ABSTRACT
Se presenta un caso de mujer postmenopáusica, goajira, sin criterios de riesgo para adenocarcinoma del endometrio, que mediante el legrado uterino por aspiración de piometra se diagnosticó un carcinoma pavimentoso primitivo epitelial del endometrio (CPPEE), por llenar algunos criterios: no invasión al cuello, ni extensión de uno cervical al endometrio, ni la presencia de queratinización de la superficie endometrial y/o puentes intercelulares. No hubo evidencia de presencia de virus de papiloma humano (VPH). Después de la histerectomía se encontró que sí existía un tumor endometrial grado III, estadio IB. compuesto por elementos glandulares y tejido escamoso en ciertas áreas. Tampoco existían criterios para un diagnóstico de ictiosis uterina, infiltrante, sin componente velloso, Hubo confusión en el diagnóstico inicial. La rareza del CPPEE, menos de 100 casos reportados en el mundo, condujo al análisis con varios patólogos. Se concluye que para obtener el diagnóstico correcto, deben llenarse los criterios de Flumman y de la Organización Mundial de la Salud, excluir infección del tracto genital por VPH, los estudios de inmunohistoquímica deben ser positivos para queratinas y carecer de receptores para estrógenos y progesterona. El legrado o la biopsia no son confiables para el diagnóstico. Además de la evaluación histológica y del estadio clínico, el estudio de toda la pieza quirúrgica es fundamental para emitir pronóstico(AU)
A goajira menopausal woman, with no risk criteria for endometrial adenocarcinoma, was diagnosed through uterine curettage by aspiration of pyometra as primary squamous carcinoma of the endometrium (CPPEE) to meet following criteria: no invasion of the cervix, no extension of the cervical to the endometrium, absence of keratinization of the endometrial surface and intercellular bridges. There was no evidence of human papillomavirus. After the hysterectomy, there was an endometrial tumor composed of glandular elements and squamous tissue in areas, without filling the elements for diagnosis of ichthyosis uteri, infiltrating, without vellous component, grade III and stage IB. There was confusion in the initial diagnosis. The rarity of the CPPEE, less than 100 cases in the world, led to the analysis with several pathologists. It is concluded that in order to obtain the correct diagnosis, it must meet the criteria of Flumman and WHO, exclude infection of the genital tract by HPV, immunohistochemical studies must be positive for keratins and lack estrogen and progesterone receptors. The curettage or the biopsy are not reliable and the study of the whole surgical part is fundamental. In order to establish a prognosis, an accurate diagnosis must be made(AU)
Subject(s)
Humans , Female , Middle Aged , Carcinoma/pathology , Adenocarcinoma/pathology , Endometrial Neoplasms , Biopsy , Hysterectomy , IchthyosisABSTRACT
Graft-versus-host disease (GVHD) is a major adverse effect associated with allogeneic stem cell transplant. Previous studies in mice indicated that administration of the probiotic Lactobacillus rhamnosus GG can reduce the incidence of GVHD after hematopoietic stem cell transplant. Here we report results from the first randomized probiotic enteric regimen trial in which allogenic hematopoietic stem cell patients were supplemented with Lactobacillus rhamnosus GG. Gut microbiome analysis confirmed a previously reported gut microbiome association with GVHD. However, the clinical trial was terminated when interim analysis did not detect an appreciable probiotic-related change in the gut microbiome or incidence of GVHD. Additional studies are necessary to determine whether probiotics can alter the incidence of GVHD after allogeneic stem cell transplant.
Subject(s)
Gastrointestinal Microbiome/drug effects , Graft vs Host Disease/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Lacticaseibacillus rhamnosus/physiology , Probiotics/administration & dosage , Adult , Aged , Female , Follow-Up Studies , Graft vs Host Disease/diet therapy , Humans , Male , Middle Aged , Prognosis , Transplantation, HomologousABSTRACT
Esta revisión bibliográfica tiene como propósito exponer la relación que se ha encontrado entre la enfermedad periodontal y algunas alteraciones del embarazo como la preeclampsia, el retardo en el crecimiento fetal, la ruptura prematura de membranas, el parto a pretérmino, y el bajo peso al nacer, cuando se tienen en cuenta la manifestación clínicas de las enfermedades periodontales en las embarazadas, los hallazgos microbiológicos y las hipótesis propuestas sobre la etiopatogénesis de las complicaciones del embarazo, sugeridas a partir de los hallazgos de estudios realizados en animales y en humanos.
The aim of this bibliographic revision is to show the existing relationship between periodontal disease and some adverse pregnancy outcomes such as preeclampsia, pre-labor rupture of membranes, fetal growth restriction, preterm birth and low birth weight; by taking in account some aspects of the periodontal disease like clinical manifestations during pregnancy, microbiological findings, and the different results found in animal and human casecontrol studies.