Evaluation of the effectiveness of histopathological verification of the endometrium by means of an outpatient aspiration biopsy

Cele badań: 1) Sprawdzenie skuteczności ambulatoryjnej biopsji aspiracyjnej z jamy macicy w uzyskiwaniu satysfakcjonującego materiału do oceny. 2) Badanie czynników ryzyka uzyskania niediagnostycznego materiału. 3) Poszukiwanie wzorców obrazu ultrasonograficznego według systemu International Endometrial Tumor Analysis, które mogą przemawiać za potencjalną nieskutecznością biopsji. 4) Ocena skuteczności biopsji ambulatoryjnej w wykrywaniu raka endometrium. Materiał i metody: Obserwacyjne badanie prospektywne na niewyselekcjonowanej populacji kobiet zgłaszających się do poradni ginekologicznej podejrzanych o patologie endometrium. Wyniki: Przeanalizowano 116 biopsji aspiracyjnych endometrium. Diagnostyczny wynik histopatologiczny udało się uzyskać w 100 przypadkach (86,2%). Nie wykazano istotności statystycznej w uzyskiwaniu niediagnostycznego wyniku biopsji w aspekcie statusu menopauzalnego, obecności mięśniaków macicy, występowania nieprawidłowych krwawień macicznych, wieku, grubości endometrium oraz liczby przebytych porodów. Uzyskano dużą różnorodność obrazów ultrasonograficznych według parametrów International Endometrial Tumor Analysis. Nie stwierdzono jednoznacznie dominujących wzorców parametrów ultrasonograficznych endometrium u pacjentek z niediagnostycznym wynikiem biopsji. U wszystkich (100%) badanych w wieku pomenopauzalnym z nieprawidłowymi krwawieniami macicznymi w wywiadzie ujawniono raka endometrium. Średnia grubość endometrium w tej grupie była istotnie statystycznie największa: 16,2 mm (4-22,3 mm) (p = 0,025). Wnioski: Ambulatoryjna biopsja aspiracyjna endometrium jest skutecznym, mało obciążającym postępowaniem w przypadku stwierdzenia wskazań do weryfikacji histopatologicznej endometrium.Objectives: 1) Examining the effectiveness of an outpatient aspiration biopsy from the uterine cavity in the context of satisfactory sampling. 2) Assessing risk factors of obtaining a non-diagnostic sample. 3) Search for ultrasound image patterns according to the International Endometrial Tumor Analysis that may indicate potential ineffectiveness of the biopsy. 4) Assessment of effectiveness of an outpatient biopsy in detection of endometrial cancer. Methods: Observational prospective study on a non-selected population of women suspected of endometrial pathologies. Results: 116 endometrial aspiration biopsies have been analyzed. Diagnostic histopathological samples were obtained in 100 cases (86.2%). There was no statistical significance in obtaining a non-diagnostic result of a biopsy in terms of the menopausal status, presence of uterine fibroids, occurrence of abnormal uterine bleeding, age, endometrial thickness and the number of deliveries. A large variety of ultrasound images were obtained according to the International Endometrial Tumor Analysis parameters. There were no clearly dominant patterns of endometrial ultrasound parameters in patients with non-diagnostic biopsy results. 100% of endometrial cancer cases were reported in postmenopausal patients with the history of abnormal uterine bleeding. The mean thickness of the endometrium was statistically the largest in this group: 16.2 mm (4-22.3 mm) (p = 0.025). Conclusions: An outpatient endometrial aspiration biopsy is an effective, low-impact procedure in case of indications for histopathological assessment of the endometrium

Early fetal cardiac scan as an element of the sonographic first-trimester screening

Early fetal cardiac scan (EFCS) is becoming an increasingly common element of the first trimester ultrasound screening carried out at 11-14 gestational weeks. It offers the first possibility to detect congenital heart defects (CHD) or, in ambiguous cases, to identify those pregnancies where a more detailed cardiac scan would be required later in pregnancy. The size of the fetal heart at the end of the first trimester and the associated relatively low image resolution make it impossible to capture all cardiac data to inform the ultimate picture. However, even at this stage, cues of anatomical and functional abnormalities can be picked up, which suggest not only a CHD, but also a likelihood of cardiovascular symptoms typical of genetic disorders. EFCS should focus on cardiac position, atrioventricular (AV) connections, AV valve function, initial assessment of ventriculo-arterial (VA) connections and the presence of red flag signs in the three vessel and trachea view (3VTV). Proper use of color Doppler mapping makes it possible to overcome the low resolution of B-mode to a certain extent. Here we present our long-term experience in EFCS

Is the best–worst method path dependent? Evidence from an empirical study

The Best–Worst method (BWM) is one of the latest contributions to pairwise comparisons methods. As its name suggests, it is based on pairwise comparisons of all criteria (or possibly other objects, such as alternatives, sub-criteria, etc.) with respect to the best (most important) and the worst (least important) criterion. The main aim of this study is to investigate the path and scale dependency of the BWM. Up to now, it is unknown whether the weights of compared objects obtained by the method differ when the objects are compared first with the best object, and then with the worst, or vice versa. It is also unknown if the outcomes of the method differ when compared objects are presented in a different order, or when different scales are applied. Therefore, an experiment in a laboratory setting is performed with more than 800 respondents university undergraduates from two countries in which the respondents compare areas of randomly generated figures and the relative size of objects is then estimated via the linearized version of the BWM. Last but not least, the accuracy of the BWM is examined with respect to different comparison scales, including Saaty’s nine-point linguistic scale, an integer scale from 1 to 9, and a continuous scale from 1 to infinity.Podpora mezinarodnych mobilit na Slezske, (CZ.02.2.69/0.0/0.0/18_053/0017871)The research conducted by J. Mazurek was partially supported by the project GACR No. 21-03085S, Czech Republic. The research conducted by D. Strzalstrok;ka was partially supported by the grant: Podpora mezinarodnych mobilit na Slezske univerzite v Opave, [21-03085S, CZ.02.2.69/0.0/0.0/18_053/0017871]; project GAC

Influence of Adalimumab on the Expression Profile of Genes Associated with the Histaminergic System in the Skin Fibroblasts In Vitro

Objective. The aim of this study was to evaluate the influence of adalimumab on expression profile of genes associated with the histaminergic system in Normal Human Dermal Fibroblast (NHDF) cells stimulated with 8.00 μg/ml of adalimumab and the identification of miRNAs regulating these genes’ expression. Methods. NHDFs were cultured with or without the presence of adalimumab for 2, 8, and 24 hours. The expression profile of genes and miRNA were determined with the use of microarray technology. Results. Among 22283 ID mRNA, 65 are associated with the histaminergic system. It can be observed that 15 mRNAs differentiate NHDFs cultures with adalimumab form control. The analysis of miRNAs showed that, among 1105 ID miRNA, 20 miRNAs are differentiating in cells treated with adalimumab for 2 hours, 9 miRNA after 8 hours, and only 3 miRNAs after 24 hours. Conclusion. It was also determined that miRNAs play certain role in the regulation of the expression of genes associated with the histaminergic system. The results of this study confirmed the possibility of using both genes associated with this system as well as miRNAs regulating their expression, as complementary molecular markers of sensitivity to the adalimumab treatment

Selected microRNA Expression and Protein Regulator Secretion by Adipose Tissue-Derived Mesenchymal Stem Cells and Metabolic Syndrome

The role of adipose mesenchymal stem cells (Ad-MSCs) in metabolic syndrome remains unclear. We aimed to assess the expression of selected microRNAs in Ad-MSCs of non-diabetic adults in relation to Ad-MSC secretion of protein regulators and basic metabolic parameters. Ten obese, eight overweight, and five normal weight subjects were enrolled: 19 females and 4 males; aged 43.0 ± 8.9 years. Ad-MSCs were harvested from abdominal subcutaneous fat. Ad-MSC cellular expressions of four microRNAs (2−ΔCt values) and concentrations of IL-6, IL-10, VEGF, and IGF-1 in the Ad-MSC-conditioned medium were assessed. The expressions of miR-21, miR-122, or miR-192 did not correlate with clinical parameters (age, sex, BMI, visceral fat, HOMA-IR, fasting glycemia, HbA1c, serum lipids, CRP, and eGFR). Conversely, the expression of miR-155 was lowest in obese subjects (3.69 ± 2.67 × 10−3 vs. 7.07 ± 4.42 × 10−3 in overweight and 10.25 ± 7.05 × 10−3 in normal weight ones, p = 0.04). The expression of miR-155 correlated inversely with BMI (sex-adjusted r = −0.64; p p = 0.03), and serum CRP (r = −0.63; p p = 0.02). Moreover, miR-155 synthesis was associated marginally negatively with Ad-MSC secretion of IGF-1 (r = −0.42; p = 0.05), and positively with that of IL-10 (r = 0.40; p = 0.06). Ad-MSC expression of miR-155 appears blunted in visceral obesity, which correlates with Ad-MSC IGF-1 hypersecretion and IL-10 hyposecretion, systemic microinflammation, and HDL dyslipidemia. Ad-MSC studies in metabolic syndrome should focus on miR-155