Assessment of the response to chemotherapy in gestational trophoblastic neoplasia with vaginal metastases

Background and goals  This study is designed to survey gestational trophoblastic neoplasia with vaginal metastases (GTN + VM) manifestations, prognosis and chemotherapy response in order to consider appropriate chemotherapy regimen for these patients. There have been just a few studies about treatment of GTN + VM. Materials and methods  Patients with Stage III GTN with or without vaginal metastases who had referred to Vali-e-Asr Hospital during 1996–2006 have been selected to take part in this study and the size of metastases was measured. Then response and resistance to single and combination chemotherapy regimens have been compared in these two groups. The data were processed using SPSS system (release 10). Statistical analysis was done with X² to determine factors associated with complete clinical response. The level of significance was assigned at P < .05. Results  Forty-eight patients with stage III (with pulmonary metastases) GTN patients have been selected, 13 with vaginal metastases and 35 without vaginal metastases. Incidence of vaginal metastases in stage III was 26%. Metastases were mainly in distal part of vagina and suburethra. Chief complaint was severe hemorrhage in 25% of patients and was controlled by vaginal packing with just one exception. Group of vaginal metastases showed 66.6% resistance to first-line chemotherapy, compared to 28.6% in patients with no vaginal metastases (P-value = 0.010). Median of chemotherapy courses in low-risk vaginal metastatic patients was 5 (mean = 5.2), compared to three courses in the group without vaginal metastases. Resistance to single chemotherapy was significantly higher in GTN + VM versus GTN without VM patients and resistance was higher especially in patients with metastases with more than 3 cm (in diameter). Conclusions  Vaginal metastasis with more than 3 cm in diameter is an important prognostic factor in GTN patients. There have higher risks for severe hemorrhage and resistance to single agent chemotherapy, so in these patients combination chemotherapy, with no regard to staging and scoring, would be a better choice. An erratum to this article can be found at     

Use of microsatellite DNA polymorphisms on mouse chromosome 11 for in vitro analysis of thymidine kinase gene mutations

The mouse lymphoma (L5178Y tk^³/– 3.7.2C) in vitromuta-genesis assay can measure the genotoxic effects of a widevariety of chemical agents by inactivation of a single functionalthymidine kinase (tk-1) gene. We have previously demonstrated,using cytogenetic and molecular techniques, that the types ofmolecular lesions associated with tk-1 gene inactivation spana wide range similar to that seen in tumor cells at specificoncogene and tumor suppressor gene loci. We have identified,using polymerase chain reaction techniques, 21 microsatellite,or ‘simple sequence repeat’, polymorphisms betweenchromosomes 11_a and 11_b in 3.7.2C cells. These microsatellitepolymorphisms span virtually the entire chromosome, from mappingpositions of 3–78 centiMorgans (cM) from the centromere,thus providing landmarks to study loss of genetic material acrossthe entire chromosome. Four of the microsatellite polymorphismslie within 12 cM of tk-1, and provide a means of mapping lossof genetic material in the immediate vicinity of tk-1, a capabilitythat we have not previously had in the mouse lymphoma assay.Loss of alleles (i. e. loss of heterozygosity) is an importantfeature of tumor development, having to do with tumor suppressorgene expression. Therefore, the ability to detect loss of heterozygosityin the mouse lymphoma assay will make the assay an extremelyvaluable tool in the detection of agents capable of inducingloss of heterozygosity. ³To whom correspondence should be addressed     

Metastatic brain tumors: a retrospective review in East Azarbyjan (Tabriz)

A set of one hundred and twenty nine patients with known primary malignancy and suspected brain metastasis was reviewed in present study. The patients were selected among patients presented to the MRI section of Imam Khomeini Hospital or a private MRI center in Tabriz (Iran). Primary tumor site, clinical manifestations, number and site of lesions were identified in this patient population. The primary tumor site was breast in 55 patients (42.6%), followed by lung (40.3%), kidney (7.7%), colorectal (4.6%), lymphoma (3.1%) and melanoma (1.5%). Most patients were presented with features of increased intracranial pressure (headaches and vomiting), seizures and focal neurologic signs. Single brain metastasis occurred in 16.3% of patients, while multiple lesions accounted for 83.7% of patients. Ninety seven patients had supratentorial metastases (75.2%). Twenty cases (15.5%) had metastases in both compartments. Infratentorial lesions were observed only in twelve patients (9.3%).     

Comparison of Pelvic Organ Prolapse Quantification and Simplified Pelvic Organ Prolapse Quantification Systems in Clinical Staging of Iranian Women with Pelvic Organ Prolapse

BackgroundPelvic organ prolapse is a common pelvic disorder among women. A standard staging system is needed to carefully evaluate the extent and severity of the disease, and initiate appropriate treatment. The aim of this study was to compare the two methods of standard and simplified pelvic organ prolapse quantification systems in clinical staging of Iranian women with pelvic organ prolapse.MethodsThis observational cross-sectional study was conducted on all women with complaints of seeing or feeling a vaginal lump or bulge and/or a dragging sensation who were presented to a pelvic floor disorders clinic of Imam Khomeini Hospital in Tehran, Iran, from October 2018 to June 2019. All patients were evaluated in terms of pelvic organ prolapse severity and staging using both instruments. Also, length of time needed to complete the questionnaires were calculated. After data collection, the results of pelvic organ prolapse staging and degree of agreement between two examiners were evaluated.ResultsA total of 120 women with mean age of 50.92±13.12 years were evaluated. It was shown that there is an almost perfect agreement (kappa coefficient > 0.8) between standard and simplified pelvic organ prolapse quantification systems in all the 3 compartments. Also, there was almost a twofold increase in the time needed to perform standard pelvic organ prolapse quantification (4.16±1.01 minutes) compared to performing simplified pelvic organ prolapse quantification (2.12±1.14 minutes) (p=0.03).ConclusionAccording to the results of this study, there is a substantial and almost perfect agreement between standard and simplified pelvic organ prolapse quantification systems in clinical staging of Iranian women with pelvic organ prolapse. It seems that using simplified pelvic organ prolapse quantification system is more applicable in clinical practice for staging of pelvic organ prolapse, with high reliability coefficient     

The effect of Achillea millefolium and Hypericum perforatum ointments on episiotomy wound healing in primiparous women

Background: The purpose of this study was to assess the efficacy of Achillea millefolium and Hypericum perforatum ointments on episiotomy wound healing in primiparous women.

Materials and methods: This is a double-blind clinical trial study performed on 140 primiparous women. They were randomly divided into four groups, each group containing 35 women: 2control groups including nonintervention and placebo ointment; and 2 case groups including Hypericum perforatum ointment and Achillea millefolium ointment. Healing process was assessed by five specifications: redness, ecchymosis, edema, discharge and wound dehiscence on 7th, 10th, and 14th days after delivery; pain level was assessed by means of visual analog scale.

Results: There was significant difference between groups in perineal pain level at 7th, 10th and 14th days postpartum, redness and edema at 7th and 10th days postpartum and ecchymosis at 7th day postpartum; the pain level, redness, edema and ecchymosis in groups who consume Hypericum perforatum and Achillea millefolium ointments were less than the control groups (p?p?>?0.05).

Conclusions: Achillea millefolium and Hypericum perforatum ointments reduce perineal pain level, redness, edema and ecchymosis of episiotomy wound, so it seems that consuming them was useful for episiotomy treatment.     

The effects and side effects of laquinimod for the treatment of multiple sclerosis patients: a systematic review and meta-analysis of clinical trials

European Journal of Clinical Pharmacology - Although studies have shown the efficacy of laquinimod (LAQ) on disease progression in patients with multiple sclerosis (MS), there is some controversy...     

The Determinants of young Adult Social well-being and Health (DASH) study: diversity,psychosocial determinants and health

Purpose

The Determinants of young Adult Social well-being and Health longitudinal study draws on life-course models to understand ethnic differences in health. A key hypothesis relates to the role of psychosocial factors in nurturing the health and well-being of ethnic minorities growing up in the UK. We report the effects of culturally patterned exposures in childhood.

Methods

In 2002/2003, 6643 11–13 year olds in London, ~80 % ethnic minorities, participated in the baseline survey. In 2005/2006, 4782 were followed-up. In 2012–2014, 665 took part in a pilot follow-up aged 21–23 years, including 42 qualitative interviews. Measures of socioeconomic and psychosocial factors and health were collected.

Results

Ethnic minority adolescents reported better mental health than White British, despite more adversity (e.g. economic disadvantage, racism). It is unclear what explains this resilience but findings support a role for cultural factors. Racism was an adverse influence on mental health, while family care and connectedness, religious involvement and ethnic diversity of friendships were protective. While mental health resilience was a feature throughout adolescence, a less positive picture emerged for cardio-respiratory health. Both, mental health and cultural factors played a role. These patterns largely endured in early 20s with family support reducing stressful transitions to adulthood. Education levels, however, signal potential for socio-economic parity across ethnic groups.