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1.
Pan Afr Med J ; 38: 47, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33854676

RESUMO

Endometriosis is the presence of endometrial tissue in abnormal locations outside the uterine cavity. These locations are usually the ovaries, the peritoneum, and the uterine ligaments. Less frequently, the endometrial tissue can affect the perineum especially after surgical procedures or obstetric lesions. In this case report, we describe the case of a patient suffering from pain and swelling, with a sizeable nodule in an old episiotomy scar. Clinical examination, ultrasonography (USG) and magnetic resonance imaging (MRI) helped evoke the diagnosis of perineal endometriosis, and there were no signs of other endometriosis locations. Hormonal treatment was provided at first, but there was no clinical improvement after three months, so the treatment had to be surgical. Histopathological examination of the endometriotic mass confirmed the diagnosis. There were no immediate postoperative complications, and no clinical symptoms or recurrence signs six months and one year after.


Assuntos
Cicatriz/patologia , Endometriose/diagnóstico , Períneo/patologia , Adulto , Endometriose/patologia , Episiotomia/efeitos adversos , Feminino , Humanos , Imagem por Ressonância Magnética , Dor/etiologia
2.
Medicine (Baltimore) ; 100(14): e25460, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832157

RESUMO

RATIONALE: We report a case with inguinal subcutaneous endometriosis without typical cyclic dysmenorrhea and accompanied with a hernia sac treated with resection of the tumor and herniorrhaphy. PATIENT CONCERNS: A 40-year-old woman had a painless enlarged inguinal nodule for 3 months. DIAGNOSES: Subcutaneous endometriosis accompanied with a hernia sac. INTERVENTIONS: Ultrasonography showed a hypoechoic lesion (3.0 cm × 2.0 cm), and an inguinal subcutaneous tumor was first suspected. After surgical exploration, a cystic lesion was excised and the hernia hole was repaired by herniorrhaphy. The immunohistochemical analysis of the small endometriotic cyst-like lesion revealed calretinin (-) in epithelial cells and CD10 (+) in stromal cells, indicative of subcutaneous endometriosis accompanied with a hernia sac. OUTCOMES: The patient was followed up for 1 year and without recurrence. LESSONS: Cutaneous endometriosis accompanied with a hernia sac can be presented without typical endometriosis-associated symptoms such as dysmenorrhea. Inguinal endometriosis might be the differential diagnosis of inguinal painless nodules.


Assuntos
Endometriose/diagnóstico , Hérnia Inguinal/etiologia , Adulto , Endometriose/complicações , Endometriose/patologia , Endometriose/cirurgia , Feminino , Hérnia Inguinal/diagnóstico , Hérnia Inguinal/patologia , Hérnia Inguinal/cirurgia , Herniorrafia , Humanos , Canal Inguinal/diagnóstico por imagem , Canal Inguinal/cirurgia
3.
Life Sci ; 274: 119291, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33667515

RESUMO

AIMS: Most therapeutic drugs of endometriosis have been contraceptives but symptoms recur in up to 75% of cases, which makes it a presses need to try to find novel and safer therapeutic drugs. Imperatorin is a furanocoumarin existing in many plants, possessing multiple activities, including anti-inflammatory. The purpose of this study was to assess the effects and mechanisms of imperatorin in endometriosis. MAIN METHODS: Ectopic endometrial volume and hematoxylin-eosin staining were used to estimate the effects of imperatorin in experimental endometriosis model rats. Potential mechanisms of imperatorin in endometriosis were systematically analyzed by network pharmacology and molecular docking. Western blotting and enzyme-linked immunosorbent assay were employed to evaluate proteins expression and cytokines levels in PI3K/Akt/NF-κB pathway. KEY FINDINGS: Imperatorin could significantly inhibit the growth and ameliorate the histopathological features of ectopic endometrium in experimental endometriosis rats. Network pharmacology approaches showed that imperatorin might regulate inflammatory response and cellular function via primarily affecting PI3K-Akt pathway, Endocrine resistance, Th17 cell differentiation in endometriosis. Moreover, 7 core targets (PIK3CA, AKT1, SRC, MAPK8, MAPK14, ERBB2 and CCND1) resulted from the intersection of KEGG and PPI network topological analysis were used to dock with imperatorin, which indicated that imperatorin could preferably fit in the binding pocket of the above target proteins, except for CCND1. Lastly, imperatorin markedly inhibited the activation of PI3K/Akt/NF-κB pathway via suppressing the phosphorylation levels of PI3K, Akt and p65 in the ectopic endometrium tissue. SIGNIFICANCE: Our findings revealed that imperatorin is a significant multi-target natural active ingredient for treatment endometriosis.


Assuntos
Endometriose/tratamento farmacológico , Furocumarinas/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , NF-kappa B/antagonistas & inibidores , Fosfatidilinositol 3-Quinases/química , Proteínas Proto-Oncogênicas c-akt/antagonistas & inibidores , Animais , Endometriose/metabolismo , Endometriose/patologia , Feminino , NF-kappa B/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos , Ratos Sprague-Dawley , Transdução de Sinais
4.
Int J Mol Sci ; 22(5)2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33669013

RESUMO

Endometriosis is a gynecological disease, the pathogenesis of which seems to be directly associated with inflammatory processes. Serum concentrations of IL-1ß, IL-6, hs-CRP, IgG, YKL 40 and PRL, in comparison to the well-known CA 125 levels, were studied with the aim of identifying an additional noninvasive inflammatory marker or set of markers characteristic for endometriosis. The study group included 43 women with endometriosis (E), 35 women with benign gynecological disorders but without endometriosis (NE, non-endometriosis) as a comparative group, and a control group consisting of 18 healthy subjects (C). The serum concentrations of IL-1ß, IL-6, hs-CRP, YKL-40, PRL and CA 125 were significantly higher in the E group (median values: 0.41 pg/mL, 2.42 pg/mL, 2.33 mg/L, 79.30 ng/mL, 21.88 ng/mL and 68.00 U/mL, respectively) than in the control group (median values: 0.21 pg/mL, 0.98 pg/mL, 0.52 mg/L, 49.77 ng/mL, 12.08 ng/mL and 12.20 U/mL respectively), with the significance of p = 0.011, p < 0.001, p = 0.028, p = 0.005, p < 0.001 and p < 0.001, respectively. The IgG concentrations were significantly lower in the endometriosis group (median value: 1061.21 mg/dL) as compared to healthy women (median value: 1210.50 mg/dL; p = 0.025). Significant differences in concentrations of IL-6 (p = 0.040), hs-CRP (p = 0.007) and CA 125 (p < 0.001) were observed in stage III vs. stage IV of endometriosis. Significantly higher concentrations of IL-6 (p = 0.010), hs-CRP (p = 0.037) and PRL (p < 0.001) were observed in the NE group vs. the control group. Only CA 125 concentrations were significantly higher in endometriosis patients as compared to the non-endometriosis group (p < 0.001). The proposed panel of inflammatory markers, especially IL-6, PRL and CA 125, may become a useful tool to identify women with advanced endometriosis who could qualify for treatment.


Assuntos
Endometriose/sangue , Endometriose/diagnóstico , Adulto , Biomarcadores/sangue , Proteína C-Reativa/análise , Antígeno Ca-125/sangue , Proteína 1 Semelhante à Quitinase-3/sangue , Análise por Conglomerados , Endometriose/patologia , Feminino , Humanos , Inflamação/metabolismo , Interleucina-1beta/sangue , Interleucina-6/sangue , Pessoa de Meia-Idade , Curva ROC , Receptores da Prolactina/sangue
5.
Rozhl Chir ; 100(1): 27-31, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33691420

RESUMO

INTRODUCTION: Endometriosis is defined as the presence of endometrial tissue, endometrial glands or endometrial stroma outside the uterine cavity causing chronic inflammatory response. The prevalence of abdominal wall endometriosis is less than 1%. Cesarean scar endometriosis is the most common type of abdominal wall endometriosis. Chronic lower abdominal pain amplified during menstruation and palpable mass in the area of scar are the main symptoms. Generally, surgical resection with negative resection margins offers the best chance for definitive treatment of abdominal wall endometriosis. CASE REPORT: The authors present two female patients in fertile age with chronic pain in the area of Cesarean scar. The preoperatively assumed endometriosis was histologically confirmed after complete surgical excision. CONCLUSION: Abdominal wall endometriosis is rare. However, it is a possible cause of constant lower abdominal pain, impacting quality of life of the patient.


Assuntos
Parede Abdominal , Endometriose , Parede Abdominal/cirurgia , Cesárea/efeitos adversos , Cicatriz/etiologia , Cicatriz/patologia , Endometriose/etiologia , Endometriose/patologia , Endometriose/cirurgia , Feminino , Humanos , Gravidez , Qualidade de Vida
6.
Anaesthesia ; 76 Suppl 4: 46-55, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33682092

RESUMO

A number of benign and malignant gynaecological conditions can cause infertility. Advancements in assisted reproductive technologies have facilitated the rapidly evolving subspecialty of fertility preservation. Regardless of clinical indication, women now have the reproductive autonomy to make fully informed decisions regarding their future fertility. In particular, there has been an increasing interest and demand among patients and healthcare professionals for fertility-sparing surgery. Gynaecologists find themselves continually adapting surgical techniques and introducing novel procedures to facilitate this rapidly emerging field and anaesthetists need to manage the consequent physiological demands intra-operatively. Not only is it important to understand the surgical procedures now undertaken, but also the intra-operative management in an ever evolving field. This article reviews the methods of fertility-sparing surgery and also describes important anaesthetic challenges including peri-operative care for women undergoing complex fertility-sparing surgeries such as uterus transplantation.


Assuntos
Anestésicos/administração & dosagem , Útero/cirurgia , Endometriose/patologia , Endometriose/cirurgia , Feminino , Preservação da Fertilidade , Humanos , Leiomioma/patologia , Leiomioma/cirurgia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia , Útero/transplante
7.
Medicine (Baltimore) ; 100(7): e24362, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607770

RESUMO

ABSTRACT: This study investigates the effect of 2 laparoscopic methods on ovarian reserve in patients of reproductive age with endometriomas.This was a retrospective study performed at a tertiary medical center from Jan 1st to Dec 31st, 2016. Laparoscopic cystectomy (group 1, 46 patients) and laparoscopic ovarian drainage and ablation with bipolar coagulation at low power (group 2, 30 patients) were performed to treat endometriomas larger than 3 cm. Anti-Müllerian hormone was used to assess ovarian reserve before and after surgery.There were no statistically significant differences in patients' baseline clinical characteristics, endometriotic stage, operative time, and follow-up time between the groups. The mean serum anti-Müllerian hormone concentration decreased significantly from 4.25 ng/ml to 3.40 ng/ml in group 1 compared with 4.47 ng/ml to 3.95 ng/ml in group 2 (P  = .04). Pregnancy rates were 71.05% in group 1 and 73.08% in group 2, with a mean follow-up of 30.40 months and 32.35 months (P  > .99), respectively. Although there was no statistical significance, the recurrence rate in group 1 was lower than that in group 2 (4.35% vs 16.67%, respectively; P = .11). The mean diameter of recurrent cysts was 1.75 cm in group 1 and 1.54 cm in group 2 (P = .13).Appropriate laparoscopic electrocautery of the endometrioma wall with a bipolar instrument may be a valid alternative to traditional laparoscopic cystectomy, with less effects on ovarian reserve.


Assuntos
Cistos/cirurgia , Técnicas de Ablação Endometrial/métodos , Endometriose/cirurgia , Laparoscopia/métodos , Reserva Ovariana , Adulto , Hormônio Antimülleriano/sangue , Cistos/patologia , Endometriose/patologia , Feminino , Humanos , Gravidez , Estudos Retrospectivos
9.
Molecules ; 26(2)2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33430114

RESUMO

Endometriosis is an estrogen-linked gynecological disease defined by the presence of endometrial tissue on extrauterine sites where it forms invasive lesions. Alterations in estrogen-mediated cellular signaling seems to have an essential role in the pathogenesis of endometriosis. Higher estrogen receptor (ER)-ß levels and enhanced ER-ß activity were detected in endometriotic tissues. It is well known that ER-ß interacts with components of the cytoplasmic inflammasome-3 (NALP-3), the NALP-3 activation increases interleukin (IL)-1ß and IL-18, enhancing cellular adhesion and proliferation. Otherwise, the inhibition of ER-ß activity suppresses the ectopic lesions growth. The present study aims to investigate the potential effect of α-lipoic acid (ALA) on NALP-3 and ER-ß expression using a western blot analysis, NALP-3-induced cytokines production by ELISA, migration and invasion of immortalized epithelial (12Z) and stromal endometriotic cells (22B) using a 3D culture invasion assay, and matrix-metalloprotease (MMPs) activity using gelatin zymography. ALA significantly reduces ER-ß, NALP-3 protein expression/activity and the secretion of IL-1ß and IL-18 in both 12Z and 22B cells. ALA treatment reduces cellular adhesion and invasion via a lower expression of adhesion molecules and MMPs activities. These results provide convincing evidence that ALA might inhibit endometriosis progression.


Assuntos
Endometriose/metabolismo , Endométrio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Ácido Tióctico/farmacologia , Adesão Celular/efeitos dos fármacos , Linhagem Celular , Endometriose/tratamento farmacológico , Endometriose/patologia , Endométrio/patologia , Receptor beta de Estrogênio/metabolismo , Feminino , Humanos , Interleucina-18/metabolismo , Interleucina-1beta/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo
10.
Eur J Med Res ; 26(1): 12, 2021 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-33485396

RESUMO

INTRODUCTION: Endometriosis is associated with a high number of chronic pelvic pain and reduced quality of life. Colorectal resections in case of bowel involvement of endometriosis are associated with an unneglectable morbidity in young and healthy patients. There is no linear correlation established between the degree of symptoms and stage of endometriosis. The aim of this study was to correlate the histological findings to preoperative pain scores in colorectal resected patients with endometriosis. METHODS: Twenty-five patients who underwent laparoscopic colorectal resection for endometriosis between 2014 and 2019 were included in this retrospective study. Pain level was assessed preoperatively and postoperatively via phone call in May 2020. Histopathology was correlated to preoperative symptoms and postoperative outcome. RESULTS: Average follow-up time was 38.68 months (± 19.92). Preoperative VAS-score was 8.32 (± 1.70). We observed a significant reduction of pain level in all patients after surgery (p ≤ 0.005). Pain levels were equal regarding the presence of satellite spots and various degrees of infiltration depth. The resection margins were clear in all patients. Postoperative complications occurred in 6 cases (24%) and anastomotic leakage was observed in 3 patients (12%). Average VAS-score at time of follow-up was 1.70 (± 2.54). CONCLUSION: Our data demonstrate that adequate colorectal resection leads to reduction of pain and an increase of quality of life irrespective of histopathological findings. An experienced team is necessary to improve intraoperative outcome and to reduce postoperative morbidity in case of complication.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Endometriose/cirurgia , Enteropatias/etiologia , Enteropatias/cirurgia , Adulto , Endometriose/complicações , Endometriose/patologia , Feminino , Humanos , Enteropatias/patologia , Laparoscopia/métodos , Dor/etiologia , Complicações Pós-Operatórias/epidemiologia , Qualidade de Vida , Resultado do Tratamento
12.
Adv Anat Pathol ; 28(1): 30-43, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33044230

RESUMO

Endometriosis is a relatively common condition in which endometrial tissue is established in locations outside the uterus where, like the eutopic endometrium, it responds to hormonal stimuli and develops internal bleeding, inflammation, and fibrosis. These changes are associated with chronic and often debilitating cyclic pain and infertility. The pathogenesis of endometriosis is multifactorial, and several theories have been proposed to explain it. These include retrograde menstruation, celomic metaplasia, embryologic rests, and lymphovascular spread. Hormones, immunologic status, and genetic factors may also play a role. In most patients, the disease involves pelvic organs, but rarely it may also extend to a large variety of distant locations in the body. Patients with ovarian endometriosis are at higher risk for developing ovarian carcinomas including endometrioid and clear cell carcinomas. Some of these carcinomas may arise in a background of structural and/or nuclear atypia within the endometriotic foci. There is no known cure for endometriosis and treatment mostly consists of managing chronic pain or infertility.


Assuntos
Endometriose/patologia , Endométrio/patologia , Doenças Ovarianas/patologia , Doenças Peritoneais/patologia , Feminino , Humanos , Inflamação/patologia
13.
Adv Exp Med Biol ; 1287: 47-57, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33034025

RESUMO

The human endometrium is a unique, highly dynamic tissue that undergoes cyclic changes of cell proliferation, differentiation, and death. Endometrial cancer is the most common malignancy among women in developed countries. Importantly, the incidence of endometrial cancer is rising in high-income countries. Currently histological classification is used for subtyping of endometrial cancer, while ongoing research is evaluating markers for more accurate molecular classification. Evolutionary conserved Notch signaling pathway regulates diverse cellular processes such as proliferation, differentiation, and cell invasion. Accumulating evidence links aberrant Notch signaling with diseases such as hyperplasia and endometrial cancer. This chapter summarizes the current state of Notch signaling investigations in the endometrium, endometriosis, and endometrial cancer.


Assuntos
Neoplasias do Endométrio , Endometriose , Receptores Notch/metabolismo , Neoplasias do Endométrio/metabolismo , Neoplasias do Endométrio/patologia , Endometriose/metabolismo , Endometriose/patologia , Endométrio/metabolismo , Endométrio/patologia , Feminino , Humanos , Transdução de Sinais
14.
J Vis Exp ; (165)2020 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-33311435

RESUMO

Endometriosis is a leading cause of pelvic pain and infertility. It is defined by the presence of endometrial tissue in extrauterine locations. The development of novel therapies and diagnostic tools for endometriosis has been limited due in part to challenges in studying the disease. Outside of primates, few mammals menstruate, and none develop spontaneous endometriosis. Rodent models are popular but require artificial induction of endometriosis, with many utilizing either immunocompromised mice or surgically induced disease. Recently, more attention has been given to models involving intraperitoneal injection. We present a murine model of endometriosis that integrates several features of existing endometriosis models into a novel, simplified system that relies on microscopic quantification in lieu of subjective grading. In this model, we perform hormonal stimulation of donor mice, intraperitoneal injection, systematic abdominal survey and tissue harvest, and histologic quantification that can be performed and verified at any time after necropsy. This model requires minimal resources and training; does not require expertise by lab technicians in murine survival surgery or in the identification of gross endometriotic lesions; can be used in immunocompromised, immunocompetent, and/or mutant mice; and reliably creates endometriotic lesions that are histologically consistent with human endometriotic disease.


Assuntos
Endometriose/patologia , Animais , Modelos Animais de Doenças , Endometriose/tratamento farmacológico , Endometriose/etiologia , Endométrio/patologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Injeções Intraperitoneais , Camundongos Endogâmicos C57BL , Software
15.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370959

RESUMO

A 65-year-old woman with a previous history of bilateral salpingo-oophorectomy had peritoneal cysts, increasing in size over 15 years and an increasing cancer antigen 19-9 (CA 19-9) level. The size of the cysts eventually reached 86 mm and 70 mm. As malignant transformation of endometriosis was suspected, we performed peritoneal cystectomy and hysterectomy. Histopathology revealed seromucinous borderline tumours (SMBTs) derived from endometriosis. One month after surgery, her CA 19-9 level had decreased. It is rare for SMBT to occur after bilateral salpingo-oophorectomy; surgical management is the best treatment at present.


Assuntos
Cistos/cirurgia , Endometriose/complicações , Neoplasias Epiteliais e Glandulares/diagnóstico , Neoplasias Peritoneais/diagnóstico , Salpingo-Ooforectomia , Idoso , Antígeno CA-19-9/sangue , Cistos/etiologia , Endometriose/patologia , Endometriose/cirurgia , Feminino , Humanos , Histerectomia , Imagem por Ressonância Magnética , Neoplasias Epiteliais e Glandulares/sangue , Neoplasias Epiteliais e Glandulares/etiologia , Neoplasias Epiteliais e Glandulares/cirurgia , Neoplasias Peritoneais/sangue , Neoplasias Peritoneais/etiologia , Neoplasias Peritoneais/cirurgia
16.
J Med Life ; 13(3): 314-320, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33072202

RESUMO

Endometriosis is a chronic benign hormone-dependent condition when the endometrial tissue, identical with the endometrium by its morphological and functional properties, grows outside the borders of the uterine mucous membrane. Recent studies have pointed to the possible role of matrix metalloproteinases (MMPs) in the pathogenesis of endometriosis. We suggested a hypothesis that increased expression of MMPs activity in eutopic and ectopic endometrium of patients with endometriosis might correlate with the presence of endometriotic lesions. The aim of the study was to evaluate the level of MMP-2 and MMP-9 expression in the ectopic endometrium of women with visible endometriotic lesions and eutopic endometrium in patients with no signs of endometriosis. The study was conducted on 43 patients. They were divided into two groups. Group 1 included 31 patients with peritoneal/ovarian endometriosis who had undergone laparoscopy and hysteroscopy. Group 2 consisted of 12 patients with leiomyoma, endometrial polyps or relatively healthy patients who had undergone hysterectomy or polypectomy and endometrial curettage. This study showed statistically higher expression of MMP-2 (1.7783 ± 0.22 immunohistochemistry (IHC) optical density score compared to the control group - 1.41± 0.34, p = 0.0017) and MMP-9 (1.352 ± 0.067 versus 1.85 ± 0.26 in the control group, p = 0.001) in ectopic and eutopic endometrium samples from patients with endometriosis compared to samples taken from patients without endometriosis. A strong correlation between expression of the above-mentioned MMPs (r=0.74 for MMP-2 and r=0.88 for MMP-9) in ectopic and eutopic endometrium might be of promising diagnostic value.


Assuntos
Endometriose/enzimologia , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Adulto , Endometriose/patologia , Endométrio/enzimologia , Endométrio/patologia , Feminino , Humanos , Imuno-Histoquímica
17.
Zhonghua Fu Chan Ke Za Zhi ; 55(6): 384-389, 2020 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-32842244

RESUMO

Objective: To evaluate the incidence of deeply infiltrating endometriosis (DIE) among patients of pelvic endometriosis confirmed by pathology and to make analysis of its clinical and pathological characteristics. Methods: From January 1, 2018 to December 31, 2018, clinical data of 240 cases of pelvic endometriosis diagnosed by laparoscopy and pathology hospitalized in Peking University First Hospital were analyzed retrospectively for the characteristics of symptoms, pelvic examination and anatomic distribution of endometriosis foci. Results: (1) Among 240 cases of pelvic endometriosis, 94 were diagnosed with DIE with an incidence of 39.2% (94/240); of them the diagnosis were made preoperatively in 44 cases (46.8%, 44/94). (2) Compared with those without DIE, patients with DIE had higher rates of secondary dysmenorrhea [53.2% (50/94) versus 38.4% (56/146), P=0.033], anal pain [43.6% (41/94) versus 28.1% (41/146), P=0.013], dyspareunea [39.4% (37/94) versus 18.5% (27/146), P=0.001] and frequent bowel movement [33.0% (31/94) versus 15.8%(23/146), P=0.002]. (3) Patients with DIE had higher rates of bad movement of uterus [21.3% (20/94) versus 6.8% (10/146), P=0.001], painful nodularity on uterosacral ligaments [26.6% (25/94) versus 6.2% (9/146), P<0.01], painful nodularity of posterior fornix [19.1% (18/94) versus 4.8% (7/146), P<0.01], blue nodule in vaginal wall [6.4% (6/94) versus 0 (0/146), P=0.003] by pelvic examination compared with those without DIE. (4) Ninety-four patients with DIE had a total of 162 nodules, of those 88 (54.3%, 88/162) located in uterosacral ligaments, 14 (8.6%, 14/162) in the rectum, 7 (4.3%, 7/162) in vaginal wall, 6 (3.7%, 6/162) in ureter, 4 in bladder (2.5%, 4/162), 2 (1.2%, 2/162) in Douglas pouch. Forty-three DIE patients (45.7%, 43/94) had more than one nodules. Patients with DIE had concomitant ovarian endometriosis in 69 cases (73.4%, 69/94), with a total of 103 endometrial cysts. (5) Patients with DIE had a higher rate of obliterated Douglas pouch [76.6% (72/94) versus 19.2% (28/146), P<0.01]. Conclusions: More than one third of patients with pelvic endometriosis have concomitant DIE with a lower rate of preoperative diagnosis. Pelvic pains, bad movement of uterus and painful nodulirity around cervix suggest the presence of DIE.


Assuntos
Endometriose/patologia , Laparoscopia , Dor Pélvica/etiologia , Dismenorreia/epidemiologia , Endometriose/epidemiologia , Feminino , Humanos , Incidência , Estudos Retrospectivos
18.
Zhonghua Fu Chan Ke Za Zhi ; 55(6): 402-407, 2020 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-32842247

RESUMO

Objective: To further understand the current status of diagnosis and treatment of endometriosis in China, the implementation of guideline in different levels of hospitals, and the need for continuing education in endometriosis among primary doctors. Methods: The survey was conducted in the form of convenience sampling questionnaire among the Wechat public platform. The doctors were free to participate in the investigation without any reward. All questions answered were assessed as valid questionnaire. The datas were collected on the questionnaire network platform and analyzed by SPSS 19.0. Results: Totally 1 494 valid questionnaires were collected in this survey. 60.17% (899/1 494) of them were from tertiary hospital, and 32.60% (487/1 494) were from grade two hospital. Only the hospitals where 9.97% (149/1 494) participants based opened the specialist clinic for endometriosis. 70.35% (1 051/1 494) of participants said they had read the second edition of guideline for the diagnosis and treatment of endometriosis which published in 2015. The American Society for Reproductive Medicine (ASRM) staging system was adopted in the clinical practices of only 25.03% (374/1 494) participants. And 18.74% (280/1 494) participants used the endometriosis fertility index (EFI) scoring during the laparoscopic surgery for endometriosis with infertility. 45.18% (675/1 494) of participants said they had not attended any academic conference on endometriosis in the past six months. 64.46% (963/1 494) of the participants believed their diagnosis and treatment in practice should be improved and standardized. 87.15% (1 302/1 494) of the participants expressed the hope that more conferences or workshops on endometriosis would be held. Conclusions: At presents, the diagnosis and treatment of endometriosis in China has been greatly improved, but the implementation of guidelines and the new concept is still a long-term job. The specialist clinic are held only in a few hospitals. It's the expectation and voice of primary doctors to the association to organize the more academic congresses on endometriosis.


Assuntos
Endometriose/patologia , Endometriose/terapia , Infertilidade Feminina/etiologia , Dor Pélvica/patologia , China , Endometriose/complicações , Feminino , Fertilidade , Humanos , Infertilidade Feminina/patologia , Dor Pélvica/etiologia , Inquéritos e Questionários
19.
Gene ; 757: 144926, 2020 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-32621951

RESUMO

Endometriosis is a frequent gynecologic disease in the world. CircRNAs can exert a crucial role in various diseases. Nevertheless, little is known about its roles in endometriosis. We investigated the involvement of circ_0061140 in endometriosis. Tissues from endometriosis women displayed an increased expression of circ_0061140. Then, we found loss of circ_0061140 significantly repressed ectopic endometrial cell proliferation, migration and invasion. Meanwhile,miR-140-3pcan demonstrate an important role in several cancers.Here, we reported miR-140-3p was reduced in ectopic endometrial cells and it acted as a target of circ_0061140. Moreover, miR-140-3p was able to reverse the effect of circ_0061140 on ectopic endometrial cells. Furthermore, Notch2 was predicted as a putative target of miR-140-3p. A positive correlation between circ_0061140 and Notch2 was indicated. miR-140-3p and Notch2 were operated as downstream effectors in the circ_0061140 mediated signaling in endometriosis. Decrease of circ_0061140 could depress endometriosis progression through modulating miR-140-3p and Notch2.


Assuntos
Movimento Celular , Proliferação de Células , Endometriose/genética , RNA Circular/genética , Células Cultivadas , Regulação para Baixo , Endometriose/metabolismo , Endometriose/patologia , Endométrio/metabolismo , Endométrio/patologia , Feminino , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo , RNA Circular/metabolismo , Receptor Notch2/genética , Receptor Notch2/metabolismo
20.
Br J Radiol ; 93(1114): 20200690, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32706984

RESUMO

OBJECTIVES: Our objective was to establish the primary mode of imaging and MR protocols utilised in the preoperative staging of deeply infiltrating endometriosis in centres accredited by the British Society of Gynaecological Endoscopy (BSGE). METHODS: The lead consultant radiologist in each centre was invited to complete an online survey detailing their protocols. RESULTS: Out of 49 centres, 32 (65%) responded to the survey. Two centres performed transvaginal ultrasound as the primary method for preoperative staging of deeply infiltrating endometriosis and the remainder performed MRI. 21/25 centres did not recommend a period of fasting prior to MRI and 22/25 administered hyoscine butylbromide. None of the centres routinely offered bowel preparation or recommended a specific pre-procedure diet. 21/25 centres did not time imaging according to the woman's menstrual cycle, and instructions regarding bladder filling were varied. Rectal and vaginal opacification methods were infrequently utilised. All centres preferentially performed MRI in the supine position - six used an abdominal strap and four could facilitate prone imaging. Just under half of centres used pelvic-phased array coils and three centres used gadolinium contrast agents routinely. All centres performed T1W with fat-suppression and T2W without fat-suppression sequences. There was significant variation relating to other MR sequences depending on the unit. CONCLUSIONS: There was significant inconsistency between centres in terms of MR protocols, patient preparation and the sequences performed. Many practices were out of line with current published evidence. ADVANCES IN KNOWLEDGE: Our survey demonstrates a need for evidence-based standardisation of imaging in BSGE accredited endometriosis centres.


Assuntos
Endometriose/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Protocolos Clínicos , Meios de Contraste , Endometriose/patologia , Feminino , Humanos
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