Expression of IL-1 and TNF-α in uterine myomas and myometrium in women of different age

INTRODUCTION Fibroids are the most common benign tumors of the female reproductive organ. In uterine myoma cells, a disturbed expression of some cytokines and growth factors is found. AIM OF STUDY The aim of the study was to evaluate IL-1 and TNF-α expression in uterine myomas and myometrium in women of different age. MATERIAL AND METHODS The studies included 60 women. The control was a group of 20 patients in whom there were no fibroidal changes. The subjects were both in the reproductive and menopausal age. 20 women of childbearing age with fibroidal changes in the uterus (under age 45, FSH 30 mIU/ml) also qualified for the study. Immunohistochemical studies were performed on the sampled material. In the examined tissue fragments, the optical density of cells expressing IL-1 and TNF-α was evaluated, which reflects the concentration of the immunocytochemical reaction product. RESULTS Expression of the studied cytokines was higher in the myoma and surrounding myometrium comparing to the uterine myometrium of healthy women. CONCLUSIONS Increased expression of cytokines at the edge of uterine myomas may be a signal of the appearance of new tumors. Therefore, use of the expression levels of IL-1 and TNF-α as a prognostic factor should be considered.WSTĘP Mięśniaki macicy są najczęstszymi nowotworami o łagodnym charakterze żeńskiego narządu rodnego. W ich komórkach stwierdza się zaburzoną ekspresję niektórych cytokin i czynników wzrostu. CEL PRACY Celem badań była ocena ekspresji interleukiny-1 (IL-1) i czynnika martwicy nowotworu- (TNF-) w mięśniakach macicy kobiet w różnym wieku. MATERIAŁY I METODY W badaniach uczestniczyło 60 kobiet. Kontrolę czystą stanowiły pacjentki, u których nie stwierdzono zmian mięśniakowatych, zarówno w wieku reprodukcyjnym (10 kobiet), jak i okołomenopauzalnym (10 kobiet). Do badań zakwalifikowano 20 kobiet w wieku rozrodczym ze zmianami mięśniakowymi w macicy (poniżej 45 roku życia, FSH 30 mIU/ml). W badaniu immunohistochemicznym pobranych skrawków oceniono gęstość optyczną komórek z ekspresją IL-1 oraz TNF-α, która stanowi odzwierciedlenie stężenia produktu reakcji immunocytochemicznej. WYNIKI Ekspresja badanych cytokin w mięśniaku oraz otaczającym go miometrium w była wyższa niż w miometrium macicy kobiet zdrowych. WNIOSKI Zwiększona ekspresja cytokin na obrzeżu mięśniaków macicy może decydować o pojawieniu się nowych guzów, dlatego należy rozważyć wykorzystanie poziomu ekspresji IL-1 i TNF-α jako czynnika prognostycznego

The Predictive Role of Lactate in the Emergency Department in Patients with Severe Dyspnea

Objective. An accurate identification of patients at the need for prioritized diagnostics and care are crucial in the emergency department (ED). Blood gas (BG) analysis is a widely available laboratory test, which allows to measure vital parameters, including markers of ventilation and perfusion. The aim of our analysis was to assess whether blood gas parameters in patients with dyspnea at an increased risk of respiratory failure admitted to the ED can predict short-term outcomes. Methods. The study group eventually consisted of 108 patients, with available BG analysis. The clinical and laboratory parameters were retrospectively evaluated, and three groups were distinguished—arterial blood gas (ABG), venous blood gas (VBG), and mixed blood gas. The primary endpoint was short-term, all-cause mortality during the follow-up of median (quartile 1–quartile 3) 2 (1–4) months. The independent risk factors for mortality that could be obtained from blood gas sampling were evaluated. Results. The short-term mortality was 35.2% (38/108). Patients who died were more frequently initially assigned to the red triage risk group, more burdened with comorbidities, and the median SpO2 on admission was significantly lower than in patients who survived the follow-up period. In the multivariable analysis, lactate was the strongest independent predictor of death, with 1 mmol/L increasing all-cause mortality by 58% in ABG (95% CI: 1.01–2.47), by 80% in VBG (95% CI: 1.13–2.88), and by 68% in the mixed blood gas analysis (95% CI: 1.22–2.31), what remained significant in VBG and mixed group after correction for base excess. In each group, pH, pO2, and pCO2 did not predict short-term mortality. Conclusions. In patients admitted to the ED due to dyspnea, at risk of respiratory failure, lactate levels in arterial, venous, and mixed blood samples are independent predictors of short-term mortality