The study compared tumor characteristics and survival in women with breast cancer who subsequently developed endometrial cancer with or without a history of tamoxifen use. The British Columbia Cancer Agency registry identified 163 women diagnosed with breast cancer between 1989-1999 who received a subsequent diagnosis of endometrial cancer. Of these, 55% (n = 90) had a history of tamoxifen use. Outcomes analyzed were breast cancer-specific survival (BCSS), endometrial cancer-specific survival (ECSS), and overall survival (OS). Median follow-up was 9.4 years. Distributions of age, menopausal status, body mass index, and comorbidities were similar in the tamoxifen-treated and nontamoxifen cohorts. Proportions of aggressive endometrial cancer subtypes including papillary serous, clear cell, and mixed mullerian tumors were higher in the tamoxifen cohort (28% vs14%, P = .03). Distributions of endometrial cancer grade and stage were similar in the 2 groups (P > .05). Hysterectomy and/or oophorectomy were the primary treatments for endometrial cancer in 99% of patients, with comparable pelvic control rates in the tamoxifen and nontamoxifen groups. At 10 years, patients in the tamoxifen group experienced lower BCSS compared with the nontamoxifen group (89% vs 97%, P = .02). No significant differences in ECSS and OS were observed between the 2 groups (ECSS 82% and 82%, P = .85; and OS 69% v. 66%, P = .85). In patients with breast cancer who developed a subsequent endometrial cancer, tamoxifen-treated patients had higher proportions of aggressive endometrial cancer subtypes, but almost all cases were amenable to surgery, thus resulting in similar endometrial cancer control and survival when compared with nontamoxifen treated patients. Copyright (c) 2007 American Cancer Society.

  5. Incidence of new primary cancers after adjuvant tamoxifen therapy and radiotherapy for early breast cancer

    International Nuclear Information System (INIS)

    Andersson, M.; Storm, H.H.; Mouridsen, H.T.

    1991-01-01

    The incidence of new primary cancers was evaluated in 3538 postmenopausal patients who had received surgical treatment for primary breast cancer. Of these patients, 1828 with a low risk of recurrence received no further treatment. High-risk patients were randomly assigned to one of two groups. The first group (n = 846) received postoperative radiotherapy, while the second group (n = 864) received radiotherapy plus tamoxifen at a dose of 30 mg given daily for 48 weeks. The median observation time was 7.9 years. In comparison with the number of new cancers in the general population, the number of new cancers in the three groups was elevated mostly due to a high number of cancers of the contralateral breast and of colorectal cancers in the high-risk groups. The cumulative risk of nonlymphatic leukemia was increased among patients who received postoperative radiotherapy (P = .04). Cancer incidence in the high-risk tamoxifen-treated group relative to that in the high-risk group not treated with tamoxifen was not significant (1.3). No protective effect of tamoxifen on the opposite breast was seen (rate ratio for breast cancer = 1.1), but a tendency to an elevated risk of endometrial cancer was observed (rate ratio = 3.3; 95% confidence interval = 0.6-32.4). Continued and careful follow-up of women treated with tamoxifen is necessary to clarify the potential cancer-suppressive or cancer-promoting effects of this drug

  6. Incidence of Early Post Operative Infection after Primary Total Knee ...

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    Operation theatres in Africa are not as sophisticated as those in the west and one may expect higher rates of infection after primary Total Knee Replacement Arthroplasties (TKRA). We conducted a study to determine the incidence and risk factors for the development of post operative SSI after primary TKRA at a hospital in ...

  7. Patient safety incidents are common in primary care: A national prospective active incident reporting survey.

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    Philippe Michel

    Full Text Available The study objectives were to describe the incidence and the nature of patient safety incidents (PSIs in primary care general practice settings, and to explore the association between these incidents and practice or organizational characteristics.GPs, randomly selected from a national influenza surveillance network (n = 800 across France, prospectively reported any incidents observed each day over a one-week period between May and July 2013. An incident was an event or circumstance that could have resulted, or did result, in harm to a patient, which the GP would not wish to recur. Primary outcome was the incidence of PSIs which was determined by counting reports per total number of patient encounters. Reports were categorized using existing taxonomies. The association with practice and organizational characteristics was calculated using a negative binomial regression model.127 GPs (participation rate 79% reported 317 incidents of which 270 were deemed to be a posteriori judged preventable, among 12,348 encounters. 77% had no consequences for the patient. The incidence of reported PSIs was 26 per 1000 patient encounters per week (95% CI [23‰ -28‰]. Incidents were three times more frequently related to the organization of healthcare than to knowledge and skills of health professionals, and especially to the workflow in the GPs' offices and to the communication between providers and with patients. Among GP characteristics, three were related with an increased incidence in the final multivariable model: length of consultation higher than 15 minutes, method of receiving radiological results (by fax compared to paper or email, and being in a multidisciplinary clinic compared with sole practitioners.Patient safety incidents (PSIs occurred in mean once every two days in the sampled GPs and 2% of them were associated with a definite possibility for harm. Studying the association between organizational features of general practices and PSIs remains a

  8. Endometrial hyperplasia, endometrial cancer and prevention: gaps in existing research of modifiable risk factors.

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    Linkov, Faina; Edwards, Robert; Balk, Judith; Yurkovetsky, Zoya; Stadterman, Barbara; Lokshin, Anna; Taioli, Emanuela

    2008-08-01

    Endometrial carcinoma is the most common cancer of the lower female genital tract in Europe and the United States. Faced with the growing incidence of endometrial cancer in Europe and around the world, scientists, doctors and public health professionals are becoming more concerned with identifying effective preventive measures for this condition. This review paper presents the existing knowledge about modifiable risk factors leading to endometrial hyperplasia and endometrial cancer and highlights the need for more studies in this area. Extensive literature review of modifiable risk factors for endometrial cancer and endometrial hyperplasia has been performed. Additionally, biomarker approaches to cancer monitoring, existing therapies for endometrial hyperplasia and factors affecting patient survival are reviewed. Obesity and inactivity are two of the major risk factors associated with the development of endometrial cancer and endometrial hyperplasia. Other modifiable risk factors include dietary habits, exercise and the use of hormonal therapy. Similar factors, along with cancer biomarkers, may play an important role in the early detection of endometrial cancer and survival after the diagnosis. The majority of these factors fit well with the unopposed oestrogen theory. Diet and exercise programmes are currently not integrated into a standard treatment programmes for patients with endometrial hyperplasia or endometrial cancer. More studies are needed to investigate modifiable risk factors for endometrial cancer and endometrial hyperplasia. Existing therapies for endometrial hyperplasia target hormone imbalance, which is just one aspect of endometrial cancer development. Next generation therapies for endometrial cancer and endometrial hyperplasia patients should include diet, exercise and weight loss plans, which would target other modifiable aspects of endometrial cancer risk.

  9. The incidence of endometrial hyperplasia and cancer in 1031 patients with a granulosa cell tumor of the ovary: long-term follow-up in a population-based cohort study

    NARCIS (Netherlands)

    van Meurs, Hannah S.; Bleeker, Maaike C. G.; van der Velden, Jacobus; Overbeek, Lucy I. H.; Kenter, Gemma G.; Buist, Marrije R.

    2013-01-01

    Concurrent presence of endometrial hyperplasia or cancer in patients with granulosa cell tumors (GCTs) is common, with reported incidences of 25.6% to 65.5%. Consequently, bilateral salpingo-oophorectomy and hysterectomy is usually recommended in patients with a GCT, but this remains debatable. Our

  10. Self-reported stress and risk of endometrial cancer: a prospective cohort study

    DEFF Research Database (Denmark)

    Nielsen, Naja Rod; Strandberg-Larsen, Katrine; Grønbaek, Morten

    2007-01-01

    OBJECTIVES: To assess a possible relationship between perceived stress and first-time incidence of primary endometrial cancer. Psychological stress may affect the synthesis and metabolism of estrogens and thereby be related to risk of endometrial cancer. METHODS: The 6760 women participating...... in the Copenhagen City Heart Study were asked about their stress level at baseline from 1981 to 1983. These women were prospectively followed up in the Danish nationwide cancer registry until 2000 and ...-up, 72 women were diagnosed with endometrial cancer. For each increase in stress level on a 7-point stress scale, there was a lower risk of primary endometrial cancer (hazard ratio (HR) = 0.88; 95% confidence interval (CI), 0.76-1.01). This inverse association was particularly strong in women who...

  11. Gene expression changes induced by estrogen and selective estrogen receptor modulators in primary-cultured human endometrial cells: signals that distinguish the human carcinogen tamoxifen

    International Nuclear Information System (INIS)

    Pole, Jessica C.M.; Gold, Leslie I.; Orton, Terry; Huby, Russell; Carmichael, Paul L.

    2005-01-01

    Tamoxifen has long been the endocrine treatment of choice for women with breast cancer and is now employed for prophylactic use in women at high risk from breast cancer. Other selective estrogen receptor modulators (SERMs), such as raloxifene, mimic some of tamoxifen's beneficial effects and, like tamoxifen, exhibit a complex mixture of organ-specific estrogen agonist and antagonistic properties. However, accompanying the positive effects of tamoxifen has been the emergence of evidence for an increased risk of endometrial cancer associated with its use. A more complete understanding of the mechanism(s) of SERM carcinogenicity and endometrial effects is therefore required. We have sought to compare and characterise the transcript profile of tamoxifen, raloxifene and the agonist estradiol in human endometrial cells. Using primary cultures of human endometria, to best emulate the in vivo responses in a manageable in vitro system, we have shown 230 significant changes in gene expression for epithelial cultures and 83 in stromal cultures, either specific to 17β-estradiol, tamoxifen or raloxifene, or changed across more than one of the treatments. Considering the transcriptome as a whole, the endometrial responses to raloxifene or tamoxifen were more similar than either drug was to 17β-estradiol. Treatment of endometrial cultures with tamoxifen resulted in the largest number of gene changes relative to control cultures and a high proportion of genes associated with regulation of gene transcription, cell-cycle control and signal transduction. Tamoxifen-specific changes that might point towards mechanisms for its proliferative response in the endometrium included changes in retinoblastoma and c-myc binding proteins, the APCL, dihydrofolate reductase (DHFR) and E2F1 genes and other transcription factors. Tamoxifen was also found to give rise to the highest number of gene expression changes common to those that characterise malignant endometria. It is anticipated that this

  12. Primary endometrial squamous cell carcinoma with extensive squamous metaplasia and dysplasia

    OpenAIRE

    Bagga Permeet; Jaswal T; Datta Usha; Mahajan N

    2008-01-01

    Primary squamous cell carcinoma of endometrium is a rare entity. Only 64 cases have been documented in the literature. We report a case of 60-year-old postmenopausal woman who presented with abdominal distention and blood-stained vaginal discharge for 6-7 months. Clinically, chronic pyometra was considered. Total abdominal hysterectomy was performed and histopathologically, it was diagnosed as a case of primary squamous cell carcinoma of endometrium with extensive squamous metaplasia and dysp...

  13. Primary endometrial squamous cell carcinoma with extensive squamous metaplasia and dysplasia

    Directory of Open Access Journals (Sweden)

    Bagga Permeet

    2008-04-01

    Full Text Available Primary squamous cell carcinoma of endometrium is a rare entity. Only 64 cases have been documented in the literature. We report a case of 60-year-old postmenopausal woman who presented with abdominal distention and blood-stained vaginal discharge for 6-7 months. Clinically, chronic pyometra was considered. Total abdominal hysterectomy was performed and histopathologically, it was diagnosed as a case of primary squamous cell carcinoma of endometrium with extensive squamous metaplasia and dysplasia.

  14. Endometrial biopsy

    Science.gov (United States)

    ... due to changes in hormone levels ( anovulatory bleeding ) Risks Risks of endometrial biopsy include: Infection Causing a ... American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, ...

  15. Endometrial Cancer

    Science.gov (United States)

    ... treatment. A healthy lifestyle is recommended after cancer treatment. Several studies have found that obesity, high blood pressure, and diabetes can contribute to long-term health risks for women with type 1 endometrial cancer. A healthy diet ...

  16. Primary biliary cirrhosis: an increased incidence of extrahepatic malignancies?

    OpenAIRE

    Mills, P R; Boyle, P; Quigley, E M; Birnie, G G; Jarrett, F; Watkinson, G; MacSween, R N

    1982-01-01

    In a retrospective review of 85 patients with primary biliary cirrhosis (PBC), 10 (11.8%) were noted to have extrahepatic malignant neoplasm. In seven female patients the tumour developed within a mean of 3.5 yr after the clinical onset of PBC. This observed number of tumours, 3.5 times more common than the expected age-adjusted incidence, was statistically significant at the 0.5% level.

  17. PIpelle Prospective ENDOmetrial carcinoma (PIPENDO) study, pre-operative recognition of high risk endometrial carcinoma: a multicentre prospective cohort study

    International Nuclear Information System (INIS)

    Visser, Nicole C. M.; Bulten, Johan; Wurff, Anneke A. M. van der; Boss, Erik A.; Bronkhorst, Carolien M.; Feijen, Harrie W. H.; Haartsen, Joke E.; Herk, Hilde A. D. M. van; Kievit, Ineke M. de; Klinkhamer, Paul J. J. M.; Pijlman, Brenda M.; Snijders, Marc P. M. L.; Vandenput, Ingrid; Vos, M. Caroline; Wit, Peter E. J. de; Poll-Franse, Lonneke V. van de; Massuger, Leon F.A.G.; Pijnenborg, Johanna M. A.

    2015-01-01

    Endometrial carcinoma is the most common gynaecologic malignancy in industrialised countries and the incidence is still rising. Primary treatment is based on preoperative risk classification and consists in most cases of hysterectomy with bilateral salpingo-oophorectomy. In patients with serous and clear cell histology a complete surgical staging is mandatory. However, in routine clinical practice final histology regularly does not correspond with the preoperative histological diagnosis. This results in both over and under treatment. The aim of this multicentre, prospective cohort study is to select a panel of prognostic biomarkers to improve preoperative diagnosis of endometrial carcinoma in order to identify those patients that need extended surgery and/or additional treatment. Additionally, we will determine whether incorporation of cervical cytology and comorbidity could improve this preoperative risk classification. All patients treated for endometrial carcinoma in the participating hospitals from September 2011 till December 2013 are included. Patient characteristics, as well as comorbidity are registered. Patients without preoperative histology, history of hysterectomy and/or endometrial carcinoma or no surgical treatment including hysterectomy are excluded. The preoperative histology and final pathology will be reviewed and compared by expert pathologists. Additional immunohistochemical analysis of IMP3, p53, ER, PR, MLH1, PTEN, beta-catenin, p16, Ki-67, stathmin, ARID1A and L1CAM will be performed. Preoperative histology will be compared with the final pathology results. Follow-up will be at least 24 months to determine risk factors for recurrence and outcome. This study is designed to improve surgical treatment of endometrial carcinoma patients. A total of 432 endometrial carcinoma patients were enrolled between 2011 and 2013. Follow-up will be completed in 2015. Preoperative histology will be evaluated systematically and background endometrium will be

  18. Prognostic impact of primary tumor SUVmaxon preoperative18F-fluoro-2-deoxy-D-glucose positron emission tomography and computed tomography in endometrial cancer and uterine carcinosarcoma.

    Science.gov (United States)

    Yahata, Tamaki; Yagi, Shigetaka; Mabuchi, Yasushi; Tanizaki, Yuko; Kobayashi, Aya; Yamamoto, Madoka; Mizoguchi, Mika; Nanjo, Sakiko; Shiro, Michihisa; Ota, Nami; Minami, Sawako; Terada, Masaki; Ino, Kazuhiko

    2016-10-01

    The objective of the present study was to investigate the usefulness of the maximum standardized uptake value (SUV max ) of the primary tumor on preoperative 18 F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and computed tomography (PET/CT) as a prognostic indicator in patients with endometrial neoplasms. A total of 75 patients with endometrial cancer or uterine carcinosarcoma who underwent surgical treatment were included in the present study. All patients underwent preoperative PET/CT, and the correlation between the SUV max of the primary tumor and clinical outcomes was analyzed. The SUV max was significantly higher in patients with stage II/III disease, a histology of grade 3 endometrioid adenocarcinoma and carcinosarcoma, a positive lymph node (LN) status, positive lymph-vascular space involvement (LVSI), and deep (≥1/2) myometrial invasion. Receiver operating characteristic curve analysis revealed that the optimal cut-off values of SUV max for predicting a positive LN, LVSI and deep myometrial invasion were 7.49, 6.45 and 6.45, respectively. The overall survival (OS) and progression-free survival (PFS) of patients with a high SUV max were significantly lower compared with those of patients with a low SUV max using the cut-off value of 7.30. However, no significant difference was observed in the OS or PFS between the high and low SUV max groups when analyzed in carcinosarcoma patients alone. Finally, multivariate analyses demonstrated that the SUV max of the primary tumor was an independent prognostic factor for impaired PFS in 55 endometrioid adenocarcinoma patients; however, not in all patients, including those with carcinosarcoma. The present findings demonstrated that the SUV max of the primary tumor may be a useful biomarker for predicting clinical outcomes of patients with endometrial cancer, although its prognostic impact appears to be limited in patients with uterine carcinosarcoma.

  19. Adenovirus mediated homozygous endometrial epithelial Pten deletion results in aggressive endometrial carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Joshi, Ayesha; Ellenson, Lora Hedrick, E-mail: lora.ellenson@med.cornell.edu

    2011-07-01

    Pten is the most frequently mutated gene in uterine endometriod carcinoma (UEC) and its precursor complex atypical hyperplasia (CAH). Because the mutation frequency is similar in CAH and UEC, Pten mutations are thought to occur relatively early in endometrial tumorigenesis. Previous work from our laboratory using the Pten{sup +/-} mouse model has demonstrated somatic inactivation of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into the uterine lumen of adult Pten floxed mice in an attempt to somatically delete both alleles of Pten specifically in the endometrium. Our results demonstrate that biallelic inactivation of Pten results in an increased incidence of carcinoma as compared to the Pten{sup +/-} mouse model. In addition, the carcinomas were more aggressive with extension beyond the uterus into adjacent tissues and were associated with decreased expression of nuclear ER{alpha} as compared to associated CAH. Primary cultures of epithelial and stromal cells were prepared from uteri of Pten floxed mice and Pten was deleted in vitro using Cre expressing adenovirus. Pten deletion was evident in both the epithelial and stromal cells and the treatment of the primary cultures with estrogen had different effects on Akt activation as well as Cyclin D3 expression in the two purified components. This study demonstrates that somatic biallelic inactivation of Pten in endometrial epithelium in vivo results in an increased incidence and aggressiveness of endometrial carcinoma compared to mice carrying a germline deletion of one allele and provides an important in vivo and in vitro model system for understanding the genetic underpinnings of endometrial carcinoma.

  20. [Incidence of intestinal parasites among primary school children in Malatya].

    Science.gov (United States)

    Celik, Tuncay; Daldal, Nilgün; Karaman, Ulkü; Aycan, Ozlem M; Atambay, Metin

    2006-01-01

    The aim of this study was to determine the incidence of intestinal parasites among primary school children in the central region of Malatya and to educate the children about parasitic diseases. During the study, cellophane tape preparations and stool samples that had been prepared using direct mounting methods were examined. In addition the students were informed about intestinal parasites. Parasitic infection was observed in 415 (22.5%) out of 1838 students and the highest rate of 10.6% was that of Enterobius vermicularis. The rates of Giardia intestinalis, Entamoeba coli, Blastocystis hominis, Taenia sp., Hymenolepis nana, Trichomonas hominis, Ascaris lumbricoides and Iodamoeba butschlii were found to be 8.5%, 1.9%, 1.4%, 0.3%, 0.1%, 0.1%, 0.05%, and 0.05%, respectively. Thus, intestinal parasites are important among primary school children in Malatya and it seems that there is a relationship between socioeconomic conditions and the rate of intestinal parasites.

  1. Endometrial Ablation

    Science.gov (United States)

    ... Disorders of the uterus or endometrium • Endometrial hyperplasia • Cancer of the uterus • Recent pregnancy • Current or recent infection of the ... A condition in which the lining of the uterus grows too thick. A specific type of ... lead to cancer. General Anesthesia: The use of drugs that produce ...

  2. Follicular Variant of Papillary Thyroid Cancer with Bilateral Renal Metastases Discovered Incidentally During Work-Up of Primary Endometrial Cancer: A Rare Occurrence.

    Science.gov (United States)

    Lubana, Sandeep Singh; Singh, Navdeep; Tuli, Sandeep S; Bashir, Tayyaba; Sachmechi, Issac; Kemeny, Margaret M

    2015-07-16

    Follicular variant of papillary thyroid cancer (FV-PTC) is the second most common subtype of papillary thyroid cancer (PTC) after classic PTC. FV-PTC is characterized by nuclear features consistent with classic PTC but has a follicular architecture that lacks classic papillary morphology. Thyroid cancer rarely metastasizes to the kidney. Only 6 cases of FV-PTC metastasizing to the kidney have been reported in the English literature. We are reporting a case of FV-PTC with bilateral renal metastases discovered incidentally during work-up of primary endometrial cancer. A 70-year-old woman presented with post-menopausal bleeding secondary to endometrial cancer. Staging work-up showed multiple bilateral lung nodules, bilateral soft tissue kidney masses, and multinodular goiter. The pathological and immnohistochemical profile of the lung biopsy was consistent with primary well-differentiated lung adenocarcinoma. Follow-up computerized tomography scan showed stable lung nodules and enlarging renal masses, which was suggestive of bilateral renal cancer. While the histologic features of the renal biopsy were not typical, the immunohistochemical staining of renal biopsy was positive for Paired box 8, thyroid transcription factor-1, thyroglobulin, and cytokeratin 7, suggesting the thyroid as the primary cancer site. The final histopathology on surgical specimen of total thyroidectomy revealed follicular variant of papillary thyroid cancer. The presence of pulmonary nodules and kidney masses does not always suggest the lung or the kidney as primary tumor sites. The clinician should be aware of the possibility of metastasis and look for the primary source, which in the present case was FV-PTC. Immunohistochemistry plays an important role in determining the primary site of origin. In case of multiple-organ metastases, each metastatic lesion should be biopsied as soon as possible for definitive diagnosis and appropriate treatment.

  3. Statin use and risk of endometrial cancer

    DEFF Research Database (Denmark)

    Sperling, Cecilie D.; Verdoodt, Freija; Friis, Soren

    2017-01-01

    INTRODUCTION: Laboratory and epidemiological evidence have suggested that statin use may protect against the development of certain cancers, including endometrial cancer. In a nationwide registry-based case-control study, we examined the association between statin use and risk of endometrial cancer....... MATERIAL AND METHODS: Cases were female residents of Denmark with a primary diagnosis of endometrial cancer during 2000-2009. For each case, we selected 15 female population controls matched on date of birth (±one month) using risk-set sampling. Ever use of statin was defined as two or more prescriptions...... 5382 endometrial cancer cases and 72 127 population controls. We observed no association between ever use of statins and endometrial cancer risk (OR 1.03, 95% CI 0.94-1.14). In addition, endometrial cancer risk did not vary substantially with duration or intensity of statin use. Stratification by type...

  4. Current treatment of metastatic endometrial cancer.

    Science.gov (United States)

    Temkin, Sarah M; Fleming, Gini

    2009-01-01

    Endometrial cancer is the most common gynecologic malignancy. The majority of patients have disease confined to the uterus and have an excellent overall prognosis. However, subgroups of patients have advanced primary disease or recurrences following primary treatment. The management of metastatic disease is variable, depending on factors such as comorbidities, tumor grade, performance status, and prior treatments. Management options include hormonal therapy and cytotoxic chemotherapy, as well as targeted therapies that inhibit angiogenesis and the cellular signaling pathways involved in cell growth and proliferation. A comprehensive review of these treatments for metastatic endometrial cancer was conducted and is discussed. Hormonal therapy and cytotoxic chemotherapy have traditionally been used in the treatment of metastatic endometrial cancer. Advances in molecular biology have led to multiple potential targeted therapies to be used in the treatment of metastatic endometrial cancer. While several treatment modalities are now available to treat patients who present with metastatic endometrial cancer, overall prognosis remains poor.

  5. Mass Casualty Incident Primary Triage Methods in China

    Science.gov (United States)

    Chen, Jin-Hong; Yang, Jun; Yang, Yu; Zheng, Jing-Chen

    2015-01-01

    Objective: To evaluate the technical characteristics and application of mass casualty incident (MCI) primary triage (PT) methods applied in China. Data Sources: Chinese literature was searched by Chinese Academic Journal Network Publishing Database (founded in June 2014). The English literature was searched by PubMed (MEDLINE) (1950 to June 2014). We also searched Official Websites of Chinese Central Government's (http://www.gov.cn/), National Health and Family Planning Commission of China (http://www.nhfpc.gov.cn/), and China Earthquake Information (http://www.csi.ac.cn/). Study Selection: We included studies associated with mass casualty events related to China, the PT applied in China, guidelines and standards, and application and development of the carding PT method in China. Results: From 3976 potentially relevant articles, 22 met the inclusion criteria, 20 Chinese, and 2 English. These articles included 13 case reports, 3 retrospective analyses of MCI, two methods introductions, three national or sectoral criteria, and one simulated field testing and validation. There were a total of 19 kinds of MCI PT methods that have been reported in China from 1950 to 2014. In addition, there were 15 kinds of PT methods reported in the literature from the instance of the application. Conclusions: The national and sectoral current triage criteria are developed mainly for earthquake relief. Classification is not clear. Vague criteria (especially between moderate and severe injuries) operability are not practical. There are no triage methods and research for children and special populations. There is no data and evidence supported triage method. We should revise our existing classification and criteria so it is clearer and easier to be grasped in order to build a real, practical, and efficient PT method. PMID:26415807

  6. Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen.

    Science.gov (United States)

    Dominick, Sally; Hickey, Martha; Chin, Jason; Su, H Irene

    2015-12-09

    Adjuvant tamoxifen reduces the risk of breast cancer recurrence in women with oestrogen receptor-positive breast cancer. Tamoxifen also increases the risk of postmenopausal bleeding, endometrial polyps, hyperplasia, and endometrial cancer. The levonorgestrel-releasing intrauterine system (LNG-IUS) causes profound endometrial suppression. This systematic review considered the evidence that the LNG-IUS prevents the development of endometrial pathology in women taking tamoxifen as adjuvant endocrine therapy for breast cancer. To determine the effectiveness and safety of levonorgestrel intrauterine system (LNG-IUS) in pre- and postmenopausal women taking adjuvant tamoxifen following breast cancer for the outcomes of endometrial and uterine pathology including abnormal vaginal bleeding or spotting, and secondary breast cancer events. We searched the following databases: Cochrane Menstrual Disorders and Subfertility Group Specialised Register (MDSG), Cochrane Breast Cancer Group Specialised Register (CBCG), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Abstracts of Reviews of Effects (DARE), The Cochrane Library, clinicaltrials.gov, The World Health Organisation International Trials Registry, ProQuest Dissertations & Theses, MEDLINE, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycINFO, Web of Science, OpenGrey, LILACS, PubMed, and Google. The final search was performed in October 2015. Randomised controlled trials of women with breast cancer on adjuvant tamoxifen that compared endometrial surveillance alone (control condition) versus the LNG-IUS with endometrial surveillance (experimental condition) on the incidence of endometrial pathology. Study selection, risk of bias assessment and data extraction were performed independently by two review authors. The primary outcome measure was endometrial pathology (including polyps, endometrial hyperplasia, or endometrial cancer) diagnosed at hysteroscopy or

  7. Safety incidents in the primary care office setting.

    Science.gov (United States)

    Rees, Philippa; Edwards, Adrian; Panesar, Sukhmeet; Powell, Colin; Carter, Ben; Williams, Huw; Hibbert, Peter; Luff, Donna; Parry, Gareth; Mayor, Sharon; Avery, Anthony; Sheikh, Aziz; Donaldson, Sir Liam; Carson-Stevens, Andrew

    2015-06-01

    In the United Kingdom, 26% of child deaths have identifiable failures in care. Although children account for 40% of family physicians' workload, little is known about the safety of care in the community setting. Using data from a national patient safety incident reporting system, this study aimed to characterize the pediatric safety incidents occurring in family practice. We undertook a retrospective, cross-sectional, mixed methods study of pediatric reports submitted to the UK National Reporting and Learning System from family practice. Analysis involved detailed data coding using multiaxial frameworks, descriptive statistical analysis, and thematic analysis of a special-case sample of reports. Using frequency distributions and cross-tabulations, the relationships between incident types and contributory factors were explored. Of 1788 reports identified, 763 (42.7%) described harm to children. Three crosscutting priority areas were identified: medication management, assessment and referral, and treatment. The 4 incident types associated with the most harmful outcomes are errors associated with diagnosis and assessment, delivery of treatment and procedures, referrals, and medication provision. Poor referral and treatment decisions in severely unwell or vulnerable children, along with delayed diagnosis and insufficient assessment of such children, featured prominently in incidents resulting in severe harm or death. This is the first analysis of nationally collected, family practice-related pediatric safety incident reports. Recommendations to mitigate harm in these priority areas include mandatory pediatric training for all family physicians; use of electronic tools to support diagnosis, management, and referral decision-making; and use of technological adjuncts such as barcode scanning to reduce medication errors. Copyright © 2015 by the American Academy of Pediatrics.

  8. Endometrial Cancer Prevention

    Science.gov (United States)

    ... the most common invasive cancer of the female reproductive system. Endometrial cancer is diagnosed most often in postmenopausal women at an average age of 60 years . From 2005 to 2014, the number of new cases of endometrial cancer increased slightly ...

  9. Endometrial Cancer Screening

    Science.gov (United States)

    ... the most common invasive cancer of the female reproductive system. Endometrial cancer is diagnosed most often in postmenopausal women at an average age of 60 years. From 2005 to 2014, the number of new cases of endometrial cancer increased slightly ...

  10. Incidence of Early Post Operative Infection after Primary Total Knee ...

    African Journals Online (AJOL)

    in literature. We also sought to determine any risk factors that may be associated with an increased risk of the development of SSI in our setting. Methods. This was a retrospective cohort study of all primary total knee .... of this study, the implants for revision surgery were not easily available and the costs were beyond the.

  11. Incidence and risk of primary cytomegalovirus infection among ...

    African Journals Online (AJOL)

    Background: Primary cytomegalovirus infection in pregnancy remains a leading cause of congenital hearing loss and mental retardation worldwide. Most women acquired CMV infection horizontally from their infected children or younger children who were cross- infected at school or day care facilities. Over 90% of infected ...

  12. Endometrial carcinoma occuring from polycystic ovary disease : A case report

    Energy Technology Data Exchange (ETDEWEB)

    Seong, Su Ok; Jeon, Woo Ki [Inje Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-12-01

    Endometrial carcinoma usually occurs in postmenopausal women ; less than 5% occurs in women under the age of 40. Up to one quarter of endometrial carcinoma patients below this age have PCO(polycystic ovary disease, Stein-Leventhal syndrome). The increased incidence of endometrial carcinoma in patients with PCO is related to chronic estrogenic stimulation. We report MR imaging in one case of endometrial carcinoma occuring in a 23 year old woman with PCO and had complained of hypermenorrhea for about three years. On T2-weighted MR image the endometrial cavity was seen to be distended with protruded endometrial masses of intermediate signal intensity, and the junctional zone was disrupted beneath the masses. Both ovaries were best seen on T2-weighted MR imaging and showed multiple small peripheral cysts and low signal-intensity central stroma.

  13. Endometrial carcinoma occuring from polycystic ovary disease : A case report

    International Nuclear Information System (INIS)

    Seong, Su Ok; Jeon, Woo Ki

    1996-01-01

    Endometrial carcinoma usually occurs in postmenopausal women ; less than 5% occurs in women under the age of 40. Up to one quarter of endometrial carcinoma patients below this age have PCO(polycystic ovary disease, Stein-Leventhal syndrome). The increased incidence of endometrial carcinoma in patients with PCO is related to chronic estrogenic stimulation. We report MR imaging in one case of endometrial carcinoma occuring in a 23 year old woman with PCO and had complained of hypermenorrhea for about three years. On T2-weighted MR image the endometrial cavity was seen to be distended with protruded endometrial masses of intermediate signal intensity, and the junctional zone was disrupted beneath the masses. Both ovaries were best seen on T2-weighted MR imaging and showed multiple small peripheral cysts and low signal-intensity central stroma

  14. Targeted Therapies in Endometrial Cancer

    Directory of Open Access Journals (Sweden)

    Selen Dogan

    2014-04-01

    Full Text Available Endometrial cancer is the most common genital cancer in developed world. It is generally diagnosed in early stage and it has a favorable prognosis. However, advanced staged disease and recurrences are difficult to manage. There are some common genetic alterations related to endometrial carcinogenesis in similar fashion to other cancers. Personalized medicine, which means selection of best suited treatment for an individual, has gain attention in clinical care of patients in recent years. Targeted therapies were developed as a part of personalized or %u201Ctailored%u201D medicine and specifically acts on a target or biologic pathway. There are quite a number of molecular alteration points in endometrial cancer such as PTEN tumor suppressor genes, DNA mismatch repair genes, PI3K/AKT/mTOR pathway and p53 oncogene which all might be potential candidates for tailored targeted therapy. In recent years targeted therapies has clinical application in ovarian cancer patients and in near future with the advent of new agents these %u201Ctailored%u201D drugs will be in market for routine clinical practice in endometrial cancer patients, in primary disease and recurrences as well.

  15. Endometrial cancer: multiplexed Luminex approaches for early detection.

    Science.gov (United States)

    Linkov, Faina; Yurkovetsky, Zoya; Taioli, Emanuela; Havrilesky, Laura J; Maxwell, G Larry; Lokshin, Anna

    2008-05-01

    Endometrial carcinoma is the most common gynecologic cancer. Despite the advances that have been made in other cancers, both the annual incidence of and the death rate associated with endometrial cancer appear to be rising, both in the US and around the world. In the US, ∼ 41,000 cases are diagnosed and about 7000 women die from the disease each year. Adenocarcinoma, which originates in surface cells of the endometrium, accounts for ∼ 90% of cases of endometrial cancer. At this time, there are no early detection tests or exams that can find endometrial cancer early in women without symptoms. There is growing interest in the use of biomarker approaches for the early detection of endometrial cancer. Endometrial cancer has been linked to altered growth factor signaling, immune inflammatory responses and angiogenesis. This article provides an overview of endometrial cancer and outlines the rationale and need for the clinical application of multiplexed ELISA-based assays for the early detection of cancer. Although endometrial cancer has a generally favorable long-term outcome, its screening and diagnosis pose a challenge in women without symptoms. An extensive literature review of biomarker approaches to endometrial cancer detection has been performed. Also, several studies conducted by the present team at the University of Pittsburgh Cancer Institute were reviewed. In the authors' published studies, it was hypothesized that an expanded panel of biomarkers comprised of cytokines, chemokines, growth factors and other tumor markers, which individually may show some promising correlation with disease status, might provide higher diagnostic power if used in combination, especially in the case of endometrial cancer detection. It was also discovered that prolactin may be very important for endometrial cancer detection. In this article, the potential clinical role for using multimarker testing in the early detection of endometrial cancer and for tumor surveillance to

  16. Incidence of typically Severe Primary Immunodeficiency Diseases in Consanguineous and Non-consanguineous Populations.

    Science.gov (United States)

    Broides, Arnon; Nahum, Amit; Mandola, Amarilla B; Rozner, Lihi; Pinsk, Vered; Ling, Galina; Yerushalmi, Baruch; Levy, Jacov; Givon-Lavi, Noga

    2017-04-01

    Primary immunodeficiency diseases are considered to be rare diseases; however, data on the exact birth incidences of these diseases are sparse. Southern Israel is inhabited by two major populations: a relatively non-consanguineous Jewish population and a highly consanguineous Muslim Bedouin population. We sought to calculate the incidences of typically severe primary immunodeficiency diseases and compare the incidences in these populations. A retrospective analysis of all typically severe primary immunodeficiency diseases evaluated at a single center from January 1, 1996 to December 31, 2016. The amount of live births by population was the denominator for calculating the incidences by population. A total of 95 patients were included, 85 of Bedouin and 10 of Jewish ethnicities. There were 152,331 births in the Bedouin and 160,998 births in the Jewish populations. The total incidence of typically severe primary immunodeficiency diseases was higher in the Bedouin population than expected based on previous studies. The total incidences were 55.8/10 5 births in the Bedouin population compared with 6.2/10 5 births in the Jewish population (P combined immunodeficiency diseases, ataxia telangiectasia, and infantile IBD due to interleukin 10 receptor defects were all significantly higher in the Bedouin population (P severe primary immunodeficiency diseases are not rare diseases in a consanguineous population; these diseases are significantly more common in the Bedouin population. This finding is probably also applicable to other consanguineous populations, and in these populations, primary immunodeficiency diseases should not be regarded as rare diseases.

  17. Correlation of Minimum Apparent Diffusion Coefficient and Maximum Standardized Uptake Value of the Primary Tumor with Clinicopathologic Characteristics in Endometrial Cancer

    Directory of Open Access Journals (Sweden)

    Evrim Sürer Budak

    2017-02-01

    Full Text Available Objective: To explore the correlation of the primary tumor’s maximum standardized uptake value (SUVmax and minimum apparent diffusion coefficient (ADCmin with clinicopathologic features, and to determine their predictive power in endometrial cancer (EC. Methods: A total of 45 patients who had undergone staging surgery after a preoperative evaluation with 18F-fluorodeoxyglucose (FDG positron emission tomography/computerized tomography (PET/CT and diffusion-weighted magnetic resonance imaging (DW-MRI were included in a prospective case-series study with planned data collection. Multiple linear regression analysis was used to determine the correlations between the study variables. Results: The mean ADCmin and SUVmax values were determined as 0.72±0.22 and 16.54±8.73, respectively. A univariate analysis identified age, myometrial invasion (MI and lymphovascular space involvement (LVSI as the potential factors associated with ADCmin while it identified age, stage, tumor size, MI, LVSI and number of metastatic lymph nodes as the potential variables correlated to SUVmax. In multivariate analysis, on the other hand, MI was the only significant variable that correlated with ADCmin (p=0.007 and SUVmax (p=0.024. Deep MI was best predicted by an ADCmin cutoff value of ≤0.77 [93.7% sensitivity, 48.2% specificity, and 93.0% negative predictive value (NPV] and SUVmax cutoff value of >20.5 (62.5% sensitivity, 86.2% specificity, and 81.0% NPV; however, the two diagnostic tests were not significantly different (p=0.266. Conclusion: Among clinicopathologic features, only MI was independently correlated with SUVmax and ADCmin. However, the routine use of 18F-FDG PET/CT or DW-MRI cannot be recommended at the moment due to less than ideal predictive performances of both parameters.

  18. Stages of Endometrial Cancer

    Science.gov (United States)

    ... uterus. See the PDQ summary on Uterine Sarcoma Treatment for more information about uterine sarcoma . Obesity and having metabolic syndrome may increase the risk of endometrial cancer. Anything ...

  19. A safety incident reporting system for primary care. A systematic literature review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care

    NARCIS (Netherlands)

    Klemp, Kerstin; Zwart, Dorien; Hansen, Jørgen; Hellebek, Torben; Luettel, Dagmar; Verstappen, Wim; Beyer, Martin; Gerlach, Ferdin M.; Hoffmann, Barbara; Esmail, Aneez

    2015-01-01

    Background: Incident reporting is widely used in both patient safety improvement programmes, and in research on patient safety.Objective: To identify the key requirements for incident reporting systems in primary care; to develop an Internet-based incident reporting and learning system for primary

  20. Sociodemographic trends in the incidence of pancreatic and biliary tract cancer in UK primary care.

    Directory of Open Access Journals (Sweden)

    Margaret G Keane

    Full Text Available The UK incidence of pancreatic ductal adenocarcinoma (PDAC is approximately 9/100,000 population compared with 1-2/100,000 for biliary tract cancer (BTC. This study explores the incidence of these cancers over time and the influence of socio-demographic and geographic factors in a UK primary care cohort.This study uses data from a large UK primary care database, The Health Improvement Network (THIN. All adult patients contributing data to THIN between January 2000 and December 2010 were included. Annual incidence rates were calculated, adjusted for age, gender, time period, deprivation score (Townsend quintile and strategic health authority.From 2000-2010, the annual incidence of PDAC increased by an average of 3% per year (95% CI 1.00-4.00% and BTC by 4% (95% CI 2.00-6.00%. Incidence of both cancers increased steeply with age and was higher in men. BTC was associated with increasing deprivation (most deprived versus least deprived quintile (OR: 1.45 [95% CI: 1.17, 1.79.].The overall incidence of both cancers is low but increasing. Variations in incidence may reflect changes in coding practice or increased exposure to associated risk factors.

  1. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review.

    Science.gov (United States)

    Gierisch, Jennifer M; Coeytaux, Remy R; Urrutia, Rachel Peragallo; Havrilesky, Laura J; Moorman, Patricia G; Lowery, William J; Dinan, Michaela; McBroom, Amanda J; Hasselblad, Vic; Sanders, Gillian D; Myers, Evan R

    2013-11-01

    Oral contraceptives may influence the risk of certain cancers. As part of the AHRQ Evidence Report, Oral Contraceptive Use for the Primary Prevention of Ovarian Cancer, we conducted a systematic review to estimate associations between oral contraceptive use and breast, cervical, colorectal, and endometrial cancer incidence. We searched PubMed, Embase, and Cochrane Database of Systematic Reviews. Study inclusion criteria were women taking oral contraceptives for contraception or ovarian cancer prevention; includes comparison group with no oral contraceptive use; study reports quantitative associations between oral contraceptive exposure and relevant cancers; controlled study or pooled patient-level meta-analyses; sample size for nonrandomized studies ≥100; peer-reviewed, English-language; published from January 1, 2000 forward. Random-effects meta-analyses were conducted by estimating pooled ORs with 95% confidence intervals (CIs). We included 44 breast, 12 cervical, 11 colorectal, and 9 endometrial cancers studies. Breast cancer incidence was slightly but significantly increased in users (OR, 1.08; CI, 1.00-1.17); results show a higher risk associated with more recent use of oral contraceptives. Risk of cervical cancer was increased with duration of oral contraceptive use in women with human papillomavirus infection; heterogeneity prevented meta-analysis. Colorectal cancer (OR, 0.86; CI, 0.79-0.95) and endometrial cancer incidences (OR, 0.57; CI, 0.43-0.77) were significantly reduced by oral contraceptive use. Compared with never use, ever use of oral contraceptives is significantly associated with decreases in colorectal and endometrial cancers and increases in breast cancers. Although elevated breast cancer risk was small, relatively high incidence of breast cancers means that oral contraceptives may contribute to a substantial number of cases. ©2013 AACR.

  2. The Incidence of Primary Hip Osteoarthritis in Active Duty US Military Servicemembers

    Science.gov (United States)

    2009-04-15

    the hip and knee joint in retired football players. Acta Orthop Scand 1980;51:925–7. 36. Kujala UM, Kaprio J, Sarno S. Osteoarthritis of weightbearing...The Incidence of Primary Hip Osteoarthritis in Active Duty US Military Servicemembers DANIELLE L. SCHER,1 PHILIP J. BELMONT, JR.,1 SALLY MOUNTCASTLE...2 AND BRETT D. OWENS1 Objective. Although multiple studies have reported the prevalence of primary hip osteoarthritis (OA), little has been reported

  3. New concepts for an old problem: the diagnosis of endometrial hyperplasia

    Science.gov (United States)

    Sanderson, Peter A.; Critchley, Hilary O.D.; Williams, Alistair R.W.; Arends, Mark J.; Saunders, Philippa T.K.

    2017-01-01

    Abstract BACKGROUND Endometrial hyperplasia (EH) is a uterine pathology representing a spectrum of morphological endometrial alterations. It is predominantly characterized by an increase in the endometrial gland-to-stroma ratio when compared to normal proliferative endometrium. The clinical significance of EH lies in the associated risk of progression to endometrioid endometrial cancer (EC) and ‘atypical’ forms of EH are regarded as premalignant lesions. Traditional histopathological classification systems for EH exhibit wide and varying degrees of diagnostic reproducibility and, as a consequence, standardized patient management can be challenging. OBJECTIVE AND RATIONALE EC is the most common gynaecological malignancy in developed countries. The incidence of EC is rising, with alarming increases described in the 40–44-year-old age group. This review appraises the current EH classification systems used to stratify women at risk of malignant progression to EC. In addition, we summarize the evidence base regarding the use of immunohistochemical biomarkers for EH and discuss an emerging role for genomic analysis. SEARCH METHODS PubMed, Medline and the Cochrane Database were searched for original peer-reviewed primary and review articles, from January 2000 to January 2016. The following search terms were used: ‘endometrial hyperplasia’, ‘endometrial intraepithelial neoplasia’, ‘atypical hyperplasia’, ‘complex atypical hyperplasia’, ‘biomarker’, ‘immunohistochemistry’, ‘progression’, ‘genomic’, ‘classification’ and ‘stratification’. OUTCOMES Recent changes to EH classification reflect our current understanding of the genesis of endometrioid ECs. The concept of endometrial intraepithelial neoplasia (EIN) as a mutationally activated, monoclonal pre-malignancy represents a fundamental shift from the previously held notion that unopposed oestrogenic stimulation causes ever-increasing hyperplastic proliferation, with accumulating

  4. Incidence of colour blindness (colour defect among Iranian primary school children

    Directory of Open Access Journals (Sweden)

    M. SADIGHIAN

    1974-07-01

    Full Text Available An investigation of the incidence of colour defects was made in primary school students. The children ranged in age from 7 to 14 years. The frequencies were 7,04 per cent. for males and 0,53 per cent. for females.

  5. Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction

    NARCIS (Netherlands)

    Lodders, J.N.; Parmar, S.; Stienen, N.L.M.; Martin, T.J.; Karagozoglu, K.H.; Heymans, M.W.; Nandra, B.; Forouzanfar, T.

    2015-01-01

    BACKGROUND: The aims of the study were 1) to evaluate the incidence and types of postoperative complications after ablative oral cancer surgery with primary free flap reconstruction and 2) identify prognostic variables for postoperative complications. MATERIAL AND METHODS: Desired data was retrieved

  6. Ambient air pollution and primary liver cancer incidence in four European cohorts within the ESCAPE project

    NARCIS (Netherlands)

    Pedersen, Marie; Andersen, Zorana J; Stafoggia, Massimo; Weinmayr, Gudrun; Galassi, Claudia; Sørensen, Mette; Eriksen, Kirsten T; Tjønneland, Anne; Loft, Steffen; Jaensch, Andrea; Nagel, Gabriele; Concin, Hans; Tsai, Ming-Yi; Grioni, Sara; Marcon, Alessandro; Krogh, Vittorio; Ricceri, Fulvio; Sacerdote, Carlotta; Ranzi, Andrea; Sokhi, Ranjeet; Vermeulen, Roel|info:eu-repo/dai/nl/216532620; Hoogh, Kees de; Wang, Meng; Beelen, Rob|info:eu-repo/dai/nl/30483100X; Vineis, Paolo; Brunekreef, Bert|info:eu-repo/dai/nl/067548180; Hoek, Gerard|info:eu-repo/dai/nl/069553475; Raaschou-Nielsen, Ole

    2017-01-01

    BACKGROUND: Tobacco smoke exposure increases the risk of cancer in the liver, but little is known about the possible risk associated with exposure to ambient air pollution. OBJECTIVES: We evaluated the association between residential exposure to air pollution and primary liver cancer incidence.

  7. The identification of incident cancers in UK primary care databases : a systematic review

    NARCIS (Netherlands)

    Rañopa, Michael; Douglas, Ian; van Staa, Tjeerd; Smeeth, Liam; Klungel, Olaf; Reynolds, Robert; Bhaskaran, Krishnan

    2015-01-01

    PURPOSE: UK primary care databases are frequently used in observational studies with cancer outcomes. We aimed to systematically review methods used by such studies to identify and validate incident cancers of the breast, colorectum, and prostate. METHODS: Medline and Embase (1980-2013) were

  8. Incidence of primary dengue virus infections in Southern Vietnamese children and reactivity against other flaviviruses

    NARCIS (Netherlands)

    Thai, Khoa T. D.; Nga, Tran Thi Thanh; van Nam, Nguyen; Phuong, Hoang Lan; Giao, Phan Trong; Hung, Le Quoc; Binh, Tran Quang; van Doornum, Gerard J. J.; de Vries, Peter J.

    2007-01-01

    OBJECTIVE: To study the incidence of asymptomatic primary dengue infections among children and reactivity against other flaviviruses. METHODS: A total of 216 children, who had no dengue-specific IgG antibodies during a serosurvey in 2003 were re-examined 23 months later to determine if

  9. Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction

    NARCIS (Netherlands)

    Lodders, J.N.; Parmar, S.; Stienen, N.-L.M.; Martin, T.J.; Karagozoglu, K.H.; Heymans, M.W.; Nandra, B.; Forouzanfar, T.

    2015-01-01

    Background: The aims of the study were 1) to evaluate the incidence and types of postoperative complications after ablative oral cancer surgery with primary free flap reconstruction and 2) identify prognostic variables for postoperative complications. Material and Methods: Desired data was retrieved

  10. Time trends in the incidence of eating disorders : A primary care study in the Netherlands

    NARCIS (Netherlands)

    van Son, Gabrielle E.; van Hoeken, Daphne; Bartelds, Aad I. M.; van Furth, Eric F.; Hoek, Hans W.

    2006-01-01

    Objective: This Dutch epidemiological study used primary care-based data to examine changes in the incidence of eating disorders in the 1990s compared to the 1980s. Method: A nationwide network of general practitioners, serving a representative sample of the total Dutch population, recorded newly

  11. Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study.

    Science.gov (United States)

    Hernan, Andrea L; Giles, Sally J; Fuller, Jeffrey; Johnson, Julie K; Walker, Christine; Dunbar, James A

    2015-09-01

    Patients can have an important role in reducing harm in primary-care settings. Learning from patient experience and feedback could improve patient safety. Evidence that captures patients' views of the various contributory factors to creating safe primary care is largely absent. The aim of this study was to address this evidence gap. Four focus groups and eight semistructured interviews were conducted with 34 patients and carers from south-east Australia. Participants were asked to describe their experiences of primary care. Audio recordings were transcribed verbatim and specific factors that contribute to safety incidents were identified in the analysis using the Yorkshire Contributory Factors Framework (YCFF). Other factors emerging from the data were also ascertained and added to the analytical framework. Thirteen factors that contribute to safety incidents in primary care were ascertained. Five unique factors for the primary-care setting were discovered in conjunction with eight factors present in the YCFF from hospital settings. The five unique primary care contributing factors to safety incidents represented a range of levels within the primary-care system from local working conditions to the upstream organisational level and the external policy context. The 13 factors included communication, access, patient factors, external policy context, dignity and respect, primary-secondary interface, continuity of care, task performance, task characteristics, time in the consultation, safety culture, team factors and the physical environment. Patient and carer feedback of this type could help primary-care professionals better understand and identify potential safety concerns and make appropriate service improvements. The comprehensive range of factors identified provides the groundwork for developing tools that systematically capture the multiple contributory factors to patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not

  12. Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Panagioti, Maria; Stokes, Jonathan; Esmail, Aneez; Coventry, Peter; Cheraghi-Sohi, Sudeh; Alam, Rahul; Bower, Peter

    2015-01-01

    Multimorbidity is increasingly prevalent and represents a major challenge in primary care. Patients with multimorbidity are potentially more likely to experience safety incidents due to the complexity of their needs and frequency of their interactions with health services. However, rigorous syntheses of the link between patient safety incidents and multimorbidity are not available. This review examined the relationship between multimorbidity and patient safety incidents in primary care. We followed our published protocol (PROSPERO registration number: CRD42014007434). Medline, Embase and CINAHL were searched up to May 2015. Study design and quality were assessed. Odds ratios (OR) and 95% confidence intervals (95% CIs) were calculated for the associations between multimorbidity and two categories of patient safety outcomes: 'active patient safety incidents' (such as adverse drug events and medical complications) and 'precursors of safety incidents' (such as prescription errors, medication non-adherence, poor quality of care and diagnostic errors). Meta-analyses using random effects models were undertaken. Eighty six relevant comparisons from 75 studies were included in the analysis. Meta-analysis demonstrated that physical-mental multimorbidity was associated with an increased risk for 'active patient safety incidents' (OR = 2.39, 95% CI = 1.40 to 3.38) and 'precursors of safety incidents' (OR = 1.69, 95% CI = 1.36 to 2.03). Physical multimorbidity was associated with an increased risk for active safety incidents (OR = 1.63, 95% CI = 1.45 to 1.80) but was not associated with precursors of safety incidents (OR = 1.02, 95% CI = 0.90 to 1.13). Statistical heterogeneity was high and the methodological quality of the studies was generally low. The association between multimorbidity and patient safety is complex, and varies by type of multimorbidity and type of safety incident. Our analyses suggest that multimorbidity involving mental health may be a key driver of safety

  13. Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Maria Panagioti

    Full Text Available Multimorbidity is increasingly prevalent and represents a major challenge in primary care. Patients with multimorbidity are potentially more likely to experience safety incidents due to the complexity of their needs and frequency of their interactions with health services. However, rigorous syntheses of the link between patient safety incidents and multimorbidity are not available. This review examined the relationship between multimorbidity and patient safety incidents in primary care.We followed our published protocol (PROSPERO registration number: CRD42014007434. Medline, Embase and CINAHL were searched up to May 2015. Study design and quality were assessed. Odds ratios (OR and 95% confidence intervals (95% CIs were calculated for the associations between multimorbidity and two categories of patient safety outcomes: 'active patient safety incidents' (such as adverse drug events and medical complications and 'precursors of safety incidents' (such as prescription errors, medication non-adherence, poor quality of care and diagnostic errors. Meta-analyses using random effects models were undertaken.Eighty six relevant comparisons from 75 studies were included in the analysis. Meta-analysis demonstrated that physical-mental multimorbidity was associated with an increased risk for 'active patient safety incidents' (OR = 2.39, 95% CI = 1.40 to 3.38 and 'precursors of safety incidents' (OR = 1.69, 95% CI = 1.36 to 2.03. Physical multimorbidity was associated with an increased risk for active safety incidents (OR = 1.63, 95% CI = 1.45 to 1.80 but was not associated with precursors of safety incidents (OR = 1.02, 95% CI = 0.90 to 1.13. Statistical heterogeneity was high and the methodological quality of the studies was generally low.The association between multimorbidity and patient safety is complex, and varies by type of multimorbidity and type of safety incident. Our analyses suggest that multimorbidity involving mental health may be a key driver of

  14. Microsatellite Status of Primary Colorectal Cancer Predicts the Incidence of Postoperative Colorectal Neoplasms.

    Science.gov (United States)

    Takiyama, Aki; Tanaka, Toshiaki; Yamamoto, Yoko; Hata, Keisuke; Ishihara, Soichiro; Nozawa, Hiroaki; Kawai, Kazushige; Kiyomatsu, Tomomichi; Nishikawa, Takeshi; Otani, Kensuke; Sasaki, Kazuhito; Watanabe, Toshiaki

    2017-10-01

    Few studies have evaluated the risk of postoperative colorectal neoplasms stratified by the nature of primary colorectal cancer (CRC). In this study, we revealed it on the basis of the microsatellite (MS) status of primary CRC. We retrospectively reviewed 338 patients with CRC and calculated the risk of neoplasms during postoperative surveillance colonoscopy in association with the MS status of primary CRC. A propensity score method was applied. We identified a higher incidence of metachronous rectal neoplasms after the resection of MS stable CRC than MS instable CRC (adjusted HR 5.74, p=0.04). We also observed a higher incidence of colorectal tubular adenoma in patients with MSS CRC (adjusted hazard ratio 7.09, pcolorectal cancer influenced the risk of postoperative colorectal neoplasms. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  15. Progesterone receptor levels independently predict survival in endometrial adenocarcinoma

    DEFF Research Database (Denmark)

    Nyholm, H C; Christensen, Ib Jarle; Nielsen, Anette Lynge

    1995-01-01

    Estrogen receptor (ER) and progesterone receptor (PR) contents were determined by biochemical (dextran charcoal-coated (DCC) assay) and immunohistochemical (ICA) methods in biopsies from 145 primary endometrial adenocarcinomas and those with eligible receptor measurements were analyzed with respect...

  16. Usefulness of primary care electronic networks to assess the incidence of chlamydia, diagnosed by general practitioners

    Directory of Open Access Journals (Sweden)

    van der Sande Marianne AB

    2011-07-01

    Full Text Available Abstract Background Chlamydia is the most common curable sexually transmitted infection (STI in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs. Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening in the Netherlands. The aim of this study was to assess the usefulness of electronic medical records for monitoring the incidence of chlamydia cases diagnosed in primary care in the Netherlands. Methods In the electronic records of two regional and two national networks, we identified chlamydia diagnoses by means of ICPC codes (International Classification of Primary Care, laboratory results in free text and the prescription of antibiotics. The year of study was 2007 for the two regional networks and one national network, for the other national network the year of study was 2005. We calculated the incidence of diagnosed chlamydia cases per sex, age group and degree of urbanization. Results A large diversity was observed in the way chlamydia episodes were coded in the four different GP networks and how easily information concerning chlamydia diagnoses could be extracted. The overall incidence ranged from 103.2/100,000 to 590.2/100,000. Differences were partly related to differences between patient populations. Nevertheless, we observed similar trends in the incidence of chlamydia diagnoses in all networks and findings were in line with earlier reports. Conclusions Electronic patient records, originally intended for individual patient care in general practice, can be an additional source of data for monitoring chlamydia incidence in primary care and can be of use in assessing the future impact of population-based chlamydia screening programs. To increase the usefulness of data we recommend more efforts to standardize registration by (specific ICPC code and laboratory results across the existing GP networks.

  17. Medication incidents in primary care medicine: a prospective study in the Swiss Sentinel Surveillance Network (Sentinella).

    Science.gov (United States)

    Gnädinger, Markus; Conen, Dieter; Herzig, Lilli; Puhan, Milo A; Staehelin, Alfred; Zoller, Marco; Ceschi, Alessandro

    2017-07-26

    To describe the type, frequency, seasonal and regional distribution of medication incidents in primary care in Switzerland and to elucidate possible risk factors for medication incidents. Prospective surveillance study. Swiss primary healthcare, Swiss Sentinel Surveillance Network. Patients with drug treatment who experienced any erroneous event related to the medication process and interfering with normal treatment course, as judged by their physician. The 180 physicians in the study were general practitioners or paediatricians participating in the Swiss Federal Sentinel reporting system in 2015. Primary: medication incidents; secondary: potential risk factors like age, gender, polymedication, morbidity, care-dependency, previous hospitalisation. The mean rates of detected medication incidents were 2.07 per general practitioner per year (46.5 per 1 00 000 contacts) and 0.15 per paediatrician per year (2.8 per 1 00 000 contacts), respectively. The following factors were associated with medication incidents (OR, 95% CI): higher age 1.004 per year (1.001; 1.006), care by community nurse 1.458 (1.025; 2.073) and care by an institution 1.802 (1.399; 2.323), chronic conditions 1.052 (1.029; 1.075) per condition, medications 1.052 (1.030; 1.074) per medication, as well as Thurgau Morbidity Index for stage 4: 1.292 (1.004; 1.662), stage 5: 1.420 (1.078; 1.868) and stage 6: 1.680 (1.178; 2.396), respectively. Most cases were linked to an incorrect dosage for a given patient, while prescription of an erroneous medication was the second most common error. Medication incidents are common in adult primary care, whereas they rarely occur in paediatrics. Older and multimorbid patients are at a particularly high risk for medication incidents. Reasons for medication incidents are diverse but often seem to be linked to communication problems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  18. Postoperative vaginal radiation in endometrial cancer using a remote afterloading technique

    International Nuclear Information System (INIS)

    Mandell, L.; Nori, D.; Anderson, L.; Hilaris, B.

    1985-01-01

    Carcinoma of the endometrium is the most common malignancy of the female genital tract. In early stage endometrial cancer, surgery remains the primary mode of treatment while radiation therapy plays an adjuvant role. Prophylactic vaginal radiation has been shown to reduce significantly the incidence of vaginal recurrences. Between the years 1969-1976, 330 patients with FIGO Stages I and II endometrial cancer were treated according to a standard departmental policy in which 40 Gy of external radiation was given to high risk Stage I and II patients in combination with surgery and intravaginal radiation. With this regimen, the mucosal surface received a total equivalent dose of 40 Gy. These treatments were given on an outpatient basis without the need for any sedation or analgesics. The minimum follow-up was 5 years, with a median follow-up of 8.5 years. The overall pelvic and/or vaginal recurrence rate was 2.7%. The incidence of vaginal complications was 3.7%. The advantages of a remote after loading technique in delivering vaginal vault radiation in endometrial cancer are discussed

  19. Dementia incidence trend over 1992-2014 in the Netherlands: Analysis of primary care data.

    Directory of Open Access Journals (Sweden)

    Emma F van Bussel

    2017-03-01

    Full Text Available Recent reports have suggested declining age-specific incidence rates of dementia in high-income countries over time. Improved education and cardiovascular health in early age have been suggested to be bringing about this effect. The aim of this study was to estimate the age-specific dementia incidence trend in primary care records from a large population in the Netherlands.A dynamic cohort representative of the Dutch population was composed using primary care records from general practice registration networks (GPRNs across the country. Data regarding dementia incidence were obtained using general-practitioner-recorded diagnosis of dementia within the electronic health records. Age-specific dementia incidence rates were calculated for all persons aged 60 y and over; negative binomial regression analysis was used to estimate the time trend. Nine out of eleven GPRNs provided data on more than 800,000 older people for the years 1992 to 2014, corresponding to over 4 million person-years and 23,186 incident dementia cases. The annual growth in dementia incidence rate was estimated to be 2.1% (95% CI 0.5% to 3.8%, and incidence rates were 1.08 (95% CI 1.04 to 1.13 times higher for women compared to men. Despite their relatively low numbers of person-years, the highest age groups contributed most to the increasing trend. There was no significant overall change in incidence rates since the start of a national dementia program in 2003 (-0.025; 95% CI -0.062 to 0.011. Increased awareness of dementia by patients and doctors in more recent years may have influenced dementia diagnosis by general practitioners in electronic health records, and needs to be taken into account when interpreting the data.Within the clinical records of a large, representative sample of the Dutch population, we found no evidence for a declining incidence trend of dementia in the Netherlands. This could indicate true stability in incidence rates, or a balance between increased

  20. [The incidence of bilateral multiple primary breast cancer among the female inhabitants of Crimea].

    Science.gov (United States)

    Tel'kina, G N; Sorkin, V M

    1998-08-01

    A method is proposed for calculation of PMSO frequency depending on succession of origination of polyneoplasias. The incidence rate of synchronous bilateral breast cancer (BC) was calculated in reference to all primary BC patients and came to 0.75%. The incidence rate of metachronous bilateral BC was calculated depending on the number of those BC patients having been registered every year of observation and it was found to be 5.4%. The total frequency of bilateral BC in a 20-year follow-up in the Crimean region appeared to be 6.15%. The incidence of metachronous bilateral BC was noted to be dependent on the length of follow-up: 1.27 percent and 4.14 percent in the 3- to 10- and 11- to 20-year periods respectively. The risk for the development of bilateral BC is conditioned by the time having elapsed since detection of the first tumor and increases after 10 and 18 years.

  1. Incidence and outcomes of primary central nervous system lymphoma in solid organ transplant recipients.

    Science.gov (United States)

    Mahale, Parag; Shiels, Meredith S; Lynch, Charles F; Engels, Eric A

    2018-02-01

    Primary central nervous system lymphoma (PCNSL) risk is greatly increased in immunosuppressed human immunodeficiency virus-infected people. Using data from the US transplant registry linked with 17 cancer registries (1987-2014), we studied PCNSL and systemic non-Hodgkin lymphoma (NHL) in 288 029 solid organ transplant recipients. Transplant recipients had elevated incidence for PCNSL compared with the general population (standardized incidence ratio = 65.1; N = 168), and this elevation was stronger than for systemic NHL (standardized incidence ratio=11.5; N = 2043). Compared to kidney recipients, PCNSL incidence was lower in liver recipients (adjusted incidence rate ratio [aIRR] = 0.52), similar in heart and/or lung recipients, and higher in other/multiple organ recipients (aIRR = 2.45). PCNSL incidence was higher in Asians/Pacific Islanders than non-Hispanic whites (aIRR = 2.09); after induction immunosuppression with alemtuzumab (aIRR = 3.12), monoclonal antibodies (aIRR = 1.83), or polyclonal antibodies (aIRR = 2.03); in recipients who were Epstein-Barr virus-seronegative at the time of transplant and at risk of primary infection (aIRR = 1.95); and within the first 1.5 years after transplant. Compared to other recipients, those with PCNSL had increased risk of death (adjusted hazard ratio [aHR] = 11.79) or graft failure/retransplantation (aHR = 3.24). Recipients with PCNSL also had higher mortality than those with systemic NHL (aHR = 1.48). In conclusion, PCNSL risk is highly elevated among transplant recipients, and it carries a poor prognosis. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  2. Developing a patient safety incident classification system for primary care. A literature review and Delphi-survey by the LINNEAUS collaboration on patient safety in primary care.

    Science.gov (United States)

    Klemp, Kerstin; Dovey, Susan; Valderas, Jose M; Rohe, Julia; Godycki-Cwirko, Maciek; Elliott, Phillip; Beyer, Martin; Gerlach, Ferdin M; Hoffmann, Barbara

    2015-09-01

    Despite awareness that comparative analysis of patient safety data from several data sources would promote risk reduction, there has been little effort to establish an incident classification system that is generally applicable to patient safety data in European primary care. To describe the development of a patient safety incident classification system for primary care. A systematic review was followed by an expert group discussion and a modified Delphi survey, to provide consensus statements. We developed a classification system providing a mechanism for classifying patient safety incidents across Europe, taking into account the varying organizational arrangements that exist for primary care. It takes into account organizational processes and outcomes related to patient safety incidents and can supplement existing classification systems. Classification systems are key tools in the analysis of patient safety incidents. A system that has relevance for primary care is now available.

  3. Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Panagioti, Maria; Stokes, Jonathan; Esmail, Aneez; Coventry, Peter; Cheraghi-Sohi, Sudeh; Alam, Rahul; Bower, Peter

    2015-01-01

    Background Multimorbidity is increasingly prevalent and represents a major challenge in primary care. Patients with multimorbidity are potentially more likely to experience safety incidents due to the complexity of their needs and frequency of their interactions with health services. However, rigorous syntheses of the link between patient safety incidents and multimorbidity are not available. This review examined the relationship between multimorbidity and patient safety incidents in primary care. Methods We followed our published protocol (PROSPERO registration number: CRD42014007434). Medline, Embase and CINAHL were searched up to May 2015. Study design and quality were assessed. Odds ratios (OR) and 95% confidence intervals (95% CIs) were calculated for the associations between multimorbidity and two categories of patient safety outcomes: ‘active patient safety incidents’ (such as adverse drug events and medical complications) and ‘precursors of safety incidents’ (such as prescription errors, medication non-adherence, poor quality of care and diagnostic errors). Meta-analyses using random effects models were undertaken. Results Eighty six relevant comparisons from 75 studies were included in the analysis. Meta-analysis demonstrated that physical-mental multimorbidity was associated with an increased risk for ‘active patient safety incidents’ (OR = 2.39, 95% CI = 1.40 to 3.38) and ‘precursors of safety incidents’ (OR = 1.69, 95% CI = 1.36 to 2.03). Physical multimorbidity was associated with an increased risk for active safety incidents (OR = 1.63, 95% CI = 1.45 to 1.80) but was not associated with precursors of safety incidents (OR = 1.02, 95% CI = 0.90 to 1.13). Statistical heterogeneity was high and the methodological quality of the studies was generally low. Conclusions The association between multimorbidity and patient safety is complex, and varies by type of multimorbidity and type of safety incident. Our analyses suggest that multimorbidity

  4. Risks of Endometrial Cancer Screening

    Science.gov (United States)

    ... the most common invasive cancer of the female reproductive system. Endometrial cancer is diagnosed most often in postmenopausal women at an average age of 60 years. From 2005 to 2014, the number of new cases of endometrial cancer increased slightly ...

  5. [Development of an algorithm to predict the incidence of major depression among primary care consultants].

    Science.gov (United States)

    Saldivia, Sandra; Vicente, Benjamin; Marston, Louise; Melipillán, Roberto; Nazareth, Irwin; Bellón-Saameño, Juan; Xavier, Miguel; Maaroos, Heidi Ingrid; Svab, Igor; Geerlings, M-I; King, Michael

    2014-03-01

    The reduction of major depression incidence is a public health challenge. To develop an algorithm to estimate the risk of occurrence of major depression in patients attending primary health centers (PHC). Prospective cohort study of a random sample of 2832 patients attending PHC centers in Concepción, Chile, with evaluations at baseline, six and twelve months. Thirty nine known risk factors for depression were measured to build a model, using a logistic regression. The algorithm was developed in 2,133 patients not depressed at baseline and compared with risk algorithms developed in a sample of 5,216 European primary care attenders. The main outcome was the incidence of major depression in the follow-up period. The cumulative incidence of depression during the 12 months follow up in Chile was 12%. Eight variables were identified. Four corresponded to the patient (gender, age, depression background and educational level) and four to patients' current situation (physical and mental health, satisfaction with their situation at home and satisfaction with the relationship with their partner). The C-Index, used to assess the discriminating power of the final model, was 0.746 (95% confidence intervals (CI = 0,707-0,785), slightly lower than the equation obtained in European (0.790 95% CI = 0.767-0.813) and Spanish attenders (0.82; 95% CI = 0.79-0.84). Four of the factors identified in the risk algorithm are not modifiable. The other two factors are directly associated with the primary support network (family and partner). This risk algorithm for the incidence of major depression provides a tool that can guide efforts towards design, implementation and evaluation of effectiveness of interventions to prevent major depression.

  6. Endometrial Stem Cells and Reproduction

    OpenAIRE

    Morelli, Sara S.; Yi, Pauline; Goldsmith, Laura T.

    2012-01-01

    Abnormal endometrial function remains a significant cause of implantation failure, recurrent pregnancy loss, and other pathologies responsible for female infertility. The development of novel therapies to treat infertility due to endometrial dysfunction requires an understanding of the latest advancements in endometrial cell biology, such as the role of endometrial stem cells. The remarkable regenerative capacity of the human endometrium is absolutely essential for successful reproduction an...

  7. Coding, recording and incidence of different forms of coronary heart disease in primary care.

    Directory of Open Access Journals (Sweden)

    Nawaraj Bhattarai

    Full Text Available To evaluate the coding, recording and incidence of coronary heart disease (CHD in primary care electronic medical records.Data were drawn from the UK General Practice Research Database. Analyses evaluated the occurrence of 271 READ medical diagnostic codes, including categories for 'Angina', 'Myocardial Infarction', 'Coronary Artery Bypass Grafting' (CABG, 'percutaneous transluminal coronary angioplasty' (PCTA and 'Other Coronary Heart Disease'. Time-to-event analyses were implemented to evaluate occurrences of different groups of codes after the index date.Among 300,020 participants aged greater than 30 years there were 75,197 unique occurrences of coronary heart disease codes in 24,244 participants, with 12,495 codes for incident events and 62,702 for prevalent events. Among incident event codes, 3,607 (28.87% were for angina, 3,262 (26.11% were for MI, 514 (4.11% for PCTA, 161 (1.29% for CABG and 4,951 (39.62% were for 'Other CHD'. Among prevalent codes, 20,254 (32.30% were for angina, 3,644 (5.81% for MI, 34,542 (55.09% for 'Other CHD' and 4,262 (6.80% for CABG or PCTA. Among 3,685 participants initially diagnosed exclusively with 'Other CHD' codes, 17.1% were recorded with angina within 5 years, 5.6% with myocardial infarction, 6.3% with CABG and 8.6% with PCTA. From 2000 to 2010, the overall incidence of CHD declined, as did the incidence of angina, but the incidence of MI did not change. The frequency of CABG declined, while PCTA increased.In primary care electronic records, a substantial proportion of coronary heart disease events are recorded with codes that do not distinguish between different clinical presentations of CHD. The results draw attention to the need to improve coding practice in primary care. The results also draw attention to the importance of code selection in research studies and the need for sensitivity analyses using different sets of codes.

  8. A safety incident reporting system for primary care. A systematic literature review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care.

    Science.gov (United States)

    Klemp, Kerstin; Zwart, Dorien; Hansen, Jørgen; Hellebek, Torben; Luettel, Dagmar; Verstappen, Wim; Beyer, Martin; Gerlach, Ferdin M; Hoffmann, Barbara; Esmail, Aneez

    2015-09-01

    Incident reporting is widely used in both patient safety improvement programmes, and in research on patient safety. To identify the key requirements for incident reporting systems in primary care; to develop an Internet-based incident reporting and learning system for primary care. A literature review looking at the purpose, design and requirements of an incident reporting system (IRS) was used to update an existing incident reporting system, widely used in Germany. Then, an international expert panel with knowledge on IRS developed the criteria for the design of a new web-based incident reporting system for European primary care. A small demonstration project was used to create a web-based reporting system, to be made freely available for practitioners and researchers. The expert group compiled recommendations regarding the desirable features of an incident reporting system for European primary care. These features covered the purpose of reporting, who should be involved in reporting, the mode of reporting, design considerations, feedback mechanisms and preconditions necessary for the implementation of an IRS. A freely available web-based reporting form was developed, based on these criteria. It can be modified for local contexts. Practitioners and researchers can use this system as a means of recording patient safety incidents in their locality and use it as a basis for learning from errors. The LINNEAUS collaboration has provided a freely available incident reporting system that can be modified for a local context and used throughout Europe.

  9. Genetics of Endometrial Cancers

    Directory of Open Access Journals (Sweden)

    Tsuyoshi Okuda

    2010-01-01

    Full Text Available Endometrial cancers exhibit a different mechanism of tumorigenesis and progression depending on histopathological and clinical types. The most frequently altered gene in estrogen-dependent endometrioid endometrial carcinoma tumors is PTEN. Microsatellite instability is another important genetic event in this type of tumor. In contrast, p53 mutations or Her2/neu overexpression are more frequent in non-endometrioid tumors. On the other hand, it is possible that the clear cell type may arise from a unique pathway which appears similar to the ovarian clear cell carcinoma. K-ras mutations are detected in approximately 15%–30% of endometrioid carcinomas, are unrelated to the existence of endometrial hyperplasia. A β-catenin mutation was detected in about 20% of endometrioid carcinomas, but is rare in serous carcinoma. Telomere shortening is another important type of genomic instability observed in endometrial cancer. Only non-endometrioid endometrial carcinoma tumors were significantly associated with critical telomere shortening in the adjacent morphologically normal epithelium. Lynch syndrome, which is an autosomal dominantly inherited disorder of cancer susceptibility and is characterized by a MSH2/MSH6 protein complex deficiency, is associated with the development of non-endometrioid carcinomas.

  10. Kawasaki disease incidence in children and adolescents: an observational study in primary care.

    Science.gov (United States)

    Hall, Gillian C; Tulloh, Louise E; Tulloh, Robert M R

    2016-04-01

    Kawasaki disease is reported to be increasing in incidence and is the commonest childhood cause of acquired heart disease in the Western world. To determine the current UK incidence of Kawasaki disease across childhood and adolescence; and investigate trends over time and season. An observational, descriptive study in the UK. The Health Improvement Network (THIN) database of primary healthcare records was searched for codes or text indicating Kawasaki disease. Identified records were compared with a study case definition and a date of onset was assigned to cases. The incidence, age/sex distribution, and trend in seasonal and temporal distribution were estimated (2008-2012). A total of 110 episodes of Kawasaki disease in 109 children were identified from 3.9 million person-years observation. The incidence of Kawasaki disease was 2.8 per 100 000 person-years (95% confidence interval [CI] = 2.3 to 3.4) when aged Kawasaki disease remains low and has stabilised in the UK, GPs should recognise that the condition occurs throughout childhood and across the seasons. © British Journal of General Practice 2016.

  11. Incidence, clinical features, treatment and outcome of primary central nervous system lymphoma in Norway.

    Science.gov (United States)

    Salvesen Haldorsen, Ingfrid; Aarseth, Jan Harald; Hollender, Aase; Larsen, John Ludvig; Espeland, Ansgar; Mella, Olav

    2004-01-01

    The incidence of primary central nervous system lymphoma (PCNSL) has been reported to increase in some parts of the world, while being stable in other regions. In an attempt to characterize the incidence rate, clinical features, treatment, outcome, and prognostic factors of PCNSL in Norway, we report our experience in a large unselected series of patients. Clinical features, histological diagnosis, radiological findings, treatment, and outcome of all patients diagnosed with PCNSL in Norway in the years 1989-1998 were registered. During the 10-year period 58 new cases of histologically verified PCNSL were registered in Norway. The annual incidence rate of PCNSL was on average 1.34 cases per million people with a non-significant increasing trend (p=0.069). For patients diagnosed before death (n=45) the estimated survival following histological diagnosis was 55%, 47%, and 23% at 1, 2, and 5 years, respectively. In Cox-regression analysis age, WHO performance status and treatment had independent prognostic impact on survival. In the studied decade, there was a non-significant trend towards increased incidence of PCNSL, perhaps due to increased availability of diagnostic imaging, especially magnetic resonance imaging.

  12. Vabrasio is a reliable test to rule out endometrial cancer

    DEFF Research Database (Denmark)

    Andersen, Anita; Lauszus, Finn Friis

    2015-01-01

    Introduction: Endometrial cancer is the most common gynaecological cancer in Denmark, and its incidence peaks in the postmenopausal years. The aim of the present study was to evaluate the effectiveness of vacuum aspirator (vabrasio) for the detection of endometrial cancer in terms of sensitivity...... in 381 women (76%), insufficient in 83 women (17%), 22 (4%) had endometrial cancer and 17 (3%) had another non-malignant diagnosis. The first evaluation for cancer with vabrasio had a sensitivity of 81%, a specif­icity of 100% and predictive values of 100% (positive) and 99% (negative). Conclusion......: Vabrasio has a good diagnostic reliability with respect to endometrial cancer, but has some shortcomings due to insufficient sampling for diagnosis. Funding: none. Trial registration: not relevant. Danish Data Protection Agency: case no.: 1-16-02-601-14....

  13. Contributory factors to patient safety incidents in primary care: protocol for a systematic review.

    Science.gov (United States)

    Giles, Sally; Panagioti, Maria; Hernan, Andrea; Cheraghi-Sohi, Sudeh; Lawton, Rebecca

    2015-05-07

    Organisations need to systematically identify contributory factors (or causes) which impact on patient safety in order to effectively learn from error. Investigations of error have tended to focus on taking a reactive approach to learning from error, mainly relying on incident-reporting systems. Existing frameworks which aim to identify latent causes of error rely almost exclusively on evidence from non-healthcare settings. In view of this, the Yorkshire Contributory Factors Framework (YCFF) was developed in the hospital setting. Eighty-five percent of healthcare contacts occur in primary care. As a result, this review will build on the work that produced the YCFF, by examining the empirical evidence that relates to the contributory factors of error within a primary care setting. Four electronic bibliographic databases will be searched: MEDLINE, Embase, PsycInfo and CINAHL. The database search will be supplemented by additional search methodologies including citation searching and snowballing strategies which include reviewing reference lists and reviewing relevant journal table of contents, that is, BMJ Quality and Safety. Our search strategy will include search combinations of three key blocks of terms. Studies will not be excluded based on design. Included studies will be empirical studies conducted in a primary care setting. They will include some description of the factors that contribute to patient safety. One reviewer (SG) will screen all the titles and abstracts, whilst a second reviewer will screen 50% of the abstracts. Two reviewers (SG and AH) will perform study selection, quality assessment and data extraction using standard forms. Disagreements will be resolved through discussion or third party adjudication. Data to be collected include study characteristics (year, objective, research method, setting, country), participant characteristics (number, age, gender, diagnoses), patient safety incident type and characteristics, practice characteristics and

  14. Obesity associated advanced glycation end products within the human uterine cavity adversely impact endometrial function and embryo implantation competence.

    Science.gov (United States)

    Antoniotti, Gabriella S; Coughlan, Melinda; Salamonsen, Lois A; Evans, Jemma

    2018-04-01

    Do obese levels of advanced glycation end products (AGEs) within the uterine cavity detrimentally alter tissue function in embryo implantation and placental development? Obese levels of AGEs activate inflammatory signaling (p65 NFκB) within endometrial epithelial cells and alter their function, cause endoplasmic reticulum (ER) stress in endometrial stromal cells and impair decidualization, compromise implantation of blastocyst mimics and inhibit trophoblast invasion. Obese women experience a higher incidence of infertility, recurrent miscarriage and pregnancy complications compared with lean women. Oocyte donation cycles suggest a detrimental uterine environment plays a role in these outcomes. Uterine lavage and tissues from lean (BMI 19.5-24.9, n = 17) and obese (BMI > 30, n = 16) women examined. Cell culture experiments utilizing human endometrial epithelial, trophectoderm and trophoblast cell lines and primary human stromal cells used to examine the functional impact of obese levels of AGEs. Levels of AGEs examined within uterine lavage assessed by ELISA to determine differences between lean and obese women. Expression and localization of AGEs, receptor for AGEs (RAGE) and NFκB within endometrial tissues obtained from lean and obese women determined by immunohistochemistry. Endometrial epithelial cells (ECC-1), primary human stromal cells and trophoblast cells (HTR8-SVneo) treated with lean (2000 nmol/mol lysine) or obese (8000 nmol/mol lysine) uterine levels of AGEs and p65 NFκB (western immunoblot), real-time adhesion, proliferation migration and invasion (xCelligence real-time cell function analysis), decidualization (cell morphology and prolactin release), ER stress (western immunoblot for p-PERK) determined. Co-cultures of endometrial epithelial cells and blastocyst mimics (trophectoderm spheroids) similarly treated with lean or obese uterine levels of AGEs to determine their impact on embryo implantation. AGEs were significantly elevated (P = 0

  15. Patient safety in primary allied health care: what can we learn from incidents in a Dutch exploratory cohort study?

    Science.gov (United States)

    van Dulmen, Simone A; Tacken, Margot A J B; Staal, J Bart; Gaal, Sander; Wensing, Michel; Nijhuis-van der Sanden, Maria W G

    2011-12-01

    Research on patient safety in allied healthcare is scarce. Our aim was to document patient safety in primary allied healthcare in the Netherlands and to identify factors associated with incidents. DESIGN AND SUBJECT: A retrospective study of 1000 patient records in a representative sample of 20 allied healthcare practices was combined with a prospective incident-reporting study. All records were reviewed by trained researchers to identify patient safety incidents. The incidents were classified and analyzed, using the Prevention and Recovery Information System for Monitoring and Analysis method. Factors associated with incidents were examined in a logistic regression analysis. In 18 out of 1000 (1.8%; 95% confidence interval: 1.0-2.6) records an incident was detected. The main causes of incidents were related to errors in clinical decisions (89%), communication with other healthcare providers (67%), and monitoring (56%). The probability of incidents was higher if more care providers had been involved and if patient records were incomplete (37% of the records). No incidents were reported in the prospective study. The absolute number of incidents was low, which could imply a low risk of harm in Dutch primary allied healthcare. Nevertheless, incompleteness of the patient records and the fact that incidents were mainly caused through human actions suggest that a focus on clinical reasoning and record keeping is needed to further enhance patient safety. Improvements in record keeping will be necessary before accurate incident reporting will be feasible and valid.

  16. Developing a patient safety incident classification system for primary care. A literature review and Delphi-survey by the LINNEAUS collaboration on patient safety in primary care

    OpenAIRE

    Klemp, Kerstin; Dovey, Susan; Valderas, Jose M; Rohe, Julia; Godycki-Cwirko, Maciek; Elliott, Phillip; Beyer, Martin; Gerlach, Ferdin M.; Hoffmann, Barbara

    2015-01-01

    ABSTRACT Background: Despite awareness that comparative analysis of patient safety data from several data sources would promote risk reduction, there has been little effort to establish an incident classification system that is generally applicable to patient safety data in European primary care. Objective: To describe the development of a patient safety incident classification system for primary care. Methods: A systematic review was followed by an expert group discussion and a modified Delp...

  17. Oral contraception and risk of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Mueck AO

    2011-10-01

    Full Text Available Alfred O Mueck1, Harald Seeger1, Xiangyan Ruan2 1Department of Endocrinology and Menopause, University Women's Hospital of Tuebingen, Tuebingen, Germany; 2Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China Abstract: No placebo-controlled studies concerning hormonal contraception in general have been published, and only investigations on biological mechanisms and observational clinical studies are available. Thus, associations can be described but not their causality. Experimental studies strongly suggest protective effects of the progestagen component of hormonal contraception against development of estrogen-related (type 1 endometrial cancer. In light of this research, it seems biologically plausible that, in more than 20 published studies, a reduction in endometrial cancer risk was achieved in up to 50% of users of combined oral contraceptives (COC, compared with nonusers. Few data exist for progestin-only oral preparations. However, in view of the mechanisms involved, a reduction in cancer risk should also be expected. Whereas hormonal dose-dependency has been investigated in only a few studies, which showed a stronger risk reduction with increasing progestagenic potency, a decreased risk dependent on duration of use has been clearly demonstrated, and after stopping COC this effect has persisted for up to 20 years. Possible confounders, including family history, parity, and smoking, have been investigated in a few studies, with only a minor impact on hormonal effect of endometrial cancer risk, with the exception of obesity, which was a strong risk factor in most but not all studies. There are obvious differences in the incidence of endometrial cancer in women using COC when evaluated in absolute numbers for Western and Asian countries, being about 3–5-fold higher in the US than in Asia. Further research should include the noncontraceptive benefit of COC

  18. Three decades of eating disorders in Dutch primary care : decreasing incidence of bulimia nervosa but not of anorexia nervosa

    NARCIS (Netherlands)

    Smink, F. R. E.; van Hoeken, D.; Donker, G. A.; Susser, E. S.; Oldehinkel, A. J.; Hoek, H. W.

    Background Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and

  19. Three decades of eating disorders in Dutch primary care: decreasing incidence of bulimia nervosa but not of anorexia nervosa.

    NARCIS (Netherlands)

    Smink, F.R.E.; Hoeken, D. van; Donker, G.A.; Susser, E.S.; Oldehinkel, A.L.; Hoek, H.W.

    2016-01-01

    Background: Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and

  20. Caffeinated Coffee, Decaffeinated Coffee and Endometrial Cancer Risk: A Prospective Cohort Study among US Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Katherine W. Reeves

    2011-11-01

    Full Text Available There is plausible biological evidence as well as epidemiologic evidence to suggest coffee consumption may lower endometrial cancer risk. We evaluated the associations between self-reported total coffee, caffeinated coffee and decaffeinated coffee, and endometrial cancer risk using the Women’s Health Initiative Observational Study Research Materials obtained from the National Heart, Lung, and Blood Institute Biological Specimen and Data Repository Coordinating Center. Our primary analyses included 45,696 women and 427 incident endometrial cancer cases, diagnosed over a total of 342,927 person-years of follow-up. We used Cox-proportional hazard models to evaluate coffee consumption and endometrial cancer risk. Overall, we did not find an association between coffee consumption and endometrial cancer risk. Compared to non-daily drinkers (none or < 1 cup/day, the multivariable adjusted hazard ratios for women who drank ≥4 cups/day were 0.86 (95% confidence interval (CI 0.63, 1.18 for total coffee, 0.89 (95% CI 0.63, 1.27 for caffeinated coffee, and 0.51 (95% CI 0.25, 1.03 for decaf coffee. In subgroup analyses by body mass index (BMI there were no associations among normal-weight and overweight women for total coffee and caffeinated coffee. However among obese women, compared to the referent group (none or < 1 cup/day, the hazard ratios for women who drank ≥2 cups/day were: 0.72 (95% CI 0.50, 1.04 for total coffee and 0.66 (95% CI 0.45, 0.97 for caffeinated coffee. Hazard ratios for women who drank ≥2 cups/day for decaffeinated coffee drinkers were 0.67 (0.43–1.06, 0.93 (0.55–1.58 and 0.80 (0.49–1.30 for normal, overweight and obese women, respectively. Our study suggests that caffeinated coffee consumption may be associated with lower endometrial cancer risk among obese postmenopausal women, but the association with decaffeinated coffee remains unclear.

  1. Incidence and clinical vital parameters in primary ketosis of Murrah buffaloes

    Science.gov (United States)

    Kumar, Ankit; Sindhu, Neelesh; Kumar, Parmod; Kumar, Tarun; Charaya, Gaurav; Surbhi; Jain, V. K.; Sridhar

    2015-01-01

    Aim: The present study was undertaken to ascertain the incidence and clinical vital parameters in cases of primary ketosis in Murrah buffaloes brought to teaching veterinary clinical complex, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar and from adjoining villages of the district Hisar, Haryana, India. Materials and Methods: The investigation was conducted on 24 clinical cases (out of total 145 screened) of primary ketosis. The diagnosis was confirmed on the basis of clinical signs and significantly positive two tests for ketone bodies in urine (Rothera’s and Keto-Diastix strip test). Data collected were statistically analyzed using independent Student’s t-test. Results: Overall incidence of disease in these areas was found to be 16.55% and all the animals were recently parturited (mean: 1.42±0.14 month), on an average in their third lactation (mean: 2.38±0.30) and exhibited clinical signs such as selective anorexia (refusal to feed on concentrate diet), drastic reduction in milk yield (mean: 64.4±5.35%), ketotic odor from urine, breath, and milk and rapid loss of body condition. All the clinical vital parameters in ketotic buffaloes (body temperature, heart rate, respiration rate, and rumen movements) were within normal range. Conclusion: Primary ketosis in Murrah buffaloes was the most common seen in the third lactation, within the first 2 months after parturition with characteristics clinical signs and no variability in vital parameters. The disease has severe effect on the production status of affected animal. PMID:27047203

  2. Newly diagnosed incident dizziness of older patients: a follow-up study in primary care

    Directory of Open Access Journals (Sweden)

    Hummers-Pradier Eva

    2011-06-01

    Full Text Available Abstract Background Dizziness is a common complaint of older patients in primary care, yet not much is known about the course of incident dizziness. The aim of the study was to follow-up symptoms, subjective impairments and needs of older patients (≥65 with incident dizziness and to determine predictors of chronic dizziness. Furthermore, we analysed general practitioners' (GPs' initial diagnoses, referrals and revised diagnoses after six months. Methods An observational study was performed in 21 primary care practices in Germany, including a four-week and six-month follow-up. A questionnaire comprising characteristic matters of dizziness and a series of validated instruments was completed by 66 participants during enrolment and follow-up (after 1 month and 6 months. After six months, chart reviews and face-to-face interviews were also performed with the GPs. Results Mean scores of dizziness handicap, depression and quality of life were not or only slightly affected, and did not deteriorate during follow-up; however, 24 patients (34.8% showed a moderate or severe dizziness handicap, and 43 (62.3% showed a certain disability in terms of quality of life at the time of enrolment. In multivariate analysis, n = 44 patients suffering from chronic dizziness (dependent variable, i.e. relapsing or persistent at six months initially had a greater dizziness handicap (OR 1.42, 95%CI 1.05-1.47 than patients with transient dizziness. GPs referred 47.8% of the patients to specialists who detected two additional cases of benign paroxysmal positional vertigo (BPPV. Conclusions New-onset dizziness relapsed or persisted in a considerable number of patients within six months. This was difficult to predict due to the patients' heterogeneous complaints and characteristics. Symptom persistence does not seem to be associated with deterioration of the psychological status in older primary care patients. Management strategies should routinely consider BPPV as

  3. Incidence and clinical vital parameters in primary ketosis of Murrah buffaloes

    Directory of Open Access Journals (Sweden)

    Ankit Kumar

    2015-09-01

    Full Text Available Aim: The present study was undertaken to ascertain the incidence and clinical vital parameters in cases of primary ketosis in Murrah buffaloes brought to teaching veterinary clinical complex, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar and from adjoining villages of the district Hisar, Haryana, India. Materials and Methods: The investigation was conducted on 24 clinical cases (out of total 145 screened of primary ketosis. The diagnosis was confirmed on the basis of clinical signs and significantly positive two tests for ketone bodies in urine (Rothera’s and Keto-Diastix strip test. Data collected were statistically analyzed using independent Student’s t-test. Results: Overall incidence of disease in these areas was found to be 16.55% and all the animals were recently parturited (mean: 1.42±0.14 month, on an average in their third lactation (mean: 2.38±0.30 and exhibited clinical signs such as selective anorexia (refusal to feed on concentrate diet, drastic reduction in milk yield (mean: 64.4±5.35%, ketotic odor from urine, breath, and milk and rapid loss of body condition. All the clinical vital parameters in ketotic buffaloes (body temperature, heart rate, respiration rate, and rumen movements were within normal range. Conclusion: Primary ketosis in Murrah buffaloes was the most common seen in the third lactation, within the first 2 months after parturition with characteristics clinical signs and no variability in vital parameters. The disease has severe effect on the production status of affected animal.

  4. Incidence of facial nerve sacrifice in parotidectomy for primary and metastatic malignancies.

    Science.gov (United States)

    Swendseid, Brian; Li, Shawn; Thuener, Jason; Rezaee, Rod; Lavertu, Pierre; Fowler, Nicole; Zender, Chad

    2017-10-01

    The parotid gland may become involved by primary parotid malignancies and secondarily by metastases from other primary sites. Surgical resection of these tumors can be technically challenging due to the intimate relationship of the parotid gland and the facial nerve. The primary aim of this project was to determine the incidence of facial nerve sacrifice in parotidectomy for primary and secondary malignancies of the parotid. A retrospective chart review of was performed. Patients who received parotidectomy with final pathology consistent with a malignant neoplasm were included. The primary outcome studied was necessity for facial nerve sacrifice. Co-variates included preoperative facial nerve function, preoperative pain, superficial versus total parotidectomy and pathologic diagnosis. Univariate analysis was performed using student t-test to determine odds ratios. We identified 75 patients who had a parotidectomy for a malignant process in our review. 30 patients had facial nerve sacrifice: 14 total and 16 partial sacrifices. Patients were more likely to require facial nerve sacrifice when they presented with preoperative facial nerve dysfunction [100% vs 19.6%, p=0.0006, OR 154.3, CI (8.66-2750.9)], pre-op pain [76.5% vs. 29.3%, p=0.001, OR 7.84, CI (2.23-27.50)], and required excision of both superficial and deep lobes of the parotid gland [64.9% vs 15.8%, p=0.0001, OR 9.85, CI (3.27-29.66)]. Our data illustrates that many patients with normal facial nerve function, even in the setting of malignancy, can have their facial nerve preserved. Pain, deep lobe involvement and preoperative facial nerve dysfunction are associated with an increased risk of needing at least partial facial nerve sacrifice in the setting of parotid gland malignancies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Radiation Therapy With or Without Cisplatin in Treating Patients With Recurrent Endometrial Cancer

    Science.gov (United States)

    2018-02-14

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Endometrioid Adenocarcinoma, Variant With Squamous Differentiation; Endometrial Serous Adenocarcinoma; Recurrent Uterine Corpus Carcinoma

  6. The prevalence, incidence and natural history of primary sclerosing cholangitis in an ethnically diverse population

    Directory of Open Access Journals (Sweden)

    Li Chin-Shang

    2011-07-01

    Full Text Available Abstract Background Primary sclerosing cholangitis (PSC is a rare chronic cholestatic liver disease often associated with inflammatory bowel diseases (IBD. Current epidemiological data are limited to studies of predominantly Caucasian populations. Our aim was to define the epidemiology of PSC in a large, ethnically diverse US population. Methods The Northern California Kaiser Permanente (KP database includes records from over 3 million people and was searched for cases of PSC between January 2000 and October 2006. All identified charts were reviewed for diagnosis confirmation, IBD co-morbidity, and major natural history endpoints. Results We identified 169 (101 males cases fulfilling PSC diagnostic criteria with a mean age at diagnosis of 44 years (range 11-81. The age-adjusted point prevalence was 4.15 per 100,000 on December 31, 2005. The age-adjusted incidence per 100,000 person-years was not significantly greater in men 0.45 (95% CI 0.33 - 0.61 than women 0.37 (95% CI 0.26 - 0.51. IBD was present in 109/169 (64.5% cases and was significantly more frequent in men than women with PSC (73.3% and 51.5%, respectively, p = 0.005. The cumulative average yearly mortality rate was 1.9%. Age and serum sodium, creatinine and bilirubin at diagnosis and albumin at last entry were identified as significant factors associated with death, liver transplant or cholangiocarcinoma. Conclusions The incidence and prevalence of PSC observed in a representative Northern California population are lower compared to previous studies in Caucasian populations and this might reflect differences in the incidence of PSC among various ethnic groups.

  7. The incidence and risk factors of asymptomatic primary spontaneous pneumothorax detected during health check-ups.

    Science.gov (United States)

    Mitani, Akihisa; Hakamata, Yukichika; Hosoi, Megumi; Horie, Masafumi; Murano, Yoko; Saito, Akira; Yanagimoto, Shintaro; Tsuji, Shoji; Yamamoto, Kazuhiko; Nagase, Takahide

    2017-12-07

    Patients with primary spontaneous pneumothorax (PSP) usually complain of sudden-onset dyspnea and pleuritic chest pain. However, asymptomatic PSP has been incidentally detected on chest X-rays. In this study, we analyzed the incidence, characteristics, risk factors, and prognosis of asymptomatic PSP detected during regular medical check-ups in university students. In this study, 101,709 chest X-rays were performed during medical check-ups for students at the University of Tokyo between April 2011 and March 2016. Among them, 43 cases of asymptomatic PSP (0.042%) were detected. We calculated the lung collapse rate of pneumothorax using Kircher's method. We also analyzed risk factors associated with asymptomatic PSP using characteristics inspected in medical check-ups. The incidence of asymptomatic PSP was significantly higher in men than in women (0.050% vs 0.018%). Multivariate analysis revealed an association of younger age, greater height, lower body mass index, and greater height growth per year with an increased risk of asymptomatic PSP in male students. Mild lung collapse (up is very important because a considerable number of patients with mild lung collapse eventually require an invasive medical procedure.

  8. Saline Infusion Test highly associated with the incidence of cardio- and cerebrovascular events in primary aldosteronism.

    Science.gov (United States)

    Hayashi, Reiko; Tamada, Daisuke; Murata, Masahiko; Mukai, Kosuke; Kitamura, Tetsuhiro; Otsuki, Michio; Shimomura, Iichiro

    2017-05-30

    Primary aldosteronism (PA) is caused by excess secretion of aldosterone and is an independent risk factor for cardio-cerebro-vascular (CCV) events. The goal of treatment of PA should include prevention of CCV events. A definitive diagnosis of PA is established by confirmatory tests [saline infusion test (SIT), furosemide upright test (FUT) and captopril challenge test (CCT)]. However, there is no information on whether the hormone levels measured by these confirmatory tests are associated with CCV events. The aim of this retrospective study was to elucidate the relationship between the results of the above confirmatory tests and prevalence of CCV disease in patients with PA. The study subjects were 292 PA patients who were assessed for past history of CCV events at the time of diagnosis of PA. CCV events were significantly higher in patients with positive than negative SIT (12.8% vs. 3.3%, p=0.04). There were no differences in the incidences of CCV events between patients with positive and negative CCT and FUT (CCT: 11.0% vs. 3.9%, p=0.13, FUT: 6.1% vs. 5.7%, p=0.93). Our results demonstrated a higher incidence of CCV disease in PA SIT-positive patients compared to those with negative test. SIT is a potentially useful test not only for the diagnosis of PA but also assessment of the risk of CCV events.

  9. Incidence of second primary malignancies and related mortality in patients with imatinib-treated chronic myeloid leukemia.

    Science.gov (United States)

    Gugliotta, Gabriele; Castagnetti, Fausto; Breccia, Massimo; Albano, Francesco; Iurlo, Alessandra; Intermesoli, Tamara; Abruzzese, Elisabetta; Levato, Luciano; D'Adda, Mariella; Pregno, Patrizia; Cavazzini, Francesco; Stagno, Fabio; Martino, Bruno; La Barba, Gaetano; Sorà, Federica; Tiribelli, Mario; Bigazzi, Catia; Binotto, Gianni; Bonifacio, Massimiliano; Caracciolo, Clementina; Soverini, Simona; Foà, Robin; Cavo, Michele; Martinelli, Giovanni; Pane, Fabrizio; Saglio, Giuseppe; Baccarani, Michele; Rosti, Gianantonio

    2017-09-01

    The majority of patients with chronic myeloid leukemia are successfully managed with life-long treatment with tyrosine kinase inhibitors. In patients in chronic phase, other malignancies are among the most common causes of death, raising concerns on the relationship between these deaths and the off-target effects of tyrosine kinase inhibitors. We analyzed the incidence of second primary malignancies, and related mortality, in 514 chronic myeloid leukemia patients enrolled in clinical trials in which imatinib was given as first-line treatment. We then compared the observed incidence and mortality with those expected in the age- and sex-matched Italian general population, calculating standardized incidence and standardized mortality ratios. After a median follow-up of 74 months, 5.8% patients developed second primary malignancies. The median time from chronic myeloid leukemia to diagnosis of the second primary malignancies was 34 months. We did not find a higher incidence of second primary malignancies compared to that in the age- and sex-matched Italian general population, with standardized incidence ratios of 1.06 (95% CI: 0.57-1.54) and 1.61 (95% CI: 0.92-2.31) in males and females, respectively. Overall, 3.1% patients died of second primary malignancies. The death rate in patients with second primary malignancies was 53% (median overall survival: 18 months). Among females, the observed cancer-related mortality was superior to that expected in the age- and sex-matched Italian population, with a standardized mortality ratio of 2.41 (95% CI: 1.26 - 3.56). In conclusion, our analysis of patients with imatinib-treated chronic myeloid leukemia did not reveal a higher incidence of second primary malignancies; however, the outcome of second primary malignancies in such patients was worse than expected. Clinicaltrials.gov: NCT00514488, NCT00510926. Copyright© 2017 Ferrata Storti Foundation.

  10. General Information About Endometrial Cancer

    Science.gov (United States)

    ... uterus. See the PDQ summary on Uterine Sarcoma Treatment for more information about uterine sarcoma . Obesity and having metabolic syndrome may increase the risk of endometrial cancer. Anything ...

  11. Treatment Option Overview (Endometrial Cancer)

    Science.gov (United States)

    ... uterus. See the PDQ summary on Uterine Sarcoma Treatment for more information about uterine sarcoma . Obesity and having metabolic syndrome may increase the risk of endometrial cancer. Anything ...

  12. Effect of demographic factors on brachytherapy treatment results in patients with endometrial cancer 1995-2010.

    Science.gov (United States)

    Jurczyk, Mieczysława U; Chmaj-Wierzchowska, Karolina; Klofik, Joanna; Sajdak, Stefan; Opala, Tomasz

    2013-01-01

    Approximately 1 in 20 female cancers in Europe is of the endometrium. Endometrial carcinoma is the most common gynaecologic cancer. Considering the fact that an upward tendency has recently been observed in morbidity due to this type of cancer, this is a serious medical problem. The presented report describes the results of the analysis of selected demographic factors and their effect on the incidence of endometrial cancer. Analysis of the results of treatment of endometrial cancer during 1995-2010 was also an objective of the study. Based on medical records obtained from the HDR Laboratory of Brachytherapy at the Gynaecological & Obstetrics Clinical Hospital, University of Medical Sciences in Poznań, the results of treatment of patients with endometrial cancer by brachytherapy were analyzed. The analysis covered a group of 400 patients. More than a half of the patients completed their education on the level of elementary or secondary school. Taking into consideration the weight of the patients, it appeared that most women had excessive body weight. Most frequently, concomitant hypertension was observed. Moreover, the age at menarche was 12 and 13. Demographic factors exert a significant effect on the incidence of endometrial cancer. 1. Overweight and obesity are important risk factors of endometrial cancer. 2. A strong relationship is observed between the occurrence of hypertension or diabetes, and the development of endometrial cancer. 3. Women who come from the rural environment and continue to live in this environment are more likely to contract endometrial cancer.

  13. Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction.

    Science.gov (United States)

    Lodders, Johannes N; Parmar, Satyesh; Stienen, Niki L M; Martin, Timothy J; Karagozoglu, K Hakki; Heymans, Martijn W; Nandra, Baljeet; Forouzanfar, Tymour

    2015-11-01

    The aims of the study were 1) to evaluate the incidence and types of postoperative complications after ablative oral cancer surgery with primary free flap reconstruction and 2) identify prognostic variables for postoperative complications. Desired data was retrieved from a computer database at the department of Oral and Maxillofacial Department, Queen Elisabeth hospital Birmingham, United Kingdom, between June 2007 and October 2012. Logistic regression was used to study relationships between preoperative variables and postoperative outcomes. The study population consisted 184 patients, comprising 189 composite resections with reconstruction. Complications developed in 40.2% of the patients. Three patients (1.6%) died, 11.1% returned to the operating room, 5.3% developed donor site complications and 6.9% flap complications of which 3.2% total flap failure. In the multivariable analysis systemic complications were associated with anaesthesia time and hospital stay with red cell transfusion. A significant proportion of the patients with primary free flap reconstructions after oral cancer surgery develops postoperative complications. Prolonged anaesthesia time and red cell transfusion are possible predictors for systemic complications and hospital stay respectively. Preoperative screening for risk factors is advocated for patient selection and to have realistic information and expectations.

  14. [Endometrial cancer: Predictive models and clinical impact].

    Science.gov (United States)

    Bendifallah, Sofiane; Ballester, Marcos; Daraï, Emile

    2017-12-01

    In France, in 2015, endometrial cancer (CE) is the first gynecological cancer in terms of incidence and the fourth cause of cancer of the woman. About 8151 new cases and nearly 2179 deaths have been reported. Treatments (surgery, external radiotherapy, brachytherapy and chemotherapy) are currently delivered on the basis of an estimation of the recurrence risk, an estimation of lymph node metastasis or an estimate of survival probability. This risk is determined on the basis of prognostic factors (clinical, histological, imaging, biological) taken alone or grouped together in the form of classification systems, which are currently insufficient to account for the evolutionary and prognostic heterogeneity of endometrial cancer. For endometrial cancer, the concept of mathematical modeling and its application to prediction have developed in recent years. These biomathematical tools have opened a new era of care oriented towards the promotion of targeted therapies and personalized treatments. Many predictive models have been published to estimate the risk of recurrence and lymph node metastasis, but a tiny fraction of them is sufficiently relevant and of clinical utility. The optimization tracks are multiple and varied, suggesting the possibility in the near future of a place for these mathematical models. The development of high-throughput genomics is likely to offer a more detailed molecular characterization of the disease and its heterogeneity. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  15. The "true" incidence of surgically treated deep prosthetic joint infection after 32,896 primary total hip arthroplasties

    DEFF Research Database (Denmark)

    Gundtoft, Per Hviid; Overgaard, Søren; Schønheyder, Henrik Carl

    2015-01-01

    using an algorithm incorporating data from microbiological, prescription, and clinical biochemistry databases and clinical findings from the medical records. We calculated cumulative incidence with 95% confidence interval. RESULTS: 32,896 primary THAs were identified. Of these, 1,546 had first......-time revisions reported to the DHR and/or the NRP. For the DHR only, the 1- and 5-year cumulative incidences of PJI were 0.51% (0.44-0.59) and 0.64% (0.51-0.79). For the NRP only, the 1- and 5-year cumulative incidences of PJI were 0.48% (0.41-0.56) and 0.57% (0.45-0.71). The corresponding 1- and 5-year......, the "true" incidence of PJI following primary THA was estimated to be approximately 40% higher than previously reported by national registries alone....

  16. Comparison of saline infusion sonography (SIS) versus SIS-guided endometrial sampling in the diagnosis of endometrial pathology.

    Science.gov (United States)

    Moschos, Elysia; Bailey, April A; Twickler, Diane M

    2016-09-01

    To compare saline infusion sonography (SIS) to tissue obtained from SIS-guided endometrial sampling (SISES) to determine sensitivity and specificity for benign and malignant conditions of the endometrium. Added value of SISES after SIS was evaluated over 5 years. SIS and SISES techniques have been previously described. Women with abnormal uterine bleeding and endometrial findings underwent SIS. Criteria for SISES included atypical polypoid mass, focal irregularity or global endometrial thickening, nondiagnostic SIS, discordance between SIS and endometrial biopsy, or request from the primary team. Final surgical pathology was compared with SIS and SISES. One-hundred twenty-three SIS patients had SISES. SIS alone had a sensitivity of 100%, specificity of 42%, positive predictive value of 16%, and negative predictive value of 100%. A total of 120 patients had final clinical or surgical outcomes. Specificity was greatly improved with addition of SISES (95.5%, p SIS with SISES detected all 12 premalignant and malignant endometrial lesions. Three cases had small foci of hyperplasia (n = 2) or atypia (n = 1) in polyps on final surgical pathology, which were not prospectively identified on SISES. SISES significantly improves the specificity in the diagnosis of endometrial lesions. False-negative findings of SISES in polyps in postmenopausal women with bleeding suggest the need for surgical removal in this setting. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:416-422, 2016. © 2016 Wiley Periodicals, Inc.

  17. Sources of unsafe primary care for older adults: a mixed-methods analysis of patient safety incident reports.

    Science.gov (United States)

    Cooper, Alison; Edwards, Adrian; Williams, Huw; Evans, Huw P; Avery, Anthony; Hibbert, Peter; Makeham, Meredith; Sheikh, Aziz; J Donaldson, Liam; Carson-Stevens, Andrew

    2017-09-01

    older adults are frequent users of primary healthcare services, but are at increased risk of healthcare-related harm in this setting. to describe the factors associated with actual or potential harm to patients aged 65 years and older, treated in primary care, to identify action to produce safer care. a cross-sectional mixed-methods analysis of a national (England and Wales) database of patient safety incident reports from 2005 to 2013. 1,591 primary care patient safety incident reports regarding patients aged 65 years and older. we developed a classification system for the analysis of patient safety incident reports to describe: the incident and preceding chain of incidents; other contributory factors; and patient harm outcome. We combined findings from exploratory descriptive and thematic analyses to identify key sources of unsafe care. the main sources of unsafe care in our weighted sample were due to: medication-related incidents e.g. prescribing, dispensing and administering (n = 486, 31%; 15% serious patient harm); communication-related incidents e.g. incomplete or non-transfer of information across care boundaries (n = 390, 25%; 12% serious patient harm); and clinical decision-making incidents which led to the most serious patient harm outcomes (n = 203, 13%; 41% serious patient harm). priority areas for further research to determine the burden and preventability of unsafe primary care for older adults, include: the timely electronic tools for prescribing, dispensing and administering medication in the community; electronic transfer of information between healthcare settings; and, better clinical decision-making support and guidance. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  18. Contralateral breast cancer: incidence according to ductal or lobular phenotype of the primary

    International Nuclear Information System (INIS)

    Langlands, F.; White, J.; Kearins, O.; Cheung, S.; Burns, R.; Horgan, K.; Sharma, N.; Dodwell, D.

    2016-01-01

    Aim: To identify differences in the incidence of contralateral breast cancer between patients with a primary tumour diagnosis of invasive ductal carcinoma (IDC) and those with a diagnosis of invasive lobular carcinoma (ILC). Materials and methods: Data from two large cancer registries (registry A & B) the Northern and Yorkshire Cancer Registry Information Service (NYCRIS) and the West Midlands Cancer Intelligence Unit (WMCIU) from 1998–2003 for all cases of invasive breast cancer of either pure ductal or pure lobular reported histology were obtained. The invasive status of the contralateral tumour diagnosis and tumour morphology was collected. Chi-square tests were undertaken to examine the differences in contralateral rates for both registries and univariate analysis to ascertain which predictors affected contralateral breast cancer risk for registry A the WMCIU cases. Results: A total of 38,132 patients were studied, 32,735 patients with IDC and 5397 (14.2%) patients with ILC over the 6-year period. There was no significant difference between the occurrence and time to occurrence of contralateral breast cancer according to original cancer histology, 901 (2.8%) patients with IDC versus 166 (3.1%) patients with ILC (p=0.169). The analysis of registry A cases showed no association between original histology (ductal versus lobular), age at diagnosis, tumour grade, use of radiotherapy for the primary cancer or use of systemic therapy (chemotherapy and/or endocrine therapy), and development of a contralateral breast cancer. Conclusion: There is no apparent increase in risk of developing a contralateral breast cancer according to the primary cancer histology either IDC or ILC. Standard mammographic follow-up does not need to take account of original tumour pathology. Increased intervention or post-treatment surveillance for the contralateral breast is not indicated in the context of ILC. The role of MRI should be restricted to those patients with ILC who are planning

  19. Epigenetics and genetics in endometrial cancer: new carcinogenic mechanisms and relationship with clinical practice.

    Science.gov (United States)

    Banno, Kouji; Kisu, Iori; Yanokura, Megumi; Masuda, Kenta; Ueki, Arisa; Kobayashi, Yusuke; Susumu, Nobuyuki; Aoki, Daisuke

    2012-04-01

    Endometrial cancer is the seventh most common cancer worldwide among females. An increased incidence and a younger age of patients are also predicted to occur, and therefore elucidation of the pathological mechanisms is important. However, several aspects of the mechanism of carcinogenesis in the endometrium remain unclear. Associations with genetic mutations of cancer-related genes have been shown, but these do not provide a complete explanation. Therefore, epigenetic mechanisms have been examined. Silencing of genes by DNA hypermethylation, hereditary epimutation of DNA mismatch repair genes and regulation of gene expression by miRNAs may underlie carcinogenesis in endometrial cancer. New therapies include targeting epigenetic changes using histone deacetylase inhibitors. Some cases of endometrial cancer may also be hereditary. Thus, patients with Lynch syndrome which is a hereditary disease, have a higher risk for developing endometrial cancer than the general population. Identification of such disease-related genes may contribute to early detection and prevention of endometrial cancer.

  20. Prolactin-Elevating Antipsychotics and the Risk of Endometrial Cancer.

    Science.gov (United States)

    Klil-Drori, Adi J; Yin, Hui; Abenhaim, Haim A; du Fort, Guillaume Galbaud; Azoulay, Laurent

    2017-06-01

    The use of antipsychotics may increase the risk of endometrial cancer through elevation of prolactin levels. We investigated the association between antipsychotics that are known to cause prolactin elevation and the risk of endometrial cancer. In data from the United Kingdom Clinical Practice Research Datalink, all women who were newly treated with antipsychotics from 1990-2013 were identified and followed until 2014. Within this cohort of antipsychotic users, a nested case-control analysis was conducted. Main exposure was nonsporadic use of prolactin-elevating antipsychotics, and the active comparator was prolactin-sparing antipsychotics. Cases were women newly diagnosed with endometrial cancer (ICD-10) matched with up to 20 controls on age, calendar year of cohort entry, linkability to the Hospital Episode Statistics repository, and duration of follow-up. Conditional logistic regression models were used to determine the association of prolactin-elevating antipsychotics and endometrial cancer compared with prolactin-sparing antipsychotics. All analyses were adjusted for relevant potential confounders, including smoking, obesity, and diabetes mellitus. The cohort included 65,930 women. During 366,112 person-years of follow-up, there were 139 cases of endometrial cancer (incidence rate: 38/100,000 person-years), which were matched to 1,603 controls. Compared with the use of prolactin-sparing antipsychotics, the use of prolactin-elevating antipsychotics was not associated with an increased risk of endometrial cancer (adjusted odds ratio [aOR] = 1.00; 95% CI, 0.68-1.48). These findings remained similar with different durations of use (≤ 1 year, aOR = 1.07; 95% CI, 0.64-1.78, and > 1 year, aOR = 0.95; 95% CI, 0.58-1.54) and were robust to various sensitivity analyses. Prolactin-elevating antipsychotics were not associated with an increased risk of endometrial cancer. © Copyright 2017 Physicians Postgraduate Press, Inc.

  1. Switch in FOXA1 status associates with endometrial cancer progression.

    Directory of Open Access Journals (Sweden)

    Ingvild Løberg Tangen

    Full Text Available BACKGROUND: The transcription factor Forkhead box A1 (FOXA1 is suggested to be important in hormone dependent cancers, although with little data for endometrial cancer. We investigated expression levels of FOXA1 in primary and metastatic endometrial cancer in relation to clinical phenotype, and transcriptional alterations related to FOXA1 status. METHODS: Protein expression of FOXA1 was explored by immunohistochemistry in 529 primary and 199 metastatic endometrial carcinoma lesions. mRNA levels from corresponding 158 fresh frozen primary and 42 metastatic lesions were analyzed using Agilent Microarrays (44k in parallel. RESULTS: Low FOXA1 protein expression in primary tumors significantly correlated with low FOXA1 mRNA, high age, non-endometrioid histology, high grade, loss of ERα and PR and poor survival (all p-values <0.05. Through a Connectivity Map search, HDAC inhibitors were suggested as potential treatment for patients with low FOXA1 expression. An increase in FOXA1 expression was observed from primary to metastatic lesions and it correlated with CDKN2A expression in metastases. CONCLUSION: Low FOXA1 is associated with poor survival and suggests a potential for HDAC inhibitors in endometrial carcinoma. A switch in FOXA1 expression from primary to metastatic lesions is observed and gene expression indicates a link between FOXA1 and CDKN2A in metastatic lesions.

  2. Incidence, risk factors and outcomes of seizures occurring after craniotomy for primary brain tumor resection

    Science.gov (United States)

    Al-Dorzi, Hasan M.; Alruwaita, Abdullah A.; Marae, Bothaina O.; Alraddadi, Bushra S.; Tamim, Hani M.; Ferayan, Ahmad; Arabi, Yaseen M.

    2017-01-01

    Objective: To determine the incidence, risk factors and outcomes of early post-craniotomy seizures. Method: This was a retrospective cohort study of all patients who underwent craniotomy for primary brain tumor resection (2002-2011) and admitted postoperatively to the intensive care unit. The patients were divided into 2 groups depending on the occurrence of seizures within 7 days. Results: One-hundred-ninety-three patients were studied: 35.8% had preoperative seizure history and 16.6% were on prophylactic antiepileptic drugs (AEDs). Twenty-seven (14%) patients had post-craniotomy seizures. The tumors were mostly meningiomas (63% for the post-craniotomy seizures group versus 58.1% for the other group; p=0.63) and supratentorial (92.6% for the post-craniotomy seizures versus 78.4% for the other group, p=0.09) with tumor diameter=3.7±1.5 versus 4.2±1.6 cm, (p=0.07). One (3.1%) of the 32 patients on prophylactic AEDs had post-craniotomy seizures compared with 12% of the 92 patients not receiving AEDs preoperatively (p=0.18). On multivariate analysis, predictors of post-craniotomy seizures were preoperative seizures (odds ratio, 2.62; 95% confidence interval, 1.12-6.15) and smaller tumor size craniotomy seizures were not associated with increased morbidity or mortality. Conclusion: Early seizures were common after craniotomy for primary brain tumor resection, but were not associated with worse outcomes. Preoperative seizures and smaller tumor size were independent risk factors. PMID:28416781

  3. The significance of markers in the diagnosis of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Monika M. Żyła

    2016-11-01

    Full Text Available Endometrial cancer is one of the most common cancers experienced by women throughout the world. It is also the most common malignancy within the female reproductive system, representing 37.7% of all disorders. The incidence increases with age, and is diagnosed most frequently in women between 45 and 65 years old. In the last few years, numerous studies have been performed to identify tumour biomarkers. Biomarkers include not only protein routinely used as tumour markers but also genes and chromosomes. The limiting factor in the use of markers in the diagnosis of endometrial cancer is their lack of specificity. However, specific markers for endometrial cancer are the subject of much research attention. Although moderately elevated levels of markers are present in a number of inflammatory or non-malignant diseases, significantly increased levels of markers indicate the development of cancer. Recently, research has been focused on the identification of molecular changes leading to different histological subtypes of endometrial cancer. In this paper the authors reviewed several currently investigated markers. Progress in these investigations is very important in the diagnostics and treatment of endometrial cancer. In particular, the identification of novel mutations and molecular profiles should enhance our ability to personalise adjuvant treatment with genome-guided targeted therapy.

  4. Five year prognosis in patients with angina identified in primary care: incident cohort study.

    LENUS (Irish Health Repository)

    Buckley, Brian S

    2009-01-01

    OBJECTIVE: To ascertain the risk of acute myocardial infarction, invasive cardiac procedures, and mortality among patients with newly diagnosed angina over five years. DESIGN: Incident cohort study of patients with primary care data linked to secondary care and mortality data. SETTING: 40 primary care practices in Scotland. PARTICIPANTS: 1785 patients with a diagnosis of angina as their first manifestation of ischaemic heart disease, 1 January 1998 to 31 December 2001. MAIN OUTCOME MEASURES: Adjusted hazard ratios for acute myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, death from ischaemic heart disease, and all cause mortality, adjusted for demographics, lifestyle risk factors, and comorbidity at cohort entry. RESULTS: Mean age was 62.3 (SD 11.3). Male sex was associated with an increased risk of acute myocardial infarction (hazard ratio 2.01, 95% confidence interval 1.35 to 2.97), death from ischaemic heart disease (2.80, 1.73 to 4.53), and all cause mortality (1.82, 1.33 to 2.49). Increasing age was associated with acute myocardial infarction (1.04, 1.02 to 1.06, per year of age increase), death from ischaemic heart disease (1.09, 1.06 to 1.11, per year of age increase), and all cause mortality (1.09, 1.07 to 1.11, per year of age increase). Smoking was associated with subsequent acute myocardial infarction (1.94, 1.31 to 2.89), death from ischaemic heart disease (2.12, 1.32 to 3.39), and all cause mortality (2.11, 1.52 to 2.95). Obesity was associated with death from ischaemic heart disease (2.01, 1.17 to 3.45) and all cause mortality (2.20, 1.52 to 3.19). Previous stroke was associated with all cause mortality (1.78, 1.13 to 2.80) and chronic kidney disease with death from ischaemic heart disease (5.72, 1.74 to 18.79). Men were more likely than women to have coronary artery bypass grafting or percutaneous transluminal coronary angioplasty after a diagnosis of angina; older people were less likely to

  5. Incidence of primary bone tumours and tumour like lesions in and around Dakshina Kannada district of Karnataka.

    Science.gov (United States)

    Rao, V S; Pai, M R; Rao, R C; Adhikary, M M

    1996-03-01

    A total of 523 cases of primary bone tumours and tumour like lesions in and around Dakshina Kannada district of Karnataka were diagnosed over a period of 36 years. About 39% of these tumours were malignant and the remaining benign. Among the malignant tumours the highest incidence was of osteosarcoma (45.7%) followed by Ewing's sarcoma (19.4%). Osteochondroma was the most frequent in the benign tumour category (30.3%). Peak incidence of tumour was in the 2nd and 3rd decade of life with a male preponderance. The most commonly affected bones were femur, tibia and humerus in that order. Results indicate a significantly higher incidence of primary bone tumours in this part of India.

  6. SUVmax of 18FDG PET/CT as a predictor of high-risk endometrial cancer patients

    DEFF Research Database (Denmark)

    Antonsen, Sofie Leisby; Loft, Annika; Fisker, Rune Vincents

    2013-01-01

    OBJECTIVE: To evaluate SUVmax in the assessment of endometrial cancer preoperatively with particular focus on myometrial invasion (MI), cervical invasion (CI), FIGO stage, risk-stratification and lymph node metastases (LNM). METHODS: A total of 268 women with endometrial cancer or atypical...... endometrial hyperplasia underwent FDG PET/CT imaging before surgical treatment. SUVmax of the primary tumour was compared with histological prognostic factors. RESULTS: SUVmax was significantly higher in patients with high FIGO stages (p...

  7. Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study.

    Science.gov (United States)

    Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Oki, Hiroshi; Kajii, Eiji

    2015-01-01

    Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. This was an observational study. Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6-232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2-142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere's disease among the 76 PVD patients. We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo.

  8. Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study

    Science.gov (United States)

    Wada, Masaoki; Takeshima, Taro; Nakamura, Yosikazu; Nagasaka, Shoichiro; Kamesaki, Toyomi; Oki, Hiroshi; Kajii, Eiji

    2015-01-01

    Objective Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD) is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. Design This was an observational study. Setting and participants Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic) in Japan. Outcome The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. Results The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%). During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo) and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6–232.6) per 1,000 person-years and 115.7 (95% confidence interval: 92.2–142.6) per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of benign paroxysmal positional vertigo, and three of Meniere’s disease among the 76 PVD patients. Conclusion We reported the incidence of dizziness/vertigo among Japanese primary care clinic patients, which was higher than that usually observed in the general population. Furthermore, we described the incidence of PVD and found that it was a major cause of dizziness/vertigo. PMID:25931828

  9. [Endometrial cups in horses].

    Science.gov (United States)

    Jacobs, P H; Elsinghorst, T A

    1987-04-01

    Endometrial cups in horses are outgrowths appearing in the uterine wall of the pregnant horn between approximately 38 days and 150 of gestation. The cups are structures which vary in shape from oval to irregular and have distinct raised edges, showing an ulcer-like form. The maximum measurements are approximately 5 X 2.5 X 2.5 cm. Microscopic examination shows that they consist of large epithelioid decidual-like cells having large nucleoli. Pregnant Mare Endometrium Gonadotrophin (PMEG) is produced in the endometrial cups. PMEG may be regarded as a precursor of Pregnant Mare Serum Gonadotrophin (PMSG), which can be detected in the blood of mares. The exact function of PMSG is still obscure; some possible functions are suggested in the present paper. After approximately 70 days of gestation, regression starts. The regression of the cups is an immunological process in which the cellular branch of the immunological system plays an important role. Humoral immunity plays a more protective role in the process of regression, probably as a result of the production of 'blocking' antibodies.

  10. Palbociclib has antitumour effects on Pten-deficient endometrial neoplasias.

    Science.gov (United States)

    Dosil, Maria Alba; Mirantes, Cristina; Eritja, Núria; Felip, Isidre; Navaridas, Raúl; Gatius, Sònia; Santacana, Maria; Colàs, Eva; Moiola, Cristian; Schoenenberger, Joan Antoni; Encinas, Mario; Garí, Eloi; Matias-Guiu, Xavier; Dolcet, Xavier

    2017-06-01

    PTEN is one of the most frequently mutated genes in human cancers. The frequency of PTEN alterations is particularly high in endometrial carcinomas. Loss of PTEN leads to dysregulation of cell division, and promotes the accumulation of cell cycle complexes such as cyclin D1-CDK4/6, which is an important feature of the tumour phenotype. Cell cycle proteins have been presented as key targets in the treatment of the pathogenesis of cancer, and several CDK inhibitors have been developed as a strategy to generate new anticancer drugs. Palbociclib (PD-332991) specifically inhibits CDK4/6, and it has been approved for use in metastatic breast cancer in combination with letrazole. Here, we used a tamoxifen-inducible Pten knockout mouse model to assess the antitumour effects of cyclin D1 knockout and CDK4/6 inhibition by palbociclib on endometrial tumours. Interestingly, both cyclin D1 deficiency and palbociclib treatment triggered shrinkage of endometrial neoplasias. In addition, palbociclib treatment significantly increased the survival of Pten-deficient mice, and, as expected, had a general effect in reducing tumour cell proliferation. To further analyse the effects of palbociclib on endometrial carcinoma, we established subcutaneous tumours with human endometrial cancer cell lines and primary endometrial cancer xenografts, which allowed us to provide more translational and predictive data. To date, this is the first preclinical study evaluating the response to CDK4/6 inhibition in endometrial malignancies driven by PTEN deficiency, and it reveals an important role of cyclin D-CDK4/6 activity in their development. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  11. Progesterone receptors in development and metatstais of endometrial cancer

    NARCIS (Netherlands)

    E.E. Hanekamp (Eline)

    2004-01-01

    textabstractMany women may acquire endometrial cancer during their life. The vast majority of these women will be cured because of early detection of the disease. As in most types of cancer however, the main cause of death lies in metastasis of the primary tumor to other sites in the body. In

  12. Pediatric immunization-related safety incidents in primary care: A mixed methods analysis of a national database.

    Science.gov (United States)

    Rees, Philippa; Edwards, Adrian; Powell, Colin; Evans, Huw Prosser; Carter, Ben; Hibbert, Peter; Makeham, Meredith; Sheikh, Aziz; Donaldson, Liam; Carson-Stevens, Andrew

    2015-07-31

    Children are scheduled to receive 18-20 immunizations before their 18th birthday in England and Wales; this approximates to 13 million vaccines administered per annum. Each immunization represents a potential opportunity for immunization-related error and effective immunization is imperative to maintain the public health benefit from immunization. Using data from a national reporting system, this study aimed to characterize pediatric immunization-related safety incident reports from primary care in England and Wales between 2002 and 2013. A cross-sectional mixed methods study was undertaken. This comprised reading the free-text of incident reports and applying codes to describe incident type, potential contributory factors, harm severity, and incident outcomes. A subsequent thematic analysis was undertaken to interpret the most commonly occurring codes, such as those describing the incident, events leading up to it and reported contributory factors, within the contexts they were described. We identified 1745 reports and most (n=1077, 61.7%) described harm outcomes including three deaths, 67 reports of moderate harm and 1007 reports of low harm. Failure of timely vaccination was the potential cause of three child deaths from meningitis and pneumonia, and described in a further 113 reports. Vaccine administration incidents included the wrong number of doses (n=476, 27.3%), wrong timing (n=294, 16.8%), and wrong vaccine (n=249, 14.3%). Documentation failures were frequently implicated. Socially and medically vulnerable children were commonly described. This is the largest examination of reported contributory factors for immunization-related patient safety incidents in children. Our findings suggest investments in IT infrastructure to support data linkage and identification of risk predictors, development of consultation models that promote the role of parents in mitigating safety incidents, and improvement efforts to adapt and adopt best practices from elsewhere, are

  13. Regional variation in incidence of primary total hip arthroplasties and revisions in Denmark, 1996-2002

    DEFF Research Database (Denmark)

    Pedersen, Alma Becic; Johnsen, Søren Paaske; Overgaard, Søren

    2005-01-01

    We examined incidence rates (IR) of total hip arthroplasty (THA) in Denmark according to county and type of hospital, and investigated possible factors associated with any variations.......We examined incidence rates (IR) of total hip arthroplasty (THA) in Denmark according to county and type of hospital, and investigated possible factors associated with any variations....

  14. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

    2012-09-15

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass

  15. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    International Nuclear Information System (INIS)

    Yoon, Seok Nam

    2012-01-01

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass from

  16. [Preliminary results of an anonymous internet-based reporting system for critical incidents in ambulatory primary care].

    Science.gov (United States)

    Brun, A

    2005-03-01

    To learn from errors is not always easy, especially if they happened to others! This paper describes the organization and management of a critical incident reporting system for primary care physicians in Switzerland and reports about the difficulties and experiences during the first 18 months since the start of the program. It seems to be particularly difficult to enhance the attentiveness of physicians for apparently harmless daily critical incidents and to motivate them to report it even in an anonymous reporting system. As incentives for more intensive participation there are the hope for comments on reported cases by other participants and the expectation that reported errors will be avoided by the readers.

  17. Drugs Approved for Endometrial Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for endometrial cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  18. Thicker endometrial linings are associated with better IVF outcomes: a cohort of 6331 women.

    Science.gov (United States)

    Holden, Emily C; Dodge, Laura E; Sneeringer, Rita; Moragianni, Vasiliki A; Penzias, Alan S; Hacker, Michele R

    2017-06-18

    Our objective was to determine if a correlation exists between endometrial thickness measured on the day of ovulation trigger during an in vitro fertilization (IVF) cycle and pregnancy outcomes among non-cancelled cycles. We performed a retrospective cohort study looking at 6331 women undergoing their first, fresh autologous IVF cycle from 1 May 2004 to 31 December 2012 at Boston IVF (Waltham, MA). Our primary outcome was the risk ratio (RR) of live birth and positive β-hCG. We found that thicker endometrial linings were associated with positive β-hCG and live birth rates. For each additional millimetre of endometrial thickness, we found a statistically significant increased risk of positive β-hCG (adjusted RR: 1.14; 95% CI: 1.09-1.18) and live birth (RR: 1.08; 95% CI: 1.05-1.11). There was no association between endometrial thickness and miscarriage (RR: 0.99; 95% CI: 0.91-1.07). Similar results were seen when categorizing endometrial thickness. Compared with an endometrial thickness >7 to <11 mm, the likelihood of a live birth was significantly higher for an endometrial thickness ≥11 mm (adjusted RR: 1.23; 95% CI: 1.11-1.37) and significantly lower for the ≤7 mm group (adjusted RR: 0.64; 95% CI: 0.45-0.90). In conclusion, thicker endometrial linings were associated with increased pregnancy and live birth rates.

  19. Incidence of dizziness and vertigo in Japanese primary care clinic patients with lifestyle-related diseases: an observational study

    Directory of Open Access Journals (Sweden)

    Wada M

    2015-04-01

    Full Text Available Masaoki Wada,1,2 Taro Takeshima,1 Yosikazu Nakamura,3 Shoichiro Nagasaka,4 Toyomi Kamesaki,1 Hiroshi Oki,2 Eiji Kajii1 1Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan; 2Oki Clinic, Ibaraki, Japan; 3Department of Public Health, Jichi Medical University, Tochigi, Japan; 4Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi, Japan Objective: Dizziness and vertigo are highly prevalent symptoms among patients presenting at primary care clinics, and peripheral vestibular disorder (PVD is their most frequent cause. However, the incidence of PVD has not been well documented. This study aimed to investigate the incidence of dizziness, vertigo, and PVD among patients presenting at a primary care clinic. Design: This was an observational study. Setting and participants: Between November 2011 and March 2013, we observed 393 patients, all at least 20 years old, who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for at least 6 months at a primary clinic (Oki Clinic in Japan. Outcome: The main outcome of interest was new incidence of dizziness, vertigo, and PVD events. During the 1-year follow-up period, the otorhinolaryngologist diagnosed and reported new PVD events. Results: The mean age of the 393 participants at entry was 65.5 years. Of the study participants, 12.7%, 82.4%, and 92.6% had diabetes mellitus, hypertension, and dyslipidemia, respectively. We followed up all the participants (100%. During the 662.5 person-years of follow-up, 121 cases of dizziness or vertigo (dizziness/vertigo and 76 cases of PVD were observed. The incidence of dizziness/vertigo and PVD was 194.7 (95% confidence interval: 161.6–232.6 per 1,000 person-years and 115.7 (95% confidence interval: 92.2–142.6 per 1,000 person-years, respectively. There were 61 cases of acute peripheral vestibulopathy, 12 of

  20. The incidence of epstein-barr virus primary infection among suspected patients referred to namazi hospital of shiraz, iran.

    Science.gov (United States)

    Moeini, Mahsa; Ziyaeyan, Mazyar; Asaei, Sadaf; Behzadi, Mohammad Amin

    2015-04-01

    Many children become infected with Epstein-Barr virus (EBV) during their childhood. Since the clinical profile of EBV primary infection is challenging, it is important to use the best diagnostic clinical means. Detection of IgM against viral capsid antigen (VCA) by ELISA has been shown to be a reliable method. This study was conducted to demonstrate the incidence of EBV primary infection, among suspected patients referred to Namazi hospital, Shiraz, Iran. The sample included 346 patients with an age range of 0 to 20 years (6.31 ± 4.66: 10.97 years). A volume of 5 mL of blood was collected from each case. The patients were divided to four age groups. The sera were tested for the presence of VCA-IgM by commercially available Anti-EBV-VCA ELISA kit. The results indicated that 104 (30.0%) of the patients were EBV VCA IgM positive, with no significant difference in the incidence of EBV primary infection between males and females. However, the incidence of infection was significantly different between age group I (0 - 5 years) and III (11 - 15 years), and also between age group I (0 - 5 years) and IV (16 - 20 years) (P < 0.05). Considering the results, accurate and on time diagnosis of EBV primary infection in both children and adolescents will help prevent unnecessary hospitalization, medication and incorrect medical decisions. In addition, this will decrease further treatment costs and related medical procedures.

  1. Three decades of eating disorders in Dutch primary care: decreasing incidence of bulimia nervosa but not of anorexia nervosa.

    Science.gov (United States)

    Smink, F R E; van Hoeken, D; Donker, G A; Susser, E S; Oldehinkel, A J; Hoek, H W

    2016-04-01

    Whether the incidence of eating disorders in Western, industrialized countries has changed over time has been the subject of much debate. The purpose of this primary-care study was to examine changes in the incidence of eating disorders in The Netherlands during the 1980s, 1990s and 2000s. A nationwide network of general practitioners (GPs), serving a representative sample (~1%) of the total Dutch population, recorded newly diagnosed patients with anorexia nervosa (AN) and bulimia nervosa (BN) in their practice during 1985-1989, 1995-1999, and 2005-2009. GPs are key players in the Dutch healthcare system, as their written referral is mandatory in order to get access to specialized (mental) healthcare, covered by health insurance. Health insurance is virtually universal in The Netherlands (99% of the population). A substantial number of GPs participated in all three study periods, during which the same case identification criteria were used and the same psychiatrist was responsible for making the final diagnoses. Incidence rates were calculated and for comparison between periods, incidence rate ratios. The overall incidence rate of BN decreased significantly in the past three decades (from 8.6 per 100,000 person-years in 1985-1989 to 6.1 in 1995-1999, and 3.2 in 2005-2009). The overall incidence of AN remained fairly stable during three decades, i.e. 7.4 per 100,000 person-years in 1985-1989, 7.8 in 1995-1999, and 6.0 in 2005-2009. The incidence rate of BN decreased significantly over the past three decades, while the overall incidence rate of AN remained stable.

  2. Evolution in endometrial cancer: evidence from an immunohistochemical study.

    Science.gov (United States)

    Vandenput, Ingrid; Trovik, Jone; Leunen, Karin; Wik, Elisabeth; Stefansson, Ingunn; Akslen, Lars; Moerman, Philippe; Vergote, Ignace; Salvesen, Helga; Amant, Frédéric

    2011-02-01

    It is poorly described how endometrial cancer biology changes during tumor evolution. We hypothesize that characterization of molecular targets in recurrent lesions is more relevant for targeting treatment. Paired biopsies from primary and recurrent endometrial cancer tumors (n = 85) were stained immunohistochemically for the following proteins: estrogen receptor (ER), progesterone receptor (PR), stathmin (correlating with phosphatidylinositol 3-kinase activity), HER-2/neu, WT1 (Wilms tumor gene 1), phospho-mammalian target of rapamycin (p-mTOR), and p53. Each tumor was scored, using a semiquantitative and subjective grading system. Discordance, a change in expression between primary and recurrent tumor, was defined as ≥ 2 step change; concordance was ≤ 1 step change. The frequency of change was correlated with established prognostic markers in endometrial cancer. Fifty-six patients (67%) were diagnosed with endometrioid carcinoma, 23 (27%) with serous/clear cell carcinoma. A change in expression between primary and recurrent tumor was noted in 7% to 31% of patients for ER, PR, stathmin, HER-2/neu, WT1, p-mTOR, and p53. Concordant-positive cases for PR were significantly correlated with stage, tumor grade, and histological subtype. Expression of ER, p53, and p-mTOR in cytoplasm in the recurrent tumor correlated significantly with survival. Endometrial cancer biology changes over time. The decision on targeted treatment should preferably be based on recurrent tumor characteristics.

  3. Patient Safety Incidents Involving Sick Children in Primary Care in England and Wales: A Mixed Methods Analysis.

    Directory of Open Access Journals (Sweden)

    Philippa Rees

    2017-01-01

    Full Text Available The UK performs poorly relative to other economically developed countries on numerous indicators of care quality for children. The contribution of iatrogenic harm to these outcomes is unclear. As primary care is the first point of healthcare contact for most children, we sought to investigate the safety of care provided to children in this setting.We undertook a mixed methods investigation of reports of primary care patient safety incidents involving sick children from England and Wales' National Reporting and Learning System between 1 January 2005 and 1 December 2013. Two reviewers independently selected relevant incident reports meeting prespecified criteria, and then descriptively analyzed these reports to identify the most frequent and harmful incident types. This was followed by an in-depth thematic analysis of a purposive sample of reports to understand the reasons underpinning incidents. Key candidate areas for strengthening primary care provision and reducing the risks of systems failures were then identified through multidisciplinary discussions. Of 2,191 safety incidents identified from 2,178 reports, 30% (n = 658 were harmful, including 12 deaths and 41 cases of severe harm. The children involved in these incidents had respiratory conditions (n = 387; 18%, injuries (n = 289; 13%, nonspecific signs and symptoms, e.g., fever (n = 281; 13%, and gastrointestinal or genitourinary conditions (n = 268; 12%, among others. Priority areas for improvement included safer systems for medication provision in community pharmacies; triage processes to enable effective and timely assessment, diagnosis, and referral of acutely sick children attending out-of-hours services; and enhanced communication for robust safety netting between professionals and parents. The main limitations of this study result from underreporting of safety incidents and variable data quality. Our findings therefore require further exploration in longitudinal studies utilizing

  4. Patient Safety Incidents Involving Sick Children in Primary Care in England and Wales: A Mixed Methods Analysis.

    Science.gov (United States)

    Rees, Philippa; Edwards, Adrian; Powell, Colin; Hibbert, Peter; Williams, Huw; Makeham, Meredith; Carter, Ben; Luff, Donna; Parry, Gareth; Avery, Anthony; Sheikh, Aziz; Donaldson, Liam; Carson-Stevens, Andrew

    2017-01-01

    The UK performs poorly relative to other economically developed countries on numerous indicators of care quality for children. The contribution of iatrogenic harm to these outcomes is unclear. As primary care is the first point of healthcare contact for most children, we sought to investigate the safety of care provided to children in this setting. We undertook a mixed methods investigation of reports of primary care patient safety incidents involving sick children from England and Wales' National Reporting and Learning System between 1 January 2005 and 1 December 2013. Two reviewers independently selected relevant incident reports meeting prespecified criteria, and then descriptively analyzed these reports to identify the most frequent and harmful incident types. This was followed by an in-depth thematic analysis of a purposive sample of reports to understand the reasons underpinning incidents. Key candidate areas for strengthening primary care provision and reducing the risks of systems failures were then identified through multidisciplinary discussions. Of 2,191 safety incidents identified from 2,178 reports, 30% (n = 658) were harmful, including 12 deaths and 41 cases of severe harm. The children involved in these incidents had respiratory conditions (n = 387; 18%), injuries (n = 289; 13%), nonspecific signs and symptoms, e.g., fever (n = 281; 13%), and gastrointestinal or genitourinary conditions (n = 268; 12%), among others. Priority areas for improvement included safer systems for medication provision in community pharmacies; triage processes to enable effective and timely assessment, diagnosis, and referral of acutely sick children attending out-of-hours services; and enhanced communication for robust safety netting between professionals and parents. The main limitations of this study result from underreporting of safety incidents and variable data quality. Our findings therefore require further exploration in longitudinal studies utilizing case review

  5. The prevalence of endometrial hyperplasia and endometrial cancer in women with polycystic ovary syndrome or hyperandrogenism

    DEFF Research Database (Denmark)

    Holm, Nina Sofie Lillegaard; Glintborg, Dorte; Andersen, Marianne Skovsager

    2012-01-01

    Polycystic ovary syndrome may be associated with an increased risk of endometrial hyperplasia and endometrial cancer, but substantial evidence for this remains to be established. We investigated the prevalence of endometrial hyperplasia and endometrial cancer in a well characterized group of women...... with polycystic ovary syndrome and/or clinical/biochemical hyperandrogenism....

  6. Incidence and predictors of suicide attempts among primary-care patients with depressive disorders: a 5-year prospective study.

    Science.gov (United States)

    Riihimäki, K; Vuorilehto, M; Melartin, T; Haukka, J; Isometsä, E

    2014-01-01

    No previous study has prospectively investigated incidence and risk factors for suicide attempts among primary care patients with depression. In the Vantaa Primary Care Depression Study, a stratified random sample of 1119 patients was screened for depression, and Structured Clinical Interviews for DSM-IV used to diagnose Axis I and II disorders. A total of 137 patients were diagnosed with a DSM-IV depressive disorder. Altogether, 82% of patients completed the 5-year follow-up. Information on timing of suicide attempts, plus major depressive episodes (MDEs) and partial or full remission, or periods of substance abuse were examined with life charts. Incidence of suicide attempts and their stable and time-varying risk factors (phases of depression/substance abuse) were investigated using Cox proportional hazard and Poisson regression models. During the follow-up there were 22 discrete suicide attempts by 14/134 (10.4%) patients. The incidence rates were 0, 5.8 and 107 during full or partial remission or MDEs, or 22.2 and 142 per 1000 patient-years during no or active substance abuse, respectively. In Cox models, current MDE (hazard ratio 33.5, 95% confidence interval 3.6-309.7) was the only significant independent risk factor. Primary care doctors were rarely aware of the suicide attempts. Of the primary care patients with depressive disorders, one-tenth attempted suicide in 5 years. However, risk of suicidal acts was almost exclusively confined to MDEs, with or without concurrent active substance abuse. Suicide prevention among primary care patients with depression should focus on active treatment of major depressive disorder and co-morbid substance use, and awareness of suicide risk.

  7. Prospective multicenter randomized intermediate biomarker study of oral contraceptive versus depo-provera for prevention of endometrial cancer in women with Lynch syndrome.

    Science.gov (United States)

    Lu, Karen H; Loose, David S; Yates, Melinda S; Nogueras-Gonzalez, Graciela M; Munsell, Mark F; Chen, Lee-May; Lynch, Henry; Cornelison, Terri; Boyd-Rogers, Stephanie; Rubin, Mary; Daniels, Molly S; Conrad, Peggy; Milbourne, Andrea; Gershenson, David M; Broaddus, Russell R

    2013-08-01

    Women with Lynch syndrome have a 40% to 60% lifetime risk for developing endometrial cancer, a cancer associated with estrogen imbalance. The molecular basis for endometrial-specific tumorigenesis is unclear. Progestins inhibit estrogen-driven proliferation, and epidemiologic studies have shown that progestin-containing oral contraceptives (OCP) reduce the risk of endometrial cancer by 50% in women at general population risk. It is unknown whether they are effective in women with Lynch syndrome. Asymptomatic women ages 25 to 50 with Lynch syndrome were randomized to receive the progestin compounds Depo-Provera (depo-MPA) or OCP for three months. An endometrial biopsy and transvaginal ultrasound were conducted before and after treatment. Endometrial proliferation was evaluated as the primary endpoint. Histology and a panel of surrogate endpoint biomarkers were evaluated for each endometrial biopsy as secondary endpoints. A total of 51 women were enrolled, and 46 completed treatment. Two of the 51 women had complex hyperplasia with atypia at the baseline endometrial biopsy and were excluded from the study. Overall, both depo-MPA and OCP induced a dramatic decrease in endometrial epithelial proliferation and microscopic changes in the endometrium characteristic of progestin action. Transvaginal ultrasound measurement of endometrial stripe was not a useful measure of endometrial response or baseline hyperplasia. These results show that women with Lynch syndrome do show an endometrial response to short-term exogenous progestins, suggesting that OCP and depo-MPA may be reasonable chemopreventive agents in this high-risk patient population.

  8. Long-term effects on the incidence of second primary cancers in a randomized trial of two and five years of adjuvant tamoxifen.

    Science.gov (United States)

    Rosell, Johan; Nordenskjöld, Bo; Bengtsson, Nils-Olof; Fornander, Tommy; Hatschek, Thomas; Lindman, Henrik; Malmström, Per-Olof; Wallgren, Arne; Stål, Olle; Carstensen, John

    2017-04-01

    Tamoxifen is a well established treatment for breast cancer, but its long-term effects on the incidence of secondary cancers are not fully evaluated. We have studied 4128 postmenopausal patients with early stage breast cancer who were alive and free of breast cancer recurrence after two years of tamoxifen, and who were randomized to receive totally two or five years of therapy. Compared to patients randomized to two years of tamoxifen the incidence of contralateral breast cancer [hazard ratio (HR) 0.73; 95% CI 0.56-0.96] and of lung cancer (HR 0.45; 95% CI 0.27-0.77), especially squamous cell and small cell lung cancer, were reduced in the five-year group, and similar results were seen when restricting the analysis to the 10-year period after treatment stopped. An increased incidence of endometrial cancer was observed in the five-year group, but the excess risk decreased over time. Further studies of the effects of tamoxifen on the risk of different histological types of lung cancer are needed.

  9. Analysis of incidence and risk factors for ERCP-related adverse events in patients with primary sclerosing cholangitis

    Directory of Open Access Journals (Sweden)

    BI Rongxin

    2015-02-01

    Full Text Available ObjectiveTo investigate the incidence and risk factors for endoscopic retrograde cholangiopancreatography (ERCP-related adverse events in patients with primary sclerosing cholangitis (PSC. MethodsThis study included 72 patients who were diagnosed with PSC by magnetic resonance cholangiopancreatography and underwent ERCP in the Third Hospital of Xingtai City from December 2009 to December 2013. The incidence of postoperative adverse events within 30 d after ERCP was monitored and recorded. Univariate and multivariate logistic regression analyses were used to analyze the risk factors for ERCP-related adverse events in PSC patients. ResultsThe success rate of ERCP was 94.4% (68/72. Among all adverse events, the incidence of pancreatitis and biliary tract infection were highest (6.94% and 4.17%, while the incidence of perforation was lowest (1.38%. Univariate logistic regression analysis showed that the risk of adverse events was significantly higher in patients who underwent cholangiopancreatography and sphincterotomy than in those not undergoing these procedures (OR=13.642, P=0.017; OR=7.381, P=0.000; guide wire insertion and cholangiopancreatography also increased the incidence of adverse reactions (OR=8.042, P=0.000; OR=2.651, P=0.032. Multivariate logistic regression analysis showed that guide wire insertion (OR = 4.547, 95%CI: 1.076-12.543 and biliary sphincterotomy (OR=5.023, 95%CI: 2.643-18.321 are associated with the incidence of ERCP-related adverse events. ConclusionSphincterotomy and guide wire insertion can increase the risk of adverse events in PSC patients after ERCP.

  10. Incidence of emergency contacts (red responses to Norwegian emergency primary healthcare services in 2007 – a prospective observational study

    Directory of Open Access Journals (Sweden)

    Hansen Elisabeth

    2009-07-01

    Full Text Available Abstract Background The municipalities are responsible for the emergency primary health care services in Norway. These services include casualty clinics, primary doctors on-call and local emergency medical communication centres (LEMC. The National centre for emergency primary health care has initiated an enterprise called "The Watchtowers", comprising emergency primary health care districts, to provide routine information (patients' way of contact, level of urgency and first action taken by the out-of-hours services over several years based on a minimal dataset. This will enable monitoring, evaluation and comparison of the respective activities in the emergency primary health care services. The aim of this study was to assess incidence of emergency contacts (potential life-threatening situations, red responses to the emergency primary health care service. Methods A representative sample of Norwegian emergency primary health care districts, "The Watchtowers" recorded all contacts and first action taken during the year of 2007. All the variables were continuously registered in a data program by the attending nurses and sent by email to the National Centre for Emergency Primary Health Care at a monthly basis. Results During 2007 the Watchtowers registered 85 288 contacts, of which 1 946 (2.3% were defined as emergency contacts (red responses, corresponding to a rate of 9 per 1 000 inhabitants per year. 65% of the instances were initiated by patient, next of kin or health personnel by calling local emergency medical communication centres or meeting directly at the casualty clinics. In 48% of the red responses, the first action taken was a call-out of doctor and ambulance. On a national basis we can estimate approximately 42 500 red responses per year in the EPH in Norway. Conclusion The emergency primary health care services constitute an important part of the emergency system in Norway. Patients call the LEMC or meet directly at casualty clinics

  11. Incidence of neuralgic amyotrophy (Parsonage Turner syndrome in a primary care setting--a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Nens van Alfen

    Full Text Available Neuralgic amyotrophy is considered a rare peripheral nervous system disorder but in practice seems grossly under recognized, which negatively affects care for these patients. In this study we prospectively counted the one-year incidence rate of classic neuralgic amyotrophy in a primary care setting.In a prospective cohort study during the year 2012 we registered all new cases of neck, shoulder or arm complaints from two large primary care centers serving a population of 14,118. Prior to study, general practitioners received a short training on how to diagnose classic neuralgic amyotrophy. Neuralgic amyotrophy was defined according to published criteria irrespective of family history. Only patients with a classic phenotype were counted as definite cases. After inclusion, patients with suspected neuralgic amyotrophy who had not yet seen a neurologist were offered neurologic evaluation for diagnostic confirmation.Of the 492 patients identified with new onset neck, shoulder or arm complaints, 34 were suspected of having neuralgic amyotrophy. After neurologic evaluation the diagnosis was confirmed in 14 patients. This amounts to a one-year incidence rate for classic neuralgic amyotrophy of 1 per 1000.Our findings suggest that neuralgic amyotrophy is 30-50 times more common than previously thought. Unawareness of the disorder and its clinical presentation seems the most likely explanation for this difference. An incidence rate of 1 per 1000 and the long-term sequelae many patients suffer warrant more vigilance in diagnosing the disorder, to pave the way for timely treatment and prevent complications.

  12. Frequency of endometrial carcinoma in patients with postmenopausal bleeding

    International Nuclear Information System (INIS)

    Yousaf, S.; Shaheen, M.; Rana, T.

    2010-01-01

    Introduction: Postmenopausal bleeding (PMB) is defined as bleeding that occurs after 1 year of amenorrhea in a woman who is not receiving hormone replacement therapy (HRT). About 10% of women with postmenopausal bleeding have a primary or secondary malignancy. Common malignancies among them are endometrial cancer (80%), cervical cancer or an ovarian tumour. Endometrial cancer is the second most common cancer associated with hereditary non-polyposis colorectal cancer. Ninety percent of patients have benign causes. Objective: The objective of this study was to determine the frequency of endometrial carcinoma in patients with post-menopausal bleeding. Study Design: Descriptive case series study. Setting: Department of obstetrics and gynaecology, Lady Willingdon, Lahore. Duration of Study: This study was conducted over a period of six months from January, 1 2009 to June 30, 2009. Subjects and Methods: 50 cases with postmenopausal bleeding. Results: During the period of this study a total number of 50 consecutive patients who met inclusion criteria were enrolled in the study. Ages of the patients who presented with PMB ranged between 48 years and 80 years with a mean age of 59 years. Malignancy was found in 18 out of 50 cases (36%).Cases with endometrial CA were 14 out of 50 cases (28%) and CA cervix constituted 4 out of 50 cases (8%). Benign pathology was more frequent (64%). 13 of 50 cases (26%) had hyperplasia out of which 1 case (2%) was of atypical hyperplasia. Endometrial polyp was found in 4 of 50 cases (8%). 3 of 50 cases (6%) had chronic endometritis. 5 of 50 cases (10%) had chronic cervicitis. While 7 cases (14%) had postmenopausal bleeding due to decubitus ulcer of uterovaginal prolapse. Among malignancies (36%), endometrial cancer is the most frequent malignancy in women with postmenopausal bleeding with mean age of 65 years. Conclusion: In this study it was concluded that the majority of cases of PMB would be expected to be suffering from benign problems

  13. Incidence of epithelial ingrowth in primary and retreatment laser in situ keratomileusis.

    Science.gov (United States)

    Caster, Andrew I; Friess, David W; Schwendeman, Frank J

    2010-01-01

    To analyze the risk for clinically significant epithelial ingrowth after primary laser in situ keratomileusis (LASIK) and flap-lift retreatment LASIK. Private practice, Beverly Hills, California, USA. All cases of primary and flap-lift retreatment LASIK performed by the same surgeon in a single surgical center between January 2004 and June 2007 were retrospectively reviewed. Cases that subsequently developed clinically significant epithelial ingrowth, defined as epithelial ingrowth impeding on the visual axis and negatively affecting uncorrected or corrected distance visual acuity, were identified and analyzed. Clinically significant epithelial ingrowth occurred in none of the 3866 primary LASIK cases and in 15 (2.3%) of the 646 flap-lift retreatment cases (P<.0001). Clinically significant ingrowth was more frequent when flap-lift retreatment was performed 3 or more years after primary LASIK (7.7% versus 1.0%) (P = .0001). Patient age and sex did not have a statistically significant effect on the epithelial ingrowth rate. There was a nonsignificant trend toward increased epithelial ingrowth after flap-lift retreatment of Automated Corneal Shaper (ACS) microkeratome flaps. Flap-lift retreatment performed 3 or more years after primary LASIK led to a higher risk of clinically significant epithelial ingrowth than primary LASIK or earlier flap-lift retreatment. The author has no financial or proprietary interest in any material or method mentioned. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  14. Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations

    Directory of Open Access Journals (Sweden)

    Longwen Chen

    2014-01-01

    Full Text Available The 2001 Bethesda system recommends further classifying atypical glandular cells (AGCs as either endocervical or endometrial origin. Numerous studies have investigated the clinical significance of AGC. In this study, we investigated the incidence of clinically significant lesions among women with liquid-based Papanicolaou cervicovaginal (Pap interpretations of atypical endometrial cells (AEMs or AGC favor endometrial origin (AGC-EM. More importantly, we correlated patients of AEM or AGC-EM with their clinical presentations to determine if AEM/AGC-EM combined with abnormal vaginal bleeding is associated with a higher incidence of significant endometrial pathology. All liquid-based Pap tests with an interpretation of AEM and AGC-EM from July, 2004 through June, 2009 were retrieved from the database. Women with an interpretation of atypical endocervical cells, AGC, favor endocervical origin or AGC, favor neoplastic were not included in the study. The most severe subsequent histologic diagnoses were recorded for each patient. During this 5-year period, we accessioned 332,470 Pap tests of which 169 (0.05% were interpreted as either AEM or AGC-EM. Of the 169 patients, 133 had histologic follow-up within the health care system. The patients ranged in age from 21 to 71 years old (mean 49.7. On follow-up histology, 27 (20.3% had neoplastic/preneoplastic uterine lesions. Among them, 20 patients were diagnosed with adenocarcinoma (18 endometrial, 1 endocervical, and 1 metastatic colorectal, 3 with atypical endometrial hyperplasia, and 4 with endometrial hyperplasia without atypia. All patients with significant endometrial pathology, except one, were over 40 years old, and 22 of 25 patients reported abnormal vaginal bleeding at the time of endometrial biopsy or curettage. This study represents a large series of women with liquid-based Pap test interpretations of AEM and AGC-EM with clinical follow-up. Significant preneoplastic or neoplastic endometrial

  15. Postoperative Pain and Flare-Ups: Comparison of Incidence Between Single and Multiple Visit Pulpectomy in Primary Molars.

    Science.gov (United States)

    Sevekar, Shrirang Anand; Gowda, Subhadra Halemane Nagaraj

    2017-03-01

    Endodontic treatment performed in either single- or multiple visit can be followed by numerous short- and long term complications. One of the short term complications include postoperative pain and flare-ups. The ability to predict its prevalence and forewarn the patient may go some way towards enabling coping strategies and help dentist in pain management treatment decisions. To compare the incidence and intensity of postoperative pain and flare-ups between single- and multiple visit pulpectomy in primary molars. Also, to correlate the preoperative status of the pulp to postoperative pain and flare-ups. Eighty primary molars indicated for pulpectomy were included in the study and divided into two groups. Tooth treated and preoperative status of the pulp vitality was recorded. All the conventional steps in pulpectomy were followed. Teeth in Group 1 (single visit pulpectomy) were obturated on the same visit. Teeth in Group 2 (multiple visit pulpectomy) were obturated in the subsequent appointment. The recording of postoperative pain, flare-ups, use of medication were done after 24 hours, seven days and one month. Four cases in both the groups reported postoperative pain (10%) at 24 hour recall, p=0.74. One flare-up (2.5%) was recorded in each group p=0.67. None of the patients reported pain at seventh day and one month recall. Postoperative pain was recorded in five non-vital teeth (13.5%) and three vital teeth (6.9%). However, it was statistically not significant p=0.53. From the perspective of our study there was a low incidence of postoperative pain. The majority of patients in both groups reported no pain or only minimal pain within 24 hours of treatment. There were no differences between single- and multi visit treatment protocols with respect to the incidence of postoperative pain. No significant correlation could be found between pulp vitality and the incidence of postoperative pain.

  16. Socioeconomic variation in incidence of primary and secondary major cardiovascular disease events: an Australian population-based prospective cohort study.

    Science.gov (United States)

    Korda, Rosemary J; Soga, Kay; Joshy, Grace; Calabria, Bianca; Attia, John; Wong, Deborah; Banks, Emily

    2016-11-21

    Cardiovascular disease (CVD) disproportionately affects disadvantaged people, but reliable quantitative evidence on socioeconomic variation in CVD incidence in Australia is lacking. This study aimed to quantify socioeconomic variation in rates of primary and secondary CVD events in mid-age and older Australians. Baseline data (2006-2009) from the 45 and Up Study, an Australian cohort involving 267,153 men and women aged ≥ 45, were linked to hospital and death data (to December 2013). Outcomes comprised first event - death or hospital admission - for major CVD combined, as well as myocardial infarction and stroke, in those with and without prior CVD (secondary and primary events, respectively). Cox regression estimated hazard ratios (HRs) for each outcome in relation to education (and income and area-level disadvantage), separately by age group (45-64, 65-79, and ≥ 80 years), adjusting for age and sex, and additional sociodemographic factors. There were 18,207 primary major CVD events over 1,144,845 years of follow-up (15.9/1000 person-years), and 20,048 secondary events over 260,357 years (77.0/1000 person-years). For both primary and secondary events, incidence increased with decreasing education, with the absolute difference between education groups largest for secondary events. Age-sex adjusted hazard ratios were highest in the 45-64 years group: for major CVDs, HR (no qualifications vs university degree) = 1.62 (95% CI: 1.49-1.77) for primary events, and HR = 1.49 (1.34-1.65) for secondary events; myocardial infarction HR = 2.31 (1.87-2.85) and HR = 2.57 (1.90-3.47) respectively; stroke HR = 1.48 (1.16-1.87) and HR = 1.97 (1.42-2.74) respectively. Similar but attenuated results were seen in older age groups, and with income. For area-level disadvantage, CVD gradients were weak and non-significant in older people (> 64 years). Individual-level data are important for quantifying socioeconomic variation in CVD incidence, which

  17. Endometrial carcinoma; Endometriumkarzinom

    Energy Technology Data Exchange (ETDEWEB)

    Engelhard, K. [Krankenhaus Martha-Maria, Nuernberg (Germany)

    2011-07-15

    Magnetic resonance imaging (MRI) is the method of choice in staging endometrial cancer. Using MRI early tumor invasion (stage IA) can be differentiated from a deep tumor growth (stage IB) of the myometrium with reported sensitivities of 85-95%.Tumor invasion of the uterine cervix can be depicted with a sensitivity of 80% and specificity of 96%. In demonstrating lymph node metastases MRI shows a sensitivity of 50%, a specificity of 95% and and accuracy of 90%. These diagnostic criteria are decisive for the choice of therapy procedures. So a simple hysterectomy will be performed in early stage IA disease while an extended surgical procedure with pelvic lymphadenectomy and radiotherapy will be considered in advanced stages IB and II disease. Vaginal ultrasound shows lower values in tumor staging with accuracies of 73-95%. Staging accuracies of computed tomography also show lower results with 61-76%. For planning radiotherapy and detection of cancer recurrence MRI is the most valuable tool. (orig.) [German] Fuer die Stadieneinteilung des Endometriumkarzinoms ist die Magnetresonanztomographie Methode der Wahl. Die Sensitivitaeten zur Differenzierung einer oberflaechlichen (Stadium IA) von einer tiefen myometrialen Invasion des Tumors (Stadium IB) liegen bei 85-95%, bei Spezifitaeten von 80-85%. Eine Infiltration der Zervix (Stadium II) kann mit Sensitivitaeten von 80% und Spezifitaeten von 96% nachgewiesen werden. Bei der Detektion von Lymphknotenmetastasen liegen die Sensitivitaeten der MRT bei 50%, bei Spezifitaeten von 95% und Treffsicherheiten von 90%. Die genannten diagnostischen Kriterien bestimmen das therapeutische Vorgehen. Werden fruehe Stadien mit einfacher Hysterektomie behandelt, erfordern die Stadien IB und II kombinierte erweiterte chirurgische Techniken und eine Radiotherapie. Die Treffsicherheiten des vaginalen Ultraschalls (73-93%) und der Computertomographie (61-76%) fuer die Stadieneinteilung des Tumors liegen deutlich niedriger als die Werte fuer

  18. The role of vaginal cuff brachytherapy in endometrial cancer.

    Science.gov (United States)

    Harkenrider, Matthew M; Block, Alec M; Siddiqui, Zaid A; Small, William

    2015-02-01

    The purpose of this article is to review the data, rationale, and recommendations of vaginal brachytherapy (VBT) in the post-operative treatment of endometrial cancer patients. The authors performed a thorough review of the medical literature regarding the use of adjuvant VBT in the treatment of endometrial cancer. Relevant data are presented in this review. Additionally, personal and institutional practices from the authors are incorporated where relevant. VBT for the adjuvant treatment of early stage endometrial cancer patients results in a low rate of recurrence (0-3.1%) with very low rates of toxicity. PORTEC-2 supports the use of adjuvant VBT versus external beam radiotherapy specifically for high-intermediate risk endometrial cancer patients. VBT has low rates of acute and chronic gastrointestinal and genitourinary toxicity and very low rates of second primary malignancy. The primary toxicity of VBT is vaginal atrophy and stenosis with controversy regarding the use of vaginal dilators for prevention. Data support that patients prefer to be involved in the decision making process for their adjuvant therapy, and patients have a lower minimal desired benefit of adjuvant VBT than do physicians. Guidelines exist from the American Brachytherapy Society and American Society of Radiation Oncology with support from the Society for Gynecologic Oncologists regarding the use of adjuvant VBT. VBT decreases the risk of recurrence with minimal toxicity in the adjuvant treatment of endometrial cancer. Adjuvant therapy should be discussed in a multi-disciplinary setting with detailed counseling of the risks and benefits with the patient so that she ultimately makes an informed decision regarding her adjuvant therapy. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Assessment of Primary Cancer Incidence in Growth Hormone-Treated Children: Comparison of a Multinational Prospective Observational Study with Population Databases.

    Science.gov (United States)

    Child, Christopher J; Zimmermann, Alan G; Jia, Nan; Robison, Leslie L; Brämswig, Jürgen H; Blum, Werner F

    2016-01-01

    Although results of the majority of clinical studies have shown no association between growth hormone (GH) treatment in childhood and risk of primary cancer, concerns remain regarding the potential influence of GH therapy on neoplastic cell growth. This study evaluated the incidence of primary malignancies in a large observational study of paediatric GH treatment. Primary cancer incidence was assessed in a cohort of 19,054 GH-treated children without a reported prestudy history of malignancy in the observational Genetics and Neuroendocrinology of Short Stature International Study (GeNeSIS). The standardised incidence ratio (SIR) for primary cancer in GH-treated children was determined by comparing cancer incidence in the GeNeSIS study population with incidence rates for country-, age-, and sex-matched cohorts of the general population. During a mean follow-up of 3.4 years in GeNeSIS (64,705 person-years), 13 incident potential primary cancers were identified in GH-treated patients. The SIR (95% confidence interval) for all observed cancers was 1.02 (0.54-1.75), and the crude incidence was 20.1 (10.7-34.4) cases per 100,000 person-years. Acknowledging the relatively short follow-up in our study, GH-treated children without a history of previous malignancy did not have a higher risk of all-site primary cancer during the study when compared to general-population cancer registries. © 2016 S. Karger AG, Basel.

  20. Transition from low-grade endometrial stromal sarcoma to high-grade endometrial stromal sarcoma.

    Science.gov (United States)

    Ohta, Yoshiki; Suzuki, Takao; Omatsu, Mutsuko; Hamatani, Shigeharu; Shiokawa, Akira; Kushima, Miki; Ota, Hidekazu

    2010-07-01

    We report on a case of a primary low-grade endometrial stromal sarcoma (ESS) that progressed to a secondary high-grade ESS. In the secondary tumor, the immunohistochemical profile and focal tumor cell proliferation pattern suggested that this tumor was not truly undifferentiated, but possessed features of endometrial stroma. Low-grade ESS of our patient's primary tumor showed p53 protein overexpression, which is unusual in low-grade ESS, and her secondary high-grade ESS showed more prominent p53 immunoreactivity. This indicates that low-grade ESS that shows p53 immunoreactivity might progress to high-grade ESS, and it is considered that such cases of low-grade ESS should pay attention to the prognosis. Immunoreactivity for epidermal growth factor receptor was observed in both tumors, suggesting a relationship between the primary and secondary tumors in our case. Further study requires more immunohistochemical data for cases in which low-grade ESS transitions to high-grade ESS; in particular, data on epidermal growth factor receptor expression are necessary to define new therapeutic strategies for ESS.

  1. Usefulness of primary care electronic networks to assess the incidence of chlamydia, diagnosed by general practitioners.

    NARCIS (Netherlands)

    Suijkerbuijk, A.W.M.; Broek, I.V.F. van den; Brouwer, H.J.; Vanrolleghem, A.M.; Joosten, J.H.K.; Verheij, R.A.; Sande, M.A.B. van der; Kretzschmar, M.E.E.

    2011-01-01

    BACKGROUND: Chlamydia is the most common curable sexually transmitted infection (STI) in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs). Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening

  2. Ionizing radiation increases primary cilia incidence and induces multiciliation in C2C12 myoblasts

    Czech Academy of Sciences Publication Activity Database

    Filipová, A.; Diaz-Garcia, D.; Bezrouk, A.; Čížková, D.; Havelek, R.; Vávrová, J.; Dayanithi, Govindan; Řezáčová, M.

    2015-01-01

    Roč. 39, č. 8 (2015), s. 943-953 ISSN 1065-6995 Institutional support: RVO:68378041 Keywords : cell line * ionizing radiation * multiple cilia * myoblast * primary cilium * serum starvation stress Subject RIV: FP - Other Medical Disciplines Impact factor: 1.663, year: 2015

  3. Usefulness of primary care electronic networks to assess the incidence of chlamydia, diagnosed by general practitioners

    NARCIS (Netherlands)

    Suijkerbuijk, A.W.M.; van den Broek, I.V.F.; Brouwer, H.J.; Vanrolleghem, A.M.; Joosten, J.H.K.; Verheij, R.A.; van der Sande, M.A.B.; Kretzschmar, M.E.E.

    2011-01-01

    Background: Chlamydia is the most common curable sexually transmitted infection (STI) in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs). Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening

  4. Endometrial ablation with paracervical block

    NARCIS (Netherlands)

    Penninx, Josien P. M.; Mol, Ben Willem; Bongers, Marlies Y.

    2009-01-01

    OBJECTIVE: To evaluate the safety, feasibility and efficacy of endometrial ablation under local anesthesia. STUDY DESIGN: A prospective cohort study was performed at the gynecology department of a large teaching hospital. Women with dysfunctional uterine bleeding were included to undergo NovaSure

  5. Abnormal expression of blood group-related antigens in uterine endometrial cancers.

    Science.gov (United States)

    Tsukazaki, K; Sakayori, M; Arai, H; Yamaoka, K; Kurihara, S; Nozawa, S

    1991-08-01

    The expression of A, B, and H group antigens, Lewis group antigens (Lewis(a), Lewis(b), Lewis(x), and Lewis(y)), and Lc4 and nLc4 antigens, the precursor antigens of both groups, was examined immunohistochemically with monoclonal antibodies in 9 normal endometria, 6 endometrial hyperplasias, and 31 endometrial cancers. 1) A, B and/or H antigens were detected in endometrial cancers at an incidence of 51.6%, while no distinct localization of these antigens was observed in normal endometria. H antigen, the precursor of A and B antigens, was particularly frequently detected in endometrial cancers. 2) An increased rate of expression of Lewis group antigens, particularly Lewis(b) antigen, was observed in endometrial cancers compared with its expression in normal endometria. 3) Lc4 and nLc4 antigens were detected in endometrial cancers at rates of 41.9% and 38.7%, respectively, these expressions being increased compared with those in normal endometria. 4) These results suggest that a highly abnormal expression of blood group-related antigens in endometrial cancers occurs not only at the level of A, B, and H antigens and Lewis group antigens, but also at the level of their precursor Lc4 and nLc4 antigens. 5) Lewis(a), Lewis(b), and Lc4 antigens, built on the type-1 chain, are more specific to endometrial cancers than their respective positional isomers, Lewis(x), Lewis(y), and nLc4 antigens, built on the type-2 chain.

  6. Female Hormonal Factors and the Risk of Endometrial Cancer in Lynch Syndrome

    Science.gov (United States)

    Dashti, Seyedeh Ghazaleh; Chau, Rowena; Ouakrim, Driss Ait; Buchanan, Daniel D.; Clendenning, Mark; Young, Joanne P.; Winship, Ingrid M.; Arnold, Julie; Ahnen, Dennis J.; Haile, Robert W.; Casey, Graham; Gallinger, Steven; Thibodeau, Stephen N.; Lindor, Noralane M.; Le Marchand, Loïc; Newcomb, Polly A.; Potter, John D.; Baron, John A.; Hopper, John L.; Jenkins, Mark A.; Win, Aung Ko

    2015-01-01

    Importance Apart from hysterectomy, there is no consensus recommendation for reducing endometrial cancer risk for women with a mismatch repair (MMR) gene mutation (Lynch syndrome). Objective To investigate the association between hormonal factors and endometrial cancer risk in Lynch syndrome. Design, Setting, and Participants A retrospective cohort study including 1,128 women with a MMR gene mutation identified from the Colon Cancer Family Registry was conducted. Data were analyzed using a weighted cohort approach. Participants were recruited between 1997 and 2012, from centers across the United States, Australia, Canada, and New Zealand. Exposures Age at menarche, first and last live birth, and menopause, number of live births, hormonal contraceptive use, and postmenopausal hormone use. Main Outcome and Measures Self-reported diagnosis of endometrial cancer. Results Endometrial cancer was diagnosed in 133 women (incidence per 100 person-years, 0.29; 95% confidence interval [CI], 0.24 to 0.34). A lower risk of endometrial cancer was associated with later age at menarche (hazard ratio [HR] per year, 0.85 [95%CI, 0.73 to 0.99]; P=.04), parity (parous vs nulliparous: HR, 0.21 [95%CI, 0.10 to 0.42]; P<.001), and hormonal contraceptive use (≥1 year vs <1 year: HR, 0.39 [95%CI, 0.23 to 0.64]; P<.001). There was no statistically significant association between endometrial cancer and age at first and last live birth, age at menopause, and postmenopausal hormone use. Conclusions and Relevance For women with a MMR gene mutation, some endogenous and exogenous hormonal factors were associated with a lower risk of endometrial cancer. These directions and strengths of associations were similar to those for the general population. If replicated, these findings suggest that women with a MMR gene mutation may be counseled like the general population in regard to hormonal influences on endometrial cancer risk. PMID:26151267

  7. Concurrent Endometrial Carcinoma in Patients with a Curettage Diagnosis of Endometrial Hyperplasia

    Directory of Open Access Journals (Sweden)

    Yu-Li Chen

    2009-06-01

    Conclusion: When patients are diagnosed with endometrial hyperplasia, surgical intervention should be performed in those with cytological atypia and higher BMI because of the possibility of coexisting endometrial carcinoma.

  8. Gene Tests May Improve Therapy for Endometrial Cancer

    Science.gov (United States)

    ... Special Issues Subscribe June 2013 Print this issue Gene Tests May Improve Therapy for Endometrial Cancer Send us your comments By analyzing genes in hundreds of endometrial tumors, scientists identified details ... therapies for some patients. Endometrial cancer affects the lining ...

  9. The Inflammation Response to DEHP through PPARγ in Endometrial Cells

    Directory of Open Access Journals (Sweden)

    Qiansheng Huang

    2016-03-01

    Full Text Available Epidemiological studies have shown the possible link between phthalates and endometrium-related gynecological diseases, however the molecular mechanism(s behind this is/are still unclear. In the study, both primary cultured endometrial cells and an endometrial adenocarcinoma cell line (Ishikawa were recruited to investigate the effects of di-(2-ethylhexyl phthalate (DEHP at human-relevant concentrations. The results showed that DEHP did not affect the viability of either type of cell, which showed different responses to inflammation. Primary cultured cells showed stronger inflammatory reactions than the Ishikawa cell line. The expression of inflammatory factors was induced both at the mRNA and protein levels, however the inflammation did not induce the progress of epithelial-mesenchymal transition (EMT as the protein levels of EMT markers were not affected after exposure to either cell type. Further study showed that the mRNA levels of peroxisome proliferator-activated receptor gamma (PPARγ wereup-regulated after exposure. In all, our study showed that human-relevant concentrations of DEHP could elicit the inflammatory response in primary cultured endometrial cells rather than in Ishikawa cell line. PPARγ may act as the mediating receptor in the inflammation reaction.

  10. Recurrence of gynecologic malignomas after combined and primary radiotherapy. Incidence and period until diagnosis

    International Nuclear Information System (INIS)

    Csaicsich, P.; Tatra, G.; Michalica, W.; Vienna Univ.

    1986-01-01

    A group of 1018 patients with gynecological malignancies after a combined or primary radiation therapy was studied for frequency and space of recidivs. In the first three years after therapy in cases with cervical cancer 95%, in cases with endometrical cancer 82% and in cases of ovarian cancer 98% of all recidivs were diagnosed. In cases of cancer of the vagina, the tube and vulva all recidivs were observed within the first three years. By results obtained it is put up for discussion to replace 'five-years-rate' by 'three-years-rate' in cases of gynecological malignancies with exception of mammarian carcinoma. Thereby the value of a model of therapy could be realized earlier than hitherto. (orig.) [de

  11. Oral primary care: an analysis of its impact on the incidence and mortality rates of oral cancer.

    Science.gov (United States)

    Rocha, Thiago Augusto Hernandes; Thomaz, Erika Bárbara Abreu Fonseca; da Silva, Núbia Cristina; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Barbosa, Allan Claudius Queiroz; Thumé, Elaine; Rocha, João Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Vissoci, João Ricardo Nickenig; Staton, Catherine Ann; Facchini, Luiz Augusto

    2017-10-30

    Oral cancer is a potentially fatal disease, especially when diagnosed in advanced stages. In Brazil, the primary health care (PHC) system is responsible for promoting oral health in order to prevent oral diseases. However, there is insufficient evidence to assess whether actions of the PHC system have some effect on the morbidity and mortality from oral cancer. The purpose of this study was to analyze the effect of PHC structure and work processes on the incidence and mortality rates of oral cancer after adjusting for contextual variables. An ecological, longitudinal and analytical study was carried out. Data were obtained from different secondary data sources, including three surveys that were nationally representative of Brazilian PHC and carried out over the course of 10 years (2002-2012). Data were aggregated at the state level at different times. Oral cancer incidence and mortality rates, standardized by age and gender, served as the dependent variables. Covariables (sociodemographic, structure of basic health units, and work process in oral health) were entered in the regression models using a hierarchical approach based on a theoretical model. Analysis of mixed effects with random intercept model was also conducted (alpha = 5%). The oral cancer incidence rate was positively association with the proportion of of adults over 60 years (β = 0.59; p = 0.010) and adult smokers (β = 0.29; p = 0.010). The oral cancer related mortality rate was positively associated with the proportion of of adults over 60 years (β = 0.24; p oral cancer (β = 0.02; p = 0.002). Mortality was inversely associated with the coverage of primary care teams (β = -0.01; p work processes have been shown to help reduce the mortality rate of oral cancer, but not the incidence rate of the disease. We recommend expanding investments in PHC in order to prevent oral cancer related deaths.

  12. Dependence of secondary electron emission on the incident angle and the energy of primary electrons bombarding bowl-structured beryllium surfaces

    International Nuclear Information System (INIS)

    Kawata, Jun; Ohya, Kaoru.

    1994-01-01

    A Monte Carlo simulation of the secondary electron emission from beryllium is combined with a model of bowl structure for surface roughness, for analyzing the difference between the electron emissions for normal and oblique incidences. At normal incidence, with increasing the roughness parameter H/W, the primary energy E pm at which the maximum electron yield occurs becomes higher, and at more than the E pm , the decrease in the yield is slower; where H and W are the depth and width of the bowl structure, respectively. The dispersion of incident angle to the microscopic surface causes a small increase in the yield at oblique incidence, whereas the blocking of primary electrons from bombarding the bottom of the structure causes an opposite trend. The strong anisotropy in the polar angular distribution with respect to the azimuthal angle is calculated at oblique incidence. (author)

  13. Hysterectomy-corrected rates of endometrial cancer among women younger than age 50 in the United States.

    Science.gov (United States)

    Temkin, Sarah M; Kohn, Elise C; Penberthy, Lynne; Cronin, Kathleen A; Rubinsak, Lisa; Dickie, Lois A; Minasian, Lori; Noone, Anne-Michelle

    2018-03-01

    This analysis describes the impact of hysterectomy on incidence rates and trends in endometrioid endometrial cancer in the United States among women of reproductive age. Hysterectomy prevalence for states containing Surveillance, Epidemiology, and End Results (SEER) registry was estimated using data from the Behavioral Risk Factor Surveillance System (BRFSS) between 1992 and 2010. The population was adjusted for age, race, and calendar year strata. Age-adjusted incidence rates and trends of endometrial cancer among women age 20-49 corrected for hysterectomy were estimated. Hysterectomy prevalence varied by age, race, and ethnicity. Increasing incidence trends were observed, and were attenuated after correcting for hysterectomy. Among all women, the incidence was increasing 1.6% annually (95% CI 0.9, 2.3) and this increase was no longer significant after correction for hysterectomy (+ 0.7; 95% CI - 0.1, 1.5). Stage at diagnosis was similar with and without correction for hysterectomy. The largest increase in incidence over time was among Hispanic women; even after correction for hysterectomy, incidence was increasing (1.8%; 95% CI 0.2, 3.4) annually. Overall, endometrioid endometrial cancer incidence rates in the US remain stable among women of reproductive age. Routine reporting of endometrial cancer incidence does not accurately measure incidence among racial and ethnic minorities.

  14. Pelvic inflammatory disease and salpingitis: incidence of primary and repeat episodes in England.

    Science.gov (United States)

    Price, M J; Ades, A E; Welton, N J; Simms, I; Horner, P J

    2017-01-01

    Pelvic inflammatory disease (PID) and more specifically salpingitis (visually confirmed inflammation) is the primary cause of tubal factor infertility and is an important risk factor for ectopic pregnancy. The risk of these outcomes increases following repeated episodes of PID. We developed a homogenous discrete-time Markov model for the distribution of PID history in the UK. We used a Bayesian framework to fully propagate parameter uncertainty into the model outputs. We estimated the model parameters from routine data, prospective studies, and other sources. We estimated that for women aged 35-44 years, 33·6% and 16·1% have experienced at least one episode of PID and salpingitis, respectively (diagnosed or not) and 10·7% have experienced one salpingitis and no further PID episodes, 3·7% one salpingitis and one further PID episode, and 1·7% one salpingitis and ⩾2 further PID episodes. Results are consistent with numerous external data sources, but not all. Studies of the proportion of PID that is diagnosed, and the proportion of PIDs that are salpingitis together with the severity distribution in different diagnostic settings and of overlap between routine data sources of PID would be valuable.

  15. [Primary gastric lymphoma: incidence, prognostic factors and effect of treatment with chemotherapy].

    Science.gov (United States)

    Lobato-Mendizábal, E; Ruiz Argüelles, G J; Labardini-Méndez, R; Rodríguez-Mejorada, M

    1990-08-01

    This paper deals with the prevalence, clinical features and therapeutic response of 19 patients with primary gastric lymphoma studied and treated at Centro de Hematologia y Medicina Interna de Puebla, Mexico and Instituto Nacional de la Nutricion Salvador Zubiran, Mexico City, Mexico, in a 10 year period (1979-1989). The main findings were as follows: 1) The prevalence of gastric lymphoma has increased in Mexico: Between 1950 and 1980 the prevalence was found at 4.5% of all gastric tumors, whereas between 1980 and 1990 it was found at the 7.6% level (chi square = .0001). 2) The significant prognostic factors for survival were in this series the clinico-pathologic stage and the degree of infiltration of the gastric wall: 80-month disease free survival was 80% and 44% respectively for stages I and III (p less than 0.02); 10-year disease free survival was 100% and 23% respectively for mucosal/submucosal infiltration VS mucosal/serosal infiltration (p less than 0.01). 3) The 10-year disease free survival was 68% for patients treated with chemotherapy and surgery; this figure is similar to those obtained using radiotherapy and surgery, but with a lower relapse rate. Two patients with lymphomatous lesion less than 3 cm. and invading only mucosae/submucosae were treated solely with chemotherapy and both of them remain disease free after 20 months of follow-up.

  16. Endometrial aspiration cytology in gynecological disorders

    Directory of Open Access Journals (Sweden)

    Meenal V Jadhav

    2016-01-01

    Full Text Available Context: Endometrial aspiration is not a popular modality for the study of the endometrium despite its simplicity and potential utility. Aim: The present study was aimed at evaluating the utility of endometrial aspiration in various gynecological disorders. Materials and Methods: In this diagnostic accuracy study, 55 prospectively registered women with various gynecological disorders were evaluated clinically and subjected to endometrial aspiration cytology and study of endometrial histology. Endometrial aspiration was performed by infant feeding tube in 10 cases and intra cath cannula in 45 cases. The slides were stained with rapid Papanicolaou (PAP stain and Leishman stain. Results: Endometrial aspiration cytology showed 90% and 94.6% sampling adequacy with infant feeding tube and intra cath cannula, respectively. Intra cath cannula was very convenient to handle and superior to infant feeding tube in aspirating the endometrium. Of the two stains used, rapid PAP stain was less time-consuming and superior to Leishman stain in studying the nuclear details. Leishman stain was helpful in detecting cytoplasmic vacuoles of secretory endometrium. Overall diagnostic accuracy of endometrial cytology was 90.4% while that for morphological hormonal evaluation was 97.6%. It enjoyed a sensitivity of 91.66%, a specificity of 88.23%, positive predictive value of 94.28%, and negative predictive value of 83.33%. Conclusion: Intra cath cannula emerged as an inexpensive, effective, and convenient device for endometrial aspiration. Endometrial aspiration proved to be a fairly effective, simple, and informative diagnostic modality.

  17. Endometrial biopsy findings in postmenopausal bleeding

    International Nuclear Information System (INIS)

    Sarfraz, T.; Tariq, H.

    2007-01-01

    To study endometrial histopathology in women presenting with postmenopausal bleeding. A two-year study from January 2003 to December 2004 of 100 cases of postmenopausal bleeding was conducted at Combined Military Hospital, Sialkot. The histopathology of endometrial biopsy specimens was done to find out the causes of postmenopausal bleeding in these ladies. All these 100 patients had confirmed menopause and the average age was 55 years and above. The most common histopathological diagnosis was senile endometrial atrophy (27%), followed by simple cystic hyperplasia in (17%). Three cases of simple cystic hyperplasia had coexistent ovarian tumors. Glandular hyperplasia without atypia was seen in 6% and with atypia in 4%. Other causes were endometritis (13%), endometrial polyps (8%), proliferative phase endometrium (6%) and secretary phase endometrium (5%). Endometrial carcinoma was seen in (6%) cases, (8%) biopsy specimens were non-representative. Although senile endometrial atrophy was most commonly found in these ladies but a significant percentage of endometrial hyperplasia and endometrial cancer implies the need for investigating all cases of postmenopausal bleeding. Bimanual examination and pelvic ultrasonography should be combined with endometrial sampling so that rare pelvic pathologies may not be missed. (author)

  18. Molecular Biology and Prevention of Endometrial Cancer

    National Research Council Canada - National Science Library

    Maxwell, George

    2003-01-01

    To increase our understanding of the molecular aberrations associated with endometrial carcinogenesis and the biologic mechanisms underlying the protective effect of oral contraceptive therapy. Methods: 1...

  19. Molecular Biology and Prevention of Endometrial Cancer

    National Research Council Canada - National Science Library

    Maxwell, George L

    2004-01-01

    To increase our understanding of the molecular aberrations associated with endometrial carcinogenesis and the biologic mechanisms underlying the protective effect of oral contraceptive therapy. Methods: 1...

  20. Treatment Options by Stage (Endometrial Cancer)

    Science.gov (United States)

    ... uterus. See the PDQ summary on Uterine Sarcoma Treatment for more information about uterine sarcoma . Obesity and having metabolic syndrome may increase the risk of endometrial cancer. Anything ...

  1. Molecular Biology and Prevention of Endometrial Cancer

    National Research Council Canada - National Science Library

    Maxwell, George L

    2006-01-01

    To increase our understanding of the molecular aberrations associated with endometrial carcinogenesis and the biologic mechanisms underlying the protective effect of oral contraceptive (OC) therapy. 1...

  2. Incidence and Risk Factors of Ventricular Fibrillation Before Primary Angioplasty in Patients With First ST-Elevation Myocardial Infarction

    DEFF Research Database (Denmark)

    Jabbari, Reza; Engstrøm, Thomas; Glinge, Charlotte

    2015-01-01

    BACKGROUND: We aimed to investigate the incidence and risk factors for ventricular fibrillation (VF) before primary percutaneous coronary intervention (PPCI) among patients with ST-segment elevation myocardial infarction (STEMI) in a prospective nationwide setting. METHODS AND RESULTS: In this case...... analysis identified novel associations between atrial fibrillation and alcohol consumption with VF. Patients with a history of atrial fibrillation had a 2.80-fold odds of experiencing VF before PPCI (95% CI 1.10 to 7.30). Compared with nondrinkers, patients who consumed 1 to 7 units, 8 to 14 units, or >15...... associated with VF occurring out-of-hospital or on arrival at the emergency room before PPCI in STEMI patients, thus providing potential avenues for investigation regarding improved identification and prevention of life-threatening ventricular arrhythmias....

  3. [Endometrial adenosarcoma with rhabdomyoblastic differenciation].

    Science.gov (United States)

    Haj Salah, Meriem Bel; Mekni, Amina; Ines, Chelly; Haha Bellil, Selma Ben; Bellil, Khedija; Kchir, Nidhamedine; Haouet, Slim; Zaouari, Faouzia; Zitouna, Moncef

    2007-10-01

    Mixed mullerian tumours are uncommon endometrial neoplasms that are composed by a combination of mesencymal elements and epithelial elements. They own their denomination to the mullerian origin of their components wich derive from the paramesonephric ducts. According to the benignity or the malignity of each component, four types of mixed mullerian tumours are individualised. Adenosarcoma is composed of benign glandular elements and sarcomatous, usually low-grade, stromal elements. We report a case of an endometrial adenosarcoma in a 59-year-old woman. Clinicopathological caracteristics and the etiopathogeny of this uncommun neoplasm will be discussed. A 59-year-old women complained metrorrhagia assearated pair since three months. Vaginal examination showed an incresed valure. Copathological U.S and abdominer CT showed an important. No ather turner were detected hysterrchomy with dilated annexetny werre performed. Pathological examan concluded to tummor with animation of mesenchynal and le pthel elements

  4. Prospective study of asbestos-related diseases incidence cases in primary health care in an area of Barcelona province

    Directory of Open Access Journals (Sweden)

    Orriols Ramon

    2010-04-01

    Full Text Available Abstract Background Asbestos related diseases include a number of conditions due to inhalation of asbestos fibres at work, at home or in the environment, such as pleural mesothelioma, asbestosis and calcified pleural plaques. Few epidemiological studies have established the incidence of asbestos related diseases in our area. The present proposal is based on a retrospective study externally funded in 2005 that is currently taking place in the same area and largely carried out by the same research team. The aim of the study is to achieve a comprehensive and coordinated detection of all new cases of Asbestos Related Diseases presenting to primary care practitioners. Methods/design This is a multicentre, multidisciplinary and pluri-institutional prospective study. Setting 12 municipalities in the Barcelona province within the catchment area of the health facilities that participate in the study. Sample This is a population based study, of all patients presenting with diseases caused by asbestos in the study area. Measurements A clinical and epidemiological questionnaire will be filled in by the trained researchers after interviewing the patients and examining their clinical reports. Discussion Data on the incidence of the different Asbestos Related Diseases in this area will be obtained and the most plausible exposure source and space-time-patient profile will be described. The study will also improve the standardization of patient management, the coordination between health care institutions and the development of preventive activities related with asbestos exposure and disease.

  5. Endometrial injury prior to assisted reproductive techniques for recurrent implantation failure: a systematic literature review.

    Science.gov (United States)

    Panagiotopoulou, Nikoletta; Karavolos, Stamatios; Choudhary, Meenakshi

    2015-10-01

    Endometrial injury to improve implantation for women undergoing assisted reproductive techniques has attracted a lot of attention recently and has rapidly become incorporated into clinical practice. The aim of this study is, thus, to assess the effectiveness and safety of endometrial injury performed in the cycle preceding assisted reproductive techniques in women with recurrent implantation failure. Electronic database searches, including MEDLINE, EMBASE, CENTRAL and grey literature, up to 30th May 2015 were conducted with no restrictions. Randomized controlled trials comparing endometrial injury versus placebo or no treatment in the cycle preceding assisted reproductive techniques in women with recurrent implantation failure were selected. The primary outcome was live birth rate. Secondary outcomes were clinical pregnancy, implantation, miscarriage and procedure-related complication rates. Of the 1115 publications identified, 4 met the inclusion criteria. Meta-analysis was not possible due to significant clinical heterogeneity among the included studies. Patients' characteristics differed, as did the intervention used with endometrial injury being performed at different phases of the preceding menstrual cycle. Moreover, the effect of endometrial injury on live birth and clinical pregnancy rates were inconsistent among the included studies. In summary, there is currently insufficient evidence to support the use of endometrial injury in women with recurrent implantation failure undergoing assisted reproductive techniques while the procedure-associated complication rate has not been assessed. Clinical implementation should, thus, be deferred until robust evidence becomes available. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. The influence of hormone therapies on type I and II endometrial cancer

    DEFF Research Database (Denmark)

    Mørch, Lina S.; Kjær, Susanne K.; Keiding, Niels

    2016-01-01

    identified from the National Cancer Registry: 4,972 Type I tumors and 500 Type II tumors. Incidence rate ratios (RRs) and 95% confidence intervals (Cls) were estimated by Poisson regression. Compared with women never on HT, the RR of endometrial cancer was increased with conjugated estrogen: 4.27 (1...

  7. The Presence of Endometrial Cells in Peritoneal Fluid of Women With and Without Endometriosis.

    Science.gov (United States)

    O, Dorien F; Roskams, Tania; Van den Eynde, Kathleen; Vanhie, Arne; Peterse, Daniëlle P; Meuleman, Christel; Tomassetti, Carla; Peeraer, Karen; D'Hooghe, Thomas M; Fassbender, Amelie

    2017-02-01

    To reinforce Sampson's theory of retrograde menstruation in the pathogenesis of endometriosis, proof should be provided that during menstruation endometrial cells are present in peritoneal fluid (PF). We hypothesize that the prevalence of PF samples containing endometrial cells is higher in patients with endometriosis than in controls without endometriosis during menstruation. We selected from our biobank PF samples of 17 reproductive-age women with (n = 9) or without (n = 8) endometriosis who had received a diagnostic laparoscopy for investigation of pain/infertility. Peritoneal fluid had been collected during laparoscopy in the menstrual phase of the cycle, centrifuged, and the resulting pellet was stored at -80°C. About 5-μm sections of frozen PF pellets were stained using the Dako Envision Flex system with primary antibodies against epithelial cell adhesion molecule (Ep-CAM; endometrial epithelial cells), CD10 (endometrial stromal cells), prekeratin (epithelial/mesothelial cells), vimentin (endometrial/mesothelial/immune cells), calretinin (mesothelial cells), and CD68 (macrophages). The PF cells positive for Ep-CAM were detected in 5 of 9 patients with endometriosis and 6 of 8 controls ( P = .62). CD10 stained positively in 6 of the 9 patients with endometriosis and 3 of the 8 controls ( P = .35). Calretinin and prekeratin staining showed the presence of mesothelial cells in all pellets. Vimentin stained approximately 100% of the PF cells. CD68+ macrophages represented >50% of cells in all pellets. The prevalence of PF samples containing endometrial epithelial and stromal cells was not higher in patients with endometriosis than in controls without endometriosis during menstruation. Our findings question the relevance of endometrial cells in PF for the pathogenesis of endometriosis and support the importance of other mechanisms such as immune dysfunction and/or endometrial stem cells.

  8. Prediagnostic circulating inflammation markers and endometrial cancer risk in the prostate, lung, colorectal and ovarian cancer (PLCO) screening trial.

    Science.gov (United States)

    Trabert, Britton; Eldridge, Ronald C; Pfeiffer, Ruth M; Shiels, Meredith S; Kemp, Troy J; Guillemette, Chantal; Hartge, Patricia; Sherman, Mark E; Brinton, Louise A; Black, Amanda; Chaturvedi, Anil K; Hildesheim, Allan; Berndt, Sonja I; Safaeian, Mahboobeh; Pinto, Ligia; Wentzensen, Nicolas

    2017-02-01

    Inflammation is proposed to increase risk of developing endometrial cancer, but few prospective epidemiologic studies have investigated the relationship between circulating inflammation markers and endometrial cancer risk. In a nested case-control study within the PLCO Screening Trial we measured serum levels of 64 inflammation-related biomarkers in 284 incident endometrial cancer cases and 284 matched controls. Using multivariable logistic regression inflammation markers were evaluated individually and combined into a cross-validated inflammation score. Of 64 markers, 22 were associated with endometrial cancer risk at p inflammation score categories. Endometrial cancer risk was most pronounced among obese women with the highest inflammation score tertile (T) [10.25 (3.56-29.55) vs. normal BMI/T1]. Several inflammation markers were prospectively associated with endometrial cancer, including adipokines, pro- and anti-inflammatory cytokines, angiogenic factors and acute phase proteins. Inverse associations with anti-inflammatory markers (IL13, IL21), other inflammation markers/mediators (CCL3, IL1B, IL23), and a robust positive association between VEGFA and endometrial cancer risk were independent of BMI and estradiol, suggesting that these factors may influence risk through other mechanisms. © 2016 UICC.

  9. Serum tetranectin and CA125 in endometrial adenocarcinoma

    DEFF Research Database (Denmark)

    Lundstrøm, M S; Høgdall, C K; Nielsen, Anette Lynge

    2000-01-01

    BACKGROUND: CA125 and tetranectin (TN) are prognostic markers in ovarian cancer. This study examines the values of these markers in endometrial cancer. MATERIALS AND METHODS: TN and CA125 were determined preoperatively in 99 patients with primary endometrioid adenocarcinoma and evaluated...... in relation to tumor grade, stage and cancer survival. RESULTS: The CA125 levels correlated significantly with tumor stage. Dichotomized according to a cut-off level of 35 U/ml, CA125 significantly correlated with cancer death. Multivariate regression analysis of cancer survival time showed that CA125 > 35 U....../ml was not an independent factor when stage was introduced. TN levels were within the normal range in all patients and did not show any association with tumor grade, stage or survival. CONCLUSIONS: The study confirmed the role of CA125 as a prognostic factor in endometrial cancer and may be of aid in pointing out patients...

  10. History of uterine leiomyoma and risk of endometrial cancer in black women.

    Science.gov (United States)

    Wise, Lauren A; Sponholtz, Todd R; Rosenberg, Lynn; Adams-Campbell, Lucile L; Kuohung, Wendy; LaValley, Michael P; Palmer, Julie R

    2016-04-01

    Previous studies have found an association between uterine leiomyomata (UL) and uterine malignancies. This relation has not been studied in black women, who are disproportionately affected by UL. We investigated prospectively the association between self-reported physician-diagnosed UL and endometrial cancer in the Black Women's Health Study. During 1995-2013, 47,267 participants with intact uteri completed biennial health questionnaires. Reports of endometrial cancer were confirmed by pathology data from medical records and cancer registries. Cox regression was used to derive incidence rate ratios (IRR) and 95% confidence intervals (CI). There were 300 incident endometrial cancer cases during 689,546 person-years of follow-up. In multivariable models, UL history was associated with a 42% greater incidence of endometrial cancer compared with no such history (95% CI 1.12-1.80). IRRs for cancer diagnosed 0-2, 3-9, and ≥10 years after UL diagnosis were 3.20 (95% CI 2.06-4.98), 0.95 (95% CI 0.60-1.52), and 1.35 (95% CI 1.03-1.77), respectively. Stronger overall associations between UL history and endometrial cancer were observed for later stages at cancer diagnosis (IRR = 2.25, 95% CI 1.09-4.63) and type II/III cancers (IRR = 3.13, 95% CI 1.64-5.99). In this large cohort of black women, a history of UL was positively associated with endometrial cancer, particularly type II/III tumors. The strongest association was observed for cancer diagnosed within 2 years of UL diagnosis, a finding that might be explained by greater surveillance of women with UL or misdiagnosis of cancer as UL. However, an association was also observed for cancer reported ≥10 years after UL diagnosis.

  11. Concurrent Endometrial Carcinosarcoma and Thyroid Papillary Carcinoma: PET CT Imaging Findings

    Directory of Open Access Journals (Sweden)

    Mine Genc

    2015-06-01

    Full Text Available The aim of this study is to report a patient who was diagnosed with a concurrent primary tumor by 18-fluoro-2-deoxy-glucose positron emission tomography (FDG PET imaging performed for staging of an endometrial cancer. FDG uptake was detected in the uterus, where the primary cancer was located, and in the left lobe of the thyroid gland. The biopsy sample from the hypermetabolic nodular lesion in thyroid gland revealed intermediate cytology according to Bethesda Classification. The patient underwent hysterectomy and thyroidectomy. An endometrial carcinoma in the uterus and a multicentric thyroid papillary carcinoma in the thyroid gland were diagnosed.

  12. morphological pattern of endometrial biopsies in south

    African Journals Online (AJOL)

    INTRODUCTION. Endometrial biopsies are among the most common specimens submitted for histopathological analysis.1. Endometrial biopsy is a safe, efficient and cost-effective means of evaluating the uterine endometrium. The procedure is usually associated with minimal discomfort and is easily accomplished in the ...

  13. Examestane in advanced or recurrent endometrial carcinoma

    DEFF Research Database (Denmark)

    Lindemann, Kristina; Malander, Susanne; Christensen, René dePont

    2014-01-01

    We evaluated the efficacy and safety of the aromatase inhibitor exemestane in patients with advanced, persistent or recurrent endometrial carcinoma.......We evaluated the efficacy and safety of the aromatase inhibitor exemestane in patients with advanced, persistent or recurrent endometrial carcinoma....

  14. Incidence of Nonthyroidal Primary Malignancy and the Association with (131)I Treatment in Patients with Differentiated Thyroid Cancer.

    Science.gov (United States)

    Hirsch, Dania; Shohat, Tzippy; Gorshtein, Alex; Robenshtok, Eyal; Shimon, Ilan; Benbassat, Carlos

    2016-08-01

    The occurrence of nonthyroidal primary malignancy (NTPM) and the potential association of with radioiodine (RAI) treatment are important concerns in patients with differentiated thyroid cancer (DTC), but incidence data are conflicting. The aims of the present study were to investigate the incidence of NTPM and its association with RAI treatment in a cohort of DTC patients treated at a single tertiary medical center. The data of 1943 patients with DTC recorded in the Rabin Medical Center Thyroid Cancer Registry were cross-matched with data from the Israeli National Cancer Registry to identify those diagnosed with an NTPM. Patient medical files were reviewed. Second primary malignancy (SPM) was defined as new malignancy diagnosed at least two years after DTC diagnosis. For 1434 of the 1943 patients (73.8%), the American Joint Committee on Cancer TNM stage was 1-2. The mean follow-up was 9.3 years. Of the 1943 patients, 1574 (81%) were treated with RAI, and 1467 were followed for at least 2 years, and of these, 1145 patients (78%) received a cumulative dose of ≤200 mCi. A total of 409 NTPMs were diagnosed in 368/1943 patients with DTC (18.9%; 265 female, mean age 53.9 ± 15 years), including 173 SPMs (42.3%) in 166/368 patients. The most common NTPM and SPM was breast cancer followed by hematologic malignancies. In patients followed for ≥2 years, SPMs were diagnosed in 9% of RAI-treated patients and 10.5% of non-RAI-treated patients. SPM rates were 10.2% and 7.8% for a cumulative RAI dose of ≤100 mCi and >100 mCi respectively. Hazard ratios for SPM in patients that received/did not receive RAI treatment was 1.27 (95% confidence interval 0.88-1.82; p = 0.1). There was no correlation between first or cumulative RAI dose and diagnosis of SPM. NTPMs are not uncommon in patients with DTC and usually antecede the DTC. In a population of mostly low-risk DTC patients, in whom limited activities of RAI are usually administered, this treatment is apparently not

  15. Sunitinib Malate in Treating Patients With Recurrent or Metastatic Endometrial Cancer

    Science.gov (United States)

    2017-10-24

    Endometrial Adenocarcinoma; Endometrial Endometrioid Adenocarcinoma; Endometrial Serous Adenocarcinoma; Recurrent Uterine Corpus Carcinoma; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer; Uterine Carcinosarcoma; Uterine Corpus Carcinosarcoma

  16. Robotic-assisted laparoscopic hysterectomy seems safe in women with early-stage endometrial cancer

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Havemann, Maria Cecilie; Palle, Connie

    2015-01-01

    INTRODUCTION: Robotic surgery is increasingly used in the management of endometrial cancer; and although it is known that minimally invasive surgery reduces post-operative morbidity, the outcomes of this novel treatment should be monitored carefully. The aim of this study was to examine...... the incidence of complications according to the Clavien-Dindo scale after robotic-assisted laparoscopic hysterectomy (RALH) for early-stage endometrial cancer and atypical complex hyperplasia. The Clavien-Dindo scale grades the severity of complications. METHODS: This was a retrospective, descriptive cohort...... study of 235 women with endometrial cancer or atypical complex hyperplasia who had RALH. Surgeries were stratified into two groups: with or without pelvic lymphadenectomy. RESULTS: A total of 6% developed a grade 3 or higher complication with no significant difference (p = 0.24) between the groups...

  17. {sup 18}F-FDG-PET/CT in Endometrial Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Tae Joo [Pochon CHA University College of Medicine, Sungnam (Korea, Republic of)

    2008-12-15

    Endometrial carcinoma is one of the most common gynecologic malignancies and which is predominant in postmenopausal women. Clinically many patients are hospitalized in early stage due to clinical sign and symptom such as vaginal bleeding and in this case, patient's prognosis is known to be good. However, considerable number of patients with advanced and relapsed disease reveal poor prognosis. Therefore, exact staging work up is essential for proper treatment as is primary lesion detection. {sup 18}F-FDG-PET has been widely used for the evaluation of gynecologic malignancies such as cervical carcinoma and ovarian cancer. In contrast, FDG PET application to endometrial carcinoma is limited until now and there is no sufficient data to validate the usefulness of FDG PET for this disease yet. However, several studies showed promising results that FDG PET is sensitive and specific in detection of recurrent or metastatic lesions. Therefore further active investigation in this field can facilitate the use of FDG PET for endometrial carcinoma.

  18. Laparoscopic Management of a Small Bowel Recurrence of Endometrial Cancer.

    Science.gov (United States)

    Gallotta, Valerio; Nero, Camilla; Callari, Cosimo; Lodoli, Claudio; Fanfani, Francesco; Fagotti, Anna; Scambia, Giovanni

    2016-02-01

    We present a very rare case of focal metastasis of endometrial cancer to the small bowel entirely managed laparoscopically. Case report (Canadian Task Force Classification Study design III). Tertiary referral centre in Rome, Italy. A 58 year-old patient with a FIGO Stage IB G2 N0 endometrial cancer was found to have a vaginal cuff recurrence and an isolated distant metastasis to the small bowel 13 months after primary treatment. In this video we show a fully laparoscopic management mainly focusing on small bowel resection with intracorporeal anastomosis. A laparoscopic partial colpectomy was also performed. Our institutional review board approved this study. Operative time was 180 minutes. Intraoperative blood loss was less than 100 mL. The operation was performed successfully with no intraoperative complications. Pathologic findings showed recurrent disease in the vaginal cuff and in the resected small bowel segment with free resection margins in both specimens and 3 mesenteric local nodes negative for metastasis. The patient was discharged on day 3 and 26 days later started adjuvant chemotherapy. After a 16-month follow-up period, the patient is still disease free and in good general conditions. This case shows a successful laparoscopic management of recurrent endometrial cancer equiring complex surgical procedures. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  19. Maximum dose angle for oblique incidence on primary beam protective barriers in the design of medical radiation therapy facilities

    International Nuclear Information System (INIS)

    Fondevila, Damian; Arbiser, Silvio; Sansogne, Rosana; Brunetto, Monica; Dosoretz, Bernardo

    2008-01-01

    Primary barrier determinations for the shielding of medical radiation therapy facilities are generally made assuming normal beam incidence on the barrier, since this is geometrically the most unfavorable condition for that shielding barrier whenever the occupation line is allowed to run along the barrier. However, when the occupation line (for example, the wall of an adjacent building) runs perpendicular to the barrier (especially roof barrier), then two opposing factors come in to play: increasing obliquity angle with respect to the barrier increases the attenuation, while the distance to the calculation point decreases, hence, increasing the dose. As a result, there exists an angle (α max ) for which the equivalent dose results in a maximum, constituting the most unfavorable geometric condition for that shielding barrier. Based on the usual NCRP Report No. 151 model, this article presents a simple formula for obtaining α max , which is a function of the thickness of the barrier (t E ) and the equilibrium tenth-value layer (TVL e ) of the shielding material for the nominal energy of the beam. It can be seen that α max increases for increasing TVL e (hence, beam energy) and decreases for increasing t E , with a range of variation that goes from 13 to 40 deg for concrete barriers thicknesses in the range of 50-300 cm and most commercially available teletherapy machines. This parameter has not been calculated in the existing literature for radiotherapy facilities design and has practical applications, as in calculating the required unoccupied roof shielding for the protection of a nearby building located in the plane of the primary beam rotation

  20. High-incidence of PTEN mutations in Chinese patients with primary small cell carcinoma of the esophagus

    International Nuclear Information System (INIS)

    Zhang, Zhimin; Wang, Ge; Xiao, Hualiang; Xie, Fei; Zhang, Hui; Chen, Chuan; Xiao, He; Yang, Zhenzhou; Wang, Dong; Li, Zengpeng

    2014-01-01

    Primary small cell carcinoma of the esophagus (PSCCE) is a rare and aggressive tumor with poor prognosis. The aim of this study was to investigate the existence of EGFR, KRAS, PIK3CA and PTEN mutations in PSCCE. Clinical–pathological data and paraffin-embedded specimens were collected from 38 patients. Exons 18 to 21 of EGFR, KRAS and PIK3CA status were analyzed by real-time PCR based on ARMS and Scorpion technology in all patients, and the PTEN gene was also screened using real-time PCR and high-resolution melting curve analysis (HRMA). Only 1 (2.63%) out of 38 patients had EGFR mutations in L858R missense, and KRAS and PIK3CA were not found in the mutational spot in all patients. However, PTEN mutations presented in 14 (36.84%) out of 38 patients, including exon 5 coding for PTEN missense mutation (n =4, 10.53%), exon 6 (n =7, 18.42%), concurrent exon 5 and exon 6 (n =2, 5.26%), and exon 8 (n =1, 2.63%). Concurrent mutations of these genes were not detected in all samples. No statistically significant associations were found between the clinicopathological features and the mutation status of PTEN. The incidence of PTEN mutations in Chinese patients with PSCCE was higher than that of previous reports in other histological subtypes of esophageal cancer

  1. Isolated lung events following radiation for early stage breast cancer: incidence and predictors for primary lung vs metastatic breast cancer

    International Nuclear Information System (INIS)

    Van Buren, Teresa A; Harris, Jay R; Sugarbaker, David J; Schneider, Lindsey; Healey, Elizabeth A

    1995-01-01

    Purpose: 1) To define the incidence of isolated lung events in a cohort of women treated with conservative surgery (CS) and radiation therapy (RT) for early stage breast cancer. 2) Among such patients, to define the relative distribution of primary lung cancer, metastatic breast cancer, and indeterminate lesions; and to identify any predictors for a diagnosis of lung vs metastatic breast cancer. 3) To examine the cohort with respect to whether a higher than expected incidence of lung cancer is seen following breast irradiation. Materials and Methods: Between 1968 and 1986, 1865 patients with clinical stage I-II breast cancer were treated with CS and RT; the median follow-up for surviving patients is 129 months. The study population was limited to patients who developed a subsequent isolated lung event as the first site of distant disease. Isolated lung event was defined as disease limited to the thoracic cavity, without evidence of either uncontrolled local breast disease or metastatic disease elsewhere. Diagnosis of the lung event as a primary lung cancer, a metastatic breast lesion, or an indeterminate lesion was documented from the viewpoint of 1) the pathologic analysis and 2) the clinical impression at the time of the lung event. Results: Sixty six of the 1865 patients (3.5%) developed an isolated lung event. The relative distribution of the pathologic and clinical diagnoses is shown below: The 66 lung events were characterized either as a solitary pulmonary nodule (27), multiple nodules (23), pleural effusion alone (10), unknown (2), or miscellaneous other findings (4). Among the 47 patients for whom pathology was available, the diagnosis remained indeterminate for 24 (51%). For patients with a definitive pathologic diagnosis, 69% ((9(13))) of smokers had a new lung cancer compared to 20% ((2(10))) of non-smokers (p=0.036), and 67% ((10(15))) of patients with a solitary pulmonary nodule had lung cancer compared to 14% ((1(7))) for other lung presentations (p

  2. MR staging of endometrial carcinoma

    International Nuclear Information System (INIS)

    Innocenti, P.; Agostini, S.; Erroi, C.; Ambrogetti, D.; Cellerini, A.; Nori, J.

    1991-01-01

    Biopsy is the technique of choice for the definitive diagnosis of endometrial carcinoma. Since lymphatic tumor spread has been demonstrated to depend on the degree of myometrial involvement, the definition of the latter with imaging techniques may significantly affect both pfognosis and therapy. We investigated, by means of MR imaging at 0.5 T, 14 patients with endometrial carcinoma, to assess both tumor stage and myometrial involvement. FIGO staging system was employed, and M parameter evaluated (M0= no myometrial involvement; M1involvement confined to the inner third; M2= Involvement confined to the middle third; M3= involvement of the whole myometrium). Another parameter was the characteristic high signal of the tumor on PD and T2W images. The patients were then operated and MR information was correlated with surgical findings. Overall diagnostic accuracy of MR imaging was 85.7% in tumor staging, and 92.2% in defining M parameter. Tumor spread into adnexa and into cervical canal was poorly demonstrated by MR imaging

  3. Frequency of endometrial tuberculosis in female infertility

    International Nuclear Information System (INIS)

    Yousaf, A.; Zaman, G.; Sultana, N.

    2002-01-01

    Objective: To determine the frequency of endometrial tuberculosis in infertility patients. Design: an observational analytical study. Place and Duration of Study: Military Hospital Rawalpindi and Armed Forces Institute of Pathology, Rawalpindi from August 1998 to April 1999. Subjects and Methods: Endometrial biopsies were taken from 50 cases of infertility and subjected to culture on BACTEC 460 TB instrument. Results: Tuberculous endometritis was found in 10 % (n=5) of cases. Conclusion: It was concluded that endometrial tuberculosis is not an infrequent cause of infertility in our setup. (author)

  4. Isolated Abdominal Wall Metastasis of Endometrial Carcinoma

    Directory of Open Access Journals (Sweden)

    Rita Luz

    2014-01-01

    Full Text Available A woman in her mid-60s presented with a bulky mass on the anterior abdominal wall. She had a previous incidental diagnosis of endometrial adenocarcinoma FIGO stage IB following a vaginal hysterectomy. Physical exam and imaging revealed a well circumscribed bulging tumour at the umbilical region, measuring 10 × 9 × 9 cm, with overlying intact skin and subcutaneous tissue. Surgical resection was undertaken, and histological examination showed features of endometrial carcinoma. She began chemotherapy and is alive with no signs of recurrent disease one year after surgery. This case brings up to light an atypical location of a solitary metastasis of endometrial carcinoma.

  5. Traumatic graft rupture after primary and revision anterior cruciate ligament reconstruction: retrospective analysis of incidence and risk factors in 2915 cases.

    Science.gov (United States)

    Schlumberger, Michael; Schuster, Philipp; Schulz, Martin; Immendörfer, Micha; Mayer, Philipp; Bartholomä, Jochen; Richter, Jörg

    2017-05-01

    To determine incidence and risk factors for traumatic graft rupture following primary and revision anterior cruciate ligament (ACL) reconstruction. All cases of isolated ACL reconstructions (primary or revision) performed at our institution between January 2007 and December 2010 were included. From this group of 2467 primary reconstructions (32.4 ± 12.2 years) and 448 revision reconstructions (33.0 ± 10.4 years), we identified all patients who underwent revision ACL reconstruction following traumatic graft rupture in further course and all patients who underwent contralateral primary ACL reconstruction until January 2014. Age, gender, time from index procedure and graft diameter (for hamstring autografts) were analysed in terms of being a potential risk factor for graft rupture. Within a follow-up period of 5.0 ± 1.1 years (3.0-7.0), a total of 82 traumatic graft ruptures were identified, resulting in an incidence of 2.8 %. Seventy-three cases were seen following primary reconstructions (3.0 %), and nine cases following revision reconstructions (2.0 %), respectively (n.s.). Age younger than 25 years was identified as a risk factor for both groups (p = 0.001 and p = 0.008; odds ratio 6.0 and 6.4, respectively). In primary reconstruction, male patients had a higher risk of graft rupture compared with females (3.7 vs. 1.6 %; p = 0.005), and the first year after index procedure was associated with a higher risk of graft rupture compared with the following (p < 0.001). Graft diameter did not influence the risk of graft rupture. Incidence of contralateral ACL rupture was 3.1 %, which was not different to the incidence of graft rupture ipsilaterally (n.s.). No statistically significant differences were seen between graft rupture incidence of primary and revision ACL reconstructions. Young age (<25 years) and short time to the index procedure (especially within the first year) were confirmed as risk factors for graft rupture in both groups. Male

  6. Preoperative identification of synchronous ovarian and endometrial cancers: the importance of appropriate workup

    NARCIS (Netherlands)

    Broeders, F.M.; Wurff, A.A. van der; Pijnenborg, J.M.A.; Vos, M.C.

    2012-01-01

    OBJECTIVE: For treatment of patients with both endometrial and ovarian cancer, it is important to discriminate between 2 primary tumors and metastatic disease. Currently, criteria are based on postoperative findings. The aim of this study was to determine whether clinical parameters can discriminate

  7. Soya food intake and risk of endometrial cancer among Chinese women in Shanghai: population based case-control study

    Science.gov (United States)

    Xu, Wang Hong; Zheng, Wei; Xiang, Yong Bing; Ruan, Zhi Xian; Cheng, Jia Rong; Dai, Qi; Gao, Yu Tang; Shu, Xiao Ou

    2004-01-01

    Objective To evaluate the association of intake of soya food, a rich source of phytoestrogens, with the risk of endometrial cancer. Design Population based case-control study, with detailed information on usual soya food intake over the past five years collected by face to face interview using a food frequency questionnaire. Setting Urban Shanghai, China. Participants 832 incident cases of endometrial cancer in women aged of 30 to 69 years diagnosed during 1997-2001 and identified from the Shanghai Cancer Registry; 846 control women frequency matched to cases on age and randomly selected from the Shanghai Residential Registry. Main outcome measures Odds ratios for risk of endometrial cancer in women with different intakes of soya foods. Results Regular consumption of soya foods, measured as amount of either soya protein or soya isoflavones, was inversely associated with the risk of endometrial cancer. Compared with women with the lowest quarter of intake, the adjusted odds ratio of endometrial cancer was reduced from 0.93 to 0.85 and 0.67 with increasing quarter of soya protein intake (P for trend 0.01). A similar inverse association was observed for soya isoflavones and soya fibre intake. The inverse association seemed to be more pronounced among women with high body mass index and waist:hip ratio. Conclusion Regular intake of soya foods is associated with a reduced risk of endometrial cancer. PMID:15136343

  8. Stathmin protein level, a potential predictive marker for taxane treatment response in endometrial cancer.

    Directory of Open Access Journals (Sweden)

    Henrica M J Werner

    Full Text Available Stathmin is a prognostic marker in many cancers, including endometrial cancer. Preclinical studies, predominantly in breast cancer, have suggested that stathmin may additionally be a predictive marker for response to paclitaxel. We first evaluated the response to paclitaxel in endometrial cancer cell lines before and after stathmin knock-down. Subsequently we investigated the clinical response to paclitaxel containing chemotherapy in metastatic endometrial cancer in relation to stathmin protein level in tumors. Stathmin level was also determined in metastatic lesions, analyzing changes in biomarker status on disease progression. Knock-down of stathmin improved sensitivity to paclitaxel in endometrial carcinoma cell lines with both naturally higher and lower sensitivity to paclitaxel. In clinical samples, high stathmin level was demonstrated to be associated with poor response to paclitaxel containing chemotherapy and to reduced disease specific survival only in patients treated with such combination. Stathmin level increased significantly from primary to metastatic lesions. This study suggests, supported by both preclinical and clinical data, that stathmin could be a predictive biomarker for response to paclitaxel treatment in endometrial cancer. Re-assessment of stathmin level in metastatic lesions prior to treatment start may be relevant. Also, validation in a randomized clinical trial will be important.

  9. [THE ROLE OF THE CYTOKINE PROFILE IN TREATMENT IN WOMEN WITH ENDOMETRIAL CANCER FIRST STAGE].

    Science.gov (United States)

    Dimitrov, T; Gorchev, G; Tomov, S

    2015-01-01

    Endometrial canceris the most common gynecological cancer. It is positive that more than 53% of diagnosed cases of endometrial cancer are in first stage when the therapeutic options are more successive. More and more gynecologists in addition to the normal clinical and histological tests expand the information for the neoplastic process with biochemical and immunological markers-tumor markers, hormones, lymphocyte population, cytokines, markers for lesion-inflammatory processes, etc. Several biological mechanisms track the connection between overweight and endometrial neoplastic risk. In the surgical practice is increasing the interest towards the cytokine group as independent prognostic factors, aggressiveness and options for treatment of the neoplastic process. The cytokine profile can be used as factor for evaluation of the primary neoplastic immune impairment as well as for a choice of surgical intervention. This is extremely important for obese patients because obesity is turning into worldwide medico-social problem.

  10. The use of hormonal contraception and its protective role against endometrial and ovarian cancer.

    Science.gov (United States)

    Grimbizis, Grigoris F; Tarlatzis, Basil C

    2010-02-01

    Hormonal contraception has a protective effect over ovarian and endometrial cancer development. Relative risk of ovarian cancer decreases by approximately 20% for each 5 years of use; it is approximately 50% for 15 years of use and decreasing with further use. The protective effect gained declines as time passes from its last use, but a significant effect remains a long time after ceasing. The effect is independent from the type of formulation used. Hormonal contraceptives do not protect from mucinous types of ovarian tumours. Relative risk reduction of endometrial cancer is even higher; the estimated relative risk decrease is approximately 50% with 4 years of use, approximately 70% with 12 years of use and decreasing with further use. After ceasing oral contraception, the risk begins to rise from its reduced levels but it is still approximately 50% even after >20 years after its last use. Hormonal contraception could be used for primary protection from ovarian and endometrial cancer development.

  11. Cadmium exposure and endometrial cancer risk: A large midwestern U.S. population-based case-control study.

    Directory of Open Access Journals (Sweden)

    Jane A McElroy

    Full Text Available Estrogen-mimicking chemicals, such as cadmium, may be associated with increased susceptibility to hormone-dependent cancers, though supporting data are sparse, particularly for endometrial cancer. The Health and Environmental Exposure Research (HEER study worked with the Arkansas Central Cancer Registry, Iowa Cancer Registry and Missouri Cancer Registry to obtain names of women diagnosed with endometrial cancer who were willing to be contacted for participation in our case control study. Voter registration lists from Iowa and Missouri were used to randomly select similarly aged women as represented in the case population. Participants were interviewed by telephone to obtain information on known or suspected endometrial risk factors. Urine kits were sent to participants for home collection and returned for analysis. Our case-control study consisted of 631 incident cases of endometrial cancer diagnosed from January 2010 to October 2012 and 879 age-matched population-based controls, ages 18-81 years (mean age 65 years. We quantified cadmium amounts in urine and standardized these values through creatinine adjustment. Using data from all survey completers, we developed a multivariable model for endometrial cancer. Creatinine-adjusted cadmium concentration was added to this model. Odds ratio (OR and 95% confidence intervals (CIs for endometrial cancer were calculated. After multivariable adjustment, higher creatinine-adjusted cadmium exposure was associated with a statistically significant increase of endometrial cancer risk (OR: 1.22; 95% CI: 1.03-1.44. Our results provide evidence that cadmium may increase the risk of endometrial cancer, possibly through estrogenic effects.

  12. Incidence and risk factor prevalence of community-acquired pneumonia in adults in primary care in Spain (NEUMO-ES-RISK project).

    Science.gov (United States)

    Rivero-Calle, I; Pardo-Seco, J; Aldaz, P; Vargas, D A; Mascarós, E; Redondo, E; Díaz-Maroto, J L; Linares-Rufo, M; Fierro-Alacio, M J; Gil, A; Molina, J; Ocaña, D; Martinón-Torres, Federico

    2016-11-07

    Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in adults even in developed countries. Several lifestyle factors and comorbidities have been linked to an increased risk, although their prevalence has not been well documented in the primary care setting. The aim of this study is to assess the incidence, risk factor and comorbid conditions distribution of CAP in adults in primary care in Spain. Retrospective observational study in adults (>18 years-old) with CAP diagnosed and attended at primary care in Spain between 2009 and 2013, using the Computerized Database for Pharmacoepidemiological Studies in Primary Care (BIFAP). Twenty-eight thousand four hundred thirteen patient records were retrieved and analyzed. Mean age (standard deviation): 60.5 (20.3) years, 51.7 % males. Global incidence of CAP in adults was estimated at 4.63 per 1000 persons/year. CAP incidence increased progressively with age, ranging from a 1.98 at 18-20 years of age to 23.74 in patients over 90 years of age. According to sex, global CAP incidence was slightly higher in males (5.04) than females (4.26); CAP incidence from 18 to 65 year-olds up was comparable between males (range: 2.18-5.75) and females (range: 1.47-5.21), whereas from 65 years of age, CAP incidence was noticeable higher in males (range: 7.06-36.93) than in females (range: 5.43-19.62). Average prevalence of risk factors was 71.3 %, which increased with age, doubling the risk in males by the age of 75 (females 20 % vs males 40 %). From 55 years of age, at least one risk factor was identified in 85.7 % of cases: one risk factor (23.8 %), two risk factors (23.4 %), three or more risk factors (38.5 %). Major risk factors were: metabolic disease (27.4 %), cardiovascular disease (17.8 %) and diabetes (15.5 %). The annual incidence of CAP in primary care adults in Spain is high, comparable between males and females up to 65 years of age, but clearly increasing in males from that age. CAP

  13. Postoperative radiotherapy for endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Eun Cheol; Kim, Jin Hee; Kim, Ok Bae; Byun, Sang Jun; Park, Seung Gyu; Kwon, Sang Hoon [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2012-09-15

    To investigate the prognostic factors and effectiveness of postoperative radiotherapy alone for endometrial carcinoma. Sixty four patients with stage I?III endometrial cancer (EC) treated with postoperative radiotherapy alone between January 1989 and December 2008 at the Keimyung University Dongsan Medical Center were chosen for the present study. Typically, total hysterectomy, salpingo-oophorectomy and lymphadenectomy were performed on the patient's pelvis. Total dose from 50.4 Gy to 63 Gy was irradiated at pelvis or extended fi eld. Thirteen patients were treated with Co-60 or Ir-192 intracavitary radiotherapy. Follow-up periods were from 7 to 270 months, with a median of 56 months. Five year overall survival (OS) rate was 58.7%, respectively. Five year disease-free survival (DFS) rate was 59.2%, respectively. In univariate analysis for OS and DFS, stage, menopausal age, type of operation, serosal invasion, and lymph node involvement were found to be statistically significant. Histologic type was marginally significant. In multivariate analysis for OS and DFS, stage, types of operation, histologic type were also found to be statistically significant. Treatment failure occurred in 14 patients. The main pattern of failure was found to be distant metastasis. Time to distant metastasis was from 3 to 86 months (median, 12 months). There were no grade 3 or 4 complications. Stage, types of operation, and histologic type could be the predictive prognostic factors in patients. We contemplated postoperative radiation as effective and safe treatment method for EC. Additional treatment would be needed to reduce distant metastasis.

  14. Hormones in the etiology and prevention of breast and endometrial cancer.

    Science.gov (United States)

    Gambrell, R D

    1984-12-01

    Since the incidence of endometrial cancer among estrogen-treated women at Wilford Hall Air Force Medical Center was not increased as reported by others, a prospective study was begun in 1975. With this data base, the cases of breast and endometrial cancer in estrogen and oral contraceptive users were reviewed. The incidence of mammary malignancy in postmenopausal estrogen users (141.0:100,000) was lower than that of the untreated women, ie, nonhormone users (342.3:100,000) (P less than or equal to .01). The incidence of breast cancer in the estrogen-progestogen users (67.3:100,000) was significantly lower than that of the untreated women and than that expected from the Third National Cancer Survey (188.3:100,000) and the National Cancer Institute (NCI) data (229.2:100,000) (P less than or equal to .01). Oral contraceptives also decreased the risk of breast carcinoma, since the incidence in users (10.3:100,000) was significantly lower than expected in this age group according to both the Third National Cancer Survey (53.3:100,000) and the NCI data (57.3:100,000) (P less than or equal to .01). Unopposed estrogen replacement therapy increased the incidence of endometrial cancer to 410.8:100,000, but progestogen added to estrogen therapy significantly decreased this incidence to 68.1:100,000 (P less than or equal to .0001). The estrogen-progestogen users also had a significantly lower incidence of endometrial carcinoma than the untreated women (258.3:100,000) (P less than or equal to .005). Oral contraceptives, particularly the combination pill with estrogen and progestogen in each tablet, are protective against adenocarcinoma of the endometrium. The incidence of endometrial cancer apparently increased in premenopausal women during our study from 10.9:100,000 women in the first five years to 41.9:100,000 during the last two years as birth control pill use declined from 8,693 users in 1975 to 5,563 users during 1981, primarily in women over the age of 35.

  15. Analysis of the incidence of disease among the primary school pupils related to the organization of the physical education provided to the medically fragile children

    Directory of Open Access Journals (Sweden)

    Ganna Kazantseva

    2015-12-01

    Full Text Available Purpose: to research the breadth and type of the diseases among the primary school pupils aiming on the physical education optimization. Material and Methods: general data of the incidence of disease among the primary school pupils was revealed in the analysis of the medical documentation for 235 pupils of 1–4 grades at the general secondary school-lyceum in urban village Novofyodorovka. Results: it was revealed that the most wide spread health disorders at the primary school pupils are frequent respiratory diseases, functional disorders of locomotor apparatus and visual organs. Conclusions: the need of systematical application of the eyes exercises, breathing exercises as well as exercises for prophylaxis and correction of the skeleton deformations has been shown to increase the health-improving character of the physical education lessons at the primary school

  16. Follow-up of women after a first episode of postmenopausal bleeding and endometrial thickness greater than 4 millimeters

    NARCIS (Netherlands)

    Timmermans, Anne; van Doorn, Lena C.; Opmeer, Brent C.; Kroeks, Maurice V. A. M.; Duk, M. Jitze; Bouwmeester, Annette M.; Kruitwagen, Roy F. M. P.; Dijkhuizen, F. Paul H. L. J.; Mol, Ben W. J.

    2008-01-01

    OBJECTIVE: To estimate the incidence of recurrent postmenopausal bleeding among women who were diagnosed with an endometrial thickness greater than 4 mm. METHODS: We designed a prospective cohort study and included consecutive women not using hormone replacement therapy, presenting with a first

  17. Prognostic significance and treatment implications of positive peritoneal cytology in endometrial adenocarcinoma: Unraveling a mystery.

    Science.gov (United States)

    Wethington, Stephanie L; Barrena Medel, Nicanor I; Wright, Jason D; Herzog, Thomas J

    2009-10-01

    Review the literature on positive peritoneal cytology in endometrioid endometrial adenocarcinoma, its prognostic value, proposed treatment strategies, and future avenues of investigation. PubMed search of articles pertaining to stage IIIA endometrioid endometrial adenocarcinoma identified over 50 articles that were reviewed. Low-risk stage IIIA1 was defined as those with grade 1 or 2 disease, no evidence of cervical involvement, myometrial invasion less than 50% and no lymph vascular space invasion (LVSI). Analysis of available data was completed with weighted averages, Student's-t-test and Chi square statistical analyses. Incidence of positive washings is approximately 11%. In low-risk stage IIIA1 endometrial carcinoma patients, the rate of recurrence is 4.1%. In contrast, in high-risk stage IIIA1 endometrial carcinoma patients the rate of recurrence is 32%, a statistically significant difference (p<0.001). Positive peritoneal cytology is associated with an increased incidence of extrauterine disease but is not consistently linked to other high-risk factors such as positive lymph node status, extent of myometrial invasion or LVSI. To date there is no definitive consensus on the prognostic significance of positive peritoneal cytology alone. However, even in the low-risk cohort with stage IIIA1 some patients will recur. Adjuvant therapy for low-risk stage IIIA diseased may or may not be of benefit. High-risk disease should be treated with chemotherapy, radiation or a combination thereof. A prospective, multicenter trial of comprehensively surgically staged patients with stage IIIA endometrial cancer is indicated in order to clearly define prognosis and treatment for these patients.

  18. Local anaesthesia during endometrial ablation: a systematic review

    NARCIS (Netherlands)

    Reinders, I. M. A.; Geomini, P. M. A. J.; Timmermans, A.; de Lange, M. E.; Bongers, M. Y.

    2017-01-01

    Background Endometrial ablation has been widely implemented in the outpatient setting. Many different protocols of local anaesthesia during endometrial ablation are used and described. However, prospective studies to assess and evaluate these protocols appear to be scarce. Objectives To evaluate

  19. Histopathological Patterns of Endometrial Lesions in Patients with ...

    African Journals Online (AJOL)

    Histopathological Patterns of Endometrial Lesions in Patients with Abnormal Uterine Bleeding in a Cosmopolitan Population. ... among reproductive women. Nevertheless, endometrial hyperplasia was most frequent in perimenopausal age group. Keywords: Cancer, endometrium, histopathology, lesions, private practice ...

  20. Endometrial Cancer Treatment (PDQ®)—Health Professional Version

    Science.gov (United States)

    Endometrial cancer is usually diagnosed at an early stage and can be treated with surgery. Learn about the symptoms, diagnosis, prognosis, staging, and treatment for early- and advanced-stage endometrial cancer in this expert-reviewed summary.

  1. Multiple primary cancers: An enigma

    Directory of Open Access Journals (Sweden)

    Amitabh Jena

    2016-01-01

    Full Text Available Background: Incidence of multiple primary cancers though uncommon, is being frequently reported now-a-days owing to better diagnostic techniques, the prolonged life span and the increased incidence of long-term survival of cancer patients. Materials and Methods: This is a retrospective study. Cases of multiple malignancies diagnosed histopathologically were retrieved from the archives of department of surgical oncology. Clinical data were obtained from the medical records. They were categorized as synchronous malignancies if the interval between them was less or equal to 6 months and metachronous, if the interval was more than 6 months. Results: A total of 13 cases were encountered in the 5 year study period. Out of them two were in the metachronous category and the rest were synchronous as the 2nd malignancy was detected mostly during clinical evaluation of the patients for the primary malignancy. There was female predominance with age range being 43-68 years. Majority of the cases were in the 7th decade. The most common organ involved was breast, followed by cervix. Apart from bilateral breast malignancies, there were combinations like breast with uterine endometrial carcinoma, cervical carcinoma and even papillary thyroid carcinoma. Conclusion: Detection of multiple primary malignancies is becoming increasingly common in day-to-day practice. Greater awareness of this is required among both cancer patients and their treating clinicians.

  2. Morphological pattern of endometrial biopsies in southwestern Nigeria

    African Journals Online (AJOL)

    Background: Endometrium remains the most sensitive indicator of ovarian function and endometrial biopsy is one of the diagnostic procedures in endometrial pathology. The current study was carried out to examine the morphological pattern of endometrial biopsies in Ibadan, South-western Nigeria and compare the results ...

  3. The Effect of Endometrial Thickness on In vitro Fertilization (IVF ...

    African Journals Online (AJOL)

    The value of measuring the endometrial thickness and studying the endometrial receptivity in the context of assisted conception remains a contentious issue. A prospective analysis was carried out to determine the effect of endometrial thickness on IVF - embryo transfer / ICSI outcome in dedicated Assisted Reproductive ...

  4. Hormonal and molecular aspects of endometrioid endometrial cancer

    NARCIS (Netherlands)

    Jongen, Vincentius Hubertus Willibrordus Maria

    2008-01-01

    This thesis concerns the expression and prognostic value of various hormones and molecular markers playing a role n endometrioid endometrial cancer. Especially we were interested in the enzyme aromatase, its expression and (prognostic) role in endometrioid endometrial cancer. Endometrial cancer is

  5. High coffee consumption and different brewing methods in relation to postmenopausal endometrial cancer risk in the Norwegian women and cancer study: a population-based prospective study.

    Science.gov (United States)

    Gavrilyuk, Oxana; Braaten, Tonje; Skeie, Guri; Weiderpass, Elisabete; Dumeaux, Vanessa; Lund, Eiliv

    2014-03-25

    Coffee and its compounds have been proposed to inhibit endometrial carcinogenesis. Studies in the Norwegian population can be especially interesting due to the high coffee consumption and increasing incidence of endometrial cancer in the country. A total of 97 926 postmenopausal Norwegian women from the population-based prospective Norwegian Women and Cancer (NOWAC) Study, were included in the present analysis. We evaluated the general association between total coffee consumption and endometrial cancer risk as well as the possible impact of brewing method. Multivariate Cox regression analysis was used to estimate risks, and heterogeneity tests were performed to compare brewing methods. During an average of 10.9 years of follow-up, 462 incident endometrial cancer cases were identified. After multivariate adjustment, significant risk reduction was found among participants who drank ≥8 cups/day of coffee with a hazard ratio of 0.52 (95% confidence interval, CI 0.34-0.79). However, we did not observe a significant dose-response relationship. No significant heterogeneity in risk was found when comparing filtered and boiled coffee brewing methods. A reduction in endometrial cancer risk was observed in subgroup analyses among participants who drank ≥8 cups/day and had a body mass index ≥25 kg/m2, and in current smokers. These data suggest that in this population with high coffee consumption, endometrial cancer risk decreases in women consuming ≥8 cups/day, independent of brewing method.

  6. High coffee consumption and different brewing methods in relation to postmenopausal endometrial cancer risk in the Norwegian Women and Cancer Study: a population-based prospective study

    Science.gov (United States)

    2014-01-01

    Background Coffee and its compounds have been proposed to inhibit endometrial carcinogenesis. Studies in the Norwegian population can be especially interesting due to the high coffee consumption and increasing incidence of endometrial cancer in the country. Methods A total of 97 926 postmenopausal Norwegian women from the population-based prospective Norwegian Women and Cancer (NOWAC) Study, were included in the present analysis. We evaluated the general association between total coffee consumption and endometrial cancer risk as well as the possible impact of brewing method. Multivariate Cox regression analysis was used to estimate risks, and heterogeneity tests were performed to compare brewing methods. Results During an average of 10.9 years of follow-up, 462 incident endometrial cancer cases were identified. After multivariate adjustment, significant risk reduction was found among participants who drank ≥8 cups/day of coffee with a hazard ratio of 0.52 (95% confidence interval, CI 0.34-0.79). However, we did not observe a significant dose-response relationship. No significant heterogeneity in risk was found when comparing filtered and boiled coffee brewing methods. A reduction in endometrial cancer risk was observed in subgroup analyses among participants who drank ≥8 cups/day and had a body mass index ≥25 kg/m2, and in current smokers. Conclusions These data suggest that in this population with high coffee consumption, endometrial cancer risk decreases in women consuming ≥8 cups/day, independent of brewing method. PMID:24666820

  7. Trends in primary total hip arthroplasty in Spain from 2001 to 2008: Evaluating changes in demographics, comorbidity, incidence rates, length of stay, costs and mortality

    Directory of Open Access Journals (Sweden)

    Jimenez-Trujillo Isabel

    2011-02-01

    Full Text Available Abstract Background Hip arthroplasties is one of the most frequent surgical procedures in Spain and are conducted mainly in elderly subjects. We aim to analyze changes in incidence, co-morbidity profile, length of hospital stay (LOHS, costs and in-hospital mortality (IHM of patients undergoing primary total hip arthroplasty (THA over an 8-year study period in Spain. Methods We selected all surgical admissions in individuals aged ≥40 years who had received a primary THA (ICD-9-CM procedure code 81.51 between 2001 and 2008 from the National Hospital Discharge Database. Age- and sex-specific incidence rates, LOHS, costs and IHM were estimated for each year. Co-morbidity was assessed using the Charlson comorbidity index. Multivariate analysis of time trends was conducted using Poisson regression. Logistic regression models were conducted to analyze IHM. Results We identified a total of 161,791 discharges of patients having undergone THA from 2001 to 2008. Overall crude incidence had increased from 99 to 105 THA per 100.000 inhabitants from 2001 to 2008 (p 2 and in 2008, the prevalence of 1-2 or >2 had increased to 20.4% and 1.1% respectively (p Conclusions The current study provides clear and valid data indicating increased incidence of primary THA in Spain from 2001 to 2008 with concomitant reductions in LOHS, slight reduction IHM, but a significant increase in cost per patient. The health profile of the patient undergoing a THA seems to be worsening in Spain.

  8. The incidence of second primary tumors in thyroid cancer patients is increased, but not related to treatment of thyroid cancer

    NARCIS (Netherlands)

    Verkooijen, Robbert B. T.; Smit, Jan W. A.; Romijn, Johannes A.; Stokkel, Marcel P. M.

    2006-01-01

    The aim of the present study is to assess the prevalence of second primary tumors in patients treated for thyroid cancer. Furthermore, we wanted to assess the standardized risk rates for all second primary tumors, but especially for breast cancer, as data in the literature indicate an excessive risk

  9. Stem cell-like properties of the endometrial side population: implication in endometrial regeneration.

    Directory of Open Access Journals (Sweden)

    Hirotaka Masuda

    Full Text Available BACKGROUND: The human endometrium undergoes cyclical regeneration throughout a woman's reproductive life. Ectopic implantation of endometrial cells through retrograde menstruation gives rise to endometriotic lesions which affect approximately 10% of reproductive-aged women. The high regenerative capacity of the human endometrium at eutopic and ectopic sites suggests the existence of stem/progenitor cells and a unique angiogenic system. The objective of this study was to isolate and characterize putative endometrial stem/progenitor cells and to address how they might be involved in the physiology of endometrium. METHODOLOGY/PRINCIPAL FINDINGS: We found that approximately 2% of the total cells obtained from human endometrium displayed a side population (SP phenotype, as determined by flow cytometric analysis of Hoechst-stained cells. The endometrial SP (ESP cells exhibited preferential expression of several endothelial cell markers compared to endometrial main population (EMP cells. A medium specific for endothelial cell culture enabled ESP cells to proliferate and differentiate into various types of endometrial cells, including glandular epithelial, stromal and endothelial cells in vitro, whereas in the same medium, EMP cells differentiated only into stromal cells. Furthermore, ESP cells, but not EMP cells, reconstituted organized endometrial tissue with well-delineated glandular structures when transplanted under the kidney capsule of severely immunodeficient mice. Notably, ESP cells generated endothelial cells that migrated into the mouse kidney parenchyma and formed mature blood vessels. This potential for in vivo angiogenesis and endometrial cell regeneration was more prominent in the ESP fraction than in the EMP fraction, as the latter mainly gave rise to stromal cells in vivo. CONCLUSIONS/SIGNIFICANCE: These results indicate that putative endometrial stem cells are highly enriched in the ESP cells. These unique characteristics suggest that

  10. How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies.

    Science.gov (United States)

    Simpson, Eric L; Keck, Laura E; Chalmers, Joanne R; Williams, Hywel C

    2012-07-01

    Eczema prevention is now an active area of dermatologic and allergy research. Defining an incident case is therefore a prerequisite for such a study. We sought to examine how an incident case of atopic dermatitis was defined in previous atopic dermatitis prevention studies in order to make recommendations on a standard definition of new atopic dermatitis cases for use in future prevention trials. We conducted a systematic review of controlled interventional atopic dermatitis prevention studies by using searches of MEDLINE and Cochrane databases for studies published from 1980 to the end of January 2011. Studies that included atopic dermatitis as a secondary outcome, such as asthma prevention trials, were included. One hundred two studies were included in the final analysis, of which 27 (26.5%) did not describe any criteria for defining an incident case of atopic dermatitis. Of the remaining 75 studies with reported disease criteria, the Hanifin-Rajka criteria were the most commonly used (28 studies). A disease definition unique to that particular study (21 studies) was the second most commonly used disease definition, although the sources for such novel definitions were not cited. The results from this systematic review highlight the need for improved reporting and standardization of the definition used for an incident case in atopic dermatitis prevention studies. Most prevention studies have used disease definitions such as the Hanifin-Rajka criteria that include disease chronicity. While acceptable for cumulative incidence outcomes, inclusion of disease chronicity precludes the precise measurement of disease onset. We propose a definition based on existing scientific studies that could be used in future prospective studies. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  11. Accuracy of MRI with an endorectal coil for staging endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Alt, Celine D.; Kauczor, Hans-Ulrich; Hallscheidt, Peter [Dept. of Diagnostic and Interventional Radiology, Univ. of Heidelberg Medical School, Heidelberg (Germany)], e-mail: celine.alt@med.uni-heidelberg.de; Brocker, Kerstin A.; Eichbaum, Michael; Sohn, Christof [Dept. of Obstetrics and Gynecology, Univ. of Heidelberg Medical School, Heidelberg (Germany); Kopp-Schneider, Annette [Dept. of Biostatistics, German Cancer Research Center, Heidelberg (Germany)

    2012-06-15

    Background: The very good results of magnetic resonance imaging (MRI) using an endorectal coil in staging prostate cancer at 1.5T suggested that this imaging technique might be able to be used to stage endometrial cancer, the most common tumor in postmenopausal women. Purpose: To evaluate the accuracy of MRI with an endorectal surface coil for staging primary endometrial carcinoma. Material and Methods: A total of 33 consecutive patients with biopsy-proven endometrial cancer underwent 1.5T MRI with an endorectal surface coil (eMRI) using sagittal and axial T2-weighted (T2w) turbo spin echo (TSE), axial T1 gradient echo 2D fat-saturated (fs), sagittal T1 gradient echo 3D with and without contrast enhancement (CE), and axial T1 TSE fs CE sequence. Evaluation of local tumor extension was based on the revised standard TNM classification for endometrial cancer. eMRI staging was compared with the histopathological results after surgery. Results: A total of 33 consecutive patients underwent eMRI for staging endometrial cancer, and 21 of these underwent primary surgery. The histological stages were as follows: T1a (n = 8), T1b (n = 10), T2b (n = 2), and T3a (n = 1). Overall staging accuracy by eMRI was 71% (15 of 21). With regard to depth of myometrial invasion, eMRI correctly diagnosed stage T1a in 75% (6/8) and stage T1b in 80% (8/10). eMRI overstaged the tumor in four patients and understaged it in two. Conclusion: eMRI is highly accurate in staging myometrial invasion. However, eMRI at 1.5T does not seem to be significantly more accurate than pelvic MRI without an endorectal coil at 1.5T for staging primary endometrial cancer. eMRI for endometrial carcinoma therefore might not meet expectations compared with the results obtained using eMRI for staging prostate cancer at 1.5T.

  12. Endometrial Stromal Sarcoma: A Rare Entity

    International Nuclear Information System (INIS)

    Jabeen, S.; Anwar, S.; Fatima, N.

    2015-01-01

    Endometrial Stromal Sarcoma (ESS) is a hormone sensitive tumor. It is a rare gynecological tumor and is considered to occur more often in pre-menopausal women. A proper pre-operative diagnosis is difficult and confirmed in most cases after hysterectomy for a presumed benign disease. Endometrial sampling, ultrasound, and magnetic resonance imaging can provide diagnostic clues. For early disease complete surgical cure is possible, however, adjuvant therapy is available for recurrence. This case of Low Grade Endometrial Stromal Sarcoma (LGESS) in a 21 years old woman was presented as irregular vaginal bleeding. Clinical diagnosis of fibroid was made but analysis of endometrium showed ESS confirmed on hysterectomy specimen. One should consider it in any case with rapid fibroid enlargement. (author)

  13. Laparoscopic surgery for early endometrial cancer

    DEFF Research Database (Denmark)

    Bennich, Gitte; Rudnicki, M.; Lassen, P. D.

    2016-01-01

    IntroductionThe purpose of the present study was to evaluate learning curves and short-term outcomes following laparoscopic surgery for early endometrial cancer in women of different body mass index (BMI) classes. Material and methodsData from 227 women planned for laparoscopic surgery for presumed...... stage I endometrial cancer were collected retrospectively from a Danish gynecologic oncology unit. Surgery included laparoscopic hysterectomy and bilateral salpingo-oophorectomy with or without pelvic lymphadenectomy (PLA). ResultsMedian length of operations was 60 min (range, 30-197) and 120 min (range...... peri- and postoperative outcomes were independent of BMI classes. ConclusionsOur data suggest that laparoscopic surgery for early endometrial cancer is feasible and safe. With increasing surgeon's experience there is a significant decrease in operative time and increase in the number of lymph nodes...

  14. Recurrent endometrial cancer after surgery alone: results of salvage radiotherapy

    International Nuclear Information System (INIS)

    Jereczek-Fossa, Barbara; Badzio, Andrzej; Jassem, Jacek

    2000-01-01

    Purpose: Postoperative irradiation of endometrial cancer patients decreases the risk of local recurrence but is associated with a number of long-term sequelae. In a proportion of patients, no immediate postoperative radiotherapy is applied and this treatment is introduced only at relapse. The aim of our study was to assess the long-term results of salvage radiotherapy in previously nonirradiated endometrial cancer patients who developed local recurrence, and to evaluate the impact of patient- and treatment-related factors on treatment efficacy. Methods and Materials: We performed a detailed retrospective analysis of 73 endometrial cancer patients given radiotherapy for local recurrence after the initial surgery only. The mean age at diagnosis of the recurrence was 63 years (range, 39-78 years). Median time to recurrence was 11 months (range, 1-19 months). All recurrences were staged with the use of Perez modification of the International Federation of Gynecology and Obstetrics (FIGO) staging system for primary vaginal carcinoma. There were five (7%) Stage I patients, 43 (59%) Stage II patients, and 25 (34%) Stage III patients. Forty-four patients (60%) received both external beam irradiation (EBRT) and endovaginal brachytherapy (BRT), 17 (23%) received only BRT, and 12 (17%) received only EBRT. The mean total physical radiation dose was 75.9 Gy (range, 8-130 Gy), and the mean normalized total dose (NTD) calculated on the base of the linear-quadratic model was 86.6 Gy (range, 8.5-171.9 Gy). Median follow-up for alive patients was 8.8 years (range, 3-21 years). The impact of patient-, tumor-, and therapy-related factors on the treatment outcome was evaluated with the use of uni- and multivariate analyses. Results: Three- and 5-year overall survival rates were 33% and 25%, respectively. In the univariate analysis, lower stage of recurrent disease (p < 0.0005), combined EBRT and BRT (p 0.027), higher total radiation dose (p = 0.031), and higher NTD (p = 0.006) were

  15. Endometriosis and risks for ovarian, endometrial and breast cancers

    DEFF Research Database (Denmark)

    Mogensen, Julie Brøchner; Kjær, Susanne K.; Mellemkjær, Lene

    2016-01-01

    Objective A growing body of evidence suggests that endometriosis increases the risk for ovarian cancer, but it is less well studied whether the excess risk is confined to certain histotypes. Furthermore, it is not fully resolved if endometriosis is associated with endometrial- and breast cancer....... The aim was to study overall- and histotype-specific risks for these hormone-dependent cancers in women with endometriosis. Methods In the Danish National Patient Register, we identified 45,790 women with a clinical diagnosis of endometriosis during 1977–2012. We linked the cohort to the Danish Cancer...... Register and calculated standardized incidence ratios (SIRs) with corresponding 95% confidence intervals (CIs). Results Endometriosis was associated with increased risks for ovarian cancer (SIR 1.34; 95% CI: 1.16–1.55), due primarily to endometrioid (SIR 1.64; 95% CI: 1.09–2.37) and clear-cell types (SIR 3...

  16. Annual outpatient hysteroscopy and endometrial sampling (OHES) in HNPCC/Lynch syndrome (LS).

    Science.gov (United States)

    Manchanda, Ranjit; Saridogan, Ertan; Abdelraheim, Ahmed; Johnson, Michelle; Rosenthal, Adam N; Benjamin, Elizabeth; Brunell, Carol; Side, Lucy; Gessler, Sue; Jacobs, Ian; Menon, Usha

    2012-12-01

    LS women have a 40-60% lifetime risk of endometrial cancer (EC). Most international guidelines recommend screening. However, data on efficacy are limited. To assess the performance of OHES for EC screening in LS and compare it with transvaginal ultrasound (TVS) alone. A prospective observational cohort study of LS women attending a tertiary high-risk familial gynaecological cancer clinic was conducted. LS women opting for EC screening underwent annual OHES and TVS. Histopathological specimens were processed using a strict protocol. Data of women screened between October 2007 and March 2010 were analysed from a bespoke database. Histology was used as the gold standard. Diagnostic accuracy of OHES was compared with TVS using specificity, and positive (PLR) and negative (NLR) likelihood ratios. Forty-one LS women underwent 69 screens (41 prevalent, 28 incident). Four (three prevalent, one incident) women were detected to have EC/atypical endometrial hyperplasia (AEH), five had endometrial polyps and two had endometrial hyperplasia (EH) on OHES. TVS detected two of four EC/AEH. OHES had similar specificity of 89.8% (CI 79.2, 96.2%), but higher PLR 9.8 (CI 4.6, 21) and lower NLR (zero) compared to TVS: specificity 84.75%(CI 73, 92.8%), PLR 3.28 (CI 1.04, 10.35) and NLR 0.59 (CI 0.22, 1.58). No interval cancers occurred over a median follow-up of 22 months. The annual incidence was 3.57% (CI 0.09, 18.35) for EC, 10.71% (CI 2.27, 28.23) for polyps and 21.4% (CI 8.3, 40.1) for any endometrial pathology. Our findings suggest that in LS, annual OHES is acceptable and has high diagnostic accuracy for EC/AEH screening. Larger international studies are needed for confirmation, given the relatively small numbers of LS women at individual centres. It reinforces the current recommendation that endometrial sampling is crucial when screening these women.

  17. Adjuvant chemo-radiotherapy in the "sandwich" method for high risk endometrial cancer--a review of literature.

    Science.gov (United States)

    Bie, Yachun; Zhang, Zhenyu; Wang, Xiaolan

    2015-06-24

    Endometrial cancer is a common female malignancy. Patients with high-risk endometrial cancer have relatively high incidence of metastasis and recurrence. Despite complete resection, patients with stage III or IV are at high risk of local or distant recurrence. Systemic adjuvant treatment includes chemotherapy and radiotherapy. But the optimal scheduling is not known. Recently proposed sequential chemo-radiotherapy as sandwich therapy for high risk endometrial cancer have yielded encouraging results. This article is to review the adjuvant chemo-radiotherapy in the "sandwich" method for high risk endometrial cancer to help clinicians identify the most effective adjuvant treatment for patients with high risks of it. We used MEDLINE, EMBASE, Cochrane Library and CBM databases to search the literature. A systematic review was made. And most data showed "sandwich" therapy is feasible, efficacious, well-tolerated and resulted in excellent long-term progression free and overall survival in the setting of advanced endometrial cancer. Randomized trials are necessary to compare chemo-radio therapy given in the "sandwich" fashion to other means of sequencing these treatment modalities. It is also necessary to define which population is best suited for "sandwich" adjuvant therapy.

  18. Vitamin D and calcium intake in relation to risk of endometrial cancer: a systematic review of the literature.

    Science.gov (United States)

    McCullough, Marjorie L; Bandera, Elisa V; Moore, Dirk F; Kushi, Lawrence H

    2008-04-01

    In response to a recent ecologic study of UV exposure and endometrial cancer incidence, we present the epidemiologic evidence on the relation between intake of vitamin D and its metabolically related nutrient, calcium, and the occurrence of endometrial cancer. We conducted a systematic literature review and meta-analysis of vitamin D and calcium in relation to endometrial cancer, including peer-reviewed manuscripts published up to May 2007. Random and fixed effects summary estimates were computed. Pooled analyses of the three case-control studies of dietary vitamin D and endometrial cancer uncovered heterogeneous results that were not significant in random or fixed effects analyses. Cut-points for the highest vitamin D intakes ranged from >244 to >476 IU/day. Qualitatively similar findings were observed for dietary calcium. Only two studies provided estimates for calcium supplements (random effects OR=0.62, 95% CI 0.39-0.99; fixed effects OR=0.62, 95% CI 0.42-0.93, for top vs. bottom category, p for heterogeneity=0.25). The limited epidemiological evidence suggests no relation between endometrial cancer in the ranges of dietary vitamin D examined, and suggests a possible inverse association for calcium from supplements. Prospective studies, ideally including plasma 25(OH) D to estimate vitamin D input from diet and sun exposure, are needed to further explore these hypotheses.

  19. Pediatric immunization-related safety incidents in primary care: A mixed methods analysis of a national database

    OpenAIRE

    Rees, Philippa; Edwards, Adrian; Powell, Colin; Evans, Huw Prosser; Carter, Ben; Hibbert, Peter; Makeham, Meredith; Sheikh, Aziz; Donaldson, Liam; Carson-Stevens, Andrew

    2015-01-01

    Background\\ud \\ud Children are scheduled to receive 18–20 immunizations before their 18th birthday in England and Wales; this approximates to 13 million vaccines administered per annum. Each immunization represents a potential opportunity for immunization-related error and effective immunization is imperative to maintain the public health benefit from immunization. Using data from a national reporting system, this study aimed to characterize pediatric immunization-related safety incident repo...

  20. Pelvic floor functional outcomes after total abdominal vs total laparoscopic hysterectomy for endometrial cancer.

    Science.gov (United States)

    Higgs, Peta; Janda, Monika; Asher, Rebecca; Gebski, Val; Forder, Peta; Obermair, Andreas

    2018-01-02

    Pelvic floor functioning is an important concern for women requiring a hysterectomy for endometrial cancer. The incidence of pelvic floor symptoms has not been reported in women who have undergone a hysterectomy for early-stage endometrial cancer. We sought to evaluate pelvic floor function in women who have had surgical treatment for early-stage endometrial cancer as part of the multinational Laparoscopic Approach to Cancer of the Endometrium trial and to compare patients' outcomes who had total abdominal vs total laparoscopic hysterectomy. A multinational, phase III, randomized noninferiority trial compared disease-free survival of patients who had total abdominal hysterectomy vs total laparoscopic hysterectomy. This substudy analyzes the results from a self-administered validated questionnaire on pelvic floor symptoms (Pelvic Floor Distress Inventory) administered preoperatively, and at follow-up visits 6, 18, 30, 42, and 54 months postoperatively. Overall, 381 patients with endometrial cancer were included in the analysis (total abdominal hysterectomy, n = 195; total laparoscopic hysterectomy, n = 186). At 6 months postsurgery both groups experienced an improvement in Pelvic Floor Distress Inventory scores compared to presurgical pelvic floor well-being (total abdominal hysterectomy: mean change -11.17; 95% confidence interval, -17.11 to -5.24; total laparoscopic hysterectomy: mean change -10.25; 95% confidence interval, -16.31 to -4.19). The magnitude of change from baseline in pelvic floor symptoms did not differ between both treatment groups up to 54 months postsurgery. These findings suggest that pelvic floor function in terms of urinary, bowel, and prolapse symptoms are unlikely to deteriorate following abdominal or laparoscopic hysterectomy and are reassuring for women undergoing hysterectomy for early-stage endometrial cancer. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  1. HNF1B and endometrial cancer risk: results from the PAGE study.

    Directory of Open Access Journals (Sweden)

    Veronica Wendy Setiawan

    Full Text Available We examined the association between HNF1B variants identified in a recent genome-wide association study and endometrial cancer in two large case-control studies nested in prospective cohorts: the Multiethnic Cohort Study (MEC and the Women's Health Initiative (WHI as part of the Population Architecture using Genomics and Epidemiology (PAGE study. A total of 1,357 incident cases of invasive endometrial cancer and 7,609 controls were included in the analysis (MEC: 426 cases/3,854 controls; WHI: 931 cases/3,755 controls. The majority of women in the WHI were European American, while the MEC included sizable numbers of African Americans, Japanese and Latinos. We estimated the odds ratios (ORs per allele and 95% confidence intervals (CIs of each SNP using unconditional logistic regression adjusting for age, body mass index, and four principal components of ancestry informative markers. The combined ORs were estimated using fixed effect models. Rs4430796 and rs7501939 were associated with endometrial cancer risk in MEC and WHI with no heterogeneity observed across racial/ethnic groups (P ≥ 0.21 or between studies (P ≥ 0.70. The OR(per allele was 0.82 (95% CI: 0.75, 0.89; P = 5.63 × 10(-6 for rs4430796 (G allele and 0.79 (95% CI: 0.73, 0.87; P = 3.77 × 10(-7 for rs7501939 (A allele. The associations with the risk of Type I and Type II tumors were similar (P ≥ 0.19. Adjustment for additional endometrial cancer risk factors such as parity, oral contraceptive use, menopausal hormone use, and smoking status had little effect on the results. In conclusion, HNF1B SNPs are associated with risk of endometrial cancer and that the associated relative risks are similar for Type I and Type II tumors.

  2. Definitive radiation therapy for endometrial cancer in medically inoperable elderly patients.

    Science.gov (United States)

    Wegner, Rodney E; Beriwal, Sushil; Heron, Dwight E; Richard, Scott D; Kelly, Joseph L; Edwards, Robert P; Sukumvanich, Paniti; Zorn, Kristin K; Krivak, Thomas C

    2010-01-01

    With the increasing elderly population, more women with newly diagnosed endometrial cancer may not be surgical candidates due to medical comorbidities. Definitive radiation therapy with external beam radiation (EBRT) and/or brachytherapy is a reasonable primary treatment for endometrial cancer in patients who cannot undergo surgery. A retrospective review identified 26 women 75 years and older with endometrial cancer who were not operative candidates due to comorbidities and received definitive radiation. The median age of the treated patients was 83, all of whom had significant medical comorbidities precluding surgical treatment. Seventy-three percent of the patients had stage T1 disease, 19% were stage T2, and 8% were stage T3. Seventy-three percent of patients received EBRT before brachytherapy (median dose: 45 Gy). The median brachytherapy dose was 20 Gy in 5 fractions. The types of brachytherapy used were Rotte Y applicator (42%), tandem and cylinder (42%), and ring and tandem (16%). Median followup was 12 months (1-60 months). No treatment breaks were required for the entire group and only 2 patients (8%) developed late toxicity. The overall survival for all patients was 89% and 28% at 1 and 2 years, respectively. Disease-specific survival for all patients was 93% at 1 year and 73% at 3 years. The results in this study indicate that definitive radiation with EBRT and/or brachytherapy for endometrial cancer is feasible and well tolerated in an elderly population. (c) 2010 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  3. Use of External Beam Radiotherapy Is Associated With Reduced Incidence of Second Primary Head and Neck Cancer: A SEER Database Analysis

    International Nuclear Information System (INIS)

    Rusthoven, Kyle; Chen Changhu; Raben, David; Kavanagh, Brian

    2008-01-01

    Purpose: Patients with head and neck cancer have a significant risk of developing a second primary cancer of the head and neck. We hypothesized that treatment with external beam radiotherapy (RT) might reduce this risk, because RT can eradicate occult foci of second head and neck cancer (HNCA). Methods and Materials: The data of patients with Surveillance, Epidemiology, and End Results Historic Stage A localized squamous cell carcinoma of the oral cavity, larynx, and pharynx were queried using the Surveillance, Epidemiology, and End Results database. For patients treated with or without RT, the incidence of second HNCA was determined and compared using the log-rank method. Cox proportional hazards analysis was performed for each site, evaluating the influence of covariates on the risk of second HNCA. Results: Between 1973 and 1997, 27,985 patients were entered with localized HNCA. Of these patients, 44% had received RT and 56% had not. The 15-year incidence of second HNCA was 7.7% with RT vs. 10.5% without RT (hazard ratio 0.71, p <0.0001). The effect of RT was more profound in patients diagnosed between 1988 and 1997 (hazard ratio 0.53, p <0.0001) and those with pharynx primaries (hazard ratio 0.47, p <0.0001). On multivariate analysis, RT was associated with a reduced risk of second HNCA for pharynx (p <0.0001) and larynx (p = 0.04) tumors. For oral cavity primaries, RT was associated with an increased risk of second HNCA in patients treated before 1988 (p <0.001), but had no influence on patients treated between 1988 and 1997 (p = 0.91). Conclusion: For localized HNCA, RT is associated with a reduced incidence of second HNCA. These observations are consistent with the eradication of microscopic foci of second HNCA with external beam RT

  4. Effect of Hurricane Katrina on the incidence of acute coronary syndrome at a primary angioplasty center in New Orleans.

    Science.gov (United States)

    Gautam, Sandeep; Menachem, Jonathan; Srivastav, Sudesh K; Delafontaine, Patrice; Irimpen, Anand

    2009-10-01

    In August 2005, New Orleans was hit by Hurricane Katrina, the costliest natural disaster in US history. Previous studies have shown an increase in acute myocardial infarction (AMI) in the immediate hours to weeks after natural disasters. The goals of our study were to detect any long-term increase in the incidence of AMI after Katrina and to investigate any pertinent contributing factors. This was a single-center retrospective cohort observational study. Patients admitted with AMI to Tulane Health Sciences Center hospital in the 2 years before Katrina and in the 2 years after the hospital reopened (5 months after Katrina) were identified from hospital records. The 2 groups (pre- and post-Katrina) were compared for prespecified demographic and clinical data. In the post-Katrina group, there were 246 admissions for AMI, out of a total census of 11,282 patients (2.18%), as compared with 150 AMI admissions out of a total of 21,229 patients (0.71%) in the pre-Katrina group (P affected (P housing (P = 0.003). The role of chronic stress in the pathogenesis of AMI is poorly understood, especially in the aftermath of natural disasters. Our data suggest that Katrina was associated with prolonged loss of employment and insurance, decreased access to preventive health services, and an increased incidence of AMI. In addition, it appears that chronic stress after a natural disaster can be associated with tobacco abuse and medication and therapeutic noncompliance. We found a 3-fold increased incidence of AMI more than 2 years after Hurricane Katrina. Even allowing for the loss of some local hospitals after the disaster, this represents a significant change in overall health of the study population and supports the need for further study into the health effects of chronic stress.

  5. Endometrial thickness as a test for endometrial cancer in women with postmenopausal vaginal bleeding

    DEFF Research Database (Denmark)

    Tabor, Ann; Watt, Hilary C; Wald, Nicholas J

    2002-01-01

    OBJECTIVE: To assess the value of endometrial thickness measurement as a test for endometrial cancer in postmenopausal women with vaginal bleeding (symptomatic women). DATA SOURCES: We conducted a literature search using the MEDLINE database from 1991 to 1997, and the key words "vaginal ultrasono......OBJECTIVE: To assess the value of endometrial thickness measurement as a test for endometrial cancer in postmenopausal women with vaginal bleeding (symptomatic women). DATA SOURCES: We conducted a literature search using the MEDLINE database from 1991 to 1997, and the key words "vaginal...... at the same center, and with the same menopausal status and same hormone replacement therapy use category. The detection rate was 63% (95% confidence interval 58, 69) for a 10% false-positive rate, or 96% (95% confidence interval 94, 98) for a 50% false-positive rate. CONCLUSION: Endometrial thickness...... measurement in symptomatic women does not reduce the need for invasive diagnostic testing because 4% of the endometrial cancers would still be missed with a false-positive rate as high as 50%....

  6. Serosal and Endometrial Reconstitution During Myomectomy ...

    African Journals Online (AJOL)

    Context: Myomectomy is usually performed when uterine fibroids are associated with infertility. Serosal and endometrial reconstitution are some of the subtle challenges that the gynaecologist has to deal with during myomectomy, in an attempt to minimise postoperative pelvic and intrauterine adhesions. Objective: This ...

  7. Factors Influencing Endometrial Thickness in Postmenopausal Women

    African Journals Online (AJOL)

    Background: Cut‑off values for endometrial thickness (ET) in asymptomatic postmenopausal woman have been standardized. However, there are no comprehensive studies to document how various factors can influence the ET after the age of menopause. Aim: To study the various factors influencing the ET in ...

  8. Hysteroscopic Endometrial Resection in the Management of ...

    African Journals Online (AJOL)

    Background: Abnormal uterine bleeding (AUB) is a major health problem and it is a substantial cause of ill health in women. Medical treatment has a high failure rate and adverse effects. There are few published data on hysteroscopic endometrial resection (HER) in the management of patients with AUB. Objective: To ...

  9. Prevalence of Human Papillomavirus in endometrial cancer

    DEFF Research Database (Denmark)

    Olesen, Tina Bech; Svahn, Malene Frøsig; Faber, Mette Tuxen

    2014-01-01

    HPV is a common sexually transmitted infection and is considered to be a necessary cause of cervical cancer. The anatomical proximity to the cervix has led researchers to investigate whether Human Papillomavirus (HPV) has a role in the etiology of endometrial cancer....

  10. Influence of aspirin and non-aspirin NSAID use on ovarian and endometrial cancer

    DEFF Research Database (Denmark)

    Verdoodt, F; Kjaer, S K; Friis, S

    2017-01-01

    .g., those with high body mass index). Few studies have evaluated the influence of NSAID use on the mortality of ovarian or endometrial cancer, and substantial heterogeneity of study characteristics and results preclude any conclusions. Additional studies of aspirin and non-aspirin NSAID use and ovarian...... or endometrial cancer risk and prognosis are warranted. In the present review, we discuss the importance of comprehensive exposure definitions (i.e., duration, timing, consistency and intensity/dose) and evaluation of potential effect modification according to user characteristics, with the aim of identifying......Increasing evidence supports a role for aspirin use in reducing the incidence and mortality of several cancer types. This has spurred a new wave of interest in this widely used drug. In this review, we present and evaluate the epidemiologic evidence of the association between the use of aspirin...

  11. Robotic-assisted laparoscopic hysterectomy seems safe in women with early-stage endometrial cancer

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Havemann, Maria Cecilie; Palle, Connie

    2015-01-01

    . The overall incidence of complications was 15%, also with no significant difference between groups (p = 0.32). The most frequent complications were urinary tract infections (6%) and port site/wound infections (3%). A total of 21% of the women who had lymphadenectomy developed lymphoedema within 12 months......INTRODUCTION: Robotic surgery is increasingly used in the management of endometrial cancer; and although it is known that minimally invasive surgery reduces post-operative morbidity, the outcomes of this novel treatment should be monitored carefully. The aim of this study was to examine....... CONCLUSION: The types and frequency of complications observed in this study resemble those reported in similar studies of RALH for malignant gynaecologic conditions. Health-care professionals treating and caring for women with early-stage endometrial cancer should know of the types and frequency of post-operative...

  12. The risk of extra-colonic, extra-endometrial cancer in the Lynch syndrome

    DEFF Research Database (Denmark)

    Watson, Patrice; Vasen, Hans F A; Mecklin, Jukka-Pekka

    2008-01-01

    Persons with the Lynch syndrome (LS) are at high risk for cancer, including cancers of the small bowel, stomach, upper urologic tract (renal pelvis and ureter), ovary, biliary tract and brain tumors, in addition to the more commonly observed colorectal and endometrial cancers. Cancer prevention...... persons missing crucial information, cohort included 6,041 members of 261 families with LS-associated MLH1 or MSH2 mutations. All were either mutation carriers by test, probable mutation carriers (endometrial/colorectal cancer-affected), or first-degree relatives of these. Among mutation carriers...... strategies for these less common cancers require accurate, age-specific risk estimation. We pooled data from 4 LS research centers in a retrospective cohort study, to produce absolute incidence estimates for these cancer types, and to evaluate several potential risk modifiers. After elimination of 135...

  13. Biomarkers and degree of atherosclerosis are independently associated with incident atherosclerotic cardiovascular disease in a primary prevention cohort: The ARIC study.

    Science.gov (United States)

    Agarwala, Anandita; Virani, Salim; Couper, David; Chambless, Lloyd; Boerwinkle, Eric; Astor, Brad C; Hoogeveen, Ron C; Coresh, Joe; Sharrett, A Richey; Folsom, Aaron R; Mosley, Tom; Ballantyne, Christie M; Nambi, Vijay

    2016-10-01

    Biomarkers and atherosclerosis imaging have been studied individually for association with incident cardiovascular disease (CVD); however, limited data exist on whether the biomarkers are associated with events with a similar magnitude in the presence of atherosclerosis. In this study, we assessed whether the presence of atherosclerosis as measured by carotid intima media thickness (cIMT) affects the association between biomarkers known to be associated with coronary heart disease (CHD) and incident cardiovascular disease (CVD) in a primary prevention cohort. 8127 participants from the ARIC study (4th visit, 1996-1998) were stratified as having minimal, mild, or substantial atherosclerosis by cIMT. Levels of C-reactive protein, lipoprotein-associated phospholipase A2, cardiac troponin T, N-terminal pro-brain natriuretic peptide, lipoprotein(a), cystatin C, and urine albumin to creatinine ratio were measured in each participant. Hazard ratios were used to determine the relationship between the biomarkers and incident CHD, stroke, and CVD in each category of atherosclerosis. While each of the biomarkers was significantly associated with risk of events overall, we found no significant differences noted in the strength of association of biomarkers with CHD, stroke, and CVD when analyzed by degree of atherosclerosis. These findings suggest that the level of atherosclerosis does not significantly influence the association between biomarkers and CVD. Published by Elsevier Ireland Ltd.

  14. TIMP3 and CCNA1 hypermethylation in HNSCC is associated with an increased incidence of second primary tumors

    OpenAIRE

    Rettori, Marianna Marconato; de Carvalho, Ana Carolina; Longo, Ana Luiza Bomfim; de Oliveira, Cleyton Zanardo; Kowalski, Luiz Paulo; Carvalho, André Lopes; Vettore, André Luiz

    2013-01-01

    Background: Hypermethylation in the promoter regions is associated with the suppression of gene expression and has been considered a potential molecular marker for several tumor types, including head and neck squamous cell carcinomas (HNSCC).Methods: To evaluate the gene hypermethylation profile as a prognostic marker, this retrospective study used a QMSP approach to determine the methylation status of 19 genes in 70 HNSCC patients.Results: the methylation profile analysis of primary HNSCC re...

  15. A novel solution configuration on liquid-based endometrial cytology.

    Directory of Open Access Journals (Sweden)

    Shulan Lv

    Full Text Available Early detection and diagnosis of endometrial carcinoma and precancerous change would undoubtedly become the most alluring part for researchers. With the emergence of endometrial brush samplers, a new upsurge in endometrial cytology is in the making. But endometrial specimens obtained by the endometrial brush samplers require special preservation solution. The objective of this study is to develop a new kind of endometrial-cell preservation solution and to test the availability compared with a patented liquid-based cell preservation solution.In this controlled study, we had 5 endometrial cases collected with Li Brush from the First Affiliated Hospital of Xi'an Jiaotong University (09/2016 to 12/2016. The samples of each case were collected 2 times separately and perserved in different perservation solutions. One was a kind of novel endometrial cell preservation solution and the other was a kind of patented liquid-based cell (LBC preservation solution. The endometrial cells were smeared on slides by using the ZP-C automated slide preparation system and stained with Papanicolaou stain. A semi-quantitative scoring system was used to analyze the quality of slides. Statistical analysis was performed using the Wilcoxon signed rank test on the SPSS program (SPSS 18.0. In all LBC preparations, endometrial cells from the novel endometrial cells preservation solution had more cell quantity, less red blood cell fragments, and the background was cleaner compared with control group. Although the novel endometrial-cell preservation solution showed cellularity and absence of blood and debris expressed by no statistically significant differences (p = 0.063 and 0.102 respectively. The preservation period of the two kinds of liquids was equivalent.The novel endometrial-cell preservation solution is superior to the liquid-base cell preservation solution for cervical cells, with clear background, diagnostic cells and low cost.

  16. The impact of lymph vascular space invasion on recurrence and survival in patients with early stage endometrial cancer.

    Science.gov (United States)

    Loizzi, V; Cormio, G; Lorusso, M; Latorre, D; Falagario, M; Demitri, P; Scardigno, D; Selvaggi, L E

    2014-05-01

    The aim of this study was to determine impact of lymph vascular space involvement (LVSI) on recurrence and survival in early stage of endometrial cancer. From 1991 through 2010, all endometrial cancer patients at University Hospital of Bari, Italy were identified. The Log-rank test and Kaplan-Meyer methods were used for time-to-event analysis to evaluate the effects of on lymph vascular space involvement recurrence rate and survival time. Of the 560 endometrial cancer patients, 525 underwent primary surgery. Of those, 399 had early stage disease. Three hundred and forty women were not found to have LVSI, whereas 59 were found to have lymph vascular space involvement. Forty-nine (12%) patients developed a recurrence and 20 of them showed lymph vascular space involvement. The statistical analysis demonstrated that LVSI was strongly associated with a poor survival (P < 0.0001). Lymph vascular space involvement is associated with a high risk of recurrence and poor overall survival in early stage of endometrial cancer; therefore, the clinical decision to decide whether or not a patient with early stage endometrial cancer should receive adjuvant therapy should be included the evaluation of lymph vascular space involvement. © 2013 John Wiley & Sons Ltd.

  17. Second primary pancreatic ductal carcinoma in the remnant pancreas after pancreatectomy for pancreatic ductal carcinoma: High cumulative incidence rates at 5 years after pancreatectomy.

    Science.gov (United States)

    Ishida, Jun; Toyama, Hirochika; Matsumoto, Ippei; Asari, Sadaki; Goto, Tadahiro; Terai, Sachio; Nanno, Yoshihide; Yamashita, Azusa; Mizumoto, Takuya; Ueda, Yuki; Kido, Masahiro; Ajiki, Tetsuo; Fukumoto, Takumi; Ku, Yonson

    2016-01-01

    The aim of this study was to determine the incidence rate and clinical features of second primary pancreatic ductal carcinoma (SPPDC) in the remnant pancreas after pancreatectomy for pancreatic ductal carcinoma (PDC). Data of patients undergoing R0 resection for PDC at a single high-volume center were reviewed. SPPDC was defined as a tumor in the remnant pancreas after R0 resection for PDC, and SPPDC met at least one of the following conditions: 1) the time interval between initial pancreatectomy and development of a new tumor was 3 years or more; 2) the new tumor was not located in contact with the pancreatic stump. We investigated the clinical features and treatment outcomes of patients with SPPDC. This study included 130 patients who underwent surgical resection for PDC between 2005 and 2014. Six (4.6%) patients developed SPPDC. The cumulative 3- and 5-year incidence rates were 3.1% and 17.7%, respectively. Four patients underwent remnant pancreatectomy for SPPDC. They were diagnosed with the disease in stage IIA or higher and developed recurrence within 6 months after remnant pancreatectomy. One patient received carbon ion radiotherapy and survived 45 months. One patient refused treatment and died 19 months after the diagnosis of SPPDC. The incidence rate of SPPDC is not negligible, and the cumulative 5-year incidence rate of SPPDC is markedly high. Post-operative surveillance of the remnant pancreas is critical for the early detection of SPPDC, even in long-term survivors after PDC resection. Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  18. Short Course Vaginal Cuff Brachytherapy in Treating Patients With Stage I-II Endometrial Cancer

    Science.gov (United States)

    2018-04-17

    Endometrial Clear Cell Adenocarcinoma; Endometrial Endometrioid Adenocarcinoma; Endometrial Serous Adenocarcinoma; Stage I Uterine Corpus Cancer; Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Uterine Corpus Carcinosarcoma; Uterine Corpus Sarcoma

  19. Prevalence, incidence, and risk factors of intestinal parasites in Danish primary care patients with irritable bowel syndrome

    DEFF Research Database (Denmark)

    Engsbro, Anne Line; Stensvold, Christen Rune; Nielsen, Henrik Vedel

    2014-01-01

    The gut microbiota may be involved in the aetiopathogenesis of irritable bowel syndrome (IBS). We studied the role of intestinal parasites by describing the epidemiology and risk factors for infection in primary care patients aged 18-50 y with IBS. One hundred and thirty-eight patients at baseline...... and 78/116 patients returning 1 y later, submitted faecal samples that were examined by microscopy, culture for Blastocystis, and real-time PCR for Dientamoeba fragilis, Entamoeba (dispar and histolytica), Cryptosporidium spp., and Giardia intestinalis. Overall, 42-45% of patients harboured intestinal...

  20. Xenografted tissue models for the study of human endometrial biology.

    Science.gov (United States)

    Kuokkanen, Satu; Zhu, Liyin; Pollard, Jeffrey W

    The human endometrium undergoes extensive morphological, biochemical and molecular changes under the influence of female sex steroid hormones. Besides the fact that estrogen stimulates endometrial cell proliferation and progesterone inhibits this proliferation and induces differentiation, there is limited knowledge about precise molecular mechanisms underlying human endometrial biology. The importance of paracrine signaling in endometrial physiology explains why in vitro culture of endometrial cells has been challenging. Researchers, therefore, have developed alternative experimental in vivo models for the study of endometrial biology. The objective of this review is to summarize the recent developments and work on these in vivo endometrial research models. The in vivo recombinant tissue models in which wild-type endometrial cells are combined with endometrial cells from a gene-targeted mouse strain followed by xenografting to host mice have been critical in confirming the significance of paracrine signaling between the epithelium and stroma in the growth regulation of the endometrium. Additionally, these studies have uncovered differences between the mouse and human, emphasizing the need for the development of experimental models specifically of the human endometrium. Recently, xenotransplants of human endometrial fragments into the subcutaneous space of host mice and endometrial xenografts of dissociated and recombined epithelial and stromal cells beneath the kidney capsule of immunodeficient host mice have proven to be highly promising tools for in vivo research of endometrial functions. For the first time, the latter approach provides an immense opportunity for the application of genome engineering, such as targeted ablation of endometrial genes for example by using CRISPR/CAS9 system. This research will begin to elucidate the functional role of specific genes in this complex tissue. Another advantage of xenotransplantation and xenograft models of the human

  1. Blood transfusion in primary total shoulder arthroplasty: incidence, trends, and risk factors in the United States from 2000 to 2009.

    Science.gov (United States)

    Ryan, Devon J; Yoshihara, Hiroyuki; Yoneoka, Daisuke; Zuckerman, Joseph D

    2015-05-01

    Total shoulder arthroplasty (TSA) may be associated with substantial blood loss, and some patients require perioperative blood transfusion. Possible blood transfusion methods include predonated autologous blood transfusion, perioperative autologous blood transfusion, and allogeneic blood transfusion (ALBT). The purposes of the present study were to assess the incidence and recent trends over time of blood transfusion in TSA and analyze patient and hospital characteristics that affect the risk of ALBT. This study used national hospital discharge data from the National Inpatient Sample between 2000 and 2009. The data were used to generate the overall blood transfusion rate, and linear regression was used to assess trends in transfusion patterns over time. Logistic regression analysis was performed to analyze which patient and hospital characteristics independently influence the likelihood that a given patient undergoes ALBT. The overall blood transfusion rate (ie, the proportion of patients who received at least 1 transfusion of any kind) was 6.7%. This rate increased over time, from 4.9% in 2000 to 7.1% in 2009 (P blood transfusion rate in TSA found in the present study may be related to factors specific to TSA, such as the introduction of reverse total shoulder arthroplasty during the study period. A variety of patient and hospital characteristics contribute to the risk of undergoing ALBT. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  2. Endometrial adenocarcinoma in a 13-year-old girl.

    Science.gov (United States)

    Kim, Sung Mee; Shin, So Jin; Bae, Jin Gon; Kwon, Kun Young; Rhee, Jeong Ho

    2016-03-01

    Endometrial cancer is the third most common gynecologic cancer in the Korea and occurs mainly in menopausal women. Although it can develop in young premenopausal women cancer as well, an attack in the adolescent girl is very rare. A 13-year-old girl visited gynecology department with the complaint of abnormal uterine bleeding. An endometrial biopsy revealed FIGO (International Federation of Gynecology and Obstetrics) grade II endometrial adenocarcinoma. In the treatment of endometrial cancer, conservative management should be considered if the patient is nulliparous or wants the fertility preservation. Therefore, we decided to perform a hormonal therapy and a follow-up endometrial biopsy after progestin administration for eight months revealed no residual tumor. We report a case of endometrial cancer occurred in a 13-year-old girl with a brief review of the literature.

  3. Needs and priorities of women with endometrial and cervical cancer

    DEFF Research Database (Denmark)

    Jeppesen, Mette Moustgaard; Mogensen, Ole; Dehn, Pernille

    2015-01-01

    INTRODUCTION: Rehabilitation after cancer is important, and efficient rehabilitation requires knowledge of patient's needs. This study aimed to identify short-term rehabilitation needs of women with endometrial and cervical cancer. METHODS: Ninety-six women (82.6%) were included in an exploratory...... with endometrial cancer. Of these, 38 had FIGO-stage 1 disease (73.1%) and 25 were treated with laparoscopic surgery (48.1%). Emotional functioning was significantly worse prior to treatment in both the cancers (p endometrial) and worry constituted an unmet need in 70.7% of cervical...... and 34.7% of endometrial cancer patients. Both the patient groups experienced significant lymphedema post-treatment [endometrial cancer (p = 0.006) and cervical cancer (p = 0.002)]. Further, urological problems were more prevalent post-treatment in endometrial cancer patients (p = 0.018), while sexual...

  4. Usefulness of MRI in diagnosis of endometrial carcinoma and endometrial hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Kasai, Mayumi; Moriai, Kayo; Murai, Shinya; Imai, Toshihiko; Iida, Hajime; Suzuki, Hiroshi (Iwate Prefectural Central Hospital, Morioka (Japan))

    1994-06-01

    The study was to assess the usefulness of T2-weighted and enhanced T1-weighted MR images in differentiating endometrial adenocarcinoma and hyperplasia. The subjects were 21 patients with endometrial hyperplasia (Group A), consisting of 15 with cystic glandular hyperplasia and 6 with atypical hyperplasia, and 7 with endometrial adenocarcinoma (Group B). Six other patients with no evidence of abnormal endometrial findings served as controls. In Group A, the endometrium had a high signal intensity on T2-weighted images, and was 10 mm or over in thickness before menopause and 6 mm after menopause. It was also a high or intermediate signal intensity on enhanced T1-weighted images. In patiemts with cystic glandular hyperplasia, the junctional zone was 10 mm or over on T2-weighted images. Similar findings were seen on enhanced T1-weighted images. In patients with atypical hyperplasia, the junctional zone disappeared or decreased on enhanced images compared with those on T2-weighted images. In group B, the endometrium had an intermediate or high signal intensity on T2-weighted images, with the junctional zone being 10 mm or more. Enhanced T1-weighted images showed lower signal intensities in the tumorous area than in the normal endometrium and muscular layer. These findings indicated that enhanced MR imaging may be useful in diagnosing endometrial lesions. (N.K.).

  5. Usefulness of MRI in diagnosis of endometrial carcinoma and endometrial hyperplasia

    International Nuclear Information System (INIS)

    Kasai, Mayumi; Moriai, Kayo; Murai, Shinya; Imai, Toshihiko; Iida, Hajime; Suzuki, Hiroshi

    1994-01-01

    The study was to assess the usefulness of T2-weighted and enhanced T1-weighted MR images in differentiating endometrial adenocarcinoma and hyperplasia. The subjects were 21 patients with endometrial hyperplasia (Group A), consisting of 15 with cystic glandular hyperplasia and 6 with atypical hyperplasia, and 7 with endometrial adenocarcinoma (Group B). Six other patients with no evidence of abnormal endometrial findings served as controls. In Group A, the endometrium had a high signal intensity on T2-weighted images, and was 10 mm or over in thickness before menopause and 6 mm after menopause. It was also a high or intermediate signal intensity on enhanced T1-weighted images. In patiemts with cystic glandular hyperplasia, the junctional zone was 10 mm or over on T2-weighted images. Similar findings were seen on enhanced T1-weighted images. In patients with atypical hyperplasia, the junctional zone disappeared or decreased on enhanced images compared with those on T2-weighted images. In group B, the endometrium had an intermediate or high signal intensity on T2-weighted images, with the junctional zone being 10 mm or more. Enhanced T1-weighted images showed lower signal intensities in the tumorous area than in the normal endometrium and muscular layer. These findings indicated that enhanced MR imaging may be useful in diagnosing endometrial lesions. (N.K.)

  6. PTEN Sequence Analysis in Endometrial Hyperplasia and Endometrial Carcinoma in Slovak Women

    Directory of Open Access Journals (Sweden)

    H. Gbelcová

    2015-01-01

    Full Text Available Phosphatase and tensin homolog (PTEN is a protein that acts as a tumor suppressor by dephosphorylating the lipid second messenger phosphatidylinositol 3,4,5-trisphosphate. Loss of PTEN function has been implicated in the pathogenesis of a number of different tumors, particularly endometrial carcinoma (ECa. ECa is the most common neoplasia of the female genital tract. Our study evaluates an association between the morphological appearance of endometrial hyperplasia and endometrial carcinoma and the degree of PTEN alterations. A total of 45 endometrial biopsies from Slovak women were included in present study. Formalin-fixed and paraffin-embedded tissue samples with simple hyperplasia (3, complex hyperplasia (5, atypical complex hyperplasia (7, endometrioid carcinomas G1 (20 and G3 (5, and serous carcinoma (5 were evaluated for the presence of mutations in coding regions of PTEN gene, the most frequently mutated tumor suppressor gene in endometrial carcinoma. 75% of the detected mutations were clustered in exons 5 and 8. Out of the 39 mutations detected in 24 cases, 20 were frameshifts and 19 were nonsense, missense, or silent mutations. Some specimens harboured more than one mutation. The results of current study on Slovak women were compared to a previous study performed on Polish population. The two sets of results were similar.

  7. Evaluation of sonographic endometrial patterns and endometrial thickness as predictors of ectopic pregnancy.

    Science.gov (United States)

    Yadav, Poonam; Singla, Anshuja; Sidana, Anu; Suneja, Amita; Vaid, Neelam B

    2017-01-01

    To evaluate whether endometrial patterns and thickness could be used for the prediction of ectopic pregnancy (EP). A prospective study was conducted in a center in India between October 2007 and December 2008. It included 100 women with an early pregnancy confirmed by urine pregnancy testing but for whom an intrauterine gestational sac was not visualized on transvaginal ultrasonography (TVS). The women were divided into an EP group and an intrauterine pregnancy (IUP) group depending on the final diagnosis. The endometrial pattern and endometrial thickness were determined by TVS. Sensitivity and receiver operating characteristic curve analyses were performed to determine the predictive value. A heterogenous hyperechoic or trilaminar endometrial pattern was noted in 53 (77%) of 69 women in the EP group and 12 (39%) of 31 in the IUP group, and a homogenous hyperechoic pattern in 3 (4%) women in the EP group and 13 (42%) in the IUP group. An endometrial thickness of less than 9.8 mm was predictive of EP (Ppregnancy of unknown location for close supervision. © 2016 International Federation of Gynecology and Obstetrics.

  8. Discontinuation of low-dose acetylsalicylic acid therapy in UK primary care: incidence and predictors in patients with cardiovascular disease

    Science.gov (United States)

    Martín-Merino, Elisa; Johansson, Saga; Bueno, Héctor; García Rodríguez, Luis A

    2012-01-01

    Background Discontinuation of low-dose acetylsalicylic acid (ASA) leads to an increased risk of cardiovascular and cerebrovascular events in patients taking low-dose ASA for secondary cardiovascular prevention. However, little is known about the rate of discontinuation in everyday clinical practice. Objectives To assess the rate of low-dose ASA discontinuation in primary care, and identify factors that predict discontinuation. Methods The Health Improvement Network, a large UK primary care database, was used to identify patients aged 50–84 years who received at least two consecutive prescriptions for low-dose ASA for secondary cardiovascular or cerebrovascular prevention in 2000–2007 (n = 35,639). Discontinuation was defined as a period of at least 90 days after completion of the last prescribed course of ASA during which no repeat prescription was issued. Results During the study, 11,729 patients (32.9%) discontinued ASA therapy (mean follow-up 2.5 years). The discontinuation rate was lower in patients with ASA indicated for myocardial infarction than for other indications. The diagnosis of gastrointestinal disorders during the study (overall odds ratio: 1.74; 95% confidence interval: 1.61–1.88) was associated with increased rates of ASA discontinuation, whereas co-prescription of a proton pump inhibitor from the start of ASA therapy was associated with a decreased rate of discontinuation (odds ratio: 0.80; 95% confidence interval: 0.75–0.86). Co-prescription of several other cardioprotective medications was also associated with a reduced risk of discontinuation, as were increasing age, prior hospitalization and overall number of co-medications. Conclusion Continuous co-prescription of a PPI with low-dose ASA may improve adherence and outcomes, particularly in patients at both cardiovascular and gastrointestinal risk. PMID:27774013

  9. Controversies in the Management of Endometrial Carcinoma: An Update

    Directory of Open Access Journals (Sweden)

    Mohamed K. Mehasseb

    2012-01-01

    Full Text Available Endometrial carcinoma is the commonest type of female genital tract malignancy in the developed countries. Endometrial carcinoma is usually confined to the uterus at the time of diagnosis and as such usually carries an excellent prognosis with high curability. Our understanding and management of endometrial cancer have continuously developed. Current controversies focus on screening and early detection, the extent of nodal surgery, and the changing roles of radiation therapy and chemotherapy and will be discussed in this paper.

  10. Fundamentals and considerations of the canine endometrial pathology

    OpenAIRE

    Sánchez Riquelme, Alfonso; Escuela de Medicina Veterinaria, Facultad de Medicina Veterinaria y Agronomía, Universidad de Las Américas, Viña del Mar; Arias Ruiz, Francisco; Escuela de Medicina Veterinaria, Facultad de Medicina Veterinaria y Agronomía, Universidad de Las Américas, Viña del Mar

    2017-01-01

    The study of reproductive diseases is of great importance for clinical and medical approach. The aim of this article was to conduct a literature search on the grounds and considerations of canine endometrial pathology, with emphasis on endometrial cystic hyperplasia and pyometra, seeking support or refute the established concept or dogma, about the existing conditionality between them, which has been called cystic endometrial hyperplasia pyometra complex. According to the evidence, it is note...

  11. The association between polycystic ovary syndrome and endometrial cancer.

    OpenAIRE

    Chedumbarum Pillay, O. D.

    2010-01-01

    HYPOTHESIS: Women suffering from polycystic ovary syndrome have an increased risk of developing endometrial carcinoma. AIM: To determine whether people with polycystic ovary syndrome have an increased risk of developing endometrial carcinoma. BACKGROUND: Endometrial cancer is one of the commonest cancers to occur in women in the Western World and unopposed oestrogen stimulation of the uterus is amongst one of the aetiologies postulated for this condition. It is generally assumed that ...

  12. Molecular Biology and Prevention of Endometrial Cancer. Addendum

    National Research Council Canada - National Science Library

    Maxwell, George L

    2008-01-01

    Objective: To increase our understanding of the molecular aberrations associated with endometrial carcinogenesis and the biologic mechanisms underlying the protective effect of oral contraceptive (OC) therapy. Methods: 1...

  13. Recent Advances in Endometrial Cancer [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Arthur-Quan Tran

    2017-01-01

    Full Text Available Endometrial cancer is the most common gynecologic malignancy in the United States, with yearly rates continuing to increase. Most women present with early stage disease; however, advanced disease carries a grave prognosis. As a result, novel therapies are currently under investigation for the treatment of endometrial cancer. These advances include a better understanding of the genetic basis surrounding the development of endometrial cancer, novel surgical therapies, and new molecular targets for the treatment of this disease. This review explores the literature regarding these advancements in endometrial cancer.

  14. Pesquisa da prevalência do papilomavírus humano em amostras de tecido endometrial normal e com carcinoma pela técnica de PCR Search for human papillomavirus in samples of normal endometrial tissue and tissue with carcinoma by the PCR technique

    Directory of Open Access Journals (Sweden)

    Edison Natal Fedrizzi

    2004-05-01

    tissue, and tissue with endometrial carcinoma of women submitted to surgical treatment (hysterectomy, or between endometrial carcinoma and benign disease, through the PCR technique. METHODS: this is an observational control-case study where 100 women (50 with endometrial carcinoma and 50 with normal endometrial tissue were analyzed for the detection of HPV DNA in samples of endometrial tissue kept in paraffin blocks by the PCR technique. The cases of endometrial carcinoma with uncertain primary site of the lesion as well as the cases with previous or current history of pre-neoplasic lesions or carcinoma of the lower genital tract were excluded. Variables as age, smoking habit, endometrial trophism, squamous differentiation and degree of tumor differentiation were also evaluated. RESULTS: the estimated relative risk of the presence of HPV in the endometrial carcinoma and in the normal endometrial tissue was the same. HPV was detected in 8% of the cases of carcinoma and 10% in the normal endometrial tissue. In spite of HPV having been 3.5 times more detected in women with smoking habit in the group without carcinoma, there was no statistical difference. The presence of HPV was also not correlated with the women's age, endometrial trophism, squamous differentiation and degree of tumor differentiation. The HPV types 16 (5 cases and 18 (4 cases were the viruses most frequently found both in the normal endometrial tissue or in the tissue with carcinoma. No oncogenic low risk virus was detected in the samples. CONCLUSION: The same proportion of HPV is present in the endometrial tissue of women with endometrial cancer and with normal endometrium. It could not be demonstrated a possible correlation of DNA of HPV with the development of endometrial carcinoma.

  15. Prognostic factors and treatment of endometrial carcinoma

    International Nuclear Information System (INIS)

    Aalders, J.G.

    1982-01-01

    The aim of the present study was to gain more insight into the natural history of endometrial carcinoma, to evaluate prognostic factors and to assess the various treatment methods and the results. Using the data of the Norwegian Radium Hospital, where treatment of gynecological cancer is centralized to a great extent, a large series of patients with long term follow-up, covering all clinical stages and recurrences of endometrial carcinoma, could be evaluated. This resulted in five articles. These articles, together with a study from the University Hospital in Groningen are presented and discussed, and recommendations for treatment are given. The relevant treatments assessed are postoperative external irradiation, preoperative uterine radium packing, preoperative low dose external irradiation and radiotherapy alone. (Auth.)

  16. Trends in the demographic and clinicopathological characteristics in Japanese patients with endometrial cancer, 1990–2010

    Directory of Open Access Journals (Sweden)

    Hachisuga T

    2012-05-01

    Full Text Available Taisei Honda, Rie Urabe, Tomoko Kurita, Seiji Kagami, Toshinori Kawagoe, Naoyuki Toki, Yusuke Matsuura, Toru HachisugaDepartment of Obstetrics and Gynecology, University of Occupational and Environmental Health School of Medicine, Yahatanishi-ku, Kitakyushu, JapanObjective: Over the past 20 years, the incidence of endometrial cancer has increased remarkably in Japan. The number of elderly females has also increased within the population of Japan. We examined the impact of advanced age on the demographic and clinicopathological characteristics in Japanese patients with endometrial cancer.Methods: Data were collected from 319 surgically treated Japanese females with endometrial cancer from the files of the University Hospital of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Japan, between 1990 and 2010. χ2 tests were performed to evaluate the trends in the variables between two decades (A: 116 cases from 1990–2000 and (B: 203 cases in 2001–2010. The histological subtypes were also evaluated based on the immunohistochemical expressions of p53, estrogen receptor, and Ki-67.Results: The mean ages ± standard deviation in the decade A group and the decade B group were 57.5 years ± 9.7 years and 61.0 years ± 11.3 years, respectively (P < 0.02. There was an increase in the proportion of patients aged 70 years or older and of high-risk histological tumors including serous carcinoma, clear cell carcinoma, and carcinosarcoma (decade A group and decade B group: 9.5% vs 27.6%, P < 0.001, 10.4% vs 21.6%, P = 0.01, respectively, while the advanced surgical stage (III and IV, obesity (≥25 of body mass index, and nulliparity of the decade A group and decade B group were 23.3% vs 29.1%, P = 0.30, 28.4% vs 33.0%, P = 0.40, and 19.0% vs 21.2%, P = 0.66, respectively. The cancer-specific survival rates in the decade A group and the decade B group were 78.6% and 77.6%, respectively (P = 0.93.Conclusion: The increase in number of elderly

  17. Analysis of PSPHL as a Candidate Gene Influencing the Racial Disparity in Endometrial Cancer

    International Nuclear Information System (INIS)

    Allard, Jay E.; Chandramouli, Gadisetti V. R.; Stagliano, Katherine; Hood, Brian L.; Litzi, Tracy; Shoji, Yutaka; Boyd, Jeff; Berchuck, Andrew; Conrads, Thomas P.; Maxwell, G. Larry; Risinger, John I.

    2012-01-01

    Endometrial cancer is the most commonly diagnosed gynecologic malignancy in the United States. A well recognized disparity by race in both incidence and survival outcome exists for this cancer. Specifically Caucasians are about two times more likely to develop endometrial cancer than are African-Americans. However, African-American women are more likely to die from this disease than are Caucasians. The basis for this disparity remains unknown. Previous studies have identified differences in the types and frequencies of gene mutations among endometrial cancers from Caucasians and African-Americans suggesting that the tumors from these two groups might have differing underlying genetic defects. We performed a gene expression microarray study in an effort to identify differentially expressed transcripts between African-American and Caucasian women’s endometrial cancers. Our gene expression screen identified a list of potential biomarkers that are differentially expressed between these two groups of cancers. Of these we identified a poorly characterized transcript with a region of homology to phospho serine phosphatase (PSPH) and designated phospho serine phosphatase like (PSPHL) as the most differentially over-expressed gene in cancers from African-Americans. We further clarified the nature of expressed transcripts. Northern blot analysis confirmed the message was limited to a transcript of under 1 kB. Sequence analysis of transcripts confirmed two alternate open reading frame (ORF) isoforms due to alternative splicing events. Splice specific primer sets confirmed both isoforms were differentially expressed in tissues from Caucasians and African-Americans. We further examined the expression in other tissues from women to include normal endometrium, normal and malignant ovary. In all cases PSPHL expression was more often present in tissues from African-Americans than Caucasians. Our data confirm the African-American based expression of the PSPHL transcript in

  18. Extragenital endometrial stromal sarcoma arising in endometriosis.

    Science.gov (United States)

    Alcázar, Juan Luis; Guerriero, Stefano; Ajossa, Silvia; Parodo, Giuseppina; Piras, Bruno; Peiretti, Michele; Jurado, Matías; Idoate, Miguel Ángel

    2012-01-01

    The diagnosis rate of deep pelvic endometriosis is increasing. Endometrial stromal sarcoma (ESS) is a rare neoplasm. Extragenital ESS is an extremely uncommon event. Very few cases of extragenital ESS have been reported to date. The diagnosis of this entity is very difficult in some instances. Knowledge about its management is also limited. In this paper, we review the current literature on the clinical management, histology, immunohistochemistry, treatment and outcome of ESS arising in pelvic endometriosis. Copyright © 2012 S. Karger AG, Basel.

  19. Type I Versus Type II Endometrial Cancer

    DEFF Research Database (Denmark)

    Noer, Mette Calundann; Antonsen, Sofie Leisby; Ottesen, Bent

    2018-01-01

    OBJECTIVE: Two distinct types of endometrial carcinoma (EC) with different etiology, tumor characteristics, and prognosis are recognized. We investigated if the prognostic impact of comorbidity varies between these 2 types of EC. Furthermore, we studied if the recently developed ovarian cancer....... A consistent association between increasing levels of comorbidity and poorer survival was observed for both types. Cox regression analyses revealed a significant interaction between cancer stage and comorbidity indicating that the impact of comorbidity varied with stage. In contrast, the interaction between...

  20. Monte Carlo simulation of electron depth distribution and backscattering for carbon films deposited on aluminium as a function of incidence angle and primary energy

    International Nuclear Information System (INIS)

    Dapor, Maurizio

    2005-01-01

    Carbon films are deposited on various substrates (polymers, polyester fabrics, polyester yarns, metal alloys) both for experimental and technological motivations (medical devices, biocompatible coatings, food package and so on). Computational studies of the penetration of electron beams in supported thin film of carbon are very useful in order to compare the simulated results with analytical techniques data (obtained by scanning electron microscopy and/or Auger electron spectroscopy) and investigate the film characteristics. In the present paper, the few keV electron depth distribution and backscattering coefficient for the special case of film of carbon deposited on aluminium are investigated, by a Monte Carlo simulation, as a function of the incidence angle and primary electron energy. The simulated results can be used as a way to evaluate the carbon film thickness by a set of measurements of the backscattering coefficient

  1. Survival of endometrial cancer patients with lymphatic invasion and deficient mismatch repair expression.

    Science.gov (United States)

    Terada, Keith Y; Black, Michael; Terada, Laura H; Davis, James; Shimizu, David M

    2013-04-01

    This study examines patients under the age of 70 with endometrial cancer and lymphatic invasion or lymph node metastases. Survival of patients with loss of tumor mismatch repair expression is compared to survival of patients with normal mismatch repair expression. This is a retrospective review of patients treated from 1998-2009 for carcinoma of the endometrium. All patients with lymphatic invasion, including lymph node metastases, had immunohistochemical staining of the primary tumor for loss of expression of the mismatch repair genes MLH1, PMS2, MSH6, and MSH2. Overall survival and disease specific survival were compared using Kaplan-Meier plots. Sixty-six patients were identified for inclusion; 26 demonstrated loss of mismatch repair expression and 40 demonstrated normal mismatch repair expression. Overall survival and disease specific survival were significantly better in the group with defective mismatch repair expression. Subgroup analysis of FIGO stage 3C patients also showed significantly better survival in patients with deficient mismatch repair expression. For patients with endometrial cancer and lymphatic invasion, patients demonstrating loss of mismatch repair expression in the primary tumor appear to have a significantly better survival than patients with normal mismatch repair expression. Further investigation appears warranted to examine a possible role of mismatch repair expression as a prognostic marker for high risk patients with endometrial cancer. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Time trends in incidence and prognosis of primary liver cancer and liver metastases of unknown origin in a Danish region, 1985-2004

    DEFF Research Database (Denmark)

    Erichsen, Rune; Jepsen, Peter; Jacobsen, Jacob

    2008-01-01

    OBJECTIVES: Changes, over the last 20 years, in the diagnostic procedures and treatment of primary liver cancer (PLC) and liver metastases of unknown origin (LMUO) may have affected the clinical course of both cancers. Few longitudinal studies examined this issue. In a population-based setting, we...... studied changes in the incidence and prognosis of PLC and LMUO over time. METHODS: Between 1985 and 2004, we identified 2675 patients with PLC and LMUO in three Danish counties, with a population of 1.4 million. We computed the standardized incidence rate (SIR), ratio of PLC to LMUO diagnoses, median...... survival, and estimated mortality rate ratio adjusted for age, sex, and comorbidity. RESULTS: The SIR of PLC increased from 3.2 in 1985 to 5.0 in 2003, and the SIR of LMUO increased from 3.7 to 6.4. No increase was noted in the PLC-to-LMUO ratio over time (P=0.1 for trend). From 1985 to 2004, the median...

  3. Polymorphisms of the p53 gene in women with ovarian or endometrial carcinoma.

    Science.gov (United States)

    Peller, S; Halperin, R; Schneider, D; Kopilova, Y; Rotter, V

    1999-01-01

    The p53 gene is frequently mutated in various human tumors. Polymorphism is an additional genetic alteration observed in exons and introns of the p53 gene of normal tissues and tumors. Distributions of alleles of three common polymorphisms of the p53 gene; a 16 bp duplication in intron 3, codon 72 of exon 4 and a sequence in intron 6, were studied in peripheral white blood cells (WBC) of patients with ovarian or endometrial carcinomas. The analysis was performed by PCR and direct sequencing. The 100% linkage observed between the most common haplotypes of each polymorphism in healthy subjects was lower in the patients. A significant difference was observed between frequencies of genotype and haplotype combinations in patients with ovarian carcinoma and endometrial carcinoma. The incidence of heterozygosity was increased in ovarian carcinoma and decreased in endometrial carcinoma. Our results suggest that the p53 gene may be involved in susceptibility and predisposition to various cancers not only by mutations but also by preferential presentation of polymorphic alleles.

  4. The diagnostic problem of endometrial stromal sarcoma: report on six cases.

    Science.gov (United States)

    Amant, Frédéric; Moerman, Philippe; Cadron, Isabelle; Neven, Patrick; Berteloot, Patrick; Vergote, Ignace

    2003-07-01

    The objective was to look for the incidence and clinicopathologic findings of women in whom the diagnosis of endometrial stromal sarcoma was initially missed. We carried out a retrospective analysis of cases treated at our institution from 1990 to 2002. In 6/15 (40%) women suffering from endometrial stromal sarcoma, the diagnosis initially was missed. The first diagnosis was uterine leiomyoma (n = 2), myxoid leiomyoma (n = 2), cellular leiomyoma (n = 1), or lymphatic disorder (n = 1). The final diagnosis was only made after consultation of a pathologist with a special interest in gynecological oncology. The mean age of this group was only 34 years (range, 18-53). A mean delay in diagnosis of 143 months (range, 24-408) resulted in stage 4 disease in 5/6 women. After a mean follow-up of 16 years (range, 5-43), 4/6 are without macroscopic evidence of disease, 1/6 with evidence of disease, and 1/6 died of disease. Especially in younger women, the diagnosis of endometrial stromal sarcoma can be problematic.

  5. Incidence of primary hypothyroidism in patients exposed to therapeutic external beam radiation, where radiation portals include a part or whole of the thyroid gland

    Directory of Open Access Journals (Sweden)

    B A Laway

    2012-01-01

    Full Text Available Introduction: Hypothyroidism is a known consequence of external-beam radiotherapy to the neck encompassing a part or whole of the thyroid gland. In this non-randomized prospective study, we have tried to evaluate the response of the thyroid gland to radiation by assessing thyroid function before irradiation and at regular intervals after irradiation. Aims and Objectives: The aim of this study were to assess in the cancer patients, who were exposed to the therapeutic external beam radiation, where radiation portals include a part or whole of the thyroid gland: the incidence of primary hypothyroidism, the time required to become hypothyroid, any relation between the total dose for the development of hypothyroidism, and whether there are any patient or treatment-related factors that are predictive for the development of hypothyroidism, including the use of concurrent chemotherapy. Materials and Methods: This non-randomized, prospective study was conducted for a period of 2 years in which thyroid function was assessed in 59 patients (cases of head and neck cancer, breast cancer, lymphoma patients and other malignancies, who had received radiotherapy to the neck region. 59 euthyroid healthy patients (controls were also taken, who had not received the neck irradiation. These patients/controls were assessed periodically for 2 years. Results: The incidence of hypothyroidism after external beam radiation therapy (EBRT to neck where radiation portals include part or whole of the thyroid gland was 16.94%, seven cases had subclinical hypothyroidism (11.86% and three cases had clinical hypothyroidism (5.08%. Mean time for development of hypothyroidism was 4.5 months. There was no effect of age, gender, primary tumor site, radiation dose and chemotherapy, whether neoadjuvant or concurrent with the development of hypothyroidism. Conclusion: In summary, we found that thyroid dysfunction is a prevalent, yet easily treatable source of morbidity in patients

  6. Optimal Order of Successive Office Hysteroscopy and Endometrial Biopsy for the Evaluation of Abnormal Uterine Bleeding: A Randomized Controlled Trial.

    Science.gov (United States)

    Sarkar, Papri; Mikhail, Emad; Schickler, Robyn; Plosker, Shayne; Imudia, Anthony N

    2017-09-01

    To estimate the optimal order of office hysteroscopy and endometrial biopsy when performed successively for evaluation of abnormal uterine bleeding. Patients undergoing successive office hysteroscopy and endometrial biopsy were included in a single-blind, prospective, randomized trial. The primary outcome was to evaluate the effect of order of procedures on patients' pain score. Prespecified secondary outcomes include procedure duration, hysteroscopic visualization of the uterine cavity, endometrial sample adequacy, and number of attempts at biopsy. Pain scores were assessed using a visual analog scale from 0 to 10 and endometrial sample adequacy was determined from the histopathology report. Hysteroscopy images were recorded. Sample size of 34 per group (n=68) was determined to be adequate to detect a difference of 20% in visual analog scale score between hysteroscopy first (group A) and biopsy first (group B) at α of 0.05 and 80% power. Between October 2015 and January 2017, 78 women were randomized to group A (n=40) and group B (n=38). There was no difference in global pain perception [7 (0-10) vs 7 (0-10); P=.57, 95% CI 5.8-7.1]. Procedure duration [3 (1-9) vs 3 (2-10), P=.32, 95% CI 3.3-4.1] and endometrial sample adequacy (78.9% vs 75.7%, P=.74) were similar in both groups. Group A patients had better endometrial visualization (Pabnormal uterine bleeding, the global pain perception, and time required are independent of the order in which procedures are performed. Performing hysteroscopy first ensures better image, whereas biopsy first yields adequate tissue sample with fewer attempts. ClinicalTrials.gov, NCT02472184.

  7. Hormonal imbalance in two types of endometrial cancer and genetic polymorphism of steroidogenic enzymes.

    Science.gov (United States)

    Berstein, Lev; Zimarina, Tatjana; Imyanitov, Evgeny; Kovalevskij, Anatolij; Maximov, Sergei; Pujol, Pascal; Thijssen, Jos

    2006-07-20

    Modern data on endometrial cancer (EC) incidence demonstrate that it is one of the most prevalent gynecologic malignancies. It is possible that some allelic polymorphisms of the genes involved in steroidogenesis or steroid metabolism differently contribute into susceptibility to described types of this disease, namely to type I (which is considered to be hormone dependent) and type II. Distribution of allelic polymorphisms of CYP17 (17alpha-hydroxylase/17,20-lyase), CYP19 (aromatase), catechol-O-methyltransferase (COMT) and CYP1B1 (primarily, estrogen 4-hydroxylase) genes was compared totally in 156 endometrial cancer patients, approximately two-third of who belonged (on the basis of case history and some characteristics of host and tumor) to type I of the disease, and one-third to type II. Blood leukocytes were used as source of normal DNA for PCR-genotyping. No differences were found in distribution of CYP17 and CYP1B1 genotypes between patients belonging to type I or II of the disease. On the other side, in case of CYP19, the ratio of incidence of A6A6 genotype to the frequency of A1A6 and A3A6 genotypes was higher in type II patients (1.0) than in type I patients (0.3). Besides, incidence of high activity (HH) COMT genotype was higher among patients with type I of disease than in patients with type II of it (33.3% versus 14.7%, OR=2.9, z=1.96, p=0.05) revealing tendency to the lower inactivation of catecholestrogens in the latter group. It may be suggested that more aggressive clinically and frequently receptor-negative type II of endometrial cancer is associated with indirect signs of mainly intratumoral hyperproduction of estrogens (excess of CYP19 A6A6 genotype) without their sufficient inactivation into methoxyderivatives that warrants further study.

  8. Sonohysterographic findings of endometrial abnormalities in women with polycystic ovarian disease

    International Nuclear Information System (INIS)

    Lee, Eun Ju

    2004-01-01

    To describe the sonohysterographic findings of endometrial abnormalities, and to determine the usefulness of sonohysterography (SH) for predicting endometrial abnormalities in women with polycystic ovarian disease(PCOD). 82 patients with PCOD who had vaginal bleeding or endometrial thickening and lesion mass on baseline transvaginal sonography were prospectively examined with SH. The SH findings were evaluated for endometrial thickness, the presence of endometrial thickening and lesion mass, echogenicity and surface contour, distensibility of the endometrial cavity, and disruption of endometrial-myometrial interface. These findings were compared with the pathologic findings and the diagnostic accuracy of SH for predicting endometrial abnormalities was assessed. Endometrial abnormalities were identified in 47 (57.3%) of 82 PCOD patients, and their pathologic diagnosis included endometrial carcinoma in 7 cases, hyperplasia in 19 cases (atypical hyperplasia, n=5), and polyp in 21 cases. Of the 35 patients who did not have endometrial abnormalities, there was disordered proliferative endometrium in 18 cases and normal proliferative or secretory endometrium in 17 cases. The SH findings of endometrial carcinoma were endometrial thickening in 5 cases, endometrial thickening and lesion mass in 2 cases, and the endometrial thickness ranged from 6 mm to 15 mm (mean 9.5 mm). They were characterized as a diffuse polyploid endometrial thickening or a sessile endometrial mass with irregular surface, homogeneous hyperechogenicity, and obliteration of the endometrial cavity. Endometrial hyperplasia appeared as endometrial thickening in 14 cases, endometrial lesion mass in 3 cases, and endometrial thickening and lesion mass in 2 cases, and the endometrial thickness was between 6.5-10.7 mm (mean 8.2 mm). They showed a diffuse uniform endometrial thickening or a polyploid endometrial lesion mass with homogeneous hyperechogenicity and a regular surface. Endometrial polyps appeared as

  9. Effect of parity on endometrial glands in gravid rabbits | Pulei ...

    African Journals Online (AJOL)

    Effect of parity on endometrial glands in gravid rabbits. ... Anatomy Journal of Africa ... Image J. Endometrial gland density was noted to decrease with a rise in parity such that the percentage proportion in the primigravid rabbit was 45% compared to that of 34% and 37.5% in the biparous and multiparous groups respectively.

  10. Advanced and Recurrent Endometrial Cancer; current concepts of treatment

    NARCIS (Netherlands)

    F.H. van Wijk (Heidy)

    2008-01-01

    textabstractEndometrial cancer is the most common gynecological malignancy in Western Countries. In the United States approximately 39,000 cases will be diagnosed in 2007 and 7,400 deaths will occur. Women have a 2.6% lifetime risk of developing endometrial cancer and it accounts for 6% of all

  11. Endometrial sampling in infertility: the Ilorin, Nigeria, experience ...

    African Journals Online (AJOL)

    The aim of this study is to determine the diagnosis value of endometrium sampling in detecting endometrial pathology and presence or absence of ovulation in infertility patients. A retrospective study of endometrial tissues histopathological slides of infertility patients as recorded in the register of the department of Pathology, ...

  12. Endometrial Osseous Metaplasia: Case Report with Literature Review

    African Journals Online (AJOL)

    Endometrial osseous metaplasia is a rare entity[1] and Nearly. 80 cases have been reported in the world literature including, nine from India[2] and it is the presence of mature or immature bone in the endometrium.[1] Osseous metaplasia of the endometrium has also been incorrectly named as endometrial ossification ...

  13. Endometrial pathology in a teaching hospital in North Central ...

    African Journals Online (AJOL)

    The study was a 5 year histopathological survey of endometrial biopsies seen at the University of Ilorin Teaching Hospital , Ilorin, North Central Nigeria from January 1st 1997 to December 31st 2001. It aimed at identifying the morphological patterns of endometrial disorders, prevalence of these disorders and the ...

  14. Isolation and characterization of endometrial luminal epithelial and ...

    African Journals Online (AJOL)

    ADEYEYE

    2014-08-06

    Aug 6, 2014 ... *Correspondence: Tel.: +2349031310693, E-mail: ayoraheem1@yahoo.com. Abstract. In this study, we have described a simple method of isolating endometrial luminal epithelial (LE) and stromal (ST) cells using ovine uteri samples obtained from the abattoir. Endometrial lining were digested in trypsin, ...

  15. Histological changes in the endometrial of pregnant Sprague ...

    African Journals Online (AJOL)

    This study describes a changed uterine morphometry and its application to the endometrial structure of a pregnant rat. The number and the size of uterine gland and blood vessels changed during the pregnancy period of the rat. This effect on day 15 was significantly changed in the different groups. When the endometrial ...

  16. An endometrial histomorphometric study of CD56 + natural killer ...

    African Journals Online (AJOL)

    Background. The number of peripheral blood and endometrial natural killer cells varies greatly during implantation and the first trimester of pregnancy and is thought to play a role in the maintenance of a healthy pregnancy. However, the role of endometrial CD56+ natural killer (NK) cells as an immunological mechanism in ...

  17. A 2-decade review of histopathological pattern of endometrial ...

    African Journals Online (AJOL)

    Background: Endometrial biopsy is a commonly performed procedure with a wide range of possible histopathological diagnoses. Objective: To determine the clinical spectrum, frequency and age distribution of endometrial pathologies at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri. Methods: This was a ...

  18. Pregnancy loss: a rare consequence of premenstrual endometrial ...

    African Journals Online (AJOL)

    Two cases of pregnancy loss - a rare complication of pre-menstrual endometrial biopsy (PMEB) are reported. PMEB is an investigation performed for infertile women to assess ovulation and endometrial factors. It is usually performed during the secretory phase of the cycle. This implies that ovulation and possibly fertilization ...

  19. Biochemical evaluation of endometrial function at the time of implantation

    DEFF Research Database (Denmark)

    Lindhard, Anette; Bentin-Ley, Ursula; Ravn, Vibeke

    2002-01-01

    OBJECTIVE: To review the literature on various endometrial factors assumed to be of importance to implantation and to evaluate their potential clinical value in the assessment of endometrial function at the time of implantation in infertile women in natural and stimulated cycles. DESIGN: Literatu...

  20. An endometrial histomorphometric study of CD56+ natural killer ...

    African Journals Online (AJOL)

    The study aimed to enumerate the concentrations of CD56+ NK cells in endometrial samples, and to statistically compare these numbers between fertile ... female age <30 years; previous pregnancy in the same relationship; and <2 years ... That endometrial CD56+ NK cells stem from the proliferation and differentiation of ...

  1. Can MRI predict the diagnosis of endometrial carcinosarcoma?

    Energy Technology Data Exchange (ETDEWEB)

    Genever, A.V., E-mail: ashleigh.genever@gmail.com [Department of Radiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield (United Kingdom); Abdi, S. [Department of Radiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield (United Kingdom)

    2011-07-15

    Aim: To ascertain whether magnetic resonance imaging (MRI) can be used to suggest a diagnosis of endometrial carcinosarcoma. Materials and methods: A retrospective imaging review was performed of the MRI images of 39 patients with endometrial carcinosarcoma. Anteroposterior and longitudinal dimensions of the uterus and measurement of the endometrial thickness were taken in the sagittal plane. The ratio of antero-posterior measurement to endometrial thickness was calculated. The same measurements were taken on 50 patients with endometrial adenocarcinoma. A two-tailed t-test and receiver operator characteristic analysis were performed on these measurements for both patient groups. Results: There was a statistically significant difference between the longitudinal (p = 0.0084) and anteroposterior (p = 0.00036) dimensions of the uterus of the two groups. There was also a statistically significant difference between the ratios of anteroposterior dimension to endometrial thickness (p = 0.00018). The optimal cut-off ratio above which the radiologist should be alerted to a potential diagnosis of endometrial carcinosarcoma was shown to be 0.63. Conclusion: MRI can be helpful in suggesting a diagnosis of endometrial carcinosarcoma with the help of some simple measurements.

  2. Hypoxia and cell cycle deregulation in endometrial carcinogenesis

    NARCIS (Netherlands)

    Horrée, N.

    2007-01-01

    Because uterine endometrial carcinoma is the most common malignancy of the female genital tract and 1 of every 5 patients dies of this disease, understanding the mechanisms of carcinogenesis and progression of endometrial carcinoma is important. In general, this thesis can be summarized as a study

  3. Glycodelin in endometrial flushing fluid and endometrial biopsies from infertile and fertile women

    DEFF Research Database (Denmark)

    Bentin-Ley, Ursula; Lindhard, Anette; Skovlund, Vibeke Ravn

    2011-01-01

    To investigate in the natural cycle just before IVF, whether glycodelin levels in endometrial flushing fluid obtained days LH+1 and LH+7 can be used in predicting pregnancy in the following IVF cycle, and whether there are differences in women with tubal factor infertility compared to women...

  4. Cabozantinib-S-Malate in Treating Patients With Recurrent or Metastatic Endometrial Cancer

    Science.gov (United States)

    2017-11-20

    Endometrial Adenosquamous Carcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Mixed Adenocarcinoma; Endometrial Serous Adenocarcinoma; Metastatic Endometrioid Adenocarcinoma; Recurrent Uterine Corpus Carcinoma; Stage IV Uterine Corpus Cancer AJCC v7; Stage IVA Uterine Corpus Cancer AJCC v7; Stage IVB Uterine Corpus Cancer AJCC v7; Uterine Corpus Carcinosarcoma

  5. The additional value of endometrial sampling in the early detection of endometrial cancer in women with Lynch syndrome

    NARCIS (Netherlands)

    Helder-Woolderink, J. M.; De Bock, G. H.; Sijmons, R. H.; Hollema, H.; Mourits, M. J. E.

    2013-01-01

    Objective. Based on previous studies, standard gynecological screening consisting of annual transvaginal ultrasonography (TVU) was added with endometrial sampling in women with Lynch syndrome (LS). The aim of this study was to evaluate the additional value of endometrial sampling in detecting

  6. Surgery for menorrhagia within English regions: variation in rates of endometrial ablation and hysterectomy.

    Science.gov (United States)

    Cromwell, D A; Mahmood, T A; Templeton, A; van der Meulen, J H

    2009-09-01

    To examine variation between English regions in the use of surgery (endometrial ablation or hysterectomy) for the treatment of menorrhagia. Analysis of Hospital Episodes Statistics (HES) data to produce rates of surgery for English Strategic Health Authorities (SHAs) and Primary Care Trusts (PCTs). Women aged between 25 and 59 years who had endometrial ablation or hysterectomy for menorrhagia between April 2003 and March 2006 in English NHS hospitals. Multilevel Poisson regression was used to determine the level of systematic variation in the regional rates of surgery and their association with regional characteristics (deprivation, service provision and mix of surgical procedures). Age-standardised annual rates of surgery. The English rate of surgery for menorrhagia was 143 procedures per 100 000 women. Surgical rates within SHAs ranged from 52 to 230 procedures per 100 000 women, while rates within PCTs ranged from 20 to 420 procedures per 100 000 women. While, 60% of all procedures were endometrial ablations, the proportion across SHAs varied, ranging from 46% to 75%. Surgery rates were associated with the regional characteristics, but only weakly, and risk adjustment reduced the amount of unexplained variation by <15% at both SHA and PCT levels. Regional differences in surgical rates for menorrhagia have persisted despite changes in practice and improved evidence, suggesting there is scope for improving the management of menorrhagia within England.

  7. Management of elderly women with endometrial cancer.

    Science.gov (United States)

    Eggemann, Holm; Ignatov, Tanja; Burger, Elke; Costa, Serban Dan; Ignatov, Atanas

    2017-09-01

    Elderly women with endometrial cancer receive less therapy in comparison with their younger counterparts. The exact reason(s) for this treatment strategy remains unclear. We performed a multicenter, retrospective registry-based study of 1550 patients with endometrial cancer. The outcome measure was the reason for not performing the indicated treatment. Median follow-up was 76.8months. A total of 1550 women were eligible for analysis: 353 (22.7%) were younger than 60years, 521 (33.6%) 61-70years, 515 (33.2%) 71-80years, and 161 (10.4%) were aged 81years old and older. Elderly women were more likely to have non-endometrioid, undifferentiated endometrial cancer at an advanced stage. Patients younger than 60years were more likely to receive lymphadenectomy, brachytherapy, external-beam radiotherapy (EBRT) and systemic therapy compared with the group of patients aged older than 70years. We investigated the reason why elderly women were undertreated. The rate of indicated therapies that were not recommended by the physicians proportionally increased with an increase in patient age. Interestingly, the rate of contraindications because of performance status and/or medical disease also increased proportionally with increasing patient age. Notably, in the groups of patients older than 70years, patient refusal was a very uncommon reason for failure to perform the indicated therapy. Elderly women with EC are more likely undertreated because the therapy was not recommended by the physicians based on performance status and medical diseases rather than patient refusal. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Incidence of Augmentation in Primary Restless Legs Syndrome Patients May Not Be That High: Evidence From A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Liu, Guang Jian; Wu, Lang; Wang, Song Lin; Ding, Li; Xu, Li Li; Wang, Yun Fu; Chang, Li Ying

    2016-01-01

    Abstract Augmentation is a common complication of primary restless legs syndrome (RLS) during treatment; however, its incidence rate remains unclear. The aim of this study is investigate the rate of augmentation during RLS treatment. We searched 6 databases, including PubMed, OVID, Embase, Wiley citations, Web of Science research platform (including SciELO Citation Index, Medline, KCI Korean Journal Database, the Web of Science™ Core Collection), and the Cochrane library, and screened the reference lists of the included trials and recently published reviews. Randomized controlled trials and observational studies that reported augmentation events during RLS treatment. Primary RLS patients older than 18 years. No restrictions regarding intervention types were applied. Three investigators independently extracted and pooled the data to analyze the augmentation rate of the total sample and of patient subgroups with different interventions, treatment durations and drug regimens and different geographic origins. Fixed-effects or random-effects model was used for pooled analysis. A total of 60 studies involving 11,543 participants suggested an overall augmentation rate of 5.6% (95% confidence intervals (CI), 4.0–7.7). The augmentation incidence was 6.1% (95% CI, 4.1–9.1) for long-term treatment and 3.3% (95% CI, 1.4–7.3) for short-term treatment. In addition, 27.1% (95% CI, 12.3–49.5) of the levodopa-treated patients, 6.0% (95% CI, 4.1–8.8) of the patients treated with dopamine agonists, and 0.9% (95% CI, 0.2–3.3) of the patients taking pregabalin or gabapentin developed augmentation. Augmentation occurred in 7.2% (95% CI, 5.0–10.3) of the patients taking immediate-release drugs and in 1.7% (95% CI, 0.6–5.0) of the patients taking transdermal application. The main limitations are that the augmentation rates were not evaluated according to drug dosage, gender, and age and symptom severity. Approximately 5 to 6 in 100 RLS patients developed augmentation

  9. The Lymphedema and Gynecologic Cancer (LEG) Study: Incidence, Risk Factors, and | Division of Cancer Prevention

    Science.gov (United States)

    DESCRIPTION (provided by applicant): The proposed study, Lymphedema and Gynecologic cancer (LEG): Incidence, Risk Factors and Impact, will innovatively utilize the cooperative group setting of the GOG (Gynecologic Oncology Group) to prospectively study 1300 women newly diagnosed with cervical, endometrial, or vulvar cancer to determine the incidence and impact of lower extremity lymphedema following surgical treatment of these diseases. |

  10. Diagnosis by MRI in endometrial carcinoma

    International Nuclear Information System (INIS)

    Azumi, Rieko; Miura, Tsutomu; Seino, Yasuyuki; Ichikawa, Kiyomi; Yamada, Kiyoshi; Sudou, Hirohito

    1993-01-01

    We studied the usefulness of MRI in staging myometrial invasion, extending outside the uterus of endometrial carcinoma by 26 cases from September 1989 through August 1992. The accuracy in deep myometrial invasion was 71%, stage I and II were both 67%, while stage III was 0%. When we reviewed all 7 cases of stage III, we could recognize all lesions extending directly outside the uterus. But could only one in all 4 lymphadenopathy cases. All 7 cases of stage III had deep myometrial invasion. When we suspect deep myometrial invasion in MRI, we need to add special attention to outside the uterus. (author)

  11. Feasibility investigation of allogeneic endometrial regenerative cells

    Directory of Open Access Journals (Sweden)

    Reid Michael

    2009-02-01

    Full Text Available Abstract Endometrial Regenerative Cells (ERC are a population of mesenchymal-like stem cells having pluripotent differentiation activity and ability to induce neoangiogenesis. In vitro and animal studies suggest ERC are immune privileged and in certain situations actively suppress ongoing immune responses. In this paper we describe the production of clinical grade ERC and initial safety experiences in 4 patients with multiple sclerosis treated intravenously and intrathecally. The case with the longest follow up, of more than one year, revealed no immunological reactions or treatment associated adverse effects. These preliminary data suggest feasibility of clinical ERC administration and support further studies with this novel stem cell type.

  12. Endometrial carcinomas: which radiotherapy for which patient?

    International Nuclear Information System (INIS)

    Barillot, I.; Maingon, P.

    2003-01-01

    The endometrial carcinoma is the third most common cancer in women. The endometrioid adenocarcinomas represent 75 % to 80 % of the pathologic sub-types, and 90 % of the lesions are stages I or II at diagnosis. The treatment strategies are based upon surgery and radiotherapy, but the respective place of external irradiation and vaginal cuff brachytherapy is not strictly established. The role of the pelvic lymphadenectomy and the role of chemotherapy for aggressive histologies or locally advanced diseases remain also controversial issues. The question 'which radiotherapy for which patient?' is still a current question, however, the answers we will bring do not permit yet to remove all uncertainties. (author)

  13. Pioneer Factors FOXA1 and FOXA2 Assist Selective Glucocorticoid Receptor Signaling in Human Endometrial Cells.

    Science.gov (United States)

    Whirledge, Shannon; Kisanga, Edwina P; Taylor, Robert N; Cidlowski, John A

    2017-11-01

    Successful pregnancy relies on dynamic control of cell signaling to achieve uterine receptivity and the necessary biological changes required for endometrial decidualization, embryo implantation, and fetal development. Glucocorticoids are master regulators of intracellular signaling and can directly regulate embryo implantation and endometrial remodeling during murine pregnancy. In immortalized human uterine cells, we have shown that glucocorticoids and estradiol (E2) coregulate thousands of genes. Recently, glucocorticoids and E2 were shown to coregulate the expression of Left-right determination factor 1 (LEFTY1), previously implicated in the regulation of decidualization. To elucidate the molecular mechanism by which glucocorticoids and E2 regulate the expression of LEFTY1, immortalized and primary human endometrial cells were evaluated for gene expression and receptor recruitment to regulatory regions of the LEFTY1 gene. Glucocorticoid administration induced expression of LEFTY1 messenger RNA and protein and recruitment of the glucocorticoid receptor (GR) and activated polymerase 2 to the promoter of LEFTY1. Glucocorticoid-mediated recruitment of GR was dependent on pioneer factors FOXA1 and FOXA2. E2 was found to antagonize glucocorticoid-mediated induction of LEFTY1 by reducing recruitment of GR, FOXA1, FOXA2, and activated polymerase 2 to the LEFTY1 promoter. Gene expression analysis identified several genes whose glucocorticoid-dependent induction required FOXA1 and FOXA2 in endometrial cells. These results suggest a molecular mechanism by which E2 antagonizes GR-dependent induction of specific genes by preventing the recruitment of the pioneer factors FOXA1 and FOXA2 in a physiologically relevant model. Copyright © 2017 Endocrine Society.

  14. Genistein promotes DNA demethylation of the steroidogenic factor 1 (SF-1) promoter in endometrial stromal cells

    Energy Technology Data Exchange (ETDEWEB)

    Matsukura, Hiroshi, E-mail: hmatsukura.epi@mri.tmd.ac.jp [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan); Aisaki, Ken-ichi; Igarashi, Katsuhide; Matsushima, Yuko; Kanno, Jun [Division of Cellular and Molecular Toxicology, National Institute of Health Sciences, 1-18-1 Kamiyoga, Setagaya-ku, Tokyo 158-8501 (Japan); Muramatsu, Masaaki [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan); Sudo, Katsuko [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan); Animal Research Center, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402 (Japan); Sato, Noriko, E-mail: nsato.epi@tmd.ac.jp [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan)

    2011-08-26

    Highlights: {yields} Genistein (GEN) is a phytoestrogen found in soy products. {yields} GEN demethylated/unsilenced the steroidogenic factor 1 gene in endometrial tissue. {yields} GEN thus altered mRNA expression in uteri of ovariectomized (OVX) mice. {yields} A high-resolution melting assay was used to screen for epigenetic change. {yields} We isolated an endometrial cell clone that was epigenetically modulated by GEN. -- Abstract: It has recently been demonstrated that genistein (GEN), a phytoestrogen in soy products, is an epigenetic modulator in various types of cells; but its effect on endometrium has not yet been determined. We investigated the effects of GEN on mouse uterine cells, in vivo and in vitro. Oral administration of GEN for 1 week induced mild proliferation of the endometrium in ovariectomized (OVX) mice, which was accompanied by the induction of steroidogenic factor 1 (SF-1) gene expression. GEN administration induced demethylation of multiple CpG sites in the SF-1 promoter; these sites are extensively methylated and thus silenced in normal endometrium. The GEN-mediated promoter demethylation occurred predominantly on the luminal side, as opposed to myometrium side, indicating that the epigenetic change was mainly shown in regenerated cells. Primary cultures of endometrial stromal cell colonies were screened for GEN-mediated alterations of DNA methylation by a high-resolution melting (HRM) method. One out of 20 colony-forming cell clones showed GEN-induced demethylation of SF-1. This clone exhibited a high proliferation capacity with continuous colony formation activity through multiple serial clonings. We propose that only a portion of endometrial cells are capable of receiving epigenetic modulation by GEN.

  15. Genistein promotes DNA demethylation of the steroidogenic factor 1 (SF-1) promoter in endometrial stromal cells

    International Nuclear Information System (INIS)

    Matsukura, Hiroshi; Aisaki, Ken-ichi; Igarashi, Katsuhide; Matsushima, Yuko; Kanno, Jun; Muramatsu, Masaaki; Sudo, Katsuko; Sato, Noriko

    2011-01-01

    Highlights: → Genistein (GEN) is a phytoestrogen found in soy products. → GEN demethylated/unsilenced the steroidogenic factor 1 gene in endometrial tissue. → GEN thus altered mRNA expression in uteri of ovariectomized (OVX) mice. → A high-resolution melting assay was used to screen for epigenetic change. → We isolated an endometrial cell clone that was epigenetically modulated by GEN. -- Abstract: It has recently been demonstrated that genistein (GEN), a phytoestrogen in soy products, is an epigenetic modulator in various types of cells; but its effect on endometrium has not yet been determined. We investigated the effects of GEN on mouse uterine cells, in vivo and in vitro. Oral administration of GEN for 1 week induced mild proliferation of the endometrium in ovariectomized (OVX) mice, which was accompanied by the induction of steroidogenic factor 1 (SF-1) gene expression. GEN administration induced demethylation of multiple CpG sites in the SF-1 promoter; these sites are extensively methylated and thus silenced in normal endometrium. The GEN-mediated promoter demethylation occurred predominantly on the luminal side, as opposed to myometrium side, indicating that the epigenetic change was mainly shown in regenerated cells. Primary cultures of endometrial stromal cell colonies were screened for GEN-mediated alterations of DNA methylation by a high-resolution melting (HRM) method. One out of 20 colony-forming cell clones showed GEN-induced demethylation of SF-1. This clone exhibited a high proliferation capacity with continuous colony formation activity through multiple serial clonings. We propose that only a portion of endometrial cells are capable of receiving epigenetic modulation by GEN.

  16. Influence of aspirin and non-aspirin NSAID use on ovarian and endometrial cancer: Summary of epidemiologic evidence of cancer risk and prognosis.

    Science.gov (United States)

    Verdoodt, F; Kjaer, S K; Friis, S

    2017-06-01

    Increasing evidence supports a role for aspirin use in reducing the incidence and mortality of several cancer types. This has spurred a new wave of interest in this widely used drug. In this review, we present and evaluate the epidemiologic evidence of the association between the use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) and the incidence and prognosis of ovarian and endometrial cancer. The evidence of a preventive effect of NSAID use on risk of ovarian or endometrial cancer is based primarily on results from observational studies and, consequently, is only suggestive. Overall, observational studies indicate modest reductions in risk of ovarian and endometrial cancer with aspirin use, whereas the results for non-aspirin NSAID use are equivocal. The strongest inverse associations have been reported for long-term consistent aspirin use, notably among subgroups of users (e.g., those with high body mass index). Few studies have evaluated the influence of NSAID use on the mortality of ovarian or endometrial cancer, and substantial heterogeneity of study characteristics and results preclude any conclusions. Additional studies of aspirin and non-aspirin NSAID use and ovarian or endometrial cancer risk and prognosis are warranted. In the present review, we discuss the importance of comprehensive exposure definitions (i.e., duration, timing, consistency and intensity/dose) and evaluation of potential effect modification according to user characteristics, with the aim of identifying women who may experience the largest benefit of aspirin or non-aspirin NSAID use on risk or prognosis of ovarian and endometrial cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Does the use of the 2009 FIGO classification of endometrial cancer impact on indications of the sentinel node biopsy?

    International Nuclear Information System (INIS)

    Ballester, Marcos; Koskas, Martin; Coutant, Charles; Chéreau, Elisabeth; Seror, Jeremy; Rouzier, Roman; Daraï, Emile

    2010-01-01

    Lymphadenectomy is debated in early stages endometrial cancer. Moreover, a new FIGO classification of endometrial cancer, merging stages IA and IB has been recently published. Therefore, the aims of the present study was to evaluate the relevance of the sentinel node (SN) procedure in women with endometrial cancer and to discuss whether the use of the 2009 FIGO classification could modify the indications for SN procedure. Eighty-five patients with endometrial cancer underwent the SN procedure followed by pelvic lymphadenectomy. SNs were detected with a dual or single labelling method in 74 and 11 cases, respectively. All SNs were analysed by both H&E staining and immunohistochemistry. Presumed stage before surgery was assessed for all patients based on MR imaging features using the 1988 FIGO classification and the 2009 FIGO classification. An SN was detected in 88.2% of cases (75/85 women). Among the fourteen patients with lymph node metastases one-half were detected by serial sectioning and immunohistochemical analysis. There were no false negative case. Using the 1988 FIGO classification and the 2009 FIGO classification, the correlation between preoperative MRI staging and final histology was moderate with Kappa = 0.24 and Kappa = 0.45, respectively. None of the patients with grade 1 endometrioid carcinoma on biopsy and IA 2009 FIGO stage on MR imaging exhibited positive SN. In patients with grade 2-3 endometrioid carcinoma and stage IA on MR imaging, the rate of positive SN reached 16.6% with an incidence of micrometastases of 50%. The present study suggests that sentinel node biopsy is an adequate technique to evaluate lymph node status. The use of the 2009 FIGO classification increases the accuracy of MR imaging to stage patients with early stages of endometrial cancer and contributes to clarify the indication of SN biopsy according to tumour grade and histological type

  18. Validated Competing Event Model for the Stage I-II Endometrial Cancer Population

    Energy Technology Data Exchange (ETDEWEB)

    Carmona, Ruben; Gulaya, Sachin; Murphy, James D. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Rose, Brent S. [Harvard Radiation Oncology Program, Harvard Medical School, Boston, Massachusetts (United States); Wu, John; Noticewala, Sonal [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); McHale, Michael T. [Department of Reproductive Medicine, Division of Gynecologic Oncology, University of California San Diego, La Jolla, California (United States); Yashar, Catheryn M. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Vaida, Florin [Department of Family and Preventive Medicine, Biostatistics and Bioinformatics, University of California San Diego Medical Center, San Diego, California (United States); Mell, Loren K., E-mail: lmell@ucsd.edu [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States)

    2014-07-15

    Purpose/Objectives(s): Early-stage endometrial cancer patients are at higher risk of noncancer mortality than of cancer mortality. Competing event models incorporating comorbidity could help identify women most likely to benefit from treatment intensification. Methods and Materials: 67,397 women with stage I-II endometrioid adenocarcinoma after total hysterectomy diagnosed from 1988 to 2009 were identified in Surveillance, Epidemiology, and End Results (SEER) and linked SEER-Medicare databases. Using demographic and clinical information, including comorbidity, we sought to develop and validate a risk score to predict the incidence of competing mortality. Results: In the validation cohort, increasing competing mortality risk score was associated with increased risk of noncancer mortality (subdistribution hazard ratio [SDHR], 1.92; 95% confidence interval [CI], 1.60-2.30) and decreased risk of endometrial cancer mortality (SDHR, 0.61; 95% CI, 0.55-0.78). Controlling for other variables, Charlson Comorbidity Index (CCI) = 1 (SDHR, 1.62; 95% CI, 1.45-1.82) and CCI >1 (SDHR, 3.31; 95% CI, 2.74-4.01) were associated with increased risk of noncancer mortality. The 10-year cumulative incidences of competing mortality within low-, medium-, and high-risk strata were 27.3% (95% CI, 25.2%-29.4%), 34.6% (95% CI, 32.5%-36.7%), and 50.3% (95% CI, 48.2%-52.6%), respectively. With increasing competing mortality risk score, we observed a significant decline in omega (ω), indicating a diminishing likelihood of benefit from treatment intensification. Conclusion: Comorbidity and other factors influence the risk of competing mortality among patients with early-stage endometrial cancer. Competing event models could improve our ability to identify patients likely to benefit from treatment intensification.

  19. Case Report: Synchronous primary malignancy including the breast and endometrium [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Elham-Sadat Bani-Mostafavi

    2017-12-01

    Full Text Available Breast and endometrial cancer are the most common types of female cancers, but the incidence of both of these malignancies in a single patient is a rare event. Multiple primary malignancy has been increasingly reported over the past decade, and double primary cancer is considered as the most common type.  In this study, we present a 53-year-old woman with synchronous primary malignancy of breast and endometrium. This patient had a history of breast and endometrial cancer in her family. Mammography and chest CT of the patient revealed a mass in the right breast and left supraclavicular region. However, the patient did not want to initiate treatment. Subsequently, the patient returned with a chief complaint of persistent abnormal vaginal bleeding. Abdominopelvic CT scan of the patient revealed a huge soft tissue mass in the pelvic cavity. She underwent hysterectomy, and pathology revealed endometrioid carcinoma, which had invaded the full thickness of uterine wall. Since this type of malignancy is rare and several risk factors are associated with it, it is worth being considered by clinicians when making decisions about screening or strategy for prevention.

  20. Postoperative vesicoureteral reflux after high-pressure balloon dilation of the ureterovesical junction in primary obstructive megaureter. Incidence, management and predisposing factors.

    Science.gov (United States)

    García-Aparicio, Luis; Blázquez-Gómez, Eva; de Haro, Irene; Garcia-Smith, Natalie; Bejarano, Miguel; Martin, Oriol; Rodo, Joan

    2015-12-01

    To describe the incidence, predisposing factors and management of postoperative vesicoureteral reflux (VUR) after high-pressure balloon dilation to treat primary obstructive megaureter (POM). We have reviewed patients that underwent endoscopic treatment for POM from May 2008 to November 2013. All patients were evaluated with renal ultrasound, voiding cystourethrography and diuretic renogram. Endoscopic treatment was done with high-pressure balloon dilation of the ureterovesical junction under general anesthesia; a double-J stenting was done in all patients. Follow-up was performed with ultrasonography, voiding cystourethrography and a diuretic renogram in all patients. Fifteen boys and five girls with a mean age of 14.18 months (3-103) were reviewed. A total of 22 ureters underwent HPBD to treat POM. Ureterohydronephrosis improves in 19 ureters. After endoscopic treatment, six ureters developed VUR. Four ureters were managed surgically, and in the other two, VUR disappeared in a second cystogram. The presence of parameatal diverticulum in the preoperative cystography and those patients with bilateral POM are factors related to postoperative VUR (p < 0.05). Urinary tract infection after HPBD was observed in four patients, but only one of them was affected with VUR.

  1. Sox9 overexpression in uterine epithelia induces endometrial gland hyperplasia

    Science.gov (United States)

    Gonzalez, Gabriel; Mehra, Shyamin; Wang, Ying; Akiyama, Haruhiko

    2016-01-01

    SOX9 is a high mobility group transcription factor that is required in many biological processes, including cartilage differentiation, endoderm progenitor maintenance, hair differentiation, and testis determination. SOX9 has also been linked to colorectal, prostate, and lung cancer. We found that SOX9 is expressed in the epithelium of the adult mouse and human uterus, predominantly marking the uterine glands. To determine if SOX9 plays a role in the development of endometrial cancer we overexpressed Sox9 in the uterine epithelium using a progesterone receptor-Cre mouse model. Sox9 overexpression in the uterine epithelium led to the formation of simple and complex cystic glandular structures in the endometrium of aged-females. Histological analysis revealed that these structures appeared morphologically similar to structures present in patients with endometrial hyperplastic lesions and endometrial polyps that are thought to be precursors of endometrial cancer. The molecular mechanisms that cause the glandular epithelium to become hyperplastic, leading to endometrial cancer are still poorly understood. These findings indicate that chronic overexpression of Sox9 in the uterine epithelium can induce the development of endometrial hyperplastic lesions. Thus, SOX9 expression may be a factor in the formation of endometrial cancer. PMID:27262401

  2. Hypoxia and Angiogenesis in Endometrioid Endometrial Carcinogenesis

    Directory of Open Access Journals (Sweden)

    Nicole Horrée

    2007-01-01

    Full Text Available Background: Hypoxia-inducible factor 1α (HIF-1α plays an essential role in the adaptive response of cells to hypoxia, triggering biologic events associated with aggressive tumor behavior. Methods: Expression of HIF-1α and proteins in the HIF-1α pathway (Glut-1, CAIX, VEGF in paraffin-embedded specimens of normal (n = 17, premalignant (n = 17 and endometrioid endometrial carcinoma (n = 39 was explored by immunohistochemistry, in relation to microvessel density (MVD. Results: HIF-1α overexpression was absent in inactive endometrium but present in hyperplasia (61% and carcinoma (87%, with increasing expression in a perinecrotic fashion pointing to underlying hypoxia. No membranous expression of Glut-1 and CAIX was noticed in inactive endometrium, in contrast with expression in hyperplasia (Glut-1 0%, CAIX 61%, only focal and diffuse and carcinoma (Glut-1 94.6%, CAIX 92%, both mostly perinecrotically. Diffuse HIF-1α was accompanied by activation of downstream targets. VEGF was significantly higher expressed in hyperplasias and carcinomas compared to inactive endometrium. MVD was higher in hyperplasias and carcinomas than in normal endometrium (p < 0.001. Conclusion: HIF-1α and its downstream genes are increasingly expressed from normal through premalignant to endometrioid adenocarcinoma of the endometrium, paralleled by activation of its downstream genes and increased angiogenesis. This underlines the potential importance of hypoxia and its key regulator HIF-1α in endometrial carcinogenesis.

  3. Endometrial and Ovarian Cancer with MR Imaging Importance of Serum HE4 and CA 125 Levels in the Extent of Disease at Evaluation.

    Science.gov (United States)

    Yılmaz, Emsal Pınar Topdağı; Kumtepe, Yakup

    2016-10-01

    Currently, no clinically useful tumor marker is available for primary diagnosis in endometrial cancer. Human epididymis protein-4 (HE-4) has high sensitivity and specificity as a tumor marker. Further, HE-4 has been shown to be elevated in early stage endometrial cancer and is more sensitive than CA 125. In our study, CA 125 and HE-4 reputation as a tumor marker for diagnosis of ovarian and endometrial cancer with the use of both the availability and affect the way we investigated the rate of diagnosis. Here 20 patients with ovarian cancer, 26 patients with endometrial cancer, which had been histologically diagnosed, and 40 healthy volunteers were included. Peripheral blood samples were taken and serum CA 125 and HE-4 were tested. Serum CA 125 and HE-4 levels in patients with ovarian cancer were found to be significantly higher than those in healthy volunteers (pCA 125 (0.83) and HE-4 (0.84) levels showed increased sensitivity (95%). There was no significant difference in the CA 125 levels in patients with endometrial cancer and healthy controls (p>0.05), whereas HE-4 levels were found to be higher in patients with endometrial cancer than in healthy controls (pCA 125 (0.59) and HE-4 (0.63) levels showed increased sensitivity (88.5%). In ovarian and endometrial cancer, wherein early diagnosis is the most important factor for prognosis and survival, HE-4 is a new serum tumor marker that can be used with the aim of noninvasive diagnoses. For early diagnosis, the concomitant use of CA 125 and HE-4 is more effective and reliable than using either of them alone.

  4. Primary umbilical endometriosis - Diagnosis by fine needle aspiration

    Directory of Open Access Journals (Sweden)

    Hilda Fernandes

    2011-01-01

    Full Text Available Primary (spontaneous umbilical endometriosis is very rare with an estimated incidence of 0.5-1% of all patients with endometrial ectopia. Endometriosis is a common gynecological condition, the pelvis being the most common site of the disease. Extrapelvic site is less common and even more difficult to diagnose due to the extreme variability in presentation. A 38-year-old woman presented with a blackish nodule over the umbilicus of 3 years duration. Fine needle aspiration cytology of the lesion showed cells in clusters and sheets with background of scant stromal fragment, hemosiderin laden macrophages and RBCs, leading to a suggestion of umbilical endometriosis. Histopathological examination of the excised lesion confirmed the same.

  5. Biochemical evaluation of endometrial function at the time of implantation

    DEFF Research Database (Denmark)

    Lindhard, Anette; Bentin-Ley, Ursula; Ravn, Vibeke

    2002-01-01

    OBJECTIVE: To review the literature on various endometrial factors assumed to be of importance to implantation and to evaluate their potential clinical value in the assessment of endometrial function at the time of implantation in infertile women in natural and stimulated cycles. DESIGN: Literature....... CONCLUSION(S): The studies performed to date have mostly included only small groups of patients with a lack of fertile controls, and only a few prospective, controlled trials have been carried out. Therefore, definite conclusions about the clinical value of these factors in the assessment of endometrial...

  6. ESMO-ESGO-ESTRO consensus conference on endometrial cancer

    DEFF Research Database (Denmark)

    Colombo, Nicoletta; Creutzberg, Carien; Amant, Frederic

    2015-01-01

    The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary...... panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically-relevant questions about endometrial cancer relating to the following four areas: Prevention and screening, surgery, adjuvant treatment and advanced and recurrent...

  7. Autocrine Human Growth Hormone Stimulates Oncogenicity of Endometrial Carcinoma Cells

    OpenAIRE

    Pandey, Vijay; Perry, Jo K.; Mohankumar, Kumarasamypet M.; Kong, Xiang-Jun; Liu, Shu-Min; Wu, Zheng-Sheng; Mitchell, Murray D.; Zhu, Tao; Lobie, Peter E.

    2008-01-01

    Recent published data have demonstrated elevated levels of human GH (hGH) in endometriosis and endometrial adenocarcinoma. Herein, we demonstrate that autocrine production of hGH can enhance the in vitro and in vivo oncogenic potential of endometrial carcinoma cells. Forced expression of hGH in endometrial carcinoma cell lines RL95-2 and AN3 resulted in an increased total cell number through enhanced cell cycle progression and decreased apoptotic cell death. In addition, autocrine hGH express...

  8. Incidence and risk factors of ventricular fibrillation before primary angioplasty in patients with first ST-elevation myocardial infarction: a nationwide study in Denmark.

    Science.gov (United States)

    Jabbari, Reza; Engstrøm, Thomas; Glinge, Charlotte; Risgaard, Bjarke; Jabbari, Javad; Winkel, Bo Gregers; Terkelsen, Christian Juhl; Tilsted, Hans-Henrik; Jensen, Lisette Okkels; Hougaard, Mikkel; Chiuve, Stephanie E; Pedersen, Frants; Svendsen, Jesper Hastrup; Haunsø, Stig; Albert, Christine M; Tfelt-Hansen, Jacob

    2015-01-05

    We aimed to investigate the incidence and risk factors for ventricular fibrillation (VF) before primary percutaneous coronary intervention (PPCI) among patients with ST-segment elevation myocardial infarction (STEMI) in a prospective nationwide setting. In this case-control study, patients presenting within the first 12 hours of first STEMI who survived to undergo angiography and subsequent PPCI were enrolled. Over 2 years, 219 cases presenting with VF before PPCI and 441 controls without preceding VF were enrolled. Of the 219 case patients, 182 (83%) had STEMI with out-of-hospital cardiac arrest due to VF, and 37 (17%) had cardiac arrest upon arrival to the emergency room. Medical history was collected by standardized interviews and by linkage to national electronic health records. The incidence of VF before PPCI among STEMI patients was 11.6%. Multivariable logistic regression analysis identified novel associations between atrial fibrillation and alcohol consumption with VF. Patients with a history of atrial fibrillation had a 2.80-fold odds of experiencing VF before PPCI (95% CI 1.10 to 7.30). Compared with nondrinkers, patients who consumed 1 to 7 units, 8 to 14 units, or >15 units of alcohol per week had an odds ratio (OR) of 1.30 (95% CI, 0.80 to 2.20), 2.30 (95% CI, 1.20 to 4.20), or 3.30 (95% CI, 1.80 to 5.90), respectively, for VF. Previously reported associations for preinfarction angina (OR 0.46; 95% CI 0.32 to 0.67), age of history of sudden death (OR 1.60; 95% CI 1.10 to 2.40) were all associated with VF. Several easily assessed risk factors were associated with VF occurring out-of-hospital or on arrival at the emergency room before PPCI in STEMI patients, thus providing potential avenues for investigation regarding improved identification and prevention of life-threatening ventricular arrhythmias. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  9. SU-C-BRD-05: Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Yang, R; Wang, J [Peking University Third Hospital, Beijing, Beijing (China)

    2014-06-15

    Purpose: To explore the implementation and effectiveness of incident learning for the safety and quality of radiotherapy in a new established radiotherapy program with advanced technology. Methods: Reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically designed for reporting, investigating, and learning of individual radiotherapy incidents in a new established radiotherapy program, with 4D CBCT, Ultrasound guided radiotherapy, VMAT, gated treatment delivered on two new installed linacs. The incidents occurring in external beam radiotherapy from February, 2012 to January, 2014 were reported. Results: A total of 33 reports were analyzed, including 28 near misses and 5 incidents. Among them, 5 originated in imaging for planning, 25 in planning, 1 in plan transfer, 1 in commissioning and 1 in treatment delivery. Among them, three near misses originated in the safety barrier of the radiotherapy process. In terms of error type, 1 incident was classified as wrong patient, 7 near misses/incidents as wrong site, 6 as wrong laterality, 5 as wrong dose, 7 as wrong prescription, and 7 as suboptimal plan quality. 5 incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, inadequate training, failure to develop an effective plan, and communication contributed to 19, 15, 12, 5 and 3 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4; this rate fell to 0.28% in the second year from 0.56% in the first year. The rate of near miss fell to 1.24% from 2.22%. Conclusion: Effective incident learning can reduce the occurrence of near miss/incidents, enhance the culture of safety. Incident learning is an effective proactive method for improving the quality and safety of radiotherapy.

  10. SU-C-BRD-05: Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Techniques

    International Nuclear Information System (INIS)

    Yang, R; Wang, J

    2014-01-01

    Purpose: To explore the implementation and effectiveness of incident learning for the safety and quality of radiotherapy in a new established radiotherapy program with advanced technology. Methods: Reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically designed for reporting, investigating, and learning of individual radiotherapy incidents in a new established radiotherapy program, with 4D CBCT, Ultrasound guided radiotherapy, VMAT, gated treatment delivered on two new installed linacs. The incidents occurring in external beam radiotherapy from February, 2012 to January, 2014 were reported. Results: A total of 33 reports were analyzed, including 28 near misses and 5 incidents. Among them, 5 originated in imaging for planning, 25 in planning, 1 in plan transfer, 1 in commissioning and 1 in treatment delivery. Among them, three near misses originated in the safety barrier of the radiotherapy process. In terms of error type, 1 incident was classified as wrong patient, 7 near misses/incidents as wrong site, 6 as wrong laterality, 5 as wrong dose, 7 as wrong prescription, and 7 as suboptimal plan quality. 5 incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, inadequate training, failure to develop an effective plan, and communication contributed to 19, 15, 12, 5 and 3 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4; this rate fell to 0.28% in the second year from 0.56% in the first year. The rate of near miss fell to 1.24% from 2.22%. Conclusion: Effective incident learning can reduce the occurrence of near miss/incidents, enhance the culture of safety. Incident learning is an effective proactive method for improving the quality and safety of radiotherapy

  11. Endometrial Stromal Sarcoma Arising in Colorectal Endometriosis: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Qiao Wang

    2015-01-01

    Full Text Available Extrauterine endometrial stromal sarcoma (ESS arising in endometriosis is extremely rare, particularly in the colorectum. It should always be included in the differential diagnosis of primary tumors originating from gastrointestinal tract in females, given that preoperative endoscopical biopsy may reveal no specific changes. We reported a case of ESS arising in colorectal endometriosis and reviewed the previous 7 cases reported in the English literature. Our patient, who was unavailable for tumor resection and refused further adjuvant therapy, played a role in representing the natural history of low-grade extragenital ESS. This case was the only death from ESS arising in colorectal endometriosis.

  12. Uterine involution in colombian fine pace mares, measured by ultrasonography and endometrial cytology

    Directory of Open Access Journals (Sweden)

    Germán Ramírez

    2006-06-01

    Full Text Available Today, there still exists a controversial issue, as to the high incidence of early embryonic death in mares, mated on the first post partum oestrus. The purpose of this study was first, to determine the post partum period of uterine involution in fine pace Colombian mares using endometrial cytology and ultra sonograph. Secondly, to determine the relation between the neutrophil percentages found in cytology and the echogenicity of accumulated intrauterine fluid during the first 30 post partum days. Twenty (n=20 mares were examined beginning on the 6th post partum day and on alternate days, up to the 30th day. All subjects were grazing Kikuyo grass (Pennisetum clandestinum at la Sabana de Bogotá, 2.600 meters over sea level, 4 º north latitude and with an average temperature of 13 º C. From the 3rd postpartum day, all 20 mares were exposed to 2 healthy stallions, to establish their heat behaviour. Ten of them, following complete randomization, were inseminated on the first postpartum heat, while the others were inseminated on the second post partum heat. Genital examination was carried out by a technician, who did not know the reproductive history of any of the experimental mares. Examinations included rectal palpation, ultra sonograph (Pie Medical 480, linear array, 5 MHz, vaginal swabs and endometrial cytology. Uterine dimension was recorded by rectal palpation and ultra sonograph, it was included the uterine horn dimensions (tip, middle, and corporo-cornual junction of previously gravid and non gravid uterus. Intrauterine fluid detection was performed by the use of an echogenicity scale. Ovaric structures were recorded (preovulatory follicles and ovulation. Pregnancy diagnosis was performed on day 15 post ovulation and then confirmed on day 40. Endometrial cytology samples were taken from uterus after the perineal area was disinfected using non covered isopos with a Pollanski speculum. Smears specimens were fixed with metil alcohol for 15

  13. Exploratory study of pre-surgical medications with dienogest or leuprorelin in laparoscopic cystectomy of endometrial cysts.

    Science.gov (United States)

    Takenaka, Motoki; Yano, Ryuichiro; Hiraku, Yuka; Shibata, Mayuko; Hatano, Kayoko; Yamamoto, Shiori; Sato, Kazuki; Yamamoto, Kazushige; Morishige, Ken-ichiro

    2015-08-01

    The aim of this study was to compare the effects of pre-surgical medication with dienogest or leuprorelin on post-surgical ovarian function. We conducted an exploratory study in two centers in Japan that comprised 30 patients with ovarian endometrial cysts for whom surgical excision was planned. Patients were enrolled and divided into pre-surgical medication groups with dienogest or leuprorelin for 12 weeks. Thereafter, patients were treated by laparoscopic cystectomy. The primary outcome was ovarian function post-surgery, as assessed by serum anti-Müllerian hormone (AMH) level, antral follicle count (AFC) and resumption of menses. Secondary outcome was the effect of pre-surgical medication, as assessed by the size of endometrial cysts and visual analog scale (VAS) score. Serum AMH, AFC, size of endometrial cysts, and VAS scores were measured at baseline (before medication), after medication (1 day before surgery), and at 4 and 12 weeks post-surgery. Serum AMH levels did not change after pre-surgical medication with either dienogest or leuprorelin. Although AMH decreased after surgery, it recovered by 12 weeks post-surgery in both groups with no statistically significant difference. Mean AFC did not change after surgery in either group. Menses returned by 12 weeks post-surgery in all patients except for those who were pregnant. The rate of reduction of endometrial cyst volume did not differ between the groups. Both dienogest and leuprorelin were associated with substantial reductions in VAS scores. There were no statistically significant differences between pre-surgical medication with dienogest and leuprorelin in post-surgical ovarian function. Both medications were effective in reducing endometrial cyst volume and VAS score. © 2015 The Authors. Journal of Obstetrics and Gynaecology Research © 2015 Japan Society of Obstetrics and Gynecology.

  14. Identification of optimal reference genes for gene expression normalization in a wide cohort of endometrioid endometrial carcinoma tissues.

    Directory of Open Access Journals (Sweden)

    Chiara Romani

    Full Text Available Accurate normalization is a primary component of a reliable gene expression analysis based on qRT-PCR technique. While the use of one or more reference genes as internal controls is commonly accepted as the most appropriate normalization strategy, many qPCR-based published studies still contain data poorly normalized and reference genes arbitrarily chosen irrespective of the particular tissue and the specific experimental design. To date, no validated reference genes have been identified for endometrial cancer tissues. In this study, 10 normalization genes (GAPDH, B2M, ACTB, POLR2A, UBC, PPIA, HPRT1, GUSB, TBP, H3F3A belonging to different functional and abundance classes in various tissues and used in different studies, were analyzed to determine their applicability. In total, 100 endometrioid endometrial cancer samples, which were carefully balanced according to their tumor grade, and 29 normal endometrial tissues were examined using SYBR Green Real-Time RT-PCR. The expression stability of candidate reference genes was determined and compared by means of geNorm and NormFinder softwares. Both algorithms were in agreement in identifying GAPDH, H3F3A, PPIA, and HPRT1 as the most stably expressed genes, only differing in their ranking order. Analysis performed on the expression levels of all candidate genes confirm HPRT1 and PPIA as the most stably expressed in the study groups regardless of sample type, to be used alone or better in combination. As the stable expression of HPRT1 and PPIA between normal and tumor endometrial samples fulfill the basic requirement of a reference gene to be used for normalization purposes, HPRT1 expression showed significant differences between samples from low-grade and high-grade tumors. In conclusion, our results recommend the use of PPIA as a single reference gene to be considered for improved reliability of normalization in gene expression studies involving endometrial tumor samples at different tumor degrees.

  15. Technical Note: On the impact of the incident electron beam energy on the primary dose component of flattening filter free photon beams.

    Science.gov (United States)

    Kuess, Peter; Georg, Dietmar; Palmans, Hugo; Lechner, Wolfgang

    2016-08-01

    For commercially available linear accelerators (Linacs), the electron energies of flattening filter free (FFF) and flattened (FF) beams are either identical or the electron energy of the FFF beam is increased to match the percentage depth dose curve (PDD) of the FF beam (in reference geometry). This study focuses on the primary dose components of FFF beams for both kinds of settings, studied on the same Linac. The measurements were conducted on a VersaHD Linac (Elekta, Crawley, UK) for both FF and FFF beams with nominal energies of 6 and 10 MV. In the clinical setting of the VersaHD, the energy of FFFM (Matched) beams is set to match the PDDs of the FF beams. In contrast the incident electron beam of the FFFU beam was set to the same energy as for the FF beam. Half value layers (HVLs) and a dual parameter beam quality specifier (DPBQS) were determined. For the 6 MV FFFM beam, HVL and DPBQS values were very similar compared to those of the 6 MV FF beam, while for the 10 MV FFFM and FF beams, only %dd(10)x and HVL values were comparable (differences below 1.5%). This shows that matching the PDD at one depth does not guarantee other beam quality dependent parameters to be matched. For FFFU beams, all investigated beam quality specifiers were significantly different compared to those for FF beams of the same nominal accelerator potential. The DPBQS of the 6 MV FF and FFFM beams was equal within the measurement uncertainty and was comparable to published data of a machine with similar TPR20,10 and %dd(10)x. In contrast to that, the DPBQS's two parameters of the 10 MV FFFM beam were substantially higher compared to those for the 10 MV FF beam. PDD-matched FF and FFF beams of both nominal accelerator potentials were observed to have similar HVL values, indicating similarity of their primary dose components. Using the DPBQS revealed that the mean attenuation coefficient was found to be the same within the uncertainty of 0.8% for 6 MV FF and 6 MV FFFM beams, while for 10 MV

  16. Technical Note: On the impact of the incident electron beam energy on the primary dose component of flattening filter free photon beams

    International Nuclear Information System (INIS)

    Kuess, Peter; Georg, Dietmar; Lechner, Wolfgang; Palmans, Hugo

    2016-01-01

    Purpose: For commercially available linear accelerators (Linacs), the electron energies of flattening filter free (FFF) and flattened (FF) beams are either identical or the electron energy of the FFF beam is increased to match the percentage depth dose curve (PDD) of the FF beam (in reference geometry). This study focuses on the primary dose components of FFF beams for both kinds of settings, studied on the same Linac. Methods: The measurements were conducted on a VersaHD Linac (Elekta, Crawley, UK) for both FF and FFF beams with nominal energies of 6 and 10 MV. In the clinical setting of the VersaHD, the energy of FFF M (Matched) beams is set to match the PDDs of the FF beams. In contrast the incident electron beam of the FFF U beam was set to the same energy as for the FF beam. Half value layers (HVLs) and a dual parameter beam quality specifier (DPBQS) were determined. Results: For the 6 MV FFF M beam, HVL and DPBQS values were very similar compared to those of the 6 MV FF beam, while for the 10 MV FFF M and FF beams, only %dd(10) x and HVL values were comparable (differences below 1.5%). This shows that matching the PDD at one depth does not guarantee other beam quality dependent parameters to be matched. For FFF U beams, all investigated beam quality specifiers were significantly different compared to those for FF beams of the same nominal accelerator potential. The DPBQS of the 6 MV FF and FFF M beams was equal within the measurement uncertainty and was comparable to published data of a machine with similar TPR 20,10 and %dd(10) x . In contrast to that, the DPBQS’s two parameters of the 10 MV FFF M beam were substantially higher compared to those for the 10 MV FF beam. Conclusions: PDD-matched FF and FFF beams of both nominal accelerator potentials were observed to have similar HVL values, indicating similarity of their primary dose components. Using the DPBQS revealed that the mean attenuation coefficient was found to be the same within the uncertainty of

  17. Lipocalin 2 expression is associated with aggressive features of endometrial cancer

    International Nuclear Information System (INIS)

    Mannelqvist, Monica; Akslen, Lars A; Stefansson, Ingunn M; Wik, Elisabeth; Kusonmano, Kanthida; Raeder, Maria B; Øyan, Anne M; Kalland, Karl-Henning; Moses, Marsha A; Salvesen, Helga B

    2012-01-01

    Increased expression of lipocalin 2 (LCN2) has been observed in several cancers. The aim of the present study was to investigate LCN2 in endometrial cancer in relation to clinico-pathologic phenotype, angiogenesis, markers of epithelial-mesenchymal transition (EMT), and patient survival. Immunohistochemical staining was performed using a human LCN2 antibody on a population-based series of endometrial cancer patients collected in Hordaland County (Norway) during 1981-1990 (n = 256). Patients were followed from the time of primary surgery until death or last follow-up in 2007. The median follow-up time for survivors was 17 years. Gene expression data from a prospectively collected endometrial cancer series (n = 76) and a publicly available endometrial cancer series (n = 111) was used for gene correlation studies. Expression of LCN2 protein, found in 49% of the cases, was associated with non-endometrioid histologic type (p = 0.001), nuclear grade 3 (p = 0.001), >50% solid tumor growth (p = 0.001), ER and PR negativity (p = 0.028 and 0.006), and positive EZH2 expression (p < 0.001). LCN2 expression was significantly associated with expression of VEGF-A (p = 0.021), although not with other angiogenesis markers examined (vascular proliferation index, glomeruloid microvascular proliferation, VEGF-C, VEGF-D or bFGF2 expression). Further, LCN2 was not associated with several EMT-related markers (E-cadherin, N-cadherin, P-cadherin, β-catenin), nor with vascular invasion (tumor cells invading lymphatic or blood vessels). Notably, LCN2 was significantly associated with distant tumor recurrences, as well as with the S100A family of metastasis related genes. Patients with tumors showing no LCN2 expression had the best outcome with 81% 5-year survival, compared to 73% for intermediate and 38% for the small subgroup with strong LCN2 staining (p = 0.007). In multivariate analysis, LCN2 expression was an independent prognostic factor in addition to histologic grade and FIGO stage

  18. Endometrial cancer in unicornuate uterus: a case report.

    Science.gov (United States)

    Cobellis, L; Castaldi, M A; Frega, V; Mosca, L; Corvino, F; Cappabianca, S; Colacurci, N

    2015-01-01

    Miillerian anomalies have not been implicated as a significant risk factor for the development of cervical, uterine, and ovarian cancers; in the present literature, there are only a few reports of endometrial cancer arising in patients with Miillerian abnormalities. To the best of the authors' knowledge, this is the first reported case of endometrial cancer arising in a patient with unicornuate uterus. A 69-year-old Caucasian woman underwent clinical examination and office hysteroscopy with endometrial biopsy because of abnormal post-menopausal bleeding. The diagnosis was endometrial cancer in unicornuate uterus, hence the patient underwent total hysterectomy with pelvic lymphadenectomy. Uterine malformations and genetic disorders may cause a delayed diagnosis of gynaecological cancers. Gynaecological examination in asymptomatic patients and differential diagnosis in abnormal uterine bleeding patients should be considered.

  19. Cervical cytology in serous and endometrioid endometrial cancer

    NARCIS (Netherlands)

    Roelofsen, T.; Geels, Y.P.; Pijnenborg, J.M.A.; Ham, M.A.P.C. van; Zomer, S.F.; Tilburg, J.M. van; Snijders, M.P.; Siebers, A.G.; Bulten, J.; Massuger, L.F.A.G.

    2013-01-01

    The aim of this study was to determine the frequency of abnormal cervical cytology in preoperative cervical cytology of patients diagnosed with uterine papillary serous carcinoma (UPSC) and endometrioid endometrial carcinoma (EEC). In addition, associations between abnormal cervical cytology and

  20. Endometrial cancer, types, prognosis, female hormones and antihormones

    DEFF Research Database (Denmark)

    Ulrich, L S G

    2011-01-01

    . Prognosis is also dependent on tumor differentiation and stage, and treatment should be adjusted accordingly. In this paper, the different types of endometrial cancer, staging, prognosis, diagnosis, prevention, treatment and their relationship to estrogen and other female hormones are reviewed....

  1. Stromal-to-epithelial transition during postpartum endometrial regeneration.

    Directory of Open Access Journals (Sweden)

    Cheng-Chiu Huang

    Full Text Available Endometrium is the inner lining of the uterus which is composed of epithelial and stromal tissue compartments enclosed by the two smooth muscle layers of the myometrium. In women, much of the endometrium is shed and regenerated each month during the menstrual cycle. Endometrial regeneration also occurs after parturition. The cellular mechanisms that regulate endometrial regeneration are still poorly understood. Using genetic fate-mapping in the mouse, we found that the epithelial compartment of the endometrium maintains its epithelial identity during the estrous cycle and postpartum regeneration. However, whereas the stromal compartment maintains its identity during homeostatic cycling, after parturition a subset of stromal cells differentiates into epithelium that is subsequently maintained. These findings identify potential progenitor cells within the endometrial stromal compartment that produce long-term epithelial tissue during postpartum endometrial regeneration.

  2. Stromal-to-epithelial transition during postpartum endometrial regeneration.

    Science.gov (United States)

    Huang, Cheng-Chiu; Orvis, Grant D; Wang, Ying; Behringer, Richard R

    2012-01-01

    Endometrium is the inner lining of the uterus which is composed of epithelial and stromal tissue compartments enclosed by the two smooth muscle layers of the myometrium. In women, much of the endometrium is shed and regenerated each month during the menstrual cycle. Endometrial regeneration also occurs after parturition. The cellular mechanisms that regulate endometrial regeneration are still poorly understood. Using genetic fate-mapping in the mouse, we found that the epithelial compartment of the endometrium maintains its epithelial identity during the estrous cycle and postpartum regeneration. However, whereas the stromal compartment maintains its identity during homeostatic cycling, after parturition a subset of stromal cells differentiates into epithelium that is subsequently maintained. These findings identify potential progenitor cells within the endometrial stromal compartment that produce long-term epithelial tissue during postpartum endometrial regeneration.

  3. Inverse Relationship between Progesterone Receptor and Myc in Endometrial Cancer.

    Directory of Open Access Journals (Sweden)

    Tamar Kavlashvili

    Full Text Available Endometrial cancer, the most common gynecologic malignancy, is a hormonally-regulated disease. Response to progestin therapy positively correlates with hormone receptor expression, in particular progesterone receptor (PR. However, many advanced tumors lose PR expression. We recently reported that the efficacy of progestin therapy can be significantly enhanced by combining progestin with epigenetic modulators, which we term "molecularly enhanced progestin therapy." What remained unclear was the mechanism of action and if estrogen receptor α (ERα, the principle inducer of PR, is necessary to restore functional expression of PR via molecularly enhanced progestin therapy. Therefore, we modeled advanced endometrial tumors that have lost both ERα and PR expression by generating ERα-null endometrial cancer cell lines. CRISPR-Cas9 technology was used to delete ERα at the genomic level. Our data demonstrate that treatment with a histone deacetylase inhibitor (HDACi was sufficient to restore functional PR expression, even in cells devoid of ERα. Our studies also revealed that HDACi treatment results in marked downregulation of the oncogene Myc. We established that PR is a negative transcriptional regulator of Myc in endometrial cancer in the presence or absence of ERα, which is in contrast to studies in breast cancer cells. First, estrogen stimulation augmented PR expression and decreased Myc in endometrial cancer cell lines. Second, progesterone increased PR activity yet blunted Myc mRNA and protein expression. Finally, overexpression of PR by adenoviral transduction in ERα-null endometrial cancer cells significantly decreased expression of Myc and Myc-regulated genes. Analysis of the Cancer Genome Atlas (TCGA database of endometrial tumors identified an inverse correlation between PR and Myc mRNA levels, with a corresponding inverse correlation between PR and Myc downstream transcriptional targets SRD5A1, CDK2 and CCNB1. Together, these data

  4. Ornithine decarboxylase as a therapeutic target for endometrial cancer.

    Directory of Open Access Journals (Sweden)

    Hong Im Kim

    Full Text Available Ornithine Decarboxylase (ODC a key enzyme in polyamine biosynthesis is often overexpressed in cancers and contributes to polyamine-induced cell proliferation. We noted ubiquitous expression of ODC1 in our published endometrial cancer gene array data and confirmed this in the cancer genome atlas (TCGA with highest expression in non-endometrioid, high grade, and copy number high cancers, which have the worst clinical outcomes. ODC1 expression was associated with worse overall survival and increased recurrence in three endometrial cancer gene expression datasets. Importantly, we confirmed these findings using quantitative real-time polymerase chain reaction (qRT-PCR in a validation cohort of 60 endometrial cancers and found that endometrial cancers with elevated ODC1 had significantly shorter recurrence-free intervals (KM log-rank p = 0.0312, Wald test p = 5.59e-05. Difluoromethylornithine (DFMO a specific inhibitor of ODC significantly reduced cell proliferation, cell viability, and colony formation in cell line models derived from undifferentiated, endometrioid, serous, carcinosarcoma (mixed mesodermal tumor; MMT and clear cell endometrial cancers. DFMO also significantly reduced human endometrial cancer ACI-98 tumor burden in mice compared to controls (p = 0.0023. ODC-regulated polyamines (putrescine [Put] and/or spermidine [Spd] known activators of cell proliferation were strongly decreased in response to DFMO, in both tumor tissue ([Put] (p = 0.0006, [Spd] (p<0.0001 and blood plasma ([Put] (p<0.0001, [Spd] (p = 0.0049 of treated mice. Our study indicates that some endometrial cancers appear particularly sensitive to DFMO and that the polyamine pathway in endometrial cancers in general and specifically those most likely to suffer adverse clinical outcomes could be targeted for effective treatment, chemoprevention or chemoprevention of recurrence.

  5. The value of Pap test in women with endometrial cancer

    OpenAIRE

    Aleksandra Petrić; Vekoslav Lilić; Radomir Živadinović; Predrag Vukomanović; Olivera Dunjić; Radmila Ignjatović; Goran Lilić

    2011-01-01

    Introduction: Endometrial cancer is the second most common gynecological tumor. There is still no recommended screening method for endometrial cancer. The application of transvaginal sonography, hysteroscopy and Pap test may prove useful in screening for this disease. Atypical glandular cells represent an important finding in Pap tests and they are related to histopathological verification of the endometrium. The aim of the study was to determine the usefulness of the Pap test in assessing th...

  6. Transcript expression in endometrial cancers from Black and White patients.

    Science.gov (United States)

    Maxwell, G Larry; Allard, Jay; Gadisetti, Chandramouli V R; Litzi, Tracy; Casablanca, Yovanni; Chandran, Uma; Darcy, Kathleen M; Levine, Douglas A; Berchuck, Andrew; Hamilton, Chad A; Conrads, Thomas P; Risinger, John I

    2013-07-01

    Previous studies suggest that differences in molecular features of endometrial cancers between racial groups may contribute to the poorer survival in Blacks. The objective of this investigation was to determine whether gene expression among endometrial cancers is different between Blacks and Whites. Fresh frozen tumors from 25 Black patients were matched by stage, grade, and histology to endometrial cancer specimens from 25 White patients. Each case was macrodissected to produce specimens possessing a minimum of 75% cancer cellularity. A subset of 10 matched pairs was also prepared using laser microdissection (LMD) to produce specimens possessing a minimum of 95% cancer cells. Total RNA isolated from each sample was analyzed using the Affymetrix Human Genome U133 Plus 2.0 arrays. Data were analyzed using principal component analysis and binary class comparison analyses. Unsupervised analysis of the 50 endometrial cancers failed to identify global gene expression profiles unique to Black or White patients. In a subset analysis of 10 matched pairs from Blacks and Whites prepared using LMD and macrodissection, unsupervised analysis did not reveal a unique gene expression profile associated with race in either set, but associations were identified that relate to sample preparation technique, histology and stage. Our microarray data revealed no global gene expression differences and identified few individual gene differences between endometrial cancers from Blacks and Whites. More comprehensive methods of transcriptome analysis could uncover RNAs that may underpin the disparity of outcome or prevalence of endometrial cancers in Blacks and Whites. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Management of dysfunctional uterine bleeding based on endometrial thickness

    Directory of Open Access Journals (Sweden)

    Ozgul Muneyyirci-Delale

    2010-09-01

    Full Text Available Ozgul Muneyyirci-Delale1,2, Anuja Gupta1,2, Cynthia Abraham1, Ashadeep Chandrareddy1, Charles H Bowers Jr2, Jed B Cutler2Departments of Obstetrics and Gynecology, 1SUNY Downstate Medical Center, 2Kings County Hospital Center, Brooklyn, New York, USAObjective: To manage patients with dysfunctional uterine bleeding (DUB according to endometrial thickness.Methods: A retrospective chart review of 49 patients who reported 8 or more days of bleeding was performed. They were then divided into three groups based on endometrial thickness (mm: less than 6, 6–11, and greater than 11. These three groups were treated with combined oral contraceptive pills (OCP, conjugated estrogen plus progesterone and megestrol respectively. Patients given megestrol also underwent endometrial biopsy before treatment. Patients recorded the degree of bleeding each day for one month after starting treatment.Results: Mean endometrial thickness in the combined OCPs, conjugated estrogen plus progesterone and megestrol groups were 4, 8 and 14 mm, respectively. Combined OCPs decreased bleeding from 46 to 8 days (P < 0.05, n = 8. Conjugated estrogen plus progesterone decreased the number of days of bleeding from a mean of 41 to 9 (P < 0.01, n = 16. Megestrol decreased bleeding from 54 to 3 days (P < 0.001, n = 25. 52% of patients given megestrol had endometrial hyperplasia.Conclusion: These results support the effectiveness of treating patients with DUB according to endometrial thickness.Keywords: DUB, abnormal uterine bleeding, endometrium, hyperplasia, megestrol acetate

  8. Uterine carcinosarcoma and high-risk endometrial carcinomas: a clinicopathological comparison.

    Science.gov (United States)

    Zhang, Chuyao; Hu, Weiguo; Jia, Nan; Li, Qing; Hua, Keqin; Tao, Xiang; Wang, Li; Feng, Weiwei

    2015-05-01

    This retrospective study aimed to evaluate the clinicopathological characteristics of carcinosarcoma, grade 3 endometrial endometrioid carcinoma (G3EEC), uterine serous carcinoma (USC), and uterine clear cell adenocarcinoma (CC) to determine whether carcinosarcoma exhibited the same characteristics and outcomes as the other 3 high-risk endometrial cancers. A total of 358 patients recruited from the Obstetrics and Gynecology Hospital of Fudan University were included in this study; the cases included 44 carcinosarcomas, 118 G3EECs, 118 USCs, and 78 CCs. Kaplan-Meier and Cox proportional hazards models were used to analyze outcomes and prognostic factors. Uterine carcinosarcomas had significantly worse outcomes (overall survival, disease-specific survival, and recurrence-free survival) compared with G3EEC, USC, and CC (P Carcinosarcoma type was an independent factor, even stratified by stage. Eighty-three percent of recurred carcinosarcoma patients occurred within 1 year. Compared with USC and CC, patients with carcinosarcoma had a greater incidence of deep myometrial invasion (55.8%, P carcinosarcomas demonstrated a similar ER/P53 expression pattern as did USC and CC. However, all features were similar in carcinosarcoma and G3EEC patients, although the P53-positive rate was higher in carcinosarcoma patients compared with G3EEC patients (59.0% vs 38.5%, P = 0.037). For carcinosarcomas, a multivariate analysis showed that advanced stage (P = 0.006) was an independent prognostic factor for disease-specific survival. With regard to endometrioid-or-not epithelial and heterologous-or-homologous sarcomatous components, none of these components demonstrated apparent relationship with prognosis. Carcinosarcomas exhibited significantly poorer outcomes than did G3EECs, USCs, and CCs. Therefore, it seems reasonable to regard carcinosarcomas as a particular type among high-risk epithelial endometrial carcinomas.

  9. Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Mayumi; Matsuzaki, Kenji; Yoshida, Shusaku; Nishitani, Hiromu [University of Tokushima, Department of Radiology, Tokushima (Japan); Uehara, Hisanori [University of Tokushima, Department of Molecular and Environmental Pathology, Tokushima (Japan); Shimazu, Hideki [Oe Kyoudo Hospital, Department of Radiology (Japan)

    2005-11-01

    The endometrial cavity may demonstrate various imaging manifestations such as normal, reactive, inflammatory, and benign and malignant neoplasms. We evaluated usual and unusual magnetic resonance imaging (MRI) findings of the uterine endometrial cavity, and described the diagnostic clues to differential diagnoses. Surgically proven pathologies of the uterine endometrial cavity were evaluated retrospectively with pathologic correlation. The pathologies included benign endometrial neoplasms such as endometrial hyperplasia and polyp, malignant endometrial neoplasms such as endometrial carcinoma and carcinosarcoma, endometrial-myometrial neoplasm such as endometrial stromal sarcoma, pregnancy-related lesions in the endometrial cavity such as gestational trophoblastic diseases (hydatidiform mole, invasive mole and choriocarcinoma) and placental polyp, myometrial lesions simulating endometrial lesions such as submucosal leiomyoma and some adenomyosis, endometrial neoplasms simulating myometrial lesions such as adenomyomatous polyp and endometrial lesions arising in the hemicavity of a septate/bicornate uterus, and fluid collections in the uterine cavity (hydro/hemato/pyometra). It is important to recognize various imaging findings in these diseases, in order to make a correct preoperative diagnosis. (orig.)

  10. Is Tumor Size Really Important for Prediction of Lymphatic Dissemination in Grade 1 Endometrial Carcinoma With Superficial Myometrial Invasion?

    Science.gov (United States)

    Oz, Murat; Korkmaz, Vakkas; Meydanli, Mehmet Mutlu; Sari, Mustafa Erkan; Cuylan, Zeliha Firat; Gungor, Tayfun

    2017-09-01

    Selection of patients with endometrioid endometrial cancer (EEC), in whom systematic lymph node dissection (LND) is indicated, is an important part of management to maintain optimal oncological outcomes, while avoiding unnecessary morbidities. According to the current approach, LND is recommended for the patients with International Federation of Gynecology and Obstetrics (FIGO) grade 1 to 2 tumors and a primary tumor diameter (PTD) greater than 2 cm, even with myometrial invasion (MMI) of less than 50%. We aimed to determine incidence of LN metastasis in this particular group of patients with grade 1 tumors, superficial MMI, and a PTD greater than 2 cm. This study only focused on women with FIGO grade 1 EEC having less than 50% MMI. Therefore, women with grade 2 or 3 tumors were excluded, as well as patients with 50% or greater MMI. We also excluded women with macroscopic extrauterine disease, as well as patients with cervical stromal involvement. Patients were divided into subgroups with regard to PTD; group 1 was composed of patients with PTD of 20 mm or less, whereas group 2 was composed of patients with PTD greater than 20 mm. All clinical and pathological variables were compared between the groups. Final pathology reports of 484 women with EEC who underwent surgical staging were analyzed. Among these women, there were 123 women in group 1 (PTD ≤ 20 mm) and 120 women in group 2 (PTD > 20 mm), with FIGO grade 1 tumors and superficial MMI. The median number of total LNs removed was 54 (range, 20-151). There were no women with pelvic and/or para-aortic LN metastasis in group 2, as well as in group 1. Our results suggest that lymphadenectomy may be omitted in women with FIGO grade 1 EEC having superficial MMI regardless of PTD. Deferral of systematic LND in this subgroup of patients may lead to reductions in costs and surgical morbidity.

  11. Does risk of endometrial cancer for women without a germline mutation in a DNA mismatch repair gene depend on family history of endometrial cancer or colorectal cancer?

    Science.gov (United States)

    Bharati, Rajani; Jenkins, Mark A.; Lindor, Noralane M.; Marchand, Loïc Le; Gallinger, Steven; Haile, Robert W.; Newcomb, Polly A.; Hopper, John L.; Win, Aung Ko

    2014-01-01

    Objective To determine whether risk of endometrial cancer for women without a germline mutation in a DNA mismatch repair (MMR) gene depends on family history of endometrial or colorectal cancer. Methods We retrospectively followed a cohort of 79,166 women who were recruited to the Colon Cancer Family Registry, after exclusion of women who were relatives of a carrier of a MMR gene mutation. The Kaplan-Meier failure method was used to estimate the cumulative risk of endometrial cancer. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for association between family history of endometrial or colorectal cancer and risk of endometrial cancer. Results A total of 628 endometrial cancer cases were observed, with mean age at diagnosis of 54.4 (standard deviation 15.7) years. The cumulative risk of endometrial cancer to age 70 years was estimated to be 0.94% (95% CI 0.83–1.05) for women with no family history of endometrial cancer, and 3.80% (95% CI 2.75–4.98) for women with at least one first- or second-degree relative with endometrial cancer. Compared with women without family history, we found an increased risk of endometrial cancer for women with at least one first-or second-degree relative with endometrial cancer (HR 3.66, 95% CI 2.63–5.08), and for women with one first-degree relative with colorectal cancer diagnosed at age <50 years (HR 1.48, 95% CI 1.15–1.91). Conclusion An increased risk of endometrial cancer is associated with a family history of endometrial cancer or early-onset colorectal cancer for women without a MMR gene mutation; indicating for potential underlying genetic and environmental factors shared by colorectal and endometrial cancers other than caused by MMR gene mutations. PMID:24631449

  12. Regulation of tight junctions by sex hormones in normal human endometrial epithelial cells and uterus cancer cell line Sawano.

    Science.gov (United States)

    Someya, Masayuki; Kojima, Takashi; Ogawa, Marie; Ninomiya, Takafumi; Nomura, Kazuaki; Takasawa, Akira; Murata, Masaki; Tanaka, Satoshi; Saito, Tsuyoshi; Sawada, Norimasa

    2013-11-01

    The number of patients with uterine endometrial carcinoma, the cause of which involves sex hormones, has recently been growing rapidly because of increases in life expectancy and obesity. Tight junction proteins claudin-3 and -4 are receptors of Clostridium perfringens enterotoxin (CPE) and increase during endometrial carcinogenesis. In the present study of normal human endometrial epithelial (HEE) cells and the uterus cancer cell line Sawano, we investigate changes in the expression of tight junction proteins including claudin-3 and -4, the fence and barrier functions of the tight junction and the cytotoxic effects of CPE by sex hormones. In primary cultured HEE cells, treatment with progesterone (P4) but not estradiol (E2), induced claudin-1, -3, -4 and -7 and occludin, together with the downregulation of the barrier function but not the fence function. In Sawano cells, claudin-3 and -4 were upregulated by E2 but not by P4, together with a disruption of both the barrier and fence function. In primary cultured HEE cells, claudin-3 and -4 were localized at the apicalmost regions (tight junction areas) and no cytotoxicity of CPE was observed. In Sawano cells, claudin-3 and -4 were found not only in the apicalmost regions but also at the basolateral membrane and the cytotoxicity of CPE was enhanced by E2. Thus, tight junctions are physiological regulated by sex hormones in normal HEE cells during the menstrual cycle suggesting that safer and more effective therapeutic methods targeting claudins in uterine cancer can be developed.

  13. Clinical outcomes of image guided radiation therapy (IGRT) with gold fiducial vaginal cuff markers for high-risk endometrial cancer

    International Nuclear Information System (INIS)

    Monroe, Alan T.; Peddada, Anuj V.; Pikaart, Dirk

    2013-01-01

    Objective. To report two year clinical outcomes of image guided radiation therapy (IGRT) to the vaginal cuff and pelvic lymph nodes in a series of high-risk endometrial cancer patients. Methods . Twenty-six consecutive high-risk endometrial cancer patients requiring adjuvant radiation to the vaginal cuff and regional lymph nodes were treated with vaginal cuff fiducial-based IGRT. Seventeen (65%) received sequential chemotherapy, most commonly with a sandwich technique. Brachytherapy followed external radiation in 11 patients to a median dose of 18 Gy in 3 fractions. The median external beam dose delivered was 47.5 Gy in 25 fractions. Results. All 656 fractions were successfully imaged and treated. The median overall translational shift required for correction was 9.1 mm (standard deviation, 5.2 mm) relative to clinical set-up with skin tattoos. Shifts of 1 cm, 1.5 cm, and 2 cm or greater were performed in 43%, 14%, and 4% of patients, respectively. Acute grade 2 gastrointestinal (GI) toxicity occurred in eight patients (30%) and grade 3 toxicity occurred in one. At two years, there have been no local or regional failures and actuarial overall survival is 95%. Conclusion. Daily image guidance for high-risk endometrial cancer results in a low incidence of acute GI/genitourinary (GU) toxicity with uncompromised tumor control at two years. Vaginal cuff translations can be substantial and may possibly result in underdosing if not properly considered

  14. Clinical outcomes of image guided radiation therapy (IGRT) with gold fiducial vaginal cuff markers for high-risk endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Monroe, Alan T.; Peddada, Anuj V. [Dept. of Radiation Oncology, Penrose Cancer Center, Colorado Springs (United States); Pikaart, Dirk [Dept. of Gynecologic Oncology, Penrose Cancer Center, Colorado Springs (United States)

    2013-06-15

    Objective. To report two year clinical outcomes of image guided radiation therapy (IGRT) to the vaginal cuff and pelvic lymph nodes in a series of high-risk endometrial cancer patients. Methods . Twenty-six consecutive high-risk endometrial cancer patients requiring adjuvant radiation to the vaginal cuff and regional lymph nodes were treated with vaginal cuff fiducial-based IGRT. Seventeen (65%) received sequential chemotherapy, most commonly with a sandwich technique. Brachytherapy followed external radiation in 11 patients to a median dose of 18 Gy in 3 fractions. The median external beam dose delivered was 47.5 Gy in 25 fractions. Results. All 656 fractions were successfully imaged and treated. The median overall translational shift required for correction was 9.1 mm (standard deviation, 5.2 mm) relative to clinical set-up with skin tattoos. Shifts of 1 cm, 1.5 cm, and 2 cm or greater were performed in 43%, 14%, and 4% of patients, respectively. Acute grade 2 gastrointestinal (GI) toxicity occurred in eight patients (30%) and grade 3 toxicity occurred in one. At two years, there have been no local or regional failures and actuarial overall survival is 95%. Conclusion. Daily image guidance for high-risk endometrial cancer results in a low incidence of acute GI/genitourinary (GU) toxicity with uncompromised tumor control at two years. Vaginal cuff translations can be substantial and may possibly result in underdosing if not properly considered.

  15. Accuracy of preoperative tumor grade and intraoperative gross examination of myometrial invasion in patients with endometrial cancer

    DEFF Research Database (Denmark)

    Traen, Koen; Hølund, Berit; Mogensen, Ole

    2007-01-01

    BACKGROUND AND AIMS: Preoperative prediction of metastases to the regional lymph nodes in women with endometrioid endometrial cancer is a challenge. According to the Danish Gynaecological Cancer Society guidelines, a pelvic lymphadenectomy is warranted in all poorly differentiated tumors and all...... registered in 72 women with stage I endometrioid endometrial cancer, operated between 1 September 2004 and 18 April 2006. The pre- and intraoperative findings were compared with the final pathology report. RESULTS: The preoperative prediction of grade (well, moderate or poorly differentiated) was correct...... in 11% (8/72) of the patients. Three 'unnecessary' lymphadenectomies were performed, and 5 patients were primary operated upon without 'warranted' lymphadenectomy. CONCLUSIONS: Our data suggest that preoperative tumor grade and intraoperative gross examination of the uterus provide useful information...

  16. Exercise Programme in Endometrial Cancer; Protocol of the Feasibility and Acceptability Survivorship Trial (EPEC-FAST)

    NARCIS (Netherlands)

    Smits, A.; Lopes, A.; Das, N.; Bekkers, R.L.M.; Massuger, L.F.; Galaal, K.

    2015-01-01

    INTRODUCTION: Obesity has been associated with impaired quality of life and poorer outcomes in endometrial cancer survivors. Lifestyle interventions promoting exercise and weight reduction have been proposed for survivorship care. However, studies evaluating exercise programmes for endometrial

  17. Long-term impact of preeclampsia on maternal endometrial cancer risk

    DEFF Research Database (Denmark)

    Hallum, Sara; Pinborg, Anja; Kamper-Jørgensen, Mads

    2016-01-01

    1978-2010. The association between preeclampsia and later endometrial cancer was evaluated overall and according to preeclampsia onset and type of endometrial cancer in conditional logistic regression models. RESULTS: We observed no overall association between preeclampsia and endometrial cancer risk......BACKGROUND: Endometrial cancer is mainly dependent on oestrogen exposure. Preeclampsia has shown to reduce oestrogen levels hence preeclampsia may affect later endometrial cancer risk. METHODS: We conducted a case-control study of 523 Danish women with endometrial cancer and 52 299controls during...... (OR=1.11 (95% CI 0.68-1.81)). This was true for all endometrial cancer subtypes. In an analysis of preeclampsia onset, however, we report a markedly increased risk of endometrial cancer following early-onset preeclampsia (OR=2.64 (95% CI 1.29-5.38)). CONCLUSIONS: Although we report no obvious...

  18. Differentiation of the endometrial macrophage during pregnancy in the cow.

    Directory of Open Access Journals (Sweden)

    Lilian J Oliveira

    Full Text Available BACKGROUND: The presence of conceptus alloantigens necessitates changes in maternal immune function. One player in this process may be the macrophage. In the cow, there is large-scale recruitment of macrophages expressing CD68 and CD14 to the uterine endometrium during pregnancy. METHODOLOGY/PRINCIPAL FINDINGS: In the present study, the function of endometrial macrophages during pregnancy was inferred by comparison of the transcriptome of endometrial CD14(+ cells isolated from pregnant cows as compared to that of blood CD14(+ cells. The pattern of gene expression was largely similar for CD14(+ cells from both sources, suggesting that cells from both tissues are from the monocyte/macrophage lineage. A total of 1,364 unique genes were differentially expressed, with 680 genes upregulated in endometrial CD14(+ cells as compared to blood CD14(+ cells and with 674 genes downregulated in endometrial CD14(+ cells as compared to blood CD14(+ cells. Twelve genes characteristic of M2 activated macrophages (SLCO2B1, GATM, MRC1, ALDH1A1, PTGS1, RNASE6, CLEC7A, DPEP2, CD163, CCL22, CCL24, and CDH1 were upregulated in endometrial CD14(+ cells. M2 macrophages play roles in immune regulation, tissue remodeling, angiogenesis and apoptosis. Consistent with a role in tissue remodeling, there was over-representation of differentially expressed genes in endometrium for three ontologies related to proteolysis. A role in apoptosis is suggested by the observation that the most overrepresented gene in endometrial CD14(+ cells was GZMA. CONCLUSIONS: Results indicate that at least a subpopulation of endometrial macrophages cells differentiates along an M2 activation pathway during pregnancy and that the cells are likely to play roles in immune regulation, tissue remodeling, angiogenesis, and apoptosis.

  19. Curcumin inhibits endometriosis endometrial cells by reducing estradiol production.

    Science.gov (United States)

    Zhang, Ying; Cao, Hong; Yu, Zheng; Peng, Hai-Ying; Zhang, Chang-Jun

    2013-05-01

    Endometriosis is a complex estrogen-dependent disease that is defined as the presence of endometrial gland and stroma outside the uterine cavity. Although the exact mechanism for the development of endometriosis remains unclear, there is a large body of research data and circumstantial evidence that suggests a crucial role of estrogen in the establishment and maintenance of this disease. This study is an attempt to assess the effect of curcumin on inhibiting endometriosis endometrial cells and to investigate whether such an effect is mediated by reducing estradiol production. Endometriotic stromal cells, normal endometrial stromal cells, endometriotic epithelial cells and normal endometrial epithelial cells were isolated and cultured. E2 value of cells and the effect of curcumin on cell proliferation were evaluated. Finally, effect of curcumin on E2 assay was detected. Electrochemiluminescence immunoassay results showed that E2 value of endometriotic epithelial cells was higher than the endometriotic stromal cells (p=0.037), while the expression of E2 in normal endometrial stromal and epithelial cells was extremely low. WST-8 result showed, compared with endometrial stromal cells, ectopic endometriotic stromal cells had a higher growth rate. After intervene with curcumin (10μmol/L, 30μmol/L and 50μmol/L) for 0-96h, the number of endometriotic stromal cells was reduced and cells growth slowed, compared with 0μmol/L group. Compared with 0μmol/L group, E2 level was lower after treatment with curcumin, especially in 30μmol/L and 50μmol/L group. In summary, in this study we found that E2 is important in ectopic endometrium, and epithelial cell is in dominant position with E2 secretion. Curcumin was able to suppress the proliferation of endometrial cells by reducing the E2 value.

  20. Prognostic significance of miR-205 in endometrial cancer.

    Directory of Open Access Journals (Sweden)

    Mihriban Karaayvaz

    Full Text Available microRNAs have emerged as key regulators of gene expression, and their altered expression has been associated with tumorigenesis and tumor progression. Thus, microRNAs have potential as both cancer biomarkers and/or potential novel therapeutic targets. Although accumulating evidence suggests the role of aberrant microRNA expression in endometrial carcinogenesis, there are still limited data available about the prognostic significance of microRNAs in endometrial cancer. The goal of this study is to investigate the prognostic value of selected key microRNAs in endometrial cancer by the analysis of archival formalin-fixed paraffin-embedded tissues.Total RNAs were extracted from 48 paired normal and endometrial tumor specimens using Trizol based approach. The expression of miR-26a, let-7g, miR-21, miR-181b, miR-200c, miR-192, miR-215, miR-200c, and miR-205 were quantified by real time qRT-PCR expression analysis. Targets of the differentially expressed miRNAs were quantified using immunohistochemistry. Statistical analysis was performed by GraphPad Prism 5.0.The expression levels of miR-200c (P<0.0001 and miR-205 (P<0.0001 were significantly increased in endometrial tumors compared to normal tissues. Kaplan-Meier survival analysis revealed that high levels of miR-205 expression were associated with poor patient overall survival (hazard ratio, 0.377; Logrank test, P = 0.028. Furthermore, decreased expression of a miR-205 target PTEN was detected in endometrial cancer tissues compared to normal tissues.miR-205 holds a unique potential as a prognostic biomarker in endometrial cancer.

  1. p16 is Consistently Expressed in Endometrial Tubal Metaplasia

    Directory of Open Access Journals (Sweden)

    N. Horree

    2007-01-01

    Full Text Available Background: Cell cycle proteins and HIF-1α with downstream factors are often abberrantly expressed in (preneoplastic tissue. Methods: Paraffin-embedded specimens of inactive endometrium with TM (n=15, ovarian inclusion cysts (n=6, cervix with TM (tubal metaplasia (n=3, Fallopian tubes (n=7, cycling endometrium (n=9 and a ciliated cell tumor of the ovary were stained for p16 and LhS28. 39 Endometrioid endometrial carcinomas and 5 serous endometrial carcinomas were stained for p16. Additionally, inactive endometrium (n=15 was immunohistochemically stained for p21, p27, p53, cyclin A, cyclin D1, cyclin E, HIF-1α, CAIX, Glut-1 and MIB-1. Results: A mosaic pattern of expression of p16 was seen throughout in all cases of endometrial TM (15/15, in 2/6 of the ovarian inclusion cysts with TM, in all (3/3 cervical TM and focal in 5/7 of Fallopian tube cases. Mosaic expression was also seen in a ciliated cell tumor of the ovary and in 18/39 of endometrioid endometrial carcinomas, and diffuse p16 expression was seen in 5/5 serous carcinomas. In comparison with normal endometrium, TM areas in the endometrium showed significantly increased expression of HIF-1α, cyclin E, p21 and cyclin A, and decreased expression of p27. Membranous expression of CAIX and Glut-1 was only seen in TM areas, pointing to functional HIF-1α. Conclusion: As p16 is consistently expressed in TM, less and only patchy expressed in the normal Fallopian tube, is paralleled by aberrant expression of cell cycle proteins, HIF-1α, CAIX and Glut-1 and resembles the pattern of p16 expression frequently seen in endometrial carcinomas, we propose endometrial TM to be a potential premalignant endometrial lesion.

  2. 18F-FDG PET in the management of endometrial cancer

    International Nuclear Information System (INIS)

    Chao, Angel; Chang, Ting-Chang; Huang, Huei-Jean; Chou, Hung-Hsueh; Wu, Tzu-I; Ng, Koon-Kwan; Hsueh, Swei; Tsai, Chien-Sheng; Yen, Tzu-Chen; Lai, Chyong-Huey

    2006-01-01

    Few studies have investigated the clinical impact of whole-body positron emission tomography (PET) with 18 F-fluorodeoxyglucose (FDG) in endometrial cancer. We aimed to assess the value of integrating FDG-PET into the management of endometrial cancer in comparison with conventional imaging alone. All patients with histologically confirmed primary advanced (stage III/IV) or suspicious/documented recurrent endometrial cancer, with poor prognostic features (serum CA-125 >35 U/ml or unfavourable cell types), or surveillance after salvage therapy were eligible. Before FDG-PET scanning, each patient had received magnetic resonance imaging and/or computed tomography (MRI-CT). The receiver operating characteristic curve method with calculation of the area under the curve (AUC) was used to compare the diagnostic efficacy. Clinical impacts were determined on a scan basis. Forty-nine eligible patients were accrued and 60 studies were performed (27 primary staging, 33 post-therapy surveillance or restaging on relapse). The clinical impact was positive in 29 (48.3%) of the 60 scans. Mean standardised uptake values (SUVs) of true-positive lesions were 13.2 (range 5.7-37.4) for central pelvic lesions and 11.1 (range 1.5-37.4) for metastases. The sensitivity of FDG-PET alone (P<0.0001) or FDG-PET plus MRI-CT (P<0.0001) was significantly higher than that of MRI-CT alone in overall lesion detection. FDG-PET plus MRI-CT was significantly superior to MRI-CT alone in overall lesion detection (AUC 0.949 vs 0.872; P=0.004), detection of pelvic nodal/soft tissue metastases (P=0.048) and detection of extrapelvic metastases (P=0.010), while FDG-PET alone was only marginally superior by AUC (P=0.063). Whole-body FDG-PET coupled with MRI-CT facilitated optimal management of endometrial cancer in well-selected cases. (orig.)

  3. Surgical outcome of robotic surgery in morbidly obese patient with endometrial cancer compared to laparotomy.

    Science.gov (United States)

    Bernardini, Marcus Q; Gien, Lilian T; Tipping, Helen; Murphy, Joan; Rosen, Barry P

    2012-01-01

    Before the introduction of robotic surgery at our institution, most obese women of class 2 or greater (body mass index [BMI] >35) underwent a laparotomy for the management of endometrial cancer. Since November 2008, we have performed most of these cases in a robotic fashion. This manuscript presents the outcome of these women in comparison with a historical cohort of women treated with laparotomy. Women with clinical stage I or II endometrial cancer and a BMI greater than 35 kg/m treated with robotic surgery at our institution between November 2008 and November 2010 were compared with a historical cohort of similar patients who underwent laparotomy. Patients' characteristics, operating room time, type of surgery, length of hospital stay, and incidence of perioperative complications were compared between the 2 groups. A total of 86 women were analyzed in this study (robotic surgery, 45; laparotomy, 41). The overall intraoperative complication rate is 5.8%. There is no statistical difference in age, number of comorbidities, BMI, prior abdominal surgery, and operative complications between the women who underwent robotic surgery versus laparotomy. Postoperative complication rates are higher in the laparotomy group (44% vs 17.7%; P = 0.007), and hospital length of stay is also higher in the laparotomy group (4 vs 2 days; P surgery group. Robotic surgery for the surgical management of the morbidly obese patient is shown to be safe and have less perioperative complications compared with open surgery.

  4. Stage II endometrial carcinoma. Results and complications of a combined radiotherapeutic-surgical approach

    International Nuclear Information System (INIS)

    Larson, D.M.; Copeland, L.J.; Gallager, H.S.; Kong, J.P.; Wharton, J.T.; Stringer, C.A.

    1988-01-01

    Since one third of the patients with Stage II endometrial carcinoma have occult extrauterine pelvic metastases at diagnosis, adequate treatment must include the pelvic lymph nodes and parametria. Eighty-three patients with Stage II endometrial carcinoma were treated between January 1964 and December 1983. Sixty-nine patients (83%) received combined whole-pelvic irradiation and surgery, five (6%) had surgery alone and nine (11%) had radiotherapy alone. Five-year actuarial survival rates were 67%, 60%, and 38%, respectively. No pelvic recurrence occurred in the 69 patients who received the combined therapy, and there was no vaginal recurrence in the 80 patients treated with intracavity radium. There was a significantly lower incidence of pelvic lymph node metastases (P = 0.03) in patients treated with preoperative irradiation. The median time to recurrence was 17 months, with 67% of the recurrences diagnosed before 2 years, and 88% within 5 years. Ten patients (12%) incurred severe complications and three died as a result. Whole-pelvic irradiation, intracavity radium, and hysterectomy are effective treatment for occult pelvic and vaginal disease

  5. The effects of age and comorbidity on treatment and outcomes in women with endometrial cancer.

    Science.gov (United States)

    Truong, Pauline T; Kader, Hosam A; Lacy, Barbara; Lesperance, Mary; MacNeil, Mary V; Berthelet, Eric; McMurtrie, Elissa; Alexander, Skaria

    2005-04-01

    Although the incidence of endometrial cancer increases with age, the effect of patient age on treatment selection and outcomes is unclear. In addition, although aging is associated with increased prevalence of comorbid conditions, the extent to which comorbidities influence endometrial cancer management is not well documented. This population-based analysis evaluates the effect of age and comorbidity on endometrial cancer treatment and outcome in a cohort of 401 patients referred to the Vancouver Island Centre, British Columbia Cancer Agency from 1989 to 1996. Treatment and 5-year actuarial overall survival (OS) and disease-free survival (DFS) were compared by age at diagnosis ( or =75 years) and comorbidity index (Charlson score 0-1 and > or =2). Median follow-up time was 7.8 years. In this cohort, 148 (37%), 152 (38%), and 101 (25%) were aged or =75 years, respectively. Charlson comorbidity scores > or =2 were found in 18% of patients. Distributions of disease stage, tumor characteristics, and surgical therapy were similar across age and comorbidity subgroups. Standard surgery in this cohort comprised hysterectomy without routine lymphadenectomy. In stage Ic disease, the use of postoperative RT declined with advanced age (96%, 97%, and 74% in patients aged or =75 years, respectively, P = 0.05) and with increased comorbidities (91% and 79% in patients with Charlson score 0-1 and > or =2, respectively, P = 0.07). Among stage Ic patients aged > or =75 years, pelvic/vaginal relapse occurred in 2 of 6 patients treated with hysterectomy alone compared with 0 of 20 patients treated with postoperative radiotherapy (P = 0.006). On multivariable Cox modeling, age at diagnosis, performance status, stage, grade, lymphovascular invasion, surgery, and radiotherapy use, but not Charlson comorbidity score, were significant predictors for overall survival. Although surgical therapy for endometrial cancer was not influenced by age or comorbidities, reduced use of postoperative

  6. Coordinated Role of Toll-Like Receptor-3 and Retinoic Acid-Inducible Gene-I in the Innate Response of Bovine Endometrial Cells to Virus

    Directory of Open Access Journals (Sweden)

    Luisa C. Carneiro

    2017-08-01

    Full Text Available Bovine herpesvirus-4 (BoHV-4 and bovine viral diarrhea virus (BVDV infect the uterus of cattle, often resulting in reduced fertility, or abortion of the fetus, respectively. Here, exposure of primary bovine endometrial cells to BoHV-4 or BVDV modulated the production of inflammatory mediators. Viral pathogen-associated molecular patterns (PAMPs are detected via pattern-recognition receptors (PRRs. However, the relative contribution of specific PRRs to innate immunity, during viral infection of the uterus, is unclear. Endometrial epithelial and stromal cells constitutively express the PRR Toll-like receptor (TLR-3, but, the status of retinoic acid-inducible gene I (RIG-I, a sensor of cytosolic nucleic acids, is unknown. Primary endometrial epithelial and stromal cells had low expression of RIG-I, which was increased in stromal cells after 12 h transfection with the TLR3 ligand Poly(I:C, a synthetic analog of double-stranded RNA. Furthermore, short interfering RNA targeting TLR3, or interferon (IFN regulatory transcription factor 3, an inducer of type I IFN transcription, reduced Poly(I:C-induced RIG-I protein expression and reduced inflammatory mediator secretion from stromal cells. We conclude that antiviral defense of endometrial stromal cells requires coordinated recognition of PAMPs, initially via TLR3 and later via inducible RIG-I.

  7. Body Mass Index Genetic Risk Score and Endometrial Cancer Risk.

    Directory of Open Access Journals (Sweden)

    Jennifer Prescott

    Full Text Available Genome-wide association studies (GWAS have identified common variants that predispose individuals to a higher body mass index (BMI, an independent risk factor for endometrial cancer. Composite genotype risk scores (GRS based on the joint effect of published BMI risk loci were used to explore whether endometrial cancer shares a genetic background with obesity. Genotype and risk factor data were available on 3,376 endometrial cancer case and 3,867 control participants of European ancestry from the Epidemiology of Endometrial Cancer Consortium GWAS. A BMI GRS was calculated by summing the number of BMI risk alleles at 97 independent loci. For exploratory analyses, additional GRSs were based on subsets of risk loci within putative etiologic BMI pathways. The BMI GRS was statistically significantly associated with endometrial cancer risk (P = 0.002. For every 10 BMI risk alleles a woman had a 13% increased endometrial cancer risk (95% CI: 4%, 22%. However, after adjusting for BMI, the BMI GRS was no longer associated with risk (per 10 BMI risk alleles OR = 0.99, 95% CI: 0.91, 1.07; P = 0.78. Heterogeneity by BMI did not reach statistical significance (P = 0.06, and no effect modification was noted by age, GWAS Stage, study design or between studies (P≥0.58. In exploratory analyses, the GRS defined by variants at loci containing monogenic obesity syndrome genes was associated with reduced endometrial cancer risk independent of BMI (per BMI risk allele OR = 0.92, 95% CI: 0.88, 0.96; P = 2.1 x 10-5. Possessing a large number of BMI risk alleles does not increase endometrial cancer risk above that conferred by excess body weight among women of European descent. Thus, the GRS based on all current established BMI loci does not provide added value independent of BMI. Future studies are required to validate the unexpected observed relation between monogenic obesity syndrome genetic variants and endometrial cancer risk.

  8. Treatment and clinical behavior of endometrial endometrioid adenocarcinoma

    International Nuclear Information System (INIS)

    Katabuchi, Hidetaka; Suenaga, Yoshito; Okamura, Hitoshi

    2001-01-01

    Cases of endometrial carcinoma treated in a university hospital between 1986 and 1998 were analyzed. More specifically, cases of endometrial carcinoma treated at Kumamoto University Hospital during the past 13 years were analyzed in terms of additional treatment given as adjuvant therapy after surgery. Among the total of 175 cases of endometrial carcinoma, surgery was the primary treatment modality in 173 (98.9%) and the other 2 (1.1%) were treated by chemotherapy and/or radiotherapy without surgery. Of the 173 surgical cases, 158 (91.4%) were cases of endometrioid adenocarcinoma, and after excluding the cases of double cancer, the remaining 147 cases were included in the analysis. At Kumamoto University hospital, radical hysterectomy and pelvic lymphadenectomy have been performed in cases in which cervical invasion is indicated by hysteroscopy and/or MRI, invasion of the muscle coat of the uterus appears on MRI images, and in which carcinoma with specific histology (e.g., serous adenocarcinoma) or anaplastic endometrioid adenocarcinoma is seen. Semi-radical hysterectomy and pelvic lymphadenectomy have been considered to be indicated in all other cases. Adjuvant chemotherapy and radiotherapy after surgery has been indicated for cases in which invasion of the muscle coat of the uterus is to a depth of more than half its thickness, stromal invasion of the cervix is seen, or invasion of the serosa or metastasis to the uterine adnexae or lymph nodes is seen. Patients were externally irradiated with a dose of 50 Gy to the whole pelvis as adjuvant radiotherapy. The follow-up period ranged from 4 to 148 months. Of the 147 cases, 105 (71.4%) were treated by hysterectomy alone and the other 42 received adjuvant therapy (chemotherapy in 27 cases, radiotherapy in 15 cases). All stage Ia patients (16 cases) survived, and none were given additional therapy. Only 4.8% of the stage Ib cases (62) and 7.1% of the stage 2a cases (14) received adjuvant therapy, and no recurrences

  9. Endometrial stromal tumors with sex cord-like elements: a case report

    African Journals Online (AJOL)

    Endometrial stromal nodules are rare. They represent less than a quarter of endometrial stromal tumors. Clement and Scully described as variants of endometrial stromal nodules two types of tumor ressembling ovarian sex cord tumors. Type I is tumor that resembles focally an ovarian sex cord tumor which can be ...

  10. New classification system of endometrial hyperplasia WHO 2014 and its clinical implications

    Directory of Open Access Journals (Sweden)

    Katarzyna Sobczuk

    2017-10-01

    Full Text Available Endometrial hyperplasia (EH is a pathological condition characterised by hyperplastic changes in endometrial glandular and stromal structures lining the uterine cavity. Endometrial hyperplasia, particularly with atypia, is a significant clinical concern because it can be a precursor of endometrial cancer. Accurate diagnosis of precancerous lesions of the endometrium and exclusion of coexisting endometrial carcinomas are absolutely required for the optimal management of patients. The classification of endometrial hyperplasia has had numerous terminology. According to the classification of WHO94, based on glandular complexity and nuclear atypia, EH is divided into four groups: non-atypical endometrial hyperplasia (simple, complex and atypical endometrial hyperplasia (simple, complex. Estimated risk of progression of atypical hyperplasia to endometrial cancer is 8-29%. The American College of Obstetricians and Gynaecologists and the Society of Gynaecological Oncology states that endometrial intraepithelial neoplasia (EIN classification is superior to the World Health Organisation (WHO 94 classification for histology of endometrial hyperplasia. However, the WHO classification system remains the most commonly used and reported in existing literature. The new classification, WHO 2014, accepted by the International Society of Gynaecological Pathologists, divided hyperplasia into two groups: benign hyperplasia and atypical hyperplasia/endometrial intraepithelial neoplasia (EIN. The WHO 2014 schema is more likely to successfully identify precancerous lesions than the WHO94 classification.

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  15. Is aromatase cytochrome P450 involved in the pathogenesis of endometrioid endometrial cancer?

    NARCIS (Netherlands)

    Jongen, VHWM; Thijssen, JHH; Hollema, H; Donker, GH; Santema, JG; Van Der Zee, AGJ; Heineman, MJ

    2005-01-01

    Prospectively, the relationship between androgen levels in the utero-ovarian circulation, aromatase activity in endometrial and body fat tissue, and the presence or absence of endometrioid endometrial cancer was studied in postmenopausal women. In 43 women with endometrioid endometrial cancer and 8

  16. Role of positron emission tomography-computed tomography in endometrial cancer

    Science.gov (United States)

    Erdemoğlu, Evrim; Çerçi, Sevim Süreyya; Erdemoğlu, Ebru; Yalçın, Yakup; Tatar, Burak

    2017-01-01

    Objective: The efficacy of preoperative 18F-fluoro-D-glucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) in endometrium cancer is controversial. We examined the efficacy of PET-CT and the association between maximum standardized uptake value (SUVmax) and prognostic factors in endometrial cancer. Materials and Methods: Thirty patients with endometrial cancer underwent preoperative 18F-FDG/PET-CT. The patients were treated with abdominal hysterectomy with bilateral salpingo-oophorectomy, and bilateral systemic pelvic lymphadenectomy was planned for all patients; paraaortic lymphadenectomy was performed in patients with intermediate and high risk. Tumor histology, grade, depth of myometrial invasion, maximum tumor diameter, lymphovascular invasion, nodal status, and ovarian/adnexal metastases were recorded. Results: The mean primary tumor diameter was reported smaller in PET-CT and the effect size of PET-CT was -0.60. The kappa value was 0.06 for myometrial invasion. Pelvic lymph node metastasis was reported in 22.2% of patients in PET-CT. However, 3.7% of patients had pelvic lymph node metastasis. The kappa value for pelvic lymph node metastasis was 0.23, and sensitivity, specificity, and positive and negative predictive values were 100%, 80.7%, 16.6%, and 100%, respectively. Paraaortic lymph node metastasis in PET-CT was suspected in 10%. However, paraaortic lymph node metastasis was found in 6.7% in histopathologic analyses. The kappa value was 0.15. The sensitivity, specificity, and positive and negative predictive values of PET-CT for detecting paraaortic lymph node metastases were 100%, 93.7%, 66.6%, and 100%, respectively. Myometrial invasion and tumor diameter were the only important prognostic factors affecting SUVmax. Conclusion: According to our results, PET-CT has a limited role and diagnostic efficacy in endometrial cancer. The indications of FDG/PET-CT in endometrium cancer should be studied further and revised. PMID:29379661

  17. Inhibitory effect of curcumin in human endometriosis endometrial cells via downregulation of vascular endothelial growth factor.

    Science.gov (United States)

    Cao, Hong; Wei, Yu-Xi; Zhou, Qi; Zhang, Ying; Guo, Xiao-Peng; Zhang, Jun

    2017-10-01

    Endometriosis, which affects up to 10% of women of reproductive age, is defined as endometrial-like gland and stroma tissue growths outside the uterine cavity. Despite increasing research efforts, there are no current effective treatment methods for this disease, therefore investigations for therapeutic strategies are of primary concern. In preliminary work, the authors demonstrated that curcumin inhibits endometriosis in vivo. The present in vitro study aimed to investigate the association between endometriotic stromal cells and curcumin and to clarify the underlying mechanism of action. A total of 14 patients with endometriosis were enrolled in the present study. The purity of endometrial stromal cell cultures was proven by standard immunofluorescent staining of vimentin. The cell proliferation and curcumin effects on endometrial stromal cells were assessed by the MTT assay and Hematoxylin and Eosin staining. For cell cycle analysis, phase distribution was detected by flow cytometry. Vascular endothelial growth factor (VEGF) protein expression was examined using immunohistochemistry staining. Apoptosis was assessed using Annexin V‑fluorescein isothiocyanate staining. The results indicated that the treatment of curcumin decreased human ectopic and eutopic stromal cell growth. Following treatment with curcumin, human endometriotic stromal cells demonstrated an increased percentage of G1‑phase cells and decreased percentages of S‑phase cells, particularly in the group treated with 50 µmol/l curcumin. Treatment with curcumin additionally decreased expression of VEGF. The data provide evidence that curcumin reduces cell survival in human endometriotic stromal cells, and this may be mediated via downregulation of the VEGF signaling pathway.

  18. A cohort study evaluating robotic versus laparotomy surgical outcomes of obese women with endometrial carcinoma.

    Science.gov (United States)

    Subramaniam, Akila; Kim, Kenneth H; Bryant, Shannon A; Zhang, Bin; Sikes, Christa; Kimball, Kristopher J; Kilgore, Larry C; Huh, Warner K; Straughn, John M; Alvarez, Ronald D

    2011-09-01

    Minimally invasive surgery offers advantages for management of obese patients, but technical difficulty often deters its utilization. Compared to laparotomy, robotic surgery should allow comparable staging and improved surgical outcomes. Therefore, we evaluated outcomes in robotic and laparotomy cohorts of obese women with endometrial cancer at our institution. Retrospective robotic and laparotomy cohorts of obese women (BMI ≥ 30 kg/m(2)) undergoing surgical management of primary endometrial cancer from March 2006 to March 2009 were formulated utilizing a computerized database. Patient demographics, operative statistics, peri-operative complications, and pathologic details were collected in an intent to treat analysis. Chi-square or Fisher's exact test and t-test were used for statistical analysis. 73 women underwent robotic surgical management, 11% converted to laparotomy. Mean BMI (39.8 vs. 41.9, p=0.152), number of co-morbidities (2.49 vs. 2.62, p=0.690), number of previous surgeries (0.97 vs. 0.94, p=0.841), and lymphadenectomies performed (65.8% vs. 56.7%, p=0.227) were similar between cohorts. Total lymph nodes obtained were not statistically different between cohorts (8.01 vs. 7.24, p=0.505). Total operative time and room time was significantly longer for robotic surgery; however, estimated blood loss, the percentage of patients receiving transfusion, hospital length of stay, wound complications (4.1% vs. 20.2%, p=0.002) and other complications (9.6% vs. 29.8%, p=0.001) were improved for the robotic cohort. Robotic management of obese women with endometrial cancer yields acceptable staging results and improved surgical outcomes. Although operating time is longer, hospital time is shorter. Robotic surgery may be an ideal approach for these patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Histopathological pattern of abnormal uterine bleeding in endometrial biopsies.

    Science.gov (United States)

    Vaidya, S; Lakhey, M; Vaidya, S; Sharma, P K; Hirachand, S; Lama, S; KC, S

    2013-03-01

    Abnormal uterine bleeding is a common presenting complaint in gyanecology out patient department. Histopathological evaluation of the endometrial samples plays a significant role in the diagnosis of abnormal uterine bleeding. This study was carried out to determine the histopathological pattern of the endometrium in women of various age groups presenting with abnormal uterine bleeding. Endometrial biopsies and curettings of patients presenting with abnormal uterine bleeding was retrospectively studied. A total of 403 endometrial biopsies and curettings were analyzed. The age of the patients ranged from 18 to 70 years. Normal cyclical endometrium was seen in 165 (40.94%) cases, followed by 54 (13.40%) cases of disordered proliferative endometrium and 44 (10.92%) cases of hyperplasia. Malignancy was seen in 10 (2.48%) cases. Hyperplasia and malignancy were more common in the perimenopausal and postmenopausal age groups. Histopathological examination of endometrial biopsies and curettings in patients presenting with abnormal uterine bleeding showed a wide spectrum of changes ranging from normal endometrium to malignancy. Endometrial evaluation is specially recommended in women of perimenopausal and postmenopausal age groups presenting with AUB, to rule out a possibility of any preneoplastic condition or malignancy.

  20. Endometrial scratching in women with implantation failure after a first IVF/ICSI cycle; does it lead to a higher live birth rate? The SCRaTCH study: a randomized controlled trial (NTR 5342).

    Science.gov (United States)

    van Hoogenhuijze, N E; Torrance, H L; Mol, F; Laven, J S E; Scheenjes, E; Traas, M A F; Janssen, C; Cohlen, B; Teklenburg, G; de Bruin, J P; van Oppenraaij, R; Maas, J W M; Moll, E; Fleischer, K; van Hooff, M H; de Koning, C; Cantineau, A; Lambalk, C B; Verberg, M; Nijs, M; Manger, A P; van Rumste, M; van der Voet, L F; Preys-Bosman, A; Visser, J; Brinkhuis, E; den Hartog, J E; Sluijmer, A; Jansen, F W; Hermes, W; Bandell, M L; Pelinck, M J; van Disseldorp, J; van Wely, M; Smeenk, J; Pieterse, Q D; Boxmeer, J C; Groenewoud, E R; Eijkemans, M J C; Kasius, J C; Broekmans, F J M

    2017-07-21

    Success rates of assisted reproductive techniques (ART) are approximately 30%, with the most important limiting factor being embryo implantation. Mechanical endometrial injury, also called 'scratching', has been proposed to positively affect the chance of implantation after embryo transfer, but the currently available evidence is not yet conclusive. The primary aim of this study is to determine the effect of endometrial scratching prior to a second fresh in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle on live birth rates in women with a failed first IVF/ICSI cycle. Multicenter randomized controlled trial in Dutch academic and non-academic hospitals. A total of 900 women will be included of whom half will undergo an endometrial scratch in the luteal phase of the cycle prior to controlled ovarian hyperstimulation using an endometrial biopsy catheter. The primary endpoint is the live birth rate after the 2 nd fresh IVF/ICSI cycle. Secondary endpoints are costs, cumulative live birth rate (after the full 2 nd IVF/ICSI cycle and over 12 months of follow-up); clinical and ongoing pregnancy rate; multiple pregnancy rate; miscarriage rate and endometrial tissue parameters associated with implantation failure. Multiple studies have been performed to investigate the effect of endometrial scratching on live birth rates in women undergoing IVF/ICSI cycles. Due to heterogeneity in both the method and population being scratched, it remains unclear which group of women will benefit from the procedure. The SCRaTCH trial proposed here aims to investigate the effect of endometrial scratching prior to controlled ovarian hyperstimulation in a large group of women undergoing a second IVF/ICSI cycle. NTR 5342 , registered July 31 st , 2015. Version 4.10, January 4th, 2017.

  1. GLUT-1 Expression in Proliferative Endometrium, Endometrial Hyperplasia, Endometrial Adenocarcinoma and the Relationship Between GLUT-1 Expression and Prognostic Parameters in Endometrial Adenocarcinoma.

    Science.gov (United States)

    Canpolat, Tuba; Ersöz, Canan; Uğuz, Aysun; Vardar, Mehmet Ali; Altintaş, Aytekin

    2016-01-01

    Malignant cells show increased glucose uptake in in vitro and in vivo studies. This uptake is mediated by glucose transporter proteins. GLUT-1 is the most common transporter protein, and its expression is reported to be increase in many human cancers. The aim of this study is to determine the GLUT-1 overexpression in benign, hyperplastic, and malignant endometrial tissues, to evaluate the usefulness of GLUT-1 expression in endometrial hyperplasia, and to determine its role in the neoplastic progression to endometrioid type adenocarcinoma. We also aimed to analyze prognostic clinical parameters, predict prognosis, and survival. We examined immunohistochemical expression of GLUT-1 in 91 cases of endometrial hyperplasia, 100 cases of endometrioid type adenocarcinoma, and 10 proliferative endometrial tissues. The percentage of positive cells and staining intensity were assessed in a semi quantitative fashion and scored (1+ to 3+). GLUT-1 immunoreactivity was not present in proliferative endometrium. Twenty-nine (31.9%) of 91 endometrial hyperplasia cases showed positive immunoreactivity, of which only six were cases of hyperplasia without atypia while 23 of them were cases with atypia. We found GLUT-1 positivity of 95% in endometrioid type adenocarcinoma. GLUT-1 overexpression was not significantly correlated with any of the clinicopathological parameters except histological grade in endometrioid adenocarcinoma; the survival was not found to be correlated with GLUT-1 expression. GLUT-1 immunostaining may be useful in distinguishing hyperplasia without atypia from hyperplasia with atypia; GLUT-1 overexpression is a consistent feature of endometrioid adenocarcinoma. A correlation between GLUT -1 expression and tumor grade has been found, although other prognostic parameters and survival has no meaningful correlation.

  2. Childhood BMI growth trajectories and endometrial cancer risk

    DEFF Research Database (Denmark)

    Aarestrup, Julie; Gamborg, Michael; Tilling, Kate

    2017-01-01

    Previously, we found that excess weight already in childhood has positive associations with endometrial cancer, however, associations with changes in body mass index (BMI) during childhood are not well understood. Therefore, we examined whether growth in childhood BMI is associated with endometrial...... cancer and its sub-types. A cohort of 155,505 girls from the Copenhagen School Health Records Register with measured weights and heights at the ages of 6 to 14 years and born 1930-89 formed the analytical population. BMI was transformed to age-specific z-scores. Using linear spline multilevel models......, each girl's BMI growth trajectory was estimated as the deviance from the average trajectory for three different growth periods (6.25-7.99, 8.0-10.99, 11.0-14.0 years). Via a link to health registers, 1020 endometrial cancer cases were identified, and Cox regressions were performed. A greater gain...

  3. Mutations of the KRAS oncogene in endometrial hyperplasia and carcinoma.

    Directory of Open Access Journals (Sweden)

    Wiesława Niklińska

    2009-05-01

    Full Text Available The aim of this study was to examine the prevalence and clinicopathological significance of KRAS point mutation in endometrial hyperplasia and carcinoma. We analysed KRAS in 11 cases of complex atypical hyperplasia and in 49 endometrial carcinomas using polymerase chain reaction associated with restriction fragment length polymorphism (PCR-RFPL. Point mutations at codon 12 of KRAS oncogene were identified in 7 of 49 (14,3% tumor specimens and in 2 of 11 (18,2% hyperplasias. No correlation was found between KRAS gene mutation and age at onset, histology, grade of differentiation and clinical stage. We conclude that KRAS mutation is a relatively common event in endometrial carcinogenesis, but with no prognostic value.

  4. Plasma oestrogens in postmenopausal women with endometrial cancer

    DEFF Research Database (Denmark)

    Nyholm, H C; Nielsen, Anette Lynge; Lyndrup, J

    1993-01-01

    OBJECTIVE: To study plasma levels of estrogens and androgens, sex hormone-binding globulin (SHBG) and follicle stimulating hormone (FSH) in postmenopausal patients with endometrial cancer. DESIGN: Patients and controls were matched for age, body mass index, parity and years since menopause. SETTING......: Department of Obstetrics and Gynaecology, Hvidovre Hospital, Denmark. SUBJECTS: Fifty postmenopausal patients with endometrial cancer and 54 matching controls. MEASUREMENTS: Plasma levels of SHBG, FSH, oestrone, oestradiol, oestrone-sulphate, dehydro-epiandrosterone sulphate, testosterone...... for the effect of body mass, age, years since menopause, parity, and levels of SHBG and FSH. CONCLUSION: Patients with endometrial cancer exhibit increased plasma levels of oestradiol and oestrone. Speculatively, these oestrogens may result from an increased oestrone conversion from androstenedione, an increased...

  5. The risk of extra-colonic, extra-endometrial cancer in the Lynch syndrome

    DEFF Research Database (Denmark)

    Watson, Patrice; Vasen, Hans F A; Mecklin, Jukka-Pekka

    2008-01-01

    Persons with the Lynch syndrome (LS) are at high risk for cancer, including cancers of the small bowel, stomach, upper urologic tract (renal pelvis and ureter), ovary, biliary tract and brain tumors, in addition to the more commonly observed colorectal and endometrial cancers. Cancer prevention...... after the median year of birth (p cancers of the small bowel, stomach, breast and biliary tract were less common. Urologic tract cancer and ovarian cancer occur frequently enough in some LS subgroups to justify trials to evaluate...... strategies for these less common cancers require accurate, age-specific risk estimation. We pooled data from 4 LS research centers in a retrospective cohort study, to produce absolute incidence estimates for these cancer types, and to evaluate several potential risk modifiers. After elimination of 135...

  6. Robotic surgery in supermorbidly obese patients with endometrial cancer.

    Science.gov (United States)

    Stephan, Jean-Marie; Goodheart, Michael J; McDonald, Megan; Hansen, Jean; Reyes, Henry D; Button, Anna; Bender, David

    2015-07-01

    Morbid obesity is a known risk factor for the development of endometrial cancer. Several studies have demonstrated the overall feasibility of robotic-assisted surgical staging for endometrial cancer as well as the benefits of robotics compared with laparotomy. However, there have been few reports that have evaluated robotic surgery for endometrial cancer in the supermorbidly obese population (body mass index [BMI], ≥50 kg/m(2)). We sought to evaluate safety, feasibility, and outcomes for supermorbidly obese patients who undergo robotic surgery for endometrial cancer, compared with patients with lower body mass indices. We performed a retrospective chart review of 168 patients with suspected early-stage endometrial adenocarcinoma who underwent robotic surgery for the management of their disease. Analysis of variance and univariate logistic regression were used to compare patient characteristics and surgical variables across all body weights. Cox proportional hazard regression was used to determine the impact of body weight on recurrence-free and overall survival. The mean BMI of our cohort was 40.9 kg/m(2). Median follow up was 31 months. Fifty-six patients, 30% of which had grade 2 or 3 tumors, were supermorbidly obese with a BMI of ≥50 kg/m(2) (mean, 56.3 kg/m(2)). A comparison between the supermorbidly obese and lower-weight patients demonstrated no differences in terms of length of hospital stay, blood loss, complication rates, numbers of pelvic and paraaortic lymph nodes retrieved, or recurrence and survival. There was a correlation between BMI and conversion to an open procedure, in which the odds of conversion increased with increasing BMI (P = .02). Offering robotic surgery to supermorbidly obese patients with endometrial cancer is a safe and feasible surgical management option. When compared with patients with a lower BMI, the supermorbidly obese patient had a similar outcome, length of hospital stay, blood loss, complications, and numbers of lymph

  7. Comparison of Perioperative and Oncologic Outcomes with Laparotomy, and Laparoscopic or Robotic Surgery for Women with Endometrial Cancer.

    Science.gov (United States)

    Manchana, Tarinee; Puangsricharoen, Pimpitcha; Sirisabya, Nakarin; Worasethsin, Pongkasem; Vasuratna, Apichai; Termrungruanglert, Wichai; Tresukosol, Damrong

    2015-01-01

    To compare perioperative outcomes and oncologic outcomes in endometrial cancer patients treated with laparotomy, and laparoscopic or robotic surgery. Endometrial cancer patients who underwent primary surgery from January 2011 to December 2014 were retrospectively reviewed. Perioperative outcomes, including estimated blood loss (EBL), operation time, number of lymph nodes retrieved, and intra and postoperative complications, were reviewed. Recovery time, disease free survival (DFS) and overall survival (OS) were compared. Of the total of 218 patients, 143 underwent laparotomy, 47 laparoscopy, and 28 robotic surgery. The laparotomy group had the highest EBL (300, 200, 200 ml, plaparotomy (125 min) (plaparotomy group (four days) but there was no difference between the laparoscopy (three days) and robotic (three days) groups. Recovery was significantly faster in robotic group than laparotomy group (14 and 28 days, p=0.003). No significant difference in DFS and OS at 21 months of median follow up time was observed among the three groups. Minimally invasive surgery has more favorable outcomes, including lower blood loss, shorter hospital stay, and faster recovery time than laparotomy. It also has equivalent perioperative complications and short term oncologic outcomes. MIS is feasible as an alternative option to surgery of endometrial cancer.

  8. Premenopausal abnormal uterine bleeding and risk of endometrial cancer.

    Science.gov (United States)

    Pennant, M E; Mehta, R; Moody, P; Hackett, G; Prentice, A; Sharp, S J; Lakshman, R

    2017-02-01

    Endometrial biopsies are undertaken in premenopausal women with abnormal uterine bleeding but the risk of endometrial cancer or atypical hyperplasia is unclear. To conduct a systematic literature review to establish the risk of endometrial cancer and atypical hyperplasia in premenopausal women with abnormal uterine bleeding. Search of PubMed, Embase and the Cochrane Library from database inception to August 2015. Studies reporting rates of endometrial cancer and/or atypical hyperplasia in women with premenopausal abnormal uterine bleeding. Data were independently extracted by two reviewers and cross-checked. For each outcome, the risk and a 95% CI were estimated using logistic regression with robust standard errors to account for clustering by study. Sixty-five articles contributed to the analysis. Risk of endometrial cancer was 0.33% (95% CI 0.23-0.48%, n = 29 059; 97 cases) and risk of endometrial cancer or atypical hyperplasia was 1.31% (95% CI 0.96-1.80, n = 15 772; 207 cases). Risk of endometrial cancer was lower in women with heavy menstrual bleeding (HMB) (0.11%, 95% CI 0.04-0.32%, n = 8352; 9 cases) compared with inter-menstrual bleeding (IMB) (0.52%, 95% CI 0.23-1.16%, n = 3109; 14 cases). Of five studies reporting the rate of atypical hyperplasia in women with HMB, none identified any cases. The risk of endometrial cancer or atypical hyperplasia in premenopausal women with abnormal uterine bleeding is low. Premenopausal women with abnormal uterine bleeding should first undergo conventional medical management. Where this fails, the presence of IMB and older age may be indicators for further investigation. Further research into the risks associated with age and the cumulative risk of co-morbidities is needed. Contrary to practice, premenopausal women with heavy periods or inter-menstrual bleeding rarely require biopsy. © 2016 The Authors BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal

  9. Robotic-assisted laparoscopic hysterectomy for women with endometrial cancer

    DEFF Research Database (Denmark)

    Herling, Suzanne Forsyth; Møller, Ann M; Palle, Connie

    2017-01-01

    INTRODUCTION: Robotic-assisted laparoscopic hysterectomy (RALH) has become a widely used approach for women with endometrial cancer and has replaced laparotomy. It has been questioned if the increased costs are justified by superior surgical outcomes. The aim of the present study was to examine......-anaesthesia care unit was shorter for patients undergoing RALH. CONCLUSIONS: RALH appears advantageous for women treated for endometrial cancer in terms of post-operative complications. We recommend the use of the Clavien-Dindo classification of surgical outcomes for quality assessment. FUNDING: departmental only...

  10. Stem cell-like differentiation potentials of endometrial side population cells as revealed by a newly developed in vivo endometrial stem cell assay.

    Directory of Open Access Journals (Sweden)

    Kaoru Miyazaki

    Full Text Available Endometrial stem/progenitor cells contribute to the cyclical regeneration of human endometrium throughout a woman's reproductive life. Although the candidate cell populations have been extensively studied, no consensus exists regarding which endometrial population represents the stem/progenitor cell fraction in terms of in vivo stem cell activity. We have previously reported that human endometrial side population cells (ESP, but not endometrial main population cells (EMP, exhibit stem cell-like properties, including in vivo reconstitution of endometrium-like tissues when xenotransplanted into immunodeficient mice. The reconstitution efficiency, however, was low presumably because ESP cells alone could not provide a sufficient microenvironment (niche to support their stem cell activity. The objective of this study was to establish a novel in vivo endometrial stem cell assay employing cell tracking and tissue reconstitution systems and to examine the stem cell properties of ESP through use of this assay.ESP and EMP cells isolated from whole endometrial cells were infected with lentivirus to express tandem Tomato (TdTom, a red fluorescent protein. They were mixed with unlabeled whole endometrial cells and then transplanted under the kidney capsule of ovariectomized immunodeficient mice. These mice were treated with estradiol and progesterone for eight weeks and nephrectomized. All of the grafts reconstituted endometrium-like tissues under the kidney capsules. Immunofluorescence revealed that TdTom-positive cells were significantly more abundant in the glandular, stromal, and endothelial cells of the reconstituted endometrium in mice transplanted with TdTom-labeled ESP cells than those with TdTom-labeled EMP cells.We have established a novel in vivo endometrial stem cell assay in which multi-potential differentiation can be identified through cell tracking during in vivo endometrial tissue reconstitution. Using this assay, we demonstrated that ESP

  11. Factors affecting pregnancy outcomes in young women treated with fertility-preserving therapy for well-differentiated endometrial cancer or atypical endometrial hyperplasia

    OpenAIRE

    Inoue, Osamu; Hamatani, Toshio; Susumu, Nobuyuki; Yamagami, Wataru; Ogawa, Seiji; Takemoto, Takashi; Hirasawa, Akira; Banno, Kouji; Kuji, Naoaki; Tanaka, Mamoru; Aoki, Daisuke

    2016-01-01

    Background Patients hoping to preserve their fertility receive conservative treatment with high-dose medroxyprogesterone acetate (MPA) for well-differentiated endometrioid adenocarcinoma (EC) or atypical endometrial hyperplasia (AEH) . Such treatment generally involves frequent intrauterine operations, including dilation and curettage (D&C) and endometrial biopsy (EMB), which could result in endometritis, endometrial thinning, or intrauterine adhesion. In turn, any of these outcomes could adv...

  12. Comparing the effect of office hysteroscopy with endometrial scratch versus office hysteroscopy on intrauterine insemination outcome: a randomized controlled trial.

    Science.gov (United States)

    El-Khayat, Waleed; Elsadek, Mostafa; Saber, Waleed

    2015-11-01

    To evaluate the role of endometrial injury in the cycle preceding ovarian stimulation for intrauterine insemination (IUI) cycle on the clinical pregnancy rate. This was a prospective randomized controlled trial which included three hundred and thirty two infertile women with an indication for IUI. The subjects were randomly divided into two groups. The intervention group (group A) (n=166) subjects underwent office hysteroscopy with endometrial injury using grasping forceps with teeth, while the control group (group B) (n=166) subjects underwent office hysteroscopy alone without endometrial injury. Primary outcome was clinical pregnancy rate. There were no significant differences in baseline or clinical characteristics between the groups. There were no significant differences in clinical pregnancy rate [13.8% (23/166) versus 12% (20/166); RR 1.15 (95% CI 0.66-2.01), p=0.62]. The abortion rate [4.3% (1/23) versus 15% (3/20); RR 0.29 (95% CI 0.03-2.57), p=0.27], the multiple pregnancy rate [13% (3/23) versus 15% (3/20); RR 0.87 (95% CI 0.20-3.83), p=0.85] and the live birth rate [13.6% (22/166) versus 10.4% (17/166); RR 1.28 (95% CI 0.71-2.32), p=0.42]. There is no evidence of significant difference on the clinical pregnancy rate when endometrial scratching during hysteroscopy is compared to only hysteroscopy in women undergoing IUI. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Adenylosuccinate lyase enhances aggressiveness of endometrial cancer by increasing killer cell lectin-like receptor C3 expression by fumarate.

    Science.gov (United States)

    Park, Haengki; Ohshima, Kenji; Nojima, Satoshi; Tahara, Shinichiro; Kurashige, Masako; Hori, Yumiko; Okuzaki, Daisuke; Wada, Naoki; Ikeda, Jun-Ichiro; Morii, Eiichi

    2018-02-21

    Adenylosuccinate lyase (ADSL) is an enzyme that plays important roles in de novo purine synthesis. Although ADSL was reported to be upregulated in various malignancies, such as colorectal, breast, and prostate cancer, as well as gliomas, the mechanism by which elevated ADSL expression contributes to cancer has not been elucidated. We previously performed a shotgun proteomics analysis to characterize specific proteins associated with the properties of the aldehyde dehydrogenase (ALDH)-high cell population, which was reported to be involved in tumorigenic potential, and showed that ADSL expression is upregulated in the ALDH-high population of endometrial cancer. Here, we showed that ADSL is involved in endometrial cancer aggressiveness by regulating expression of killer cell lectin-like receptor C3 (KLRC3), which is a receptor expressed on natural killer cells. Immunohistochemical analysis indicated that ADSL expression increased as endometrioid carcinoma specimens became more poorly differentiated and higher degree of primary tumor progression. Knockdown of ADSL in endometrial cancer cells decreased cell proliferation, migration, and invasive capability, and caused the cells to adopt a more rounded shape. DNA microarray analysis and quantitative real-time PCR showed that KLRC3 expression was decreased in ADSL knockdown cells. Knockdown of KLRC3 in endometrial cancer cells resulted in the same phenotype as knockdown of ADSL. Moreover, fumarate, which could be produced by ADSL and was recently shown to be an oncometabolite, recovered KLRC3 expression in ADSL knockdown cells, suggesting that fumarate produced by ADSL could regulate KLRC3 expression. Our findings indicate that ADSL enhances cell proliferation, migration, and invasive capability through regulation of KLRC3 expression by fumarate.

  14. Cytological Study of Grade 3 Endometrioid Adenocarcinoma of Endometrial Origin: Cytoarchitecture and Features of Cell Clusters Assessed With Endometrial Brushing Cytology--Focusing on a comparison with endometrioid adenocarcinoma Grade 1, 2.

    Science.gov (United States)

    Matsui, Naruaki; Kajiwara, Hiroshi; Morishita, Akihiro; Tsukada, Hitomi; Nakazawa, Kazumi; Miyazawa, Masaki; Mikami, Mikio; Nakamura, Naoya; Sato, Shinkichi

    2015-06-20

    Aim of study was to clarify the cytological characteristics of grade 3 endometrioid adenocarcinoma of endometrial origin (G3 EA) by endometrial brushing cytology. The subjects were 11 patients in whom G3 EA was diagnosed by review of preoperative cytological specimens obtained at our hospital and related institutions between 2000 and 2010. These patients were investigated with respect to the preoperative cytological diagnosis, background changes, cell cluster patterns, and individual cellular findings. Background changes were classified as inflammatory or tumorous, while cell clusters were classified as overlapping cell cluster, sheet-like cell cluster, clump of high dense gland, papillary, or other cell cluster. Cellular findings were investigated by comparing the incidence of squamous and clear cell metaplasia, the nuclear rounding rate, and the nuclear area with the findings in a control group (35 patients with G1-2 EA). Background changes were classified as inflammatory in 63.6% and necrotic in 36.4%. The cell clusters were classified as overlapping cell cluster in 44.8%, cell cluster in 21.7%, clump of high dense gland in 10.0%, papillary in 4.0%, and other cell cluster in 19.5%. The incidence of squamous and clear cell metaplasia was 27.2% and 18.1%, respectively. The mean nuclear rounding rate was 0.97, and the mean nuclear area was 55.98 µm2. Investigation of the cytoarchitecture of G3 EA with endometrial brushing cytology revealed overlapping cell cluster and tumor cells of a relatively uniform size. These findings suggest that it is necessary to recognize that there are differences between the cytological findings of G3 EA and the usual features of G1-2 EA.

  15. Human Blastocyst Secreted microRNA Regulate Endometrial Epithelial Cell Adhesion

    Directory of Open Access Journals (Sweden)

    Carly Cuman

    2015-10-01

    Full Text Available Successful embryo implantation requires synchronous development and communication between the blastocyst and the endometrium, however the mechanisms of communication in humans are virtually unknown. Recent studies have revealed that microRNAs (miRs are present in bodily fluids and secreted by cells in culture. We have identified that human blastocysts differentially secrete miRs in a pattern associated with their implantation outcome. miR-661 was the most highly expressed miR in blastocyst culture media (BCM from blastocysts that failed to implant (non-implanted compared to blastocysts that implanted (implanted. Our results indicate a possible role for Argonaute 1 in the transport of miR-661 in non-implanted BCM and taken up by primary human endometrial epithelial cells (HEECs. miR-661 uptake by HEEC reduced trophoblast cell line spheroid attachment to HEEC via PVRL1. Our results suggest that human blastocysts alter the endometrial epithelial adhesion, the initiating event of implantation, via the secretion of miR, abnormalities in which result in implantation failure.

  16. Progesterone Receptor Transcriptome and Cistrome in Decidualized Human Endometrial Stromal Cells

    Science.gov (United States)

    Mazur, Erik C.; Vasquez, Yasmin M.; Li, Xilong; Kommagani, Ramakrishna; Jiang, Lichun; Chen, Rui; Lanz, Rainer B.; Kovanci, Ertug; Gibbons, William E.

    2015-01-01

    Decidualization is a complex process involving cellular proliferation and differentiation of the endometrial stroma that is required to establish and support pregnancy. Progesterone acting via its nuclear receptor, the progesterone receptor (PGR), is a critical regulator of decidualization and is known to interact with certain members of the activator protein-1 (AP-1) family in the regulation of transcription. In this study, we identified the cistrome and transcriptome of PGR and identified the AP-1 factors FOSL2 and JUN to be regulated by PGR and important in the decidualization process. Direct targets of PGR were identified by integrating gene expression data from RNA sequencing with the whole-genome binding profile of PGR determined by chromatin immunoprecipitation followed by deep sequencing (ChIP-seq) in primary human endometrial stromal cells exposed to 17β-estradiol, medroxyprogesterone acetate, and cAMP to promote in vitro decidualization. Ablation of FOSL2 and JUN attenuates the induction of 2 decidual marker genes, IGFBP1 and PRL. ChIP-seq analysis of genomic binding revealed that FOSL2 is bound in proximity to 8586 distinct genes, including nearly 80% of genes bound by PGR. A comprehensive assessment of the PGR-dependent decidual transcriptome integrated with the genomic binding of PGR identified FOSL2 as a potentially important transcriptional coregulator of PGR via direct interaction with regulatory regions of genes actively regulated during decidualization. PMID:25781565

  17. Cytological assessment of endometrial washings obtained with an insemination cannula and its histological correlation

    Directory of Open Access Journals (Sweden)

    Malik Reeni

    2008-01-01

    Full Text Available Background: Endometrial cytopathology is a powerful tool for the detection of a wide variety of benign atypias, inflammatory changes, and infectious organisms. It is also helpful for the cytohormonal evaluation of patients and the detection of endometrial malignancies. Aims: The present study was carried out to assess the sensitivity and specificity of endometrial cytology performed by using an insemination cannula. Materials and Methods: Endometrial aspiration using an insemination cannula was done in 60 cases who presented with dysuterine bleed, infertility, or postmenopausal bleed. The cytological evaluation of endometrial smears was correlated with histopathological findings with reference to cyclic endometrium, atypical hyperplasia, and endometrial malignancies. Results: There were 35 patients in the reproductive and 25 in the menopausal age groups. The sample was inadequate in four cases but there was an overall 100% correlation between cytological and histological findings of cyclic endometrium, atypical hyperplasia, and endometrial malignancy. The sensitivity and specificity of endometrial aspiration was 83.3 and 95.4% respectively, with two false negative and false positive cases. Conclusions: Endometrial aspiration cytology was found to be a safe outpatient procedure in the diagnosis of normal and abnormal endometrium for patients of all ages.The present study emphasizes the need for endometrial screening in postmenopausal patients to enable the detection of endometrial malignancies at an early stage.

  18. Can magnetic resonance spectroscopy differentiate endometrial cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jie; Cai, Shifeng; Han, Xue; Liu, Qingwei; Xin, Yinghui [Shandong University, Department of Radiology, Shandong Provincial Hospital, Jinan (China); Li, Changzhong; Yang, Chunrun [Shandong University, Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Jinan (China); Sun, Xichao; Zong, Yuanyuan [Shandong University, Department of Pathology, Shandong Provincial Hospital, Jinan (China); Fu, Caixia [Siemens Shenzhen Magnetic Resonance Ltd., Siemens MRI Center, Shenzhen (China)

    2014-10-15

    To investigate whether the choline-containing compounds (Cho) obtained from three-dimensional {sup 1}H magnetic resonance (MR) spectroscopy can differentiate endometrial cancer (ECa) from benign lesions in endometria or in submucosa (BLs-ESm) and is associated with the aggressiveness of ECa. Fifty-seven patients (ECa, 38; BLs-ESm, 19) underwent preoperative multi-voxel MR spectroscopy at 3.0 T. The ratio of the sum of the Cho peak integral to the sum of the unsuppressed water peak integral (Cho/water) and the coefficient of variation (CV) used to describe the variability of Cho/water in one lesion were calculated. Mean Cho/water (±standard deviation [SD]) was (3.02 ± 1.43) x 10{sup -3} for ECa and (1.68 ± 0.33) x 10{sup -3} for BLs-ESm (p < 0.001). Mean Cho/water was (4.42 ± 1.53) x 10{sup -3} for type II ECa and (2.65 ± 1.17) x 10{sup -3} for type I ECa (p = 0.001). There were no significant differences among different stages of ECa (p = 0.107) or different grades of ECa (p = 0.142). The Cho/water was positively correlated with tumour stage (r = 0.386, p = 0.017) and size (r = 0.333, p = 0.041). The CV was also positively correlated with tumour stage (r = 0.537, p = 0.001) and size (r = 0.34, p = 0.037). The Cho/water can differentiate ECa from BLs-ESm and differentiate type II from type I ECa, but cannot differentiate different stages of ECa or different grades of ECa. Cho/water increased with the increase of tumour stage and size. (orig.)

  19. The antiprogesterone Org 31710 inhibits human blastocyst-endometrial interacttions in vitro

    DEFF Research Database (Denmark)

    Petersen, A; tin-Ley, U; Ravn, V

    2005-01-01

    OBJECTIVE: To investigate the effect of the anti-P Org 31710 on human blastocyst attachment to cultured endometrial epithelial cells. DESIGN: Experimental in vitro study. SETTING: University hospital. PATIENT(S): Eleven fertile endometrial donors. INTERVENTION(S): Timed endometrial biopsy for cell......(3) on endometrial epithelial cells examined by immunohistochemistry. Endometrial pinopodes visualized by scanning electron microscopy. RESULT(S): Eleven of 16 human blastocysts attached to control cultures, whereas none of 10 blastocysts attached when Org 31710 was added to the culture medium (P...... statistical significance. The presence of swollen microvilli, precursors of endometrial pinopodes, was significantly reduced on cultures with Org 31710 (P=.03). CONCLUSION(S): The study presents a model for human blastocyst-endometrial interactions responding to an anti-P drug. The exact mechanism...

  20. Prognostic Value of Metabolic Activity Measured by {sup 18}F-FDG PET/CT in Patients with Advanced Endometrial Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Jeong; Choi, Jiyoun; Jeong, Yong Hyu; Jo, Kwan Hyeong; Lee, Jaehoon; Cho, Arthur; Yun, Mijin; Lee, Jong Doo; Kim, Young Tae; Kang, Won Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2013-12-15

    We evaluated the potential prognostic value of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with stage IIIC/IV endometrial cancer. Patients with stage IIIC/IV endometrial cancer who had undergone FDG PET/CT workup for staging were enrolled. Maximum standardized uptake values (SUV{sub max}) measured from regions of interest (ROIs) of the primary tumor (SUVt) and lymph nodes (SUVn) were correlated with overall survival (OS). The SUVn was defined as the highest SUV{sub max} of the metastatic lymph nodes. Survival probability was assessed using the Kaplan-Meier method. A total of 42 patients with a median age of 55.5 years (range 32-76 years) were included. Twenty-nine percent (n =12) of patients were premenopausal and 71 % (n =30) were postmenopausal. The average SUVt was 12.9 (range 1.8-36.5), and the average SUVn was 7.3 (range 2.0-22.5). Median follow-up time was 25.9 months (range 1.84 months). Using a SUVt of 9.5 as a cutoff value, two groups with different rates were determined (P=0.026). In addition, patients with a low SUVn had significantly better OS than those with a high SUVn (P=0.003). Patients in the International Federation of Obstetrics and Gynecology (FIGO) stage IV group with SUVt≥9.5 or SUVn≥7.3 showed a significantly longer OS than the other groups. FDG uptake of primary endometrial cancer and lymph nodes might be a prognostic factor in advanced endometrial cancer. More aggressive therapy could be considered in patients with stage IV endometrial cancer and high SUVt and/or high SUVn.

  1. Diagnostic Impacts of Serum CA-125 Levels, Pap Smear Evaluation, and Endometrial Sampling in Women with Endometrial Clear Cell Carcinoma.

    Science.gov (United States)

    Cetinkaya, Nilufer; Selcuk, İlker; Ozdal, Bulent; Meydanli, Mehmet M; Gungor, Tayfun

    2016-01-01

    Endometrial clear cell carcinoma (ECCC) is a rare variant of endometrial cancer with an unfavorable prognosis. The aim of this study was to determine the relationships, if any, between preoperative serum cancer antigen 125 (CA-125) levels, the last Papanicolaou (Pap) smear, the results of endometrial biopsy and tumor histology, and disease-stage according to permanent histopathology. The data of 26 women with ECCC were collected from their medical records to compare demographics, preoperative serum CA-125 levels, Pap test results, histological diagnosis of the endometrial biopsy, and tumor histology, as well as the disease stage according to permanent histopathology. The mean age at diagnosis was 64.0 years. There were 17 (65.3%) women with pure ECCC and 8 (30.7%) women with a mixed histology. Stage III-IV disease was diagnosed in 12 (46.2%) women and occurred more frequently in pure ECCC (n = 11, 91.7%). CA-125 values were significantly higher in advanced stage disease. Cytological evaluation indicated the presence of 71.4% (10/14) cytological abnormalities in pure ECCC. The overall sensitivity of endometrial sampling for the detection of malignancy was 92.3% (24/26), whereas the accurate diagnosis of ECCC was only 34.7% (8/23) with the Pipelle sampler. Pap test abnormalities are frequent in ECCC. Although it is less accurate in the diagnosis of ECCC than in the detection of malignancy, endometrial sampling is still the main procedure for the diagnosis of ECCC. Higher preoperative CA-125 concentrations imply the presence of advanced stage ECCC. © 2016 S. Karger GmbH, Freiburg.

  2. Incidence of the geometric parameters and of flow in the primary ventilation rate and of carbon monoxide emissions in burning atmospherics of medium and high pressure

    International Nuclear Information System (INIS)

    Amell A, Andres; Hernandez V, Jaime; Cortes T, Jaime

    2000-01-01

    In this kind of atmospheric burners, high-pressure gas supply and Venturi geometry guarantee a good primary air entrance for combustion. In this project we analyze the most important burner geometric parameters (outlet diameter, injection diameter and mixer geometry) and gas flux conditions (supply pressure) that have an influence over primary aeration rate. The results of this investigation will contribute with the methodology design improvement, focused to use this kind of burners in our country

  3. Adipose tissue concentrations of PCB, HCB, chlordane, PBDE and P,P'-DDE and the risk for endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lindstroem, G.; Bavel, B. van; Bjoernfoth, H. [MTM Research Centre, Oerebro Univ., Oerebro (Sweden); Hardell, L. [Dept. of Oncology, Univ. Hospital, Oerebro (Sweden)

    2004-09-15

    Environmental pollutants with hormonal activity, such as xenoestrogens, have for several years been of concern as potential risk factors for hormone dependant tumors. Impacts of increasing levels of xenoestrogens have been observed in aquatic organisms. In humans concern has been focused on ''endocrine disrupting chemicals'' with either estrogenic or antiestrogenic activities. Some persistent organic pollutants (POPs) such as polychlorinated biphenyls (PCBs), and especially the hydroxylated metabolites, and chlordanes, have been postulated to be endocrine disruptors. PCBs have been shown to reverse gonadal sex in turtle5 and abnormalities of reproductive development has been described in juvenile alligators living in contaminated environment in Florida. Hexachlorobenzene (HCB) has been shown to have endocrine-disrupting properties. Also p,p'-dichlorodiphenyl-dichloroethylene (p,p'-DDE) the most persistent metabolite of p,p'-DDT has been postulated to be an environmental endocrine disruptor. In a case-control study on patients with testicular cancer we found higher concentrations of PCBs, HCB and chlordanes in mothers to cases than in mothers to controls. Similar concentrations were found in cases with testicular cancer as in the population controls. The study gave support to the hypothesis that exposure to endocrine disruptors during the fetal period may be of etiologic importance in the etiology of testicular cancer. Another hormone dependent cancer is endometrial cancer. It accounted for 5.8% of all cancers incidents among Swedish women in 2002. The cumulative probability of developing the disease before 85 years of age was 2.8% in 2002. Estrogen replacement has been suggested as a risk factor among several others. The first cases of endometrial cancer among women using estrogen replacement therapy were reported in early 1960's. Is there a relationship between levels of POPs and incidence rate? The aim is to investigate

  4. Endometrial injury in women undergoing assisted reproductive techniques.

    Science.gov (United States)

    Nastri, Carolina O; Lensen, Sarah F; Gibreel, Ahmed; Raine-Fenning, Nick; Ferriani, Rui A; Bhattacharya, Siladitya; Martins, Wellington P

    2015-03-22

    Implantation of an embryo within the endometrial cavity is a critical step in assisted reproductive techniques (ART). Previous research has suggested that endometrial injury - intentional damage to the endometrium - can increase the probability of pregnancy in women undergoing ART. To assess the effectiveness and safety of endometrial injury performed before embryo transfer in women undergoing ART. We searched the Cochrane Menstrual Disorders and Subfertility Group (MDSG) Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects (DARE), MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American Caribbean Health Sciences Literature (LILACS) and ClinicalTrials.gov. The original search was performed in November 2011, and further searches were done in March 2014 and January 2015. Randomised controlled trials comparing intentional endometrial injury before embryo transfer in women undergoing ART, versus no intervention or a sham procedure. Two independent review authors screened studies and extracted data which were checked by a third review author. Two review authors independently assessed risk of bias. We contacted and corresponded with study investigators as required and analysed data using risk ratio (RR) and a random-effects model. We assessed the quality of the evidence by using GRADE (Grades of Recommendation, Assessment, Development and Evaluation) criteria. We included 14 trials that included 1063 women in the intervention groups and 1065 women in the control groups. Thirteen studies compared endometrial injury performed between day 7 of the previous cycle and day 7 of the embryo transfer (ET) cycle versus no injury, and one study compared endometrial injury on the day of oocyte retrieval versus no injury. Overall, eight of the 14 included studies were deemed to be at high risk of bias in at least one domain.In studies comparing endometrial

  5. Intrauterine devices and endometrial cancer risk: a pooled analysis of the Epidemiology of Endometrial Cancer Consortium

    Science.gov (United States)

    Felix, Ashley S.; Gaudet, Mia M.; La Vecchia, Carlo; Nagle, Christina M.; Ou Shu, Xiao; Weiderpass, Elisabete; Olov Adami, Hans; Beresford, Shirley; Bernstein, Leslie; Chen, Chu; Cook, Linda S.; De Vivo, Immaculata; Doherty, Jennifer A.; Friedenreich, Christine M.; Gapstur, Susan M.; Hill, Dierdre; Horn-Ross, Pamela L.; Lacey, James V.; Levi, Fabio; Liang, Xiaolin; Lu, Lingeng; Magliocco, Anthony; McCann, Susan E.; Negri, Eva; Olson, Sara H.; Palmer, Julie R.; Patel, Alpa V.; Petruzella, Stacey; Prescott, Jennifer; Risch, Harvey A.; Rosenberg, Lynn; Sherman, Mark E.; Spurdle, Amanda B.; Webb, Penelope M.; Wise, Lauren A.; Xiang, Yong-Bing; Xu, Wanghong; Yang, Hannah P.; Yu, Herbert; Zeleniuch-Jacquotte, Anne; Brinton, Louise A.

    2014-01-01

    Intrauterine devices (IUDs), long-acting and reversible contraceptives, induce a number of immunological and biochemical changes in the uterine environment that could affect endometrial cancer (EC) risk. We addressed this relationship through a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We combined individual-level data from 4 cohort and 14 case-control studies, in total 8,801 EC cases and 15,357 controls. Using multivariable logistic regression, we estimated pooled odds ratios (pooled-ORs) and 95% confidence intervals (CIs) for EC risk associated with ever use, type of device, ages at first and last use, duration of use, and time since last use, stratified by study and adjusted for confounders. Ever use of IUDs was inversely related to EC risk (pooled-OR=0.81, 95% CI=0.74–0.90). Compared with never use, reduced risk of EC was observed for inert IUDs (pooled-OR=0.69, 95% CI=0.58–0.82), older age at first use (≥35 years pooled-OR=0.53, 95% CI=0.43–0.67), older age at last use (≥45 years pooled-OR=0.60, 95% CI=0.50–0.72), longer duration of use (≥10 years pooled-OR=0.61, 95% CI=0.52–0.71), and recent use (within 1 year of study entry pooled-OR=0.39, 95% CI=0.30–0.49). Future studies are needed to assess the respective roles of detection biases and biologic effects related to foreign body responses in the endometrium, heavier bleeding (and increased clearance of carcinogenic cells), and localized hormonal changes. PMID:25242594

  6. Endometrial stromal sarcoma in combination with mixed type endometrial carcinomas: A case report and literature review.

    Science.gov (United States)

    Xiu, Xiao-Xin; Wang, Hua-Li; Yun-Yi, Lv; Fan-Dou, Kong; Jin-Ping, Hou

    2017-12-01

    Endometrial stromal sarcoma (ESS) is rare, representing only approximately 0.2% of all uterine malignancies. Mixed type endometrial carcinomas (MT-ECs) are rare tumors with both type I and II features, and are difficult to diagnose. Cases of ESS and MT-ECs coexisting in the same patient are extremely rare. This study aimed to describe a case of ESS in combination with MT-ECs in a 47-year-old premenopausal woman. A woman presented to the hospital complaining of occasional abdominal pain and had high tumor markers: cancer antigen (CA) 19-9 (263.6 U/mL) and CA 125 (428.0 U/mL). Transvaginal ultrasound examination revealed a complex mass (12.3 × 9.1 × 6.3 cm) with solid and cystic components on the right rear wall of the uterus. Abdominopelvic computed tomography images showed a pelvic cystic-solid mixed mass. The patient underwent an exploratory midline laparotomy. The mass was hypothesized to be malignant on the uterine posterior wall. Tumor deposits were found on bilateral parametrium. On peritoneal implantation, multiple metastases were seen on the serosal surface of the bowel and greater omentum. A frozen section revealed a spindle cell sarcoma. Pathological reports following surgery revealed concurrent ESS and MT-ECs. The patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, and macroscopic clearance of the tumor. Adjuvant chemotherapy was given. The patient was still alive when this report was written. Considering the rarity of ESS in combination with MT-ECs, this study presented an overview of the literature and discussed a number of histological and clinical issues. Nevertheless, etiology and pathogenesis of these tumors need further investigation.

  7. Wheelchair incidents

    NARCIS (Netherlands)

    Drongelen AW van; Roszek B; Hilbers-Modderman ESM; Kallewaard M; Wassenaar C; LGM

    2002-01-01

    This RIVM study was performed to gain insight into wheelchair-related incidents with powered and manual wheelchairs reported to the USA FDA, the British MDA and the Dutch Center for Quality and Usability Research of Technical Aids (KBOH). The data in the databases do not indicate that incidents with

  8. Clinical assessment of 252Californium neutron intracavitary brachytherapy using a two-channel Y applicator combined with external beam radiotherapy for endometrial cancer

    Directory of Open Access Journals (Sweden)

    Qian Zhou

    2016-01-01

    Full Text Available OBJECTIVE: The aim of this study was to determine the efficacy of 252Californium neutron intracavitary brachytherapy using a two-channel Y applicator combined with external beam radiotherapy for the treatment of endometrial cancer. METHODS: Thirty-one patients with stage I-III endometrial cancer were recruited for this study. The stage I patients received only 252Californium neutron intracavitary brachytherapy with a two-channel applicator. The stage II and III patients received both 252Californium neutron intracavitary brachytherapy using a two-channel applicator and parallel-opposed whole pelvic radiotherapy. RESULTS: The five-year local control rate was 80.6% (25/31, the overall survival rate was 51.6% (16/31, and the disease-free survival rate was 54.8% (17/31. The incidence of serious late complications was 12.9% (4/31. CONCLUSIONS: 252Californium neutron intracavitary brachytherapy using a two-channel applicator combined with external beam radiotherapy was effective for treating endometrial cancer and the incidence of serious late complications related to this combination was within an acceptable range.

  9. Radiotherapy for local recurrences of endometrial cancer after surgery and vaginal brachytherapy

    International Nuclear Information System (INIS)

    Panek, G.; Zielinski, J.; Kaminska, G.; Krynicki, R.

    2001-01-01

    The aim of the study was to evaluate the effectiveness of radiotherapy for local recurrences of endometrial cancer after primary surgery and vaginal brachytherapy. Forty one patients with histopathologically proven local recurrences of endometrial cancer were treated in years 1990-1998. The treatment of recurrences consisted of external beam irradiation of the pelvis (mean dose 46 Gy) plus intracavitary brachytherapy LDR/MDR with dose of 40-45 Gy at 0.5 cm below the surface of the mucosa. Follow-up ranged from 6 to 60 months (median 19 months). Survival curve was calculated with Kaplan-Meier method. The log-rank test was used to evaluate the influence of the following prognostic factors on the survival: time from the completion of the primary treatment to the diagnosis of recurrence, and localisation of the relapsing tumor. The probability of survival of 3 and 5 years was 0.33 and 0.21. Both analysed prognostic factors - time to the diagnosis and localisation of the recurrence had a satisfically significant influence on survival. The risk of death from the disease was significantly higher with extravaginal spread of the tumor and with the time gap of less than 1 year after completion of primary treatment. (Relative risk 1.40 and 1.44, 95% C.l.). The results of treatment, confirmed a very serious prognosis in this particular group of patients, with the use of presently available methods of treatment. Better methods of identification of prognostic factors which might be predictive of developing a recurrence are required. Better methods of early detection of relapses and more effective treatment may contribute to the better survival of these high risk patients. (author)

  10. Endometrial preparation with Dienogest before hysteroscopic surgery: a systematic review.

    Science.gov (United States)

    Laganà, Antonio Simone; Vitale, Salvatore Giovanni; Muscia, Vincenzo; Rossetti, Paola; Buscema, Massimo; Triolo, Onofrio; Rapisarda, Agnese Maria Chiara; Giunta, Loretta; Palmara, Vittorio; Granese, Roberta; Frangež, Helena Ban; Romano, Andrea

    2017-03-01

    Hysteroscopic surgery is considered the gold standard for the minimal invasive treatment of many endouterine diseases such as endometrial polyps or submucous myomas. Recently, many studies have evaluated the effect of preoperative administration of a number of drugs to reduce endometrial thickness and achieve important intraoperative advantages. The purpose of this systematic review is to summarize the available evidence about the use of Dienogest, an orally administrable progestin, for endometrial preparation before hysteroscopic surgery. All studies published on this topic and indexed on PubMed/MEDLINE, Embase or Google scholar databases were retrieved and analysed. We retrieved five studies about this topic. Considered together, the published data analyses allow us to conclude that Dienogest is effective in reducing the thickness of the endometrium, the severity of bleeding and also of operative time, with a lower number of side effects compared with other pharmacological preparations or no treatment. Administration of Dienogest may be an effective and safe treatment for endometrial thinning before operative hysteroscopy. However, this conclusion is based on few reports and further studies to prove or disprove it are warranted.

  11. Endometrial carcinoma: MR staging and causes of error.

    Science.gov (United States)

    Foti, P V; Farina, R; Coronella, M; Ruggeri, C; Palmucci, S; Montana, A; Milone, P; Zarbo, G; Caltabiano, R; Lanzafame, S; Politi, G; Ettorre, G C

    2013-04-01

    This study was undertaken to prospectively determine the diagnostic capabilities of magnetic resonance (MR) imaging in detecting myometrial and cervical invasion and lymph node involvement in endometrial carcinoma and to identify the causes of errors in staging endometrial carcinoma. Twenty consecutive patients with a histological diagnosis of endometrial carcinoma underwent preoperative MR imaging. MR findings were compared with surgical staging, considered as the standard of reference. In assessing myometrial invasion, MR imaging showed 70% accuracy, 80% sensitivity, 40% specificity, 80% positive predictive value (PPV), and 40% negative predictive value (NPV). In detecting cervical invasion, MR imaging had 95% accuracy, 100% sensitivity, 94.4% specificity, 66.7% PPV, and 100% NPV. In evaluating lymph node involvement, MR imaging showed 100% accuracy, sensitivity, specificity, PPV and NPV. Errors in evaluating myometrial invasion were caused by polypoid tumour, adenomyosis and leiomyomas, whereas those in evaluating cervical invasion were caused by dilatation and curettage. MR imaging is a reliable technique for preoperative evaluation of endometrial carcinoma. Its main limitation is differentiating between stage IA and IB carcinomas, which is not highly important for surgical planning. Cooperation between the gynaecologist and radiologist is mandatory to avoid staging errors.

  12. Endometrial Biopsy and Hystopathological Diagnosis - A 10 year ...

    African Journals Online (AJOL)

    Background: Appropriate diagnosis is the mainstay of proper and effective management. For an appropriate histopathological diagnosis to be made, an accurate record of clinical details including sex is essential. The completeness or otherwise of data supplied by clinicians submitting endometrial biopsy specimen was ...

  13. ASPECTS OF SURGERY IN OVARIAN AND ENDOMETRIAL CARCINOMA

    NARCIS (Netherlands)

    AALDERS, JG; NEIJT, JP

    1993-01-01

    In ovarian cancer and endometrial cancer the surgeon plays an important role in both the staging procedure and in the removal of as much of the tumour as possible. Although uniform treatment policies have not been developed, a better understanding of the pattern of spread in both tumours allows for

  14. Risk of endometrial cancer after tamoxifen treatment of breast cancer

    NARCIS (Netherlands)

    F.E. van Leeuwen (Flora); J. Benraadt (J.); J.W.W. Coebergh (Jan Willem); L.A.L.M. Kiemeney (Bart); C.H.F. Gimbrère (Charles); R. Otter (Renée); L.J. Scheuten (Leo); R.A. Damhuis (Ronald); M. Bontenbal (Marijke); A.I. Diepenhorst; A.W. van den Belt-Dusebout (Alexandra); H. van Tinteren (Harm)

    1994-01-01

    textabstractSince large trials have been set up to assess whether tamoxifen decreases the risk of breast cancer in healthy women, it has become important to investigate the drug's potential adverse effects, including occurrence of endometrial cancer. We undertook a case-control study in the

  15. Endometrial osseous metaplasia: case report with literature review ...

    African Journals Online (AJOL)

    Endometrial osseous metaplasia is a rare pathological condition with mature bone in the endometrium and can be a cause for menorrhagia and infertility as bone in the endometrium acts like intrauterine contraceptive device. We report one such case with brief review of literature in a 28‑year‑old woman presenting with ...

  16. An Audit of Endometrial Hyperplasias at the Lagos University ...

    African Journals Online (AJOL)

    2017-10-26

    Oct 26, 2017 ... Introduction: There has been much controversy and confusion surrounding the endometrial hyperplasias stemming from the use of a wide variety of terminologies and also from the pathophysiologic mechanisms underlying the various entities. The current classification by the World Health Organization ...

  17. Role of pelvic lymphadenectomy in stage 1A endometrial carcinoma ...

    African Journals Online (AJOL)

    Introduction: Endometrial cancer is the commonest gynecological cancer mostly affecting women in the postmenopausal age group. There is a debate regarding the need of pelvic lymphadenectomy in managing stage 1A diagnosed preoperatively, we try to evaluate this need. Objective: To evaluate the role of pelvic ...

  18. Hormone replacement therapy and the risk of endometrial cancer

    DEFF Research Database (Denmark)

    Sjögren, Lea L; Mørch, Lina Steinrud; Løkkegaard, Ellen

    2016-01-01

    BACKGROUND: In 1975, estrogen only was found to be associated with an increased risk of endometrial cancer. In November 2015, NICE guidelines on hormone therapy were published that did not take this risk into account. AIM: This systematic literature review assesses the safety of estrogen plus pro...

  19. Reproducibility of measurement of myometrial invasion in endometrial carcinoma

    NARCIS (Netherlands)

    Putten, L.J.M. van der; Vijver, K. van der; Bartosch, C.; Davidson, B.; Gatius, S.; Matias-Guiu, X.; McCluggage, W.G.; Toledo, G.; Wurff, A.A. van der; Pijnenborg, J.M.A.; Massuger, L.F.A.G.; Bulten, J.

    2017-01-01

    Myometrial invasion (MI) as a percentage (%MI), categorized into <50 or >/=50 %, is an important predictor of prognosis in endometrial carcinoma. Recent studies suggest that tumor-free distance (TFD) to serosa and the absolute depth of invasion (DOI) might be stronger predictors of prognosis.

  20. Hormone contraception before the first birth and endometrial cancer risk.

    Science.gov (United States)

    Cook, Linda S; Dong, Yan; Round, Pamela; Huang, Xun; Magliocco, Anthony M; Friedenreich, Christine M

    2014-02-01

    There is a well-documented reduction in endometrial cancer risk with combined oral contraceptive (COC) use. COC use before the first full-term pregnancy may affect breast cancer risk for decades, but this relationship has not been investigated in endometrial cancer. We investigated the risk for endometrial cancer with COC use before the first full-term pregnancy. Cases (n = 524) from a population-based cancer registry and age-matched controls (n = 1,032) were recruited between 2002 and 2006 in Alberta, Canada. Participants completed an in-person interview and provided detailed information on exogenous hormone use and other risk factors. Risk reductions in endometrial cancer with COC use over the premenopausal years were consistent with the published literature. We also found evidence of a long-term, significant risk reduction in parous women with COC use before the first full-term pregnancy. Among parous women, ≥5 years of COC use before a first full-term pregnancy was associated with a significant reduction in risk [adjusted OR, 0.42; 95% confidence interval (CI), 0.25-0.72], even if this exposure was a woman's only use of COCs (adjusted OR, 0.35; 95% CI, 0.18-0.68). Further understanding of the long-term effects of COC use may help guide the timing of chemoprevention efforts via COCs.

  1. Histopathological Patterns of Endometrial Lesions in Patients with ...

    African Journals Online (AJOL)

    Mubeen

    Background: Endometrial diseases ranked among the most common gynecological disorders that affect women globally. These diseases cut across all age groups and contribute significantly to increased maternal morbidity and mortality. Due to the wide range of histopathological patterns,the need for urgent diagnosis and ...

  2. Histological changes in the endometrial of pregnant Sprague ...

    African Journals Online (AJOL)

    Administrator

    2011-06-20

    Jun 20, 2011 ... This study describes a changed uterine morphometry and its application to the endometrial structure of a pregnant rat. The number and the size of uterine gland and blood vessels changed during the pregnancy period of the rat. This effect on day 15 was significantly changed in the different groups.

  3. Role of pelvic lymphadenectomy in stage 1A endometrial carcinoma ...

    African Journals Online (AJOL)

    Hossam Hassan Aly Hassan El Sokkary

    2013-10-31

    Oct 31, 2013 ... Abstract Introduction: Endometrial cancer is the commonest gynecological cancer mostly affect- ing women in the postmenopausal age group. There is a debate regarding the need of pelvic lym- phadenectomy in managing stage 1A diagnosed preoperatively, we try to evaluate this need. Objective: To ...

  4. Evaluation of Ovarian Lesions Inducing Endometrial Hyperplasia or ...

    African Journals Online (AJOL)

    Mubeen

    Background: Excessive and prolonged estrogenic stimulation results in endometrial hyperplasias or endometrioid adenocarcinomas. One of the major reasons for an excess endogenous estrogen production is estrogen secreting ovarian lesions which could either be neoplastic or non-neoplastic. Aims: This was a study ...

  5. Cervicovaginal Smear Findings of Endometrial Serous Carcinoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Figen Barut

    2008-08-01

    Although cervicovaginal smear generally is not a sensitive screening test for endometrial carcinomas, it played an important role in determining serous carcinoma. This may be related with advanced stage and/or aggressive features of the neoplastic process.

  6. Quantitative DNA methylation analysis of selected genes in endometrial carcinogenesis

    Directory of Open Access Journals (Sweden)

    Ying-Chieh Chen

    2015-10-01

    Conclusion: Promoter methylation of ZNF177, COL14A1, HOXA9, DPYSL4, and TMEFF2 genes is a frequent epigenetic event in EC. Furthermore, the epigenetic hypermethylation of TMEFF2 may be a valuable marker for identifying undetected EC within endometrial hyperplasia.

  7. Postoperative brachytherapy for endometrial cancer using a ring applicator

    NARCIS (Netherlands)

    Vanneste, Ben G. L.; Meijnen, Philip; Hammerstein, Chris S. J.; Bijker, Nina; van Os, Rob M.; Stalpers, Lukas J. A.; Pieters, Bradley R.

    2015-01-01

    BACKGROUND: To evaluate the rate of vaginal, pelvic, and distant failures and acute toxicity after postoperative vaginal vault brachytherapy (VBT) delivered by a ring applicator in women with high intermediate-risk endometrial cancer. METHODS AND MATERIALS: A total of 100 patients were treated with

  8. Wilms' tumor gene 1 (WT1) in endometrial carcinoma.

    Science.gov (United States)

    Coosemans, An; Moerman, Philippe; Verbist, Godelieve; Maes, Wim; Neven, Patrick; Vergote, Ignace; Van Gool, Stefaan W; Amant, Frédéric

    2008-12-01

    Wilms' tumor gene (WT1), located on chromosome 11, encodes a transcription factor that contributes to the carcinogenesis of uterine sarcomas. To expand the knowledge on the biological role of WT1 in other uterine cancers, we focused on its detection in endometrial carcinoma. In total, 36 paraffin-embedded tumors were available for WT1 immunohistochemical (IHC) analysis including endometrial endometrioid carcinoma (n=24), serous carcinoma (n=9) and clear cell carcinoma (n=3). Three slides from different sites of the tumor were analysed. Of these tumors, 32 snap frozen tissue samples were available for RT-PCR (endometrioid carcinoma (23), serous carcinoma (7) and clear cell carcinoma (2)). To compare, WT1 expression was also evaluated by IHC in benign endometrium (12) and benign endometrial polyps (5). WT1 positivity was noticed in tumor cells and endothelial cells, lining the intratumoral blood vessels. Overall, 72% (26/36) of tumors stained positive for WT1. RT-PCR results showed WT1 positivity in 75% (24/32) of samples. Comparing the staining patterns of the 3 different bioptic sites, tumor heterogeneity was demonstrated in the majority (72%) of samples. Although WT1 is expressed in a majority of endometrial carcinomas, a heterogeneous staining pattern is observed. This information is important for WT1-directed immunotherapy.

  9. Evaluation of Ovarian Lesions Inducing Endometrial Hyperplasia or ...

    African Journals Online (AJOL)

    Conclusion: Follicular cyst was the predominant lesion associated with endometrial hyperplasia and endometrioid adenocarcinoma of endometrium in post-menopausal age group. In addition, hyperplastic lesions in endometrium can occur in non-hormonal secreting ovarian epithelial tumors possibly due to functioning ...

  10. [Endometrial ablation with thermal balloon, experience in a private hospital].

    Science.gov (United States)

    Quesnel-García-Benítez, C; Sánchez-Aranda, A; López-Rioja, M J

    2016-04-01

    Traditionally, the treatment for menorrhagia includes pharmacological therapies (hormones and uterotonics) or surgical (dilatation/curettage and hysterectomy). Recently the FDA approved a non-invasive therapeutic option, known as endometrial ablation. Which it consists in a thermal balloon delivers (ThermaChoice y Thermablate EAS) which energy destroys the uterine lining, thus reducing the bleeding and even producing amenorrhea. And could offer other benefits such as reduction of the surgical time, and therefore: anesthesia time, postoperative complications and costs. Highlighting a greater patient satisfaction. Describe the demographic characteristics, outcomes and patient satisfaction, which were treated with endometrial ablation for menorrhagia. A descriptive, observational and retrospective study. During a period of 11 years (March 2012 to December 2013), in a private hospital, that includes 124 patients with menorrhagia, which were treated with endometrial ablation: 53 (43%) ThermaChoice y 71 (57%) Thermablate EAS. We used T Student and Fisher method to study the results. The 124 patients (100%) achieve all the criteria's of endometrial ablation according ACOG (American College of Obstetricians and Gynecologists) were candidates for. The mean age of our patients were 38 years old, who didn't respond to pharmacologic treatment had a definitive contraception. Among these women, 119 (96%) had a reduction in bleeding en the first 12 months, 25 (31%) presented with amenorrhea and 1 (<1%) required a surgical approach. Overall, 119 patients (96%) were satisfied with their results. Endometrial ablation is an approved FDA treatment for menorrhagia, which is safe, accessible and effective. With an easy implementation and low rate of complications.

  11. Ultrasound in assisted reproduction: a call to fill the endometrial gap.

    Science.gov (United States)

    Hershko-Klement, Anat; Tepper, Ronnie

    2016-06-01

    Ultrasound offers essential details and an overall view of the anatomic features of the reproductive organs, as well as physiologic assessment. There is still a great gap, however, in our understanding and interpretation of endometrial sonographic findings. Endometrial thickness, growth, and sonographic patterns have been repeatedly tested and compared with pregnancy rates in IVF cycles, yielding conflicting results. Generally, the data accrued so far suggest refraining from clinical decisions based solely on endometrial thickness. The three-layer ultrasound pattern reflects normal follicular/proliferative dynamics, and its presence in the pre-hCG period was reported to carry a better outcome: Significantly higher clinical pregnancy rates were found in patients with this pattern on the day of hCG administration among IVF cohorts. Subendometrial contractility (endometrial "waves") offers a tool that can be used in cases of repeated implantation failure in patients reporting cramps around the planned time of embryo transfer, or as a reassuring modality to assess uterine quiescence during preparations for embryo transfer. We support the creation of an integrated endometrial score incorporating conservative endometrial measurements, endometrial-myometrial junction studies, and endometrial contractility, as well as new concepts that remain to be tested, such as endometrial surface area. Such scores may enable us to improve the effectiveness of endometrial ultrasound imaging in the clinical setting. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  12. Accuracy of endometrial sampling compared to conventional dilatation and curettage in women with abnormal uterine bleeding.

    Science.gov (United States)

    Abdelazim, Ibrahim A; Abdelrazak, Khaled M; Elbiaa, Assem A M; Al-Kadi, Mohamed; Yehia, Amr H

    2015-05-01

    To compare the diagnostic accuracy of brush endometrial sampling with conventional dilatation and curettage in women with abnormal uterine bleeding. Two hundred and twenty (220) women with abnormal uterine bleeding were included in this comparative study; endometrial sampling was done before cervical dilatation using Tao Bruch followed by conventional dilatation and curettage (D&C). The histopathology report of the Tao Bruch samples was compared with that of the D&C samples and the D&C results were considered as the gold standard. 100% of samples obtained by conventional D&C, while 98.2% of the samples obtained by Tao Brush were adequate for histopathology examination. In this study; Tao Brush had 100% sensitivity, 100% specificity, 100% predictive values and accuracy for diagnosing endometrial hyperplasia, endometrial carcinoma, proliferative and secretory endometrium, also, it had 86.7% sensitivity, 100% specificity, 100% positive predictive value (PPV) and 99% negative predictive value (NPV) and accuracy for diagnosing endometritis (no significant difference compared to conventional D&C), while, it had 77.8% sensitivity, 100% specificity, 100% PPV and 99% NPV and accuracy for diagnosing endometrial polyps (no significant difference compared to conventional D&C) CONCLUSION: Endometrial sampling using endometrial brush cytology (EBC) is safe, accurate, cost-effective outpatient procedure, avoids general anesthesia with high sensitivity and specificity for detection of endometrial hyperplasia and endometrial carcinoma. EBC could be used as complementary diagnostic tool when hysteroscopic biopsies or other blinded procedures for endometrial sampling are unwanted or not available.

  13. Meta-analysis of bipolar radiofrequency endometrial ablation versus thermal balloon endometrial ablation for the treatment of heavy menstrual bleeding.

    Science.gov (United States)

    Zhai, Yan; Zhang, Zihan; Wang, Wei; Zheng, Tingping; Zhang, Huili

    2018-01-01

    Heavy menstrual bleeding is a common problem that can severely affect quality of life. To compare bipolar radiofrequency endometrial ablation and thermal balloon ablation for heavy menstrual bleeding in terms of efficacy and health-related quality of life (HRQoL). Online registries were systematically searched using relevant terms without language restriction from inception to November 24, 2016. Randomized control trials or cohort studies of women with heavy menstrual bleeding comparing the efficacy of two treatments were eligible. Data were extracted. Results were expressed as risk ratios (RRs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs). Six studies involving 901 patients were included. Amenorrhea rate at 12 months was significantly higher after bipolar radiofrequency endometrial ablation than after thermal balloon ablation (RR 2.73, 95% CI 2.00-3.73). However, no difference at 12 months was noted for dysmenorrhea (RR 1.04, 95% CI 0.68-1.58) or treatment failure (RR 0.78, 95% CI 0.38-1.60). The only significant difference for HRQoL outcomes was for change in SAQ pleasure score (12 months: WMD -3.51, 95% CI -5.42 to -1.60). Bipolar radiofrequency endometrial ablation and thermal balloon ablation reduce menstrual loss and improve quality of life. However, bipolar radiofrequency endometrial ablation is more effective in terms of amenorrhea rate and SAQ pleasure. © 2017 International Federation of Gynecology and Obstetrics.

  14. Gynecologic Cancer InterGroup (GCIG) endometrial cancer clinical trials planning meeting: taking endometrial cancer trials into the translational era.

    NARCIS (Netherlands)

    Creutzberg, C.L.; Kitchener, H.C.; Birrer, M.J.; Landoni, F.; Lu, K.H.; Powell, M.; Aghajanian, C.; Edmondson, R.; Goodfellow, P.J.; Quinn, M.; Salvesen, H.B.; Thomas, G; Ottevanger, N.; et al.,

    2013-01-01

    OBJECTIVE: The second Gynecologic Cancer InterGroup (GCIG) Endometrial Cancer Clinical Trials Planning Meeting was held on December 1, 2012, and included international multidisciplinary representatives of the 24 member groups. The aims were to review recent advances in molecular pathology of

  15. Evaluation of two endometriosis models by transplantation of human endometrial tissue fragments and human endometrial mesenchymal cells

    Directory of Open Access Journals (Sweden)

    Mina Jafarabadi

    2017-08-01

    Full Text Available Background: The animal models of endometriosis could be a valuable alternative tool for clarifying the etiology of endometriosis. Objective: In this study two endometriosis models at the morphological and molecular levels was evaluated and compared. Materials and Methods: The human endometrial tissues were cut into small fragments then they were randomly considered for transplantation into γ irradiated mice as model A; or they were isolated and cultured up to fourth passages. 2×106 cultured stromal cells were transplanted into γ irradiated mice subcutaneously as model B. twenty days later the ectopic tissues in both models were studied morphologically by Periodic acid-Schiff and hematoxylin and eosin staining. The expression of osteopontin (OPN and matrix metalloproteinase 2 (MMP2 genes were also assessed using real time RT-PCR. 17-β estradiol levels of mice sera were compared before and after transplantation. Results: The endometrial like glands and stromal cells were formed in the implanted subcutaneous tissue of both endometriosis models. The gland sections per cubic millimeter, the expression of OPN and MMP2 genes and the level of 17-β estradiol were higher in model B than model A (p=0.03. Conclusion: Our observation demonstrated that endometrial mesenchymal stromal cells showed more efficiency to establish endometriosis model than human endometrial tissue fragments.

  16. Usefulness of Sonohysterography in the Differentiation of Endometrial and EndometriaI Cavity Abnormalities :Comparison with TransvaginaI Sonography

    International Nuclear Information System (INIS)

    Lee, Eun Ju; Lee, Hyang Mi; Kwon, Hyuk Chan; Joo, Hee Jae

    1995-01-01

    The purpose of this study was to evaluate the diagnostic accuracy and usefulness odsonohysterography(SH) in the diagnosis of endometrial and endometrial cavity abnormalities. 51 patients with suspected endometrial abnormalities were examined with both transvaginal sonography(TVS) and SH. The results of both techniques were correlated with pathologic findings obtained by surgical procedures and the accuracies of the techniques were compared. Of 55 histologically proven lesions, there were endometrialhyperplasia(n=4), endometrial polyp(n=30), endometrial polyp with hyperplasia(n=2), placental polyp(n=3), submucosal myoma(n=10) and synechia(n=6). The diagnostic accuracy in differentiation of endometrial and endometrial cavity abnormalities was increased from 79% in conventional TVS to 95% in SH(p<0.001). SH was a simple and well-tolerated technique to perform, favorably depicting the endometrial and endometrial cavity abnormalities that were equivocal on TVS

  17. High ω-3:ω-6 fatty acids ratio increases fatty acid binding protein 4 and extracellular secretory phospholipase A2IIa in human ectopic endometrial cells

    Science.gov (United States)

    Khanaki, Korosh; Sadeghi, Mohammad Reza; Akhondi, Mohammad Mehdi; Darabi, Masoud; Mehdizadeh, Amir; Shabani, Mahdi; Rahimipour, Ali; Nouri, Mohammad

    2014-01-01

    Background: Endometriosis, a common chronic inflammatory disorder, is defined by the atypical growth of endometrium- like tissue outside of the uterus. Secretory phospholipase A2 group IIa (sPLA2-IIa) and fatty acid binding protein4 (FABP4) play several important roles in the inflammatory diseases. Objective: Due to reported potential anti-inflammatory effects of ω-3 and ω-6 fatty acids, the purpose of the present study was to investigate the effects of ω-3 and ω-6 polyunsaturated fatty acids (PUFAs) on fatty acid binding protein 4 and extracellular secretory phospholipase A2IIa in cultured endometrial cells. Materials and Methods: Ectopic and eutopic endometrial tissues obtained from 15 women were snap frozen. After thawing and tissue digestion, primary mixed stromal and endometrial epithelial cell culture was performed for 8 days in culture mediums supplemented with normal and high ratios of ω-3 and ω-6 PUFA. sPLA2-IIa in the culture medium and FABP4 level was determined using enzyme immuno assay (EIA) technique. Results: Within ectopic endometrial cells group, the level of cellular FABP4 and extracellular sPLA2-IIa were remarkably increased under high ω-3 PUFA exposure compared with control condition (p=0.014 and p=0.04 respectively). Conclusion: ω-3 PUFAs may increase the level of cellular FABP4 and extracellular sPLA2-IIa in ectopic endometrial cells, since sPLAIIa and FABP4 may affect endometriosis via several mechanisms, more relevant studies are encouraged to know the potential effect of increased cellular FABP4 and extracellular sPLA2-IIa on endometriosis. PMID:25709631

  18. The influence of cemented femoral stem choice on the incidence of revision for periprosthetic fracture after primary total hip arthroplasty: an analysis of national joint registry data.

    Science.gov (United States)

    Palan, J; Smith, M C; Gregg, P; Mellon, S; Kulkarni, A; Tucker, K; Blom, A W; Murray, D W; Pandit, H

    2016-10-01

    Periprosthetic fracture (PF) after primary total hip arthroplasty (THA) is an uncommon but potentially devastating complication. This study aims to investigate the influence of cemented stem designs on the risk of needing a revision for a PF. We analysed data on 257 202 primary THAs with cemented stems and 390 linked first revisions for PF recorded in the National Joint Registry (NJR) of England, Wales and Northern Ireland to determine if a cemented femoral stem brand was associated with the risk of having revision for a PF after primary THA. All cemented femoral stem brands with more than 10 000 primary operations recorded in the NJR were identified. The four most commonly used cemented femoral stems were the Exeter V40 (n = 146 409), CPT (n = 24 300), C-Stem (n = 15 113) and Charnley (n = 20 182). We compared the revision risk ratios due to PF amongst the stems using a Poisson regression model adjusting for patient factors. Compared with the Exeter V40, the age, gender and ASA grade adjusted revision rate ratio was 3.89 for the cemented CPT stem (95% confidence interval (CI) 3.07 to 4.93), 0.89 for the C-Stem (95% CI 0.57 to 1.41) and 0.41 for the Charnley stem (95% CI 0.24 to 0.70). The limitations of the study include incomplete data capture, analysis of only PF requiring revision and that observation does not imply causality. Nevertheless, this study demonstrates that the choice of a cemented stem may influence the risk of revision for PF. Cite this article: Bone Joint J 2016;98-B:1347-54. ©2016 The British Editorial Society of Bone & Joint Surgery.

  19. Novel incision design and primary flap closure reduces the incidence of alveolar osteitis and infection in impacted mandibular third molar surgery.

    Science.gov (United States)

    Elo, Jeffrey A; Sun, Ho-Hyun Brian; Dong, Fanglong; Tandon, Rahul; Singh, Hardev M

    2016-08-01

    To measure the influence of flap design on alveolar osteitis (AO) and postoperative complications following mandibular third molar surgery. This study was designed as a randomized single-blind, split-mouth clinical trial. The predictor variable was flap type. Envelope flap, modified triangular flap (MTF), and two related experimental flaps (second molar mesial papilla-sparing marginal incision with distobuccal release with double-pass single-layered primary closure [MPMI-2 X] and single-pass single-layered primary closure [MPMI-1 X]) were used. The primary outcome variable was AO. The secondary outcome variables were wound dehiscence and infection. Bivariate and logistic analyses were computed. P value third molars participated. No sites (0 of 196) treated with MPMI-2 X developed AO, and only two sites (2 of 196) treated with MPMI-2 X developed postoperative infection. Both MPMI-1 X and MPMI-2 X were associated with decreased odds of complications compared with MTF and envelope flap. MPMI-2 X sites were significantly less likely than MTF sites to experience complications for both sides. MPMI-2 X is a reliable technique to reduce complications, such as AO, wound dehiscence, and infection in mandibular third molar surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Temsirolimus and Bevacizumab in Treating Patients With Advanced Endometrial, Ovarian, Liver, Carcinoid, or Islet Cell Cancer

    Science.gov (United States)

    2017-07-10

    Adult Hepatocellular Carcinoma; Advanced Adult Hepatocellular Carcinoma; Endometrial Serous Adenocarcinoma; Localized Non-Resectable Adult Liver Carcinoma; Lung Carcinoid Tumor; Malignant Pancreatic Gastrinoma; Malignant Pancreatic Glucagonoma; Malignant Pancreatic Insulinoma; Malignant Pancreatic Somatostatinoma; Metastatic Digestive System Neuroendocrine Tumor G1; Ovarian Carcinosarcoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Seromucinous Carcinoma; Ovarian Serous Surface Papillary Adenocarcinoma; Pancreatic Alpha Cell Adenoma; Pancreatic Beta Cell Adenoma; Pancreatic Delta Cell Adenoma; Pancreatic G-Cell Adenoma; Pancreatic Polypeptide Tumor; Recurrent Adult Liver Carcinoma; Recurrent Digestive System Neuroendocrine Tumor G1; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Pancreatic Neuroendocrine Carcinoma; Recurrent Primary Peritoneal Carcinoma; Recurrent Uterine Corpus Carcinoma; Regional Digestive System Neuroendocrine Tumor G1; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IIIC Uterine Corpus Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer; Uterine Carcinosarcoma

  1. Ionospheric Oblique Incidence Soundings by Satellites

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The oblique incidence sweep-frequency ionospheric sounding technique uses the same principle of operation as the vertical incidence sounder. The primary difference...

  2. Do Endometrial Movements Affect The Achievement of Pregnancy during Intrauterine Insemination?

    Directory of Open Access Journals (Sweden)

    Ari Kim

    2015-02-01

    Full Text Available Background: This study was aimed to assess the effect of endometrial movements on pregnancy achievement in intrauterine insemination (IUI cycles. Materials and Methods: The population of this observational study was composed of unexplained infertility couples undergoing first-time IUI with clomiphene citrate between September 2010 and October 2011. Not only endometrial movements, but also thickness, volume, pattern, and echogenic change of endometrium were analyzed prospectively in prediction of pregnancy. Results: The total number of 241 cycles of IUI with 49 intrauterine pregnancies (20.3% was analyzed. Pregnancy was not related to endometrial thickness and endometrial volume, but significantly related to endometrial movements associated with the number of contraction, strong movement, cervicofundal direction, and hyperechoic change (p<0.05. Pregnant group showed higher cervicofundal movement rate (89.8 vs. 75.5%. Conclusion: For IUI cycles stimulated by clomiphene citrate in unexplained infertility women, endometrial movements on the day of IUI could be a predictor of pregnancy.

  3. Accuracy of doppler ultrasound in diagnosis of endometrial carcinoma

    International Nuclear Information System (INIS)

    Batool, S.; Raza, S.; Manzur, S.

    2013-01-01

    Objective: To determine the accuracy of Doppler ultrasound in the diagnosis of endometrial carcinoma in patients presenting with post-menopausal bleeding while taking histopathological findings as the gold standard. Methods: The cross-sectional study was done at the Department of Radiology, Bahawal Victoria Hospital, Bahawalpur, from April 1 to September 30, 2009, and comprised 128 patients above 50 years of age having history of post-menopausal bleeding and who were referred to the department. Name, age and hospital registration number were recorded on a proforma. Doppler ultrasound was performed and endometrial thickness and uterine artery resistive index were recorded on transabdominal ultrasonography. Patients with endometrial thickness of more than 5mm and uterine artery resistive index of less than 0.7 were considered to be having endometrial carcinoma. Histopathology findings were also recorded using the hospital registration number of the patient. The findings of Doppler ultrasound scan were validated with the findings of histopathology. Results: Of the 128 patients, 48 (37.5%) were between the ages of 51 and 55 years; 46 (35.93%) were in the 56-60 age group; and 34 (26.57%) were over 65 years. On the basis of Doppler ultrasound findings, 106 (82.8%) patients were diagnosed as having endometrial carcinoma, while 22 (17.19%) were declared negative. Ultrasonography results were compared with histopathology findings. The percentages of true positive, true negative, false positive and false negative were calculated. There were 103 (80.47%) true positive; 12 (9.37%) false positive; 10 (7.81%) true negative; and 3 (2.35%) false negative. Specificity, sensitivity, positive predictive value and negative predictive value were found to be 97.16%, 76%, 89.56% and 76.92% respectively. Conclusion: The use of Doppler ultrasonography in non-invasive diagnosis of endometrial carcinoma in patients presenting with post-menopausal bleeding was quite useful with good

  4. Predictors for lymph nodes involvement in low risk endometrial cancer.

    Science.gov (United States)

    Kadan, Yfat; Calvino, Abdul Saied; Katz, Andrew; Katz, Steven; Moore, Richard G

    2017-05-01

    Neutrophil-lymphocyte ratio (NLR) and BMI were examined as pre-operative predictors for lymph node metastases in patients with low-risk endometrial cancer. The study was a retrospective analysis of 534 endometrial cancer patients that underwent hysterectomy and lymph node dissection. Included subjects had a preoperative diagnosis of a grade 1 or 2 endometrioid carcinoma and no macroscopic extrauterine disease. We compared node-negative to node-positive patients to identify correlates of node-positive disease. The node-positive group presented with lower BMI than the node-negative group, 31.5 and 34.4, respectively (p = .03). The mean NLR was higher in the node-positive group 3.4 vs 2.9 (p = .08), showing a trend towards significance on univariate analysis. On multivariate analysis, lower BMI was found to be an independent predictor for nodal metastasis. Our data suggest that lower BMI is a risk factor for lymph nodes involvement in low-risk endometrial cancer. Impact statement Most endometrial cancer patients have low-risk disease with low risk for lymph nodes metastasis. In order to reduce the number of patients that will undergo unnecessary lymph node dissection, different types of preoperative predictors for lymph node involvement were studied. CA 125 and different imaging modalities were found as useful predictors for more advanced disease. Less studied predictors are the systemic inflammatory response markers and patient's BMI. This study suggests that lower BMI is a risk factor for lymph node involvement in low-risk endometrial cancer. The neutrophil to lymphocyte ratio was close to significance as a predictor for lymph node involvement. In practice, physicians might favour comprehensive lymph node dissection when there is a doubt regarding the procedure but the patient is lean. The study's conclusion can be utilised for triaging patients to general gynaecologist vs gynaecologic oncologist. Further research should focus on combining predictors such as

  5. Histopathology Discrepancy of Preoperative Endometrial Sampling and Final Specimen: How Does This Influence Selective Lymph Node Dissection?

    Science.gov (United States)

    Corr, Bradley R; Carrubba, Aakriti; Sheeder, Jeanelle; Cheng, Georgina; Guntupalli, Saketh R

    2017-02-01

    Preoperative histology is a major component in the perioperative selective lymph node (LN) dissection decision process. Discrepancy between preoperative endometrial sampling and final specimen histopathology is generally accepted. The goals of this project are to determine if discrepancy of histopathology is associated with alteration of adjuvant treatment or outcome. We performed a retrospective cross-sectional analysis of all patients undergoing surgery for endometrial cancer at a single institution from 2010 to 2014. All patients had preoperative endometrial sampling. Histopathology discrepancy was evaluated for potential in variation of perioperative LN dissection. Criteria for not performing LN dissection was defined as preoperative endometrioid histology, grade 1 or 2 lesion, myometrial invasion of 50% or less, and primary tumor diameter 2 cm or less. A total of 352 patients were identified; 44 were excluded because of no preoperative pathology or no residual disease on final pathology. Discrepancy of histopathology was noted in 64/308 (20.8%; 95% confidence interval [CI], 16.2%-25.3%) patients. Preoperative endometrioid histology was noted in 272 patients, and 17/272 (6.3%; 95% CI, 3.4%-9.1%) had preoperative sampling reviewed as a grade 1 or 2 endometrioid lesion and final specimen was upgraded to grade 3. Downstaging occurred in 3/272 (1.1%; 95% CI, 0%-2.3%) patients with preoperative grade 3 lesion and final specimen demonstrated grade 1 or 2 disease. All 3 patients' primary tumor diameter was greater than 2 cm and therefore received LN dissection. Histopathological discrepancy that would alter perioperative LN dissection decision based on the aforementioned criteria occurred in 2/272 (0.7%; 95% CI, 0%-1.8%). Despite a 20% discrepancy of preoperative and postoperative histopathology, discrepancy that would alter a perioperative decision for LN dissection occurs in only 0.7% of cases in this retrospective single-institutional experience. Myometrial

  6. Comparison of Unmanned Aerial Vehicle Technology Versus Standard Practice in Identification of Hazards at a Mass Casualty Incident Scenario by Primary Care Paramedic Students.

    Science.gov (United States)

    Jain, Trevor; Sibley, Aaron; Stryhn, Henrik; Hubloue, Ives

    2018-01-31

    Introduction The proliferation of unmanned aerial vehicles (UAV) has the potential to change the situational awareness of incident commanders allowing greater scene safety. The aim of this study was to compare UAV technology to standard practice (SP) in hazard identification during a simulated multi-vehicle motor collision (MVC) in terms of time to identification, accuracy and the order of hazard identification. A prospective observational cohort study was conducted with 21 students randomized into UAV or SP group, based on a MVC with 7 hazards. The UAV group remained at the UAV ground station while the SP group approached the scene. After identifying hazards the time and order was recorded. The mean time (SD, range) to identify the hazards were 3 minutes 41 seconds (1 minute 37 seconds, 1 minute 48 seconds-6 minutes 51 seconds) and 2 minutes 43 seconds (55 seconds, 1 minute 43 seconds-4 minutes 38 seconds) in UAV and SP groups corresponding to a mean difference of 58 seconds (P=0.11). A non-parametric permutation test showed a significant (P=0.04) difference in identification order. Both groups had 100% accuracy in hazard identification with no statistical difference in time for hazard identification. A difference was found in the identification order of hazards. (Disaster Med Public Health Preparedness. 2018;page 1 of 4).

  7. Endometrial histology in severely obese bariatric surgery candidates: an exploratory analysis.

    Science.gov (United States)

    Kaiyrlykyzy, Aiym; Freese, Kyle E; Elishaev, Esther; Bovbjerg, Dana H; Ramanathan, Ramesh; Hamad, Giselle G; McCloskey, Carol; Althouse, Andrew D; Huang, Marilyn; Edwards, Robert P; Linkov, Faina

    2015-01-01

    Endometrial pathology risk has been linked to obesity; however, little is known of its prevalence in severely obese women not seeking care for endometrial pathology associated symptoms. This pilot study was designed to explore the frequency and risk factors associated with endometrial pathology in cancer-free, severely obese, bariatric surgery candidates using the Pipelle endometrial sampling technique (SureFlex Preferred Curette, Bioteque America, Inc, New Taipei City, Taiwan). Twenty-nine severely obese bariatric surgery candidates with intact uteruses and no history of endometrial cancer or endometrial ablation were included in this subanalysis from a larger cohort of 47. Endometrial samples were obtained using a Pipelle endometrial suction curette at a single time point before surgery. Logistic regression was used to assess the relationship between body mass index and endometrial pathology when adjusting for age and race. Of the 29 successful biopsies, 8 (27.6%) were classified as abnormal endometrium: 1 was classified as complex atypical hyperplasia, 1 was classified as hyperplasia without atypia, 4 samples were identified with endometrial polyps, and 2 samples were identified with metaplasia. None presented with cancer. Increasing body mass index was significantly associated with higher risk of abnormal endometrium (OR = 1.19, 95% CI [1.03-1.36], P = .01). The findings in this sample suggest that obesity may be associated with increased risk of having undiagnosed endometrial pathology. More thorough examination of relationships between levels of obesity and endometrial pathology are needed to better characterize high cancer risk groups who may benefit from introducing new screening measures. Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  8. Incidents analysis

    International Nuclear Information System (INIS)

    Francois, P.

    1996-01-01

    We undertook a study programme at the end of 1991. To start with, we performed some exploratory studies aimed at learning some preliminary lessons on this type of analysis: Assessment of the interest of probabilistic incident analysis; possibility of using PSA scenarios; skills and resources required. At the same time, EPN created a working group whose assignment was to define a new approach for analysis of incidents on NPPs. This working group gave thought to both aspects of Operating Feedback that EPN wished to improve: Analysis of significant incidents; analysis of potential consequences. We took part in the work of this group, and for the second aspects, we proposed a method based on an adaptation of the event-tree method in order to establish a link between existing PSA models and actual incidents. Since PSA provides an exhaustive database of accident scenarios applicable to the two most common types of units in France, they are obviously of interest for this sort of analysis. With this method we performed some incident analyses, and at the same time explores some methods employed abroad, particularly ASP (Accident Sequence Precursor, a method used by the NRC). Early in 1994 EDF began a systematic analysis programme. The first, transient phase will set up methods and an organizational structure. 7 figs

  9. Incidência de glaucoma agudo primário no Serviço de Glaucoma do Hospital São Geraldo Incidence of primary angle-closure glaucoma in the Glaucoma Service of the São Geraldo Hospital

    Directory of Open Access Journals (Sweden)

    Rafael Vidal Mérula

    2008-06-01

    Full Text Available OBJETIVOS: Determinar a incidência do glaucoma agudo primário no Serviço de Glaucoma do Hospital São Geraldo; estabelecer o perfil destes pacientes e identificar possíveis fatores de risco. MÉTODOS: Estudo transversal. Período de análise: setembro/2005 a agosto/2006. Inclusão: diagnóstico de glaucoma agudo primário. Exclusão: presença de catarata que acarrete baixa acuidade visual ou miopização, glaucomas secundários, íris em platô. Foram avaliados: número de atendimentos, incidência de glaucoma agudo primário, idade, sexo, raça, história familiar de glaucoma, ceratometria, e dados biométricos. RESULTADOS: Dentre 879 pacientes atendidos, 20 (2,3% tiveram o diagnóstico de glaucoma agudo primário, desse modo, a incidência de glaucoma agudo primário foi de 22,7 por 1000 atendimentos. Dos pacientes com glaucoma agudo primário: 6 (30,0% eram do sexo masculino e 14 (70,0% feminino; a idade variou de 40 a 73 anos (média: 60,4 ± 8,1 anos; 12 (60,0% eram leucodérmicos e 8 (40,0% feodérmicos; 5 (25,0% com história familiar positiva para glaucoma. O risco relativo para o sexo feminino foi de 1,44 (IC 95%. Onze (55,0% pacientes tiveram glaucoma agudo primário no olho direito e 9 (45,0% no esquerdo. Não houve diferença estatisticamente significativa na comparação dos parâmetros biométricos e ceratometria entre os olhos afetados e os contralaterais. CONCLUSÕES: A incidência de glaucoma agudo primário no Serviço de Glaucoma do Hospital São Geraldo foi de 22,7 por 1000 atendimentos, sendo mais freqüente em mulheres, leucodérmicas, com história familiar negativa para glaucoma e média de idade de 60,4 anos. Os olhos afetados e olhos contralaterais foram semelhantes nos parâmetros biométricos.PURPOSE: To determine the incidence of the primary angle-closure glaucoma at the Glaucoma Service of São Geraldo Hospital, to establish the profile of these patients and to identify the possible risk factors. METHODS

  10. Medication incidents reported to an online incident reporting system.

    LENUS (Irish Health Repository)

    Alrwisan, Adel

    2011-01-15

    AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

  11. Brachytherapy-related complications for medically inoperable Stage I endometrial carcinoma

    International Nuclear Information System (INIS)

    Chao, Clifford K. S.; Grigsby, Perry W.; Perez, Carlos A.; Camel, H. Marvin; Kao, Ming-Shian; Galakatos, Andrew E.; Boyle, Walter A.

    1995-01-01

    Purpose: The current study was conducted to investigate the incidence and risk factors for medical complications associated with low dose rate brachytherapy in patients with medically inoperable Stage I endometrial cancer treated with irradiation alone. Methods and Materials: From 1965 through 1991 at Mallinckrodt Institute of Radiology, 150 implants were performed on 96 patients who were deemed medically unfit for hysterectomy because of advanced age, obesity, and various medical problems. The records of these patients were examined retrospectively to determine the incidence of medical complications that occurred in the first 30 days following the initiation of brachytherapy. The association of risk factors that precluded major surgery and the occurrence of brachytherapy-related complications was examined by logistic regression. Results: Of these 96 patients, 40 patients were older than 75 years, and 31 patients were deemed morbidly obese. Medical problems included hypertension in 45 patients, and diabetes in 37; there was a history of congestive heart failure in 23, stroke in 11, myocardial infarction in 10, and thromboembolism in 8. There were concurrent malignancies in five patients. Implants were performed using intrauterine Simon-Heyman capsules, tandems, and vaginal ovoids in all patients. General anesthesia was used for 98 implants, spinal anesthesia for 26, local anesthesia for 25, and epidural anesthesia for 1. The duration of anesthesia ranged from 30 to 120 min (median, 60 min). The duration of radioisotope application ranged from 11 to 96 h (median, 46 h). Preventive measures included low dose subcutaneous heparin in 55 patients (since 1978), and intermittent pneumatic compression boots in 29 (since 1985). Four patients developed life-threatening complications including myocardial infarction (two patients), congestive heart failure (one patient), and pulmonary embolism (one patient). Two of these four patients died; one with a myocardial infarction and

  12. Obstetric outcomes of pregnancy after conservative treatment of endometrial cancer: Case series and literature review

    Directory of Open Access Journals (Sweden)

    An-Shine Chao

    2011-03-01

    Conclusions: For women who had completed conservative treatments in early endometrial cancer, assisted reproductive technology provided a choice of scheduled conception for those with subfertility or chronic anovulation.

  13. Incidence of Cyp51 A key mutations in Aspergillus fumigatus-a study on primary clinical samples of immunocompromised patients in the period of 1995-2013.

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    Birgit Spiess

    Full Text Available As the incidence of azole resistance in Aspergillus fumigatus is rising and the diagnosis of invasive aspergillosis (IA in immunocompromised patients is rarely based on positive culture yield, we screened our Aspergillus DNA sample collection for the occurrence of azole resistance mediating cyp51 A key mutations. Using two established, a modified and a novel polymerase chain reaction (PCR assays followed by DNA sequence analysis to detect the most frequent mutations in the A. fumigatus cyp51 A gene conferring azole resistance (TR34 (tandem repeat, L98H and M220 alterations. We analyzed two itraconazole and voriconazole and two multi-azole resistant clinical isolates and screened 181 DNA aliquots derived from clinical samples (blood, bronchoalveolar lavage (BAL, biopsies, cerebrospinal fluid (CSF of 155 immunocompromised patients of our Aspergillus DNA sample collection, previously tested positive for Aspergillus DNA and collected between 1995 and 2013. Using a novel PCR assay for the detection of the cyp51 A 46 bp tandem repeat (TR46 directly from clinical samples, we found the alteration in a TR46/Y121F/T289A positive clinical isolate. Fifty stored DNA aliquots from clinical samples were TR46 negative. DNA sequence analysis revealed a single L98H mutation in 2010, two times the L98H alteration combined with TR34 in 2011 and 2012 and a so far unknown N90K mutation in 1998. In addition, four clinical isolates were tested positive for the TR34/L98H combination in the year 2012. We consider our assay of epidemiological relevance to detect A. fumigatus azole resistance in culture-negative clinical samples of immunocompromised patients; a prospective study is ongoing.

  14. Cervical invasion of endometrial carcinoma - evaluation by parasagittal MR imaging

    International Nuclear Information System (INIS)

    Murakami, T.; Kurachi, H.; Nakamura, H.; Tsuda, K.; Miyake, A.; Tomoda, K.; Hori, S.; Kozuka, T.

    1995-01-01

    Twenty-seven consecutive patients were examined by T2-(1800/70 ms) and postcontrast T1-weighted (600/15) spin echo (SE) or dynamic (200/15) SE MR imaging to determine the usefulness of parasagittal MR imaging in assessing cervical invasion of endometrial carcinoma. The images were obtained in a direction parallel to the longitudinal axis of the uterus (parasagittal). The cervical epithelium, being hyperintense on the late phase dynamic and postcontrast T1-weighted SE images, had disappeared partially or totally in all 4 patients with cervical invasion. The enhanced cervical epithelium was completely seen in one patient with the tumor protruding into the cervical canal in a polyp-like form without cervical epithelial invasion. The same was also seen in the 22 patients with the tumor remaining in the corpus cavity. The enhanced parasagittal MR images facilitated the evaluation of the extent of the endometrial carcinoma. (orig.)

  15. Transition of endometrial stromal sarcoma into high-grade sarcoma.

    Science.gov (United States)

    Amant, Frederic; Woestenborghs, Heidi; Vandenbroucke, Vanessa; Berteloot, Patrick; Neven, Patrick; Moerman, Philippe; Vergote, Ignace

    2006-12-01

    Endometrial stromal sarcoma typically is of low grade and hormone-sensitive. Although these characteristics result in an indolent behavior, little data are available on the evolution over time. We report on two cases where microscopic and immunohistochemic assessment of the tumor on several occasions during 8 and 25 years of follow up enabled us to document a transition of a low-grade into a high-grade malignancy. These were mainly characterized by increased cellular atypia, absence of spiral arterioles and an increased mitotic index and proliferation index (MIB1). Since this transition was related to clinical loss of hormone sensitivity, the therapeutic approach consisting of hormonal treatment in combination with repetitive surgery was switched to chemotherapy only. These long-term follow up data provide insight in endometrial stromal sarcoma tumor biology and highlight the importance of sampling recurrent tumors to estimate biologic behavior in order to tailor subsequent treatment.

  16. Endometrial ablation in the management of abnormal uterine bleeding.

    Science.gov (United States)

    Laberge, Philippe; Leyland, Nicholas; Murji, Ally; Fortin, Claude; Martyn, Paul; Vilos, George; Leyland, Nicholas; Wolfman, Wendy; Allaire, Catherine; Awadalla, Alaa; Dunn, Sheila; Heywood, Mark; Lemyre, Madeleine; Marcoux, Violaine; Potestio, Frank; Rittenberg, David; Singh, Sukhbir; Yeung, Grace

    2015-04-01

    Abnormal uterine bleeding (AUB) is the direct cause of a significant health care burden for women, their families, and society as a whole. Up to 30% of women will seek medical assistance for the problem during their reproductive years. To provide current evidence-based guidelines on the techniques and technologies used in endometrial ablation (EA), a minimally invasive technique for the management of AUB of benign origin. Members of the guideline committee were selected on the basis of individual expertise to represent a range of practical and academic experience in terms of both location in Canada and type of practice, as well as subspecialty expertise and general background in gynaecology. The committee reviewed all available evidence in the English medical literature, including published guidelines, and evaluated surgical and patient outcomes for the various EA techniques. Recommendations were established by consensus. Published literature was retrieved through searches of MEDLINE and The Cochrane Library in 2013 and 2014 using appropriate controlled vocabulary and key words (endometrial ablation, hysteroscopy, menorrhagia, heavy menstrual bleeding, AUB, hysterectomy). RESULTS were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies written in English from January 2000 to November 2014. Searches were updated on a regular basis and incorporated in the guideline to December 2014. Grey (unpublished) literature was identifies through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). This document reviews the evidence regarding the available techniques and technologies for EA

  17. Endometrial intraepithelial carcinoma: A case report and brief review

    Directory of Open Access Journals (Sweden)

    Ram Manisha

    2008-10-01

    Full Text Available This case report describes the precursor lesion of uterine papillary serous carcinoma (UPSC. A 65-year-old post-menopausal female presented with prolapse and vaginal discharge and underwent a hysterectomy revealing an atrophic endometrium, highly atypical endometrial glands, the lining cells of which showed pseudostratification, hobnailing, a high nuclear to cytoplasmic ratio, and prominent nucleoli. A p53 immunoreactivity score of 8 and a MIB-1 index of 80% was obtained leading to a diagnosis of endometrial intraepithelial carcinoma (EIC. Since serous EIC is commonly associated with extra-uterine serous carcinoma, it is a uniquely aggressive precursor lesion. Molecular studies support the hypothesis that EIC is a precursor of both uterine and extra-uterine invasive serous carcinomas. This is why the treatment protocol for EIC cases is total abdominal hysterectomy (TAH, accompanied by a staging procedure. In our patient, EIC was limited to the endometrium; associated with an excellent clinical outcome.

  18. Risk prediction for breast, endometrial, and ovarian cancer in white women aged 50 y or older: derivation and validation from population-based cohort studies.

    Directory of Open Access Journals (Sweden)

    Ruth M Pfeiffer

    Full Text Available Breast, endometrial, and ovarian cancers share some hormonal and epidemiologic risk factors. While several models predict absolute risk of breast cancer, there are few models for ovarian cancer in the general population, and none for endometrial cancer.Using data on white, non-Hispanic women aged 50+ y from two large population-based cohorts (the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial [PLCO] and the National Institutes of Health-AARP Diet and Health Study [NIH-AARP], we estimated relative and attributable risks and combined them with age-specific US-population incidence and competing mortality rates. All models included parity. The breast cancer model additionally included estrogen and progestin menopausal hormone therapy (MHT use, other MHT use, age at first live birth, menopausal status, age at menopause, family history of breast or ovarian cancer, benign breast disease/biopsies, alcohol consumption, and body mass index (BMI; the endometrial model included menopausal status, age at menopause, BMI, smoking, oral contraceptive use, MHT use, and an interaction term between BMI and MHT use; the ovarian model included oral contraceptive use, MHT use, and family history or breast or ovarian cancer. In independent validation data (Nurses' Health Study cohort the breast and ovarian cancer models were well calibrated; expected to observed cancer ratios were 1.00 (95% confidence interval [CI]: 0.96-1.04 for breast cancer and 1.08 (95% CI: 0.97-1.19 for ovarian cancer. The number of endometrial cancers was significantly overestimated, expected/observed = 1.20 (95% CI: 1.11-1.29. The areas under the receiver operating characteristic curves (AUCs; discriminatory power were 0.58 (95% CI: 0.57-0.59, 0.59 (95% CI: 0.56-0.63, and 0.68 (95% CI: 0.66-0.70 for the breast, ovarian, and endometrial models, respectively.These models predict absolute risks for breast, endometrial, and ovarian cancers from easily obtainable risk factors and may

  19. Hysteroscopic endometrial resection: efficacy and factors for failure

    Directory of Open Access Journals (Sweden)

    Geraldo Rodrigues de Lima

    2008-09-01

    Full Text Available Objective: To evaluate the effectiveness of hysteroscopic endometrial ablation in women with abnormal benign uterine bleeding resistant to clinical treatment, and to identify factors potentially related to its failure. Methods: Ninety patients with abnormal benign uterine bleeding were retrospectively evaluated. They were submitted to endometrial ablation between January 2000 and August 2003. Their mean age was 44.3 years and their average parity was 2.3 childbirths. All patients had been given gonadotrophin-releasing hormone analogues prior to surgery, to make the procedure easier. Rresults: After surgery, amenorrhea occurred in 20% of cases, hypomenorrhea in 30%, and eumenorrhea in 32.2%. In 17.8% of patients, the procedure failed. No intra or postoperative complications occurred. There was no statistically significant difference between the patients in which the ablation failed and those in which it was successful regarding mean age (p = 0.557, parity (p = 0.891, presence of intramural myoma (p= 0.29, submucosal myoma (p = 0.68 or endometrial polyps (p = 0.76. A significant difference between the two groups was observed with regard to the uterine size median (7  cm in the successful group and 9 cm in the failure group, p  = 0.008. A statistically significant difference was also found in follow-up time: 13 months in the first group and nine months in the second group (p = 0.001. Cconclusions: Endometrial ablation is a good treatment method for abnormal uterine bleeding of benign etiology. Special attention must be paid to patients with increased uterine size, since failure is more frequent in these cases.

  20. Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available Objective. To obtain pilot data on the endometrial histology of Depomedroxyprogesterone acetate (Depo-Provera, DMPA users experiencing breakthrough bleeding (BTB versus users with amenorrhea. To compare the endometrial histology of patients who used DMPA continuously for 3–12 months versus those who used it for 13 months or more. Methods. Cross-sectional study. Endometrial biopsy was obtained from all consenting patients who used DMPA for at least 3 months. Patients were divided into those with BTB in the last 3 months versus those with amenorrhea for at least 3 months. Histology results and duration of therapy were compared. Results. The proportion of women with chronic endometritis, uterine polyps, atrophic, proliferative, or progesterone-dominant endometrium did not differ between those DMPA users with BTB versus those with amenorrhea. Duration of therapy did not correlate with symptoms of BTB or endometrial histology. Chronic endometritis was the most common histologic finding (10/40, 25% and occurred more often in women experiencing BTB (35% versus 15% (RR 1.62 CI 0.91–2.87. Moreover, 45% of women with BTB had received DMPA for more than 12 months. Conclusions. BTB was more common than previously reported in women using DMPA for more than 12 months. Chronic endometritis, which may indicate an underlying infectious or intracavitary anatomic etiology, has not been previously reported as a frequent finding in DMPA users, and may be related to ethnic or other sociodemographic characteristics of our patient population. Further study to elucidate the etiology of chronic endometritis in these patients is warranted.

  1. Xanthogranulomatous Endometritis: A Challenging Imitator of Endometrial Carcinoma

    Directory of Open Access Journals (Sweden)

    A. Işın Doğan-Ekici

    2007-01-01

    Full Text Available Xanthogranulomatous inflammation is a distinguished histopathological entity affecting several organs, predominantly the kidney and gallbladder. So far, only a small number of cases of xanthogranulomatous inflammation occurring in female genital tract have been described, most frequently affecting the endometrium and histologically characterized by replacement of endometrium by xanthogranulomatous inflammation composed of abundant foamy histiocytes, siderophages, giant cells, fibrosis, calcification and accompanying polymorphonuclear leucocytes, plasma cells and lymphocytes of polyclonal origin. We present a case of a 69-year-old female complained of post menopausal bleeding and weight loss. Clinical preliminary diagnoses were endometrial carcinoma or hyperplasia and ultrasound was supposed to be endometrial malignancy, hyperplasia or pyometra by radiologist. Histopathological examination of uterus revealed xanthogranulomatous endometritis. Since xanthogranulomatous endometritis may mimic endometrial malignancy clinically and pathologically as a result of the replacement of the endometrium and occasionally invasion of the myometrium by friable yellowish tissue composed of histiocytes, knowledge of this unusual inflammatory disease is needed for both clinicians and pathologists.

  2. Synthetically lethal nanoparticles for treatment of endometrial cancer

    Science.gov (United States)

    Ebeid, Kareem; Meng, Xiangbing; Thiel, Kristina W.; Do, Anh-Vu; Geary, Sean M.; Morris, Angie S.; Pham, Erica L.; Wongrakpanich, Amaraporn; Chhonker, Yashpal S.; Murry, Daryl J.; Leslie, Kimberly K.; Salem, Aliasger K.

    2018-01-01

    Uterine serous carcinoma, one of the most aggressive types of endometrial cancer, is characterized by poor outcomes and mutations in the tumour suppressor p53. Our objective was to engender synthetic lethality to paclitaxel (PTX), the frontline treatment for endometrial cancer, in tumours with mutant p53 and enhance the therapeutic efficacy using polymeric nanoparticles (NPs). First, we identified the optimal NP formulation through comprehensive analyses of release profiles and cellular-uptake and cell viability studies. Not only were PTX-loaded NPs superior to PTX in solution, but the combination of PTX-loaded NPs with the antiangiogenic molecular inhibitor BIBF 1120 (BIBF) promoted synthetic lethality specifically in cells with the loss-of-function (LOF) p53 mutation. In a xenograft model of endometrial cancer, this combinatorial therapy resulted in a marked inhibition of tumour progression and extended survival. Together, our data provide compelling evidence for future studies of BIBF- and PTX-loaded NPs as a therapeutic opportunity for LOF p53 cancers.

  3. Karyometry in atypical endometrial hyperplasia: A Gynecologic Oncology Group study

    Science.gov (United States)

    Bartels, Peter H; Garcia, Francisco AR; Trimble, Cornelia L; Kauderer, James; Curtin, John; Lim, Peter C; Hess, Lisa M; Silverberg, Steven; Zaino, Richard J; Yozwiak, Michael; Bartels, Hubert G; Alberts, David S

    2014-01-01

    Objectives Treatment for atypical endometrial hyperplasia (AEH) is based on pathologic diagnosis. About 40% of AEH is found to be carcinoma at surgery. This study's objective is to derive an objective characterization of nuclei from cases diagnosed as AEH or superficially invasive endometrial cancer (SIEC). Methods Cases from GOG study 167A were classified by a central pathology committee as AEH (n=39) or SIEC (n=39). High resolution digitized images of cell nuclei were recorded. Features of the nuclear chromatin pattern were computed. Classification rules were derived by discriminant analysis. Results Nuclei from cases of AEH and SIEC occupy the same range on a progression curve for endometrial lesions. Cases of AEH and SIEC both comprise nuclei of two phenotypes: hyperplastic characteristics and premalignant/neoplastic characteristics. The principal difference between AEH and SIEC is percentage of premalignant/neoplastic nuclei. When this percentage approaches 50-60% superficial invasion is likely. SIEC may develop already from lesions at the low end of the progression curve. Conclusions AEH comprises cases which may constitute a low risk group involving 40 % of nuclei of preneoplastic phenotype. Nuclei of the preneoplastic phenotype in AEH lesions are almost indistinguishable from nuclei in SIEC, where this percentage exceeds 60%. The percentage of nuclei of the preneoplastic phenotype in AEH lesions might serve as criterion for assessment of risk for the development of invasive disease. PMID:22155796

  4. Three-dimensional ultrasound assessment of endometrial receptivity: a review

    Directory of Open Access Journals (Sweden)

    Alcázar Juan

    2006-11-01

    Full Text Available Abstract Three-dimensional ultrasound (3D US is a new imaging modality, which is being introduced into clinical practice. Although this technique will not probably replace two-dimensional ultrasound, it is being increasingly used. It has been reported that 3D US is a very high reproducible technique. The endometrium has been paid special attention when using this technique. The aim of this paper is to address some technical aspects of 3D US and to review critically its current status in evaluating endometrial function with special focus in its role in predicting pregnancy in assisted reproductive techniques. In spontaneous cycles endometrial volume grows during follicular phase remaining constant through the luteal phase. Endometrial vascularization increases during follicular phase peaking 2–3 days before ovulation, decreasing thereafter and increasing again during mid and late luteal phase. Data from studies analysing the role of 3D US for predicting IVF outcome are controversial. An explanation for these controversial findings might be different design of reported studies, specially the timing of ultrasound evaluation.

  5. Independent prognostic value of peritoneal immunocytodiagnosis in endometrial carcinoma.

    Science.gov (United States)

    Benevolo, M; Mariani, L; Vocaturo, G; Vasselli, S; Natali, P G; Mottolese, M

    2000-02-01

    Among the clinical parameters that play a pivotal role in predicting the outcome of patients with endometrial carcinoma, intraperitoneal microscopic dissemination represents an important cause of recurrences. To date, peritoneal cytology has been incorporated into the current surgical staging system (International Federation of Gynecology and Obstetrics 88), although its predictive value remains a controversial issue. In this study the authors investigated the possibility of applying immunocytochemistry (ICC) to the diagnosis of peritoneal washing (PW) aimed at improving conventional cytology and verifying the prognostic value of peritoneal malignant cells. The authors analyzed 182 PWs sampled from endometrial cancer patients. The ICC analysis was performed using two monoclonal antibodies (MAbs)--AR-3 and B72.3--that in combination recognize more than 95% of endometrial carcinomas. The presence of peritoneal-free cancer cells was identified morphologically in 27 of 182 lavages (14.8%) and ICC in 50 of 182 (27.5%), with a significant improvement (p <0.0001). Five-year survival analysis, comparing results of ICC and cytodiagnosis, demonstrated a significant decrease of disease-free survival in patients with peritoneal microscopic disease. Furthermore, multivariate analysis showed that ICC diagnosis of PWs is an independent prognostic factor. Data indicate that the use of selected MAbs allows one to identify cytologically false-negative cases, providing results that are highly predictive of a worse clinical outcome.

  6. The role of adhesive molecules in endometrial cancer: part II

    Directory of Open Access Journals (Sweden)

    Andrzej Malinowski

    2010-12-01

    Full Text Available The carcinogenesis is a result of both functional and structural disorders in the tissue. It initiates as a mutationin a gene encoding protein that is essential for cellular function. The subsequent cascade of eventsleads to accumulation of mutations and loss of cellular function. The cell loses its tissue-specific morphology,disconnects from other cells and extracellular matrix and migrates – the invasion begins. It is now clear thatadhesive molecules are a key player in this cascade. These proteins of the cell membrane surface are responsiblefor attachment of the cells to each other and to the extracellular matrix. These interactions are crucial forboth structural and functional tissue organization. Lack of this homeostasis destroys the tissue architectureand impairs its function and results in invasion. Abnormal expression of adhesive molecules was reported in allexamined cancers, including endometrial cancer.Endometrial cancer is the most common gynaecological cancer in developed countries. Although in many casesdiagnosed and treated in early stages, and thus with good results, some patients cannot be cured. Completeknowledge of the pathogenesis of the disease will be helpful in identifying the patients with negative prognosticfactors, increased risk of recurrence and, perhaps, to find other therapeutic options. In the paper we are trying tosum up the up-to-date knowledge of the role of adhesive molecules in pathogenesis of endometrial cancer.

  7. MR imaging differentiation of endometrial cysts from hemorrhagic cysts

    International Nuclear Information System (INIS)

    Lee, Ho Won; Kim, Jung Sik; Lee, Jong Hun; Sohn, Cheol Ho

    1998-01-01

    The purpose of this study is to differentiate endometrial cysts from hemorrhagic cysts on the basis of MR findings. The MR findings of twelve patients with endometrial cysts (15 cases) and of nine patients with hemorrhagic cyst (12 cases) were retrospectively evaluated. Fourteen patients were surgically confirmed and seven with hemorrhagic cysts were clinically diagnosed by resolution of the cysts during ultrasound follow up. Sixteen patients underwent MR imaging using a 1.5T system (Magnetom Vision, Siemens, Germany), and for five patients a 2.0 T system (Spectro 2000, Goldstar, Korea) was used. MR images were retrospectively evaluate with respect to size and signal intensity of the cyst, uni/multilocularity, shading, the hematocrit effect, clot fluid-fluid level and septum, and thickness, signal intensity and enhancement of the cyst wall. Uni/multilocularity, septum, and signal intensity and enhancement of the cyst wall were useful for the differentiation of endometrial from hemorrhagic cysts. Signal intensity of the cyst, shading, the hematocrit effect and clot were not helpful. (author). 20 refs., 3 tabs., 5 figs

  8. Prognostic significance of SUVmax (maximum standardized uptake value) measured by [{sup 18}F]FDG PET/CT in endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, Kazuhiro; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Kita, Masato [Kobe City Medical Center General Hospital, Department of Obstetrics and Gynecology, Kobe (Japan); Suzuki, Kayo [Institute of Biomedical Research and Innovation, Department of PET Diagnosis, Kobe (Japan); Senda, Michio [Institute of Biomedical Research and Innovation, Molecular Imaging, Kobe (Japan); Nakamoto, Yuji [Kyoto University Graduate School of Medicine, Department of Diagnostic Imaging and Nuclear Medicine, Kyoto (Japan)

    2012-05-15

    To determine if the preoperative maximum standardized uptake value (SUVmax) measured by [{sup 18}F]FDG PET/CT has prognostic value in patients with endometrial cancer. A total of 57 patients with FIGO stage I-IV endometrial cancer underwent FDG PET/CT imaging before radical surgery. SUVmax of the primary tumour was compared with histological prognostic factors, and the relationship between SUVmax and recurrence was examined. The median duration of follow-up was 33.1 months (range 4 to 68 months). SUVmax was significantly higher in patients with a higher FIGO stage (p = 0.0015), higher tumour histological grade (p < 0.0001), myometrial invasion (p = 0.0020), larger tumour size (p = 0.0056) and lymph node metastasis (p = 0.027). Univariate analysis showed that SUVmax (uncategorized value), FIGO stage, tumour histological grade, lymph node metastasis and lymphovascular space invasion were significantly associated with recurrence. However, multivariate analysis showed that only SUVmax (p = 0.045, hazard ratio 1.11, 95% CI 1.0028-1.231) was significantly associated with recurrence. Based on ROC curve analysis and log-rank tests, patients with a high a SUVmax ({>=}12.7) had a significantly lower disease-free survival rate than those with a low SUVmax (<12.7; p = 0.00042). Preoperative FDG uptake by the primary tumour is significantly associated with recurrence in patients with endometrial cancer. (orig.)

  9. Acupuncture on the Endometrial Morphology, the Serum Estradiol and Progesterone Levels, and the Expression of Endometrial Leukaemia-inhibitor Factor and Osteopontin in Rats

    Directory of Open Access Journals (Sweden)

    Houju Fu

    2011-01-01

    Full Text Available Although it is well known that acupuncture has beneficial effects on a variety of medical conditions especially in pain relief, nausea, and vomiting, it remains controversial whether it has positive impact on the female reproduction. The present study aimed to evaluate whether the following endometrial receptivity factors: the endometrial morphology, the hormone concentrations, and the protein expression of endometrial leukaemia-inhibitory factor (LIF and osteopontin (OPN could be improved by the acupuncture in clomiphene citrate(CC-induced rat model during implantation period. Results showed that, compared with the CC group, glandular development advanced, the serum estradiol levels decreased significantly, and the glandular area and endometrial LIF and OPN expression were significantly higher in acupuncture group. There were no significant differences in serum progesterone levels, endometrial thickness, and stromal area between groups. These results suggest that acupuncture can improve certain aspects of endometrial receptivity in CC-induced rat model during implantation period, which might result in endometrial state better to female reproduction.

  10. [Evaluation of postmenopausal uterine bleeding by endometrial biopsy in-office hysteroscopy vs endometrial biopsy with manual vacuum aspiration in the office. Preliminary report].

    Science.gov (United States)

    Hernández, José Arias; Franco, María Eugenia Lozano; Mendizábal, David Pablo Bulnes; Broca, Yrma Bocanegra; Escoto, Adrián Fores

    2009-11-01

    To compare endometrial biopsy by hysteroscopy vs manual endouterine aspiration in office, in patients of Climateric Clinic from Hospital Regional de Alta Especialidad de la Mujer Tabasco, with postmenopausal uterine bleeding. There were included patients that come from October 30 2007 to December 20 2008 to Climateric Clinic, with abnormal uterine bleeding and without hormonal replacement therapy. There were taken biopsy by hysteroscopy and AMEU. The histopathology results were compared. A total of 25 women were evaluated. The average age was 53 years (+/- 5.6). The delivery average was 3 births (+/- 1). We found polyps in 9 (37%) patients, endometrial atrophy in 3 (13%), cystic hyperplasia in 2 (8%), proliferative endometrium in 4 (17%), submucous myomas in 5 (21%) and neoplasia in 1 (4%). The correlation between endometrial biopsy by hysteroscopy and AMEU was 100% for endometrial atrophy, cystic hyperplasia, proliferativo endometrium and neoplasia. There was not correlation between manual endouterine aspiration and endometrial biopsy by hysteroscopy for polyps and submucous myomas. We didn't have complications during the procedures. Hysteroscopic endometrial biopsy seems to have the same histopathology results than AMEU for endometrial atrophy, cystic hyperplasia, proliferative endometrium and neoplasia, not for miomas and polyps. Hysteroscopy can give us the possibility to see miomas and polyps and treat surgical pathology at the same moment almost in all cases.

  11. Systemic hypertension and diabetes mellitus as predictors of malignancy among women with endometrial polyps: a meta-analysis of observational studies.

    Science.gov (United States)

    Pergialiotis, Vasilios; Prodromidou, Anastasia; Siotos, Charalampos; Frountzas, Maximos; Perrea, Despina; Vlachos, Georgios D

    2016-06-01

    Diabetes mellitus (DM) and systemic hypertension (SH) are frequent benign diseases which might coexist with endometrial polyps. We sought to evaluate whether women who suffer from these diseases have an increased incidence of premalignant and malignant lesions. We systematically searched the literature using the Medline (by using Pubmed) (1966-2015), Scopus (2004-2015), ClinicalTrials.gov (2008-2015), Cochrane Central Register (CENTRAL), and Google Scholar (2004-2015) databases along with the references of all articles which were retrieved in full text. We performed the meta-analysis with the RevMan 5.1 software. Both DM and SH seem to be correlated with increased odds of developing premalignant and malignant endometrial polyps (odds ratio 2.43, 95% confidence interval 1.51, 3.91) and (odds ratio 2.36, 95% confidence interval 1.16, 4.81). However, it remains unclear whether type I or type II DM exert a more pronounced effect and whether the severity of SH has an impact on these odds. Also, the potential relation of antidiabetic and antihypertensive treatment with these lesions cannot be excluded. Physicians should increase their awareness among women with endometrial polyps who suffer from DM and/or SH. Further studies are needed to corroborate our findings and elucidate the underlying mechanisms of this relation.

  12. The expression of ER, PR in endometrial cancer and analysis of their correlation with ERK signaling pathway.

    Science.gov (United States)

    Luo, Lan; Xu, Lina; Tang, Liang

    2017-12-12

    Endometrial carcinoma (EC) is a common malignant tumor in gynecology. Its incidence and development are closely associated with the levels of estrogenic and progesterone hormone. Extracellular signal-regulated kinase (ERK) signaling pathway abnormity is associated with a variety of tumors. This study detected estrogen receptor (ER), progesterone receptor (PR), ERK1, and ERK2 expression in EC and analyzed their correlations. A total of 40 EC patients in our hospital were selected as test group, while another 40 healthy volunteers were enrolled as control group. ER, PR, ERK1, and ERK2 expression in EC tissue, para-carcinoma tissue, and normal endometrial tissue were detected by immunohistochemistry and Western blot. The positive rate of ER, PR, ERK1, and ERK2 in the test group was 50%, 40%, 60%, and 65%, respectively, which were significantly higher than those in the control (PPR, ERK1, and ERK2 protein expressions in EC cell were significantly higher than those in the control (PPR (PPR, which were correlated with higher levels of ERK1 and ERK2, suggesting they might be involved in the pathogenesis of EC.

  13. Hysterosalpingography After Radiofrequency Endometrial Ablation and Hysteroscopic Sterilization as a Concomitant Procedure.

    Science.gov (United States)

    Hopkins, Matthew R; Laughlin-Tommaso, Shannon K; Wall, Darci J; Breitkopf, Daniel M; Creedon, Douglas J; El-Nashar, Sherif A; Famuyide, Abimbola O

    2015-09-01

    To evaluate the accuracy of hysterosalpingography (HSG) in patients who underwent concomitant radiofrequency endometrial ablation and hysteroscopic sterilization. This historical cohort study was conducted at a midwestern academic medical center. A total of 186 women (94 with combined procedure and 92 with sterilization alone) were identified as having undergone intervention between January 1, 2003, and June 30, 2011. Two reviewers blinded to the surgical procedure interpreted the standard clinically indicated HSGs in each group. The primary outcome assessed was the inability to rely on the microinserts for contraception based on HSG interpretation using manufacturers' guidelines (unsatisfactory HSG). Position of the devices and occlusion of tubes were assessed on all 3-month and, when available, all 6-month repeat HSGs. At the 3-month HSG, 5 of 76 (6.6%, 95% confidence interval [CI] 2.2-14.7%) in the sterilization-only group had unsatisfactory HSG compared with 13 of 71 (18.3%, 95% CI 10.1-29.3%) in the combined group (P=.03). After accounting for the seven patients who underwent repeat HSG at 6 months, 3 of 76 (3.95%, 95% CI 0.8-11.1%) in the sterilization-only group had unsatisfactory HSG compared with 13 of 71 (18.31%, 95% CI 10.1-29.3%) in the combined group (P=.005). After completing all clinically indicated HSGs, patients who undergo concomitant radiofrequency endometrial ablation and hysteroscopic sterilization have an approximate fivefold increase (odds ratio 5.45, 95% CI 1.48-20.0) in the rate of unsatisfactory HSG for purposes of documenting tubal occlusion. II.

  14. The value of diagnostic hysteroscopy with biopsy in the preoperative of endometrial ablation

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    Salete Yatabe

    2011-12-01

    Full Text Available Objective: To assess the value of diagnostic hysteroscopy with biopsy in the preoperative preparation for endometrial ablation. Methods: It was a prospective non-randomized study conducted at the division of Gynecologic Endoscopy of Hospital do Servidor Público Estadual “Francisco Morato de Oliveira” from March 2007 to May 2009. A total of 45 patients with abnormal uterine bleeding, and referred to endometrial ablation were included. All women underwent a diagnostic hysteroscopy, and were treated with a GnRH analogous – goserelin – 10.8 mg before surgery. The endometrial ablation was performed with a surgical resectoscope. Patients were submitted to one directed endometrial biopsy, one guided endometrial biopsy with Novak curette, and to endometrial ablation, which was considered as reference for pathological examination with samples from the biopsies. Data were analyze using the SPSS-v16 software, and considered significance at p = 0.05. Results: The mean age of women was 44.20 years (33-56, parity of 2.67 (0-9, uterus size of 139.99 calculated in cc (42-278, and the mean duration of symptoms was 3.68 years (0.5-15. The guided endometrial biopsy showed sensitivity of 80% for endometrium without atypia, and the directed endometrial biopsy had sensitivity of 60%. For proliferative endometrium the directed endometrial biopsy showed sensitivity of 76 and 100% for secretory endometrium, which was higher than the guided endometrial biopsy with 53 and 50%, respectively. Conclusion: The directed biopsy before endometrial ablation had lower sensitivity than guided biopsy for endometrium without atypia, however it was higher for proliferative and secretory endometrium.

  15. Progesterone inhibits epithelial-to-mesenchymal transition in endometrial cancer.

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    Paul H van der Horst

    Full Text Available BACKGROUND: Every year approximately 74,000 women die of endometrial cancer, mainly due to recurrent or metastatic disease. The presence of tumor infiltrating lymphocytes (TILs as well as progesterone receptor (PR positivity has been correlated with improved prognosis. This study describes two mechanisms by which progesterone inhibits metastatic spread of endometrial cancer: by stimulating T-cell infiltration and by inhibiting epithelial-to-mesenchymal cell transition (EMT. METHODOLOGY AND PRINCIPAL FINDINGS: Paraffin sections from patients with (n = 9 or without (n = 9 progressive endometrial cancer (recurrent or metastatic disease were assessed for the presence of CD4+ (helper, CD8+ (cytotoxic and Foxp3+ (regulatory T-lymphocytes and PR expression. Progressive disease was observed to be associated with significant loss of TILs and loss of PR expression. Frozen tumor samples, used for genome-wide expression analysis, showed significant regulation of pathways involved in immunesurveillance, EMT and metastasis. For a number of genes, such as CXCL14, DKK1, DKK4, PEG10 and WIF1, quantitive RT-PCR was performed to verify up- or downregulation in progressive disease. To corroborate the role of progesterone in regulating invasion, Ishikawa (IK endometrial cancer cell lines stably transfected with PRA (IKPRA, PRB (IKPRB and PRA+PRB (IKPRAB were cultured in presence/absence of progesterone (MPA and used for genome-wide expression analysis, Boyden- and wound healing migration assays, and IHC for known EMT markers. IKPRB and IKPRAB cell lines showed MPA induced inhibition of migration and loss of the mesenchymal marker vimentin at the invasive front of the wound healing assay. Furthermore, pathway analysis of significantly MPA regulated genes showed significant down regulation of important pathways involved in EMT, immunesuppression and metastasis: such as IL6-, TGF-β and Wnt/β-catenin signaling. CONCLUSION: Intact progesterone signaling in non

  16. Relationships between Serum Luteinizing Hormone Level, Endometrial Thickness and Body Mass Index in Polycystic Ovary Syndrome Patients with and without Endometrial Hyperplasia

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    Fariba Ramezanali

    2016-05-01

    Full Text Available Background: The endometrial hyperplasia measured by ultrasound in polycystic ovary syndrome (PCOS women is strongly related to pathologic endometrial thickness, but there is no consensus on the relation between serum luteinizing hormone (LH and either of these factors: pathologic endometrial hyperplasia and body mass index (BMI. Materials and Methods: In this observational cross-sectional study, three hundred fifty infertile PCOS women were involved in this research. An endometrial biopsy was taken by using a pipelle instrument, regardless of menstrual cycle’s day and all samples were reported by the same pathologist. Basal serum LH level was compared between two subgroups (hyperplasia and non-hyperplasia. The intended population was divided into three groups according to BMI and basal serum LH, later on the comparison was made in three groups. Chi-square test was applied to compare nominal variables between groups. Mann-Whitney U, and one way ANOVA tests were used to compare means on the basis of the result of normality test. Results: The frequency of endometrial hyperplasia was 2.6%. Endometrial thickness in the patients with endometrial hyperplasia was significantly higher than that of a normal endometrium (10.78 ± 3.70 vs. 7.90 ± 2.86 respectively, P=0.020. There was no relation between endometrial hyperplasia and serum LH (P=0.600. The ANOVA test showed serum LH levels were not the same among three BMI groups (P=0.007. Post hoc test was also performed. It showed that the LH level in normal BMI group was significantly higher than those of other groups (P=0.005 and P=0.004, but there was no statistical difference between overweight and obese groups (P=0.8. We found no relationship between BMI and endometrial thickness in PCOS patients (P=0.6. Conclusion: Sonographic endometrial stripe thickness is predictive for endometrial hyperplasia in PCOS women. We could not find out any relationship between serum LH level and BMI with endometrial

  17. Impact of Obesity on Surgical Treatment for Endometrial Cancer: A Multicenter Study Comparing Laparoscopy vs Open Surgery, with Propensity-Matched Analysis.

    Science.gov (United States)

    Uccella, Stefano; Bonzini, Matteo; Palomba, Stefano; Fanfani, Francesco; Ceccaroni, Marcello; Seracchioli, Renato; Vizza, Enrico; Ferrero, Annamaria; Roviglione, Giovanni; Casadio, Paolo; Corrado, Giacomo; Scambia, Giovanni; Ghezzi, Fabio

    2016-01-01

    To evaluate the impact of obesity on the outcomes of surgical treatment for endometrial cancer in general and also comparing laparoscopic and open abdominal approach. Retrospective case-control study (Canadian Task Force classification II-1). Obstetrics and Gynecology Department, University of Insubria, Varese, Catholic University of the Sacred Heart, Rome, International School of Surgical Anatomy, Sacred Heart Hospital, Negrar, and Sant'Orsola-Malpighi Hospital, Bologna, Italy. Data of consecutive patients who underwent surgery for endometrial cancer in 4 centers were reviewed. Univariate and multivariable analyses were performed. Adjustment for potential selection bias in surgical approach was made using propensity score (PS) matching. Laparoscopic or open surgical treatment for endometrial cancer. A total of 1266 patients were included, including 764 in the laparoscopy group and 502 in the open surgery group. A total of 391 patients (30.9%) were obese, including 238 (18.8%) with class I obesity, 89 (7%) with class II obesity, and 64 (5.1%) with class III obesity. The total number of complications, risk of wound complications, and venous thromboembolic events were higher in obese women compared with nonobese women. Blood transfusions, incidence/severity of postoperative complications, and postoperative hospital stay were significantly higher in the open surgery group compared with the laparoscopy group, irrespective of obesity. These differences remained significant in both multivariable analysis and PS-matched analysis. The percentage of patients who received lymphadenectomy declined significantly in patients with BMI ≥40 in both the laparoscopy and open surgery groups. Conversions from the initially intended minimally invasive approach to open surgery were 1.1% to 2.2% for women with BMI obese women in the laparoscopic group. Laparoscopy for endometrial cancer retains its advantages over open surgery, even in obese patients. However, operating on obese

  18. Frequency of Adequate Endometrial Biopsy in Evaluation of Postmenopausal Women With Benign Endometrial Cells on Pap Test.

    Science.gov (United States)

    Hastings, Jeffrey W; Alston, Meredith J; Mazzoni, Sara E; Stickrath, Elaine

    2017-10-01

    The aim of the study was to determine the frequency that endometrial biopsies (EMBs) performed on postmenopausal (PMP) women with benign endometrial cells (BECs) on Pap test are adequate for assessing malignancy or hyperplasia. This is a case series including all PMP women older than 55 years at a single academic institution between January 2008 and September 2015 with a Pap test result including BEC. Patients were identified via an internal cytology database. Patient data, the ability to obtain an EMB, and the result of the EMB were collected. An adequate EMB was defined as the presence of glands and stroma sufficient to assess for endometrial hyperplasia and/or malignancy. Descriptive statistics were performed, and then univariable and logistic regression analyses were used to evaluate associations of patient factors and adequacy of EMB. One hundred sixteen women met inclusion criteria. One hundred seven had an EMB scheduled (92%) and of those 91 EMBs were obtained (85%). Of the obtained biopsies, 63 were inadequate to rule out the diagnosis of hyperplasia and/or malignancy (69%). Of these, 19 patients u