Comparing the Administration of Letrozole and Megestrol Acetate in the Treatment of Women with Simple Endometrial Hyperplasia without Atypia: A Randomized Clinical Trial

Introduction

The present study was conducted as a pilot to compare the therapeutic effects and the potential side effects of oral Megestrol acetate and Letrozole in the treatment of simple hyperplasia in perimenopausal women.

Methods

The participants of this randomized clinical trial consisted of two groups of 25 women aged 44–50 presenting with abnormal uterine bleeding diagnosed with simple endometrial hyperplasia without cytologic atypia confirmed by transvaginal ultrasonography and biopsy. The first group received 40-mg doses of Megestrol acetate for 2 weeks per month for a total period of 2 months. The second group received 2.5-mg daily doses of Letrozole for a total period of 2 months. The differences in terms of quantitative measurements were analyzed using the independent two-sample t test and the paired t test. To compare the two groups in terms of the distribution of the categorical variables, Pearson’s Chi square and Fisher’s Exact tests were used at the significance level of 0.05 by Stata-9.2.

Results

Although the intervention led to significant improvements in both groups (P < .001), there was no difference between the groups in terms of accomplishing resolution (P = .74) [seven (28%) patients in the Letrozole group and five (20%) in the Megestrol group], while two patients in the Letrozole group and nine in the Megestrol group suffered from side effects, suggesting significantly lower side effects in the Letrozole group (P = .02).

Conclusion

Letrozole and Megestrol acetate seem to have similar effects on the treatment of simple endometrial hyperplasia, the only difference being that Letrozole presents fewer side effects than Megestrol acetate in patients with this condition.

Funding

Abnormal Uterine Bleeding Research Center of Semnan University of Medical Sciences, Semnan, Iran. Trial Registration: IRCT2015031011504N5

     

Chitosan (CMD)-mediated co-delivery of SN38 and Snail-specific siRNA as a useful anticancer approach against prostate cancer

Background

Prostate cancer is known as the most common malignancy in men. Chitosan has generated great interest as a useful biopolymer for the encapsulation of small interfering RNA (siRNA). Due to cationic nature, chitosan is able to efficiently encapsulate siRNA molecules and form nanoparticles. Furthermore, the biocompatible and biodegradable attributes of chitosan have paved the way for its potential application in the in vivo delivery of therapeutic siRNAs. In this study, we aimed to design chitosan/CMD nanoparticles for the efficient encapsulation of the anti-cancer drugs SN38 and Snail-specific siRNA.

Is mannose‐binding lectin serum concentration a reliable predictor for recurrent vulvovaginal candidiasis?

Recurrent vulvovaginal candidiasis (RVVC) is a common opportunistic, mucosal fungal infection, predominantly caused by the fungus Candida albicans. Mannose‐binding lectin (MBL) is an acute‐phase protein that plays a key role in the innate immunity defence against infectious disease. This study was conducted to evaluate the relationship between the MBL serum level and the relative expression of MBL mRNA in RVVC using real‐time PCR for the first time. The case‐control study included 40 female participants suffering from RVVC and 40 healthy individuals. The MBL serum level was measured using a commercial ELISA kit. The relative mRNA expression of the MBL gene was quantified using real‐time PCR. Data analysis was carried out by spss software. The MBL concentration was significantly higher in the participants suffering from RVVC compared to the control group (0.330 ng/mL vs 0.253 ng/mL). The prognostic value (P < .001) for RVVC diagnosis has been calculated. Quantitative RT‐PCR results from 35 samples showed a low to significant values for mRNA levels corresponding to MBL gene expression (1‐352 folds) (P < .001). The results of this study suggest that MBL plays a main role in the innate immunity and it is also affected by environmental factors and other genetic variations. Therefore, the MBL gene expression profile does not reflect precise phenotypic levels in the serum.     

Exploring Communication Strategies for Promoting Hepatitis B Prevention among Young Asian American Adults

In the United States, Asian Americans account for 50–60% of hepatitis B virus infections, leading to higher rates of liver cancer in this population. While some city-wide data have reported hepatitis B infection rates among young adults as high as 10–20%, little research has examined factors that impact hepatitis B beliefs, or the most effective strategies for reaching this particular population to promote hepatitis B awareness. An online survey was conducted with young Asian American adults (n = 418), aged 18–29 years old, to better understand their health information seeking, social media usage, and hepatitis B-related behaviors and beliefs. Results indicated that doctors and health organizations were the most trusted sources of health information, while the Internet was the most common source of health information. The majority of participants (99.8%) reported using social media and indicated they engaged in health-related behaviors on social media. Several factors, including non-receipt of hepatitis B vaccine, engaging in more health-related social media activities, and a higher mean score for difficulty with health information seeking, were significantly related to higher perceived susceptibility to hepatitis B. Future research should explore the effectiveness of using social media to reach young Asian American adults to promote hepatitis B awareness.