Resilience and related factors in urban, mid-aged Spanish women.

OBJECTIVE: To assess resilience and related factors among urban, mid-aged Spanish women. METHODS: This was a cross-sectional study performed in 227 women aged 40-65 years who filled out the 14-item Wagnild and Young Resilience Scale (WYRS-14), the Menopause Rating Scale (MRS) and a questionnaire containing personal sociodemographic data. RESULTS: For the whole sample, median (interquartile range) age and total WYRS-14 score were 52.4 (8.7) years and 79 (20.0) points, respectively. Resilience score was inversely related to non-working status, non-university studies, depressed mood, perimenopausal status, and higher MRS total scores (≥ 17). Using the 25th percentile of the obtained total WYRS-14 score as a cut-off value to define lower resilience (< 68.0 points), logistic regression analysis determined that low resilience was related to being unemployed, having depressed mood and being perimenopausal. Drinking less than 3 units/day of alcohol was significantly related to higher resilience. CONCLUSION: In this sample of urban, mid-aged Spanish women, low resilience (lower WYRS-14 scores) was related to unemployment status, depressed mood and severe menopausal symptoms.

Estudio clinicopatológico de los sarcomas uterinos / Clinicopathologic study of uterine sarcomas

Objetivo: Estudiar las características de los sarcomas uterinos y valorar el impacto pronóstico de los factores clinicopatológicos en la supervivencia. Material y método: Se realizó un estudio retrospectivo de 71 casos de sarcomas uterinos diagnosticados y tratados en el Hospital Clínico San Carlos durante los años 1980-1998. En 66 casos se realizó una histerectomía con doble anexectomía como tratamiento primario. Los tratamientos complementarios fueron la radioterapia y la quimioterapia. Resultados: El sarcoma más frecuentemente encontrado fue el leiomiosarcoma (LMS) (56,3 por ciento), seguido de los tumores mesodermales mixtos malignos (TMMM) (31,1 por ciento), el sarcoma de la estroma endometrial (7,1 por ciento), el rabdomiosarcoma (4,1 por ciento) y el condrosarcoma (1,4 por ciento). La edad de presentación del TMMM es mayor que en los LMS (p < 0,010). La clínica de presentación más frecuente fue la metrorragia (74,6 por ciento). Los tumores se encontraron en estadios precoces en un 64,7 por ciento de los casos. En el análisis de la supervivencia, los factores que predijeron un pronóstico peor fueron el estadio tumoral (p < 0,001), el grado de diferenciación (p = 0,010) y la invasión miometrial profunda (p < 0,001). El tipo histológico no alcanzó significación estadística. En el estudio multivariante de Cox, el estadio fue el único factor clinicopatológico predictivo de mortalidad. Conclusiones: La edad de presentación es variable según el tipo de sarcoma y la manifestación clínica más común es la metrorragia. El factor más importante para la supervivencia es el estadio de la FIGO en el momento del diagnóstico (AU)

Determinaciones analíticas de la mujer anciana en ginecología / Biological-analitical determinations in the older woman

En esta revisión se hace un análisis de los cambios anatómicos, suelo pélvico, etc. en el envejecimiento femenino, de lo déficits hormonales y marcadores tumorales, ya que los procesos oncológicos tan frecuentes en la mujer postolmatérica y anciana (AU)

A comparison of epithelial membrane antigen overexpression in benign and malignant endometrium.

OBJECTIVE: The aim of this study was to analyze the value of epithelial membrane antigen (EMA) overexpression in benign and malignant endometrium and its prognostic significance. METHODS: EMA immunostaining was performed in 178 paraffin-embedded specimens including 105 endometrial cancers, 40 endometrial hyperplasias, and 33 benign endometriums. EMA immunostaining was correlated with traditional prognostic factors and progression-free survival in endometrial cancer specimens. RESULTS: EMA overexpression was observed more frequently in adenocarcinomas (60%) than in hyperplasias (15%) or benign endometrium (9.1%). EMA overexpression was observed in two patients with endometrial hyperplasia who progressed to carcinoma. In adenocarcinomas, EMA overexpression had a positive correlation with nonendometrioid subtypes (P = 0.012). In multivariate analysis, FIGO stage (P = 0.025) and EMA overexpression (P = 0.017) were independent prognostic factors for progression-free survival. CONCLUSIONS: EMA overexpression appears to be a marker of malignant transformation in the endometrium and it is an independent predictor of recurrent disease in endometrial cancer.

P53 overexpression predicts endometrial carcinoma recurrence better than HER-2/neu overexpression.

OBJECTIVE: to investigate the prognostic value of p53 and HER-2/neu overexpression in endometrial cancer. STUDY DESIGN: p53 and HER-2/neu immunostaining was performed in 114 paraffin-embedded specimens of endometrial cancer diagnosed and treated between 1990 and 1997. Nuclear p53 and membrane HER-2/neu immunostaining were used. RESULTS: p53 and HER-2/neu overexpression was observed in 17 cases (14.9%) and in 19 cases (16.7%), respectively. In univariate analysis p53 (P<0.001) and HER-2/neu (P=0.018) overexpression had a positive correlation with a high risk of recurrence. In multivariate analysis, age (P<0.001), FIGO stage (P<0.001), differentiation (P=0.013), non-endometrioid subtypes (P<0.001) and p53 overexpression (P<0.001), but not HER-2/neu overexpression, were independent prognostic indicators of recurrence. Simultaneous p53 and HER-2/neu overexpression made worse the prognostic (P<0.001). CONCLUSIONS: p53 overexpression was an independent predictor of recurrent disease in endometrial cancer. HER-2/neu overexpression had a more limited effect but enhance the effect of p53.