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European Journal of Obstetrics and Gynecology and Reproductive Biology: X最新文献

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A national survey on Thai medical students’ attitudes towards abortion and their confidence in providing abortion services following the amendment to abortion law
IF 1.5 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-29 DOI: 10.1016/j.eurox.2024.100364
Hathaipat Leetrakool , Thanathorn Wonglerttham , Sornchaya Sonthyanonth , Jen Sothornwit

Objectives

This study aimed to evaluate medical students' attitudes towards abortion and their confidence in providing abortion services in the future.

Material and methods

A national cross-sectional online survey was conducted among fifth and sixth-year medical students from 10 Thai universities. A self-administered questionnaire assessed their knowledge, attitudes, and confidence regarding abortion services. Of 340 questionnaires sent, 234 responses were received. We used descriptive statistics and multivariable analysis to explore agreement with abortion and confidence.

Results

The mean attitude score towards abortion was 72.68 ± 7.46 out of 85, with 75.6 % of students indicated a favorable attitude toward abortion. The most widely accepted reasons for abortion were serious congenital anomalies in the fetus (99.6 %) and pregnancy resulting from sexual crimes (98.7 %). However, only 42.8 % of the students were willing to provide abortion services, and 33.8 % felt confident in doing so. Additionally, 77.8 % believed that participating in abortion procedures during medical school would increase their confidence in providing these services. No factors were found to be significantly associated with agreement on abortion.

Conclusion

Although most medical students had a positive attitude towards abortion, only a minority expressed willingness and confidence in providing abortion care. These findings underscore the importance of incorporating hands-on experience in abortion procedures in medical school curricula.
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引用次数: 0
Global, regional, and national prevalence and disability-adjusted life-years for endometriosis in 204 countries and territories, 1990–2019: Findings from a global burden of disease study
IF 1.5 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-28 DOI: 10.1016/j.eurox.2024.100363
Dong Yi Shen , Jing Li , PanWei Hu , Cong Qi , Hong Yang

Introduction

This study aimed to analyze the worldwide, regional burden of endometriosis and its trends from 1990 to 2019, utilizing the latest data from Global Burden of Disease (GBD) 2019. GBD 2019 is a global database tool for comprehensive analysis and an important result of long-term collaboration among governments worldwide.

Methods

We utilized the Global Health Data Exchange Query tool to analyze endometriosis in prevalence numbers, age-standardized prevalence rates (ASPR), and disability-adjusted life-years (DALYs) from 1990 to 2019 in 204 countries and regions. Additionally, this study investigated the impacts of period, age, and cohort on the prevalence and DALYs of endometriosis from the global perspective and in the five sociodemographic index (SDI) regions.

Results

Among the 21 regions, the most significant reduction in the prevalence of endometriosis between 1990 and 2019 occurred in Central Latin America. In 204 countries, the most pronounced decline was observed in Guatemala. At the SDI level, with the increase of SDI, the ASPR of endometriosis in all regions worldwide showed an overall decreasing trend. The prevalence of endometriosis peaked between the ages of 25 and 29.

Discussion

The findings of this study reflect the temporal and spatial tendency of the burden of endometriosis during the study period, and provide a reference for health agencies around the world to formulate policies on endometriosis, so as to reduce the harm of endometriosis to women worldwide.
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引用次数: 0
Machine learning applications in placenta accreta spectrum disorders
IF 1.5 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-24 DOI: 10.1016/j.eurox.2024.100362
Mahsa Danaei , Maryam Yeganegi , Sepideh Azizi , Fatemeh Jayervand , Seyedeh Elham Shams , Mohammad Hossein Sharifi , Reza Bahrami , Ali Masoudi , Amirhossein Shahbazi , Amirmasoud Shiri , Heewa Rashnavadi , Kazem Aghili , Hossein Neamatzadeh
This review examines the emerging applications of machine learning (ML) and radiomics in the diagnosis and prediction of placenta accreta spectrum (PAS) disorders, addressing a significant challenge in obstetric care. It highlights recent advancements in ML algorithms and radiomic techniques that utilize medical imaging modalities like magnetic resonance imaging (MRI) and ultrasound for effective classification and risk stratification of PAS. The review discusses the efficacy of various deep learning models, such as nnU-Net and DenseNet-PAS, which have demonstrated superior performance over traditional diagnostic methods through high AUC scores. Furthermore, it underscores the importance of integrating quantitative imaging features with clinical data to enhance diagnostic accuracy and optimize surgical planning. The potential of ML to predict surgical morbidity by analyzing demographic and obstetric factors is also explored. Emphasizing the need for standardized methodologies to ensure consistent feature extraction and model performance, this review advocates for the integration of radiomics and ML into clinical workflows, aiming to improve patient outcomes and foster a multidisciplinary approach in high-risk pregnancies. Future research should focus on larger datasets and validation of biomarkers to refine predictive models in obstetric care.
{"title":"Machine learning applications in placenta accreta spectrum disorders","authors":"Mahsa Danaei ,&nbsp;Maryam Yeganegi ,&nbsp;Sepideh Azizi ,&nbsp;Fatemeh Jayervand ,&nbsp;Seyedeh Elham Shams ,&nbsp;Mohammad Hossein Sharifi ,&nbsp;Reza Bahrami ,&nbsp;Ali Masoudi ,&nbsp;Amirhossein Shahbazi ,&nbsp;Amirmasoud Shiri ,&nbsp;Heewa Rashnavadi ,&nbsp;Kazem Aghili ,&nbsp;Hossein Neamatzadeh","doi":"10.1016/j.eurox.2024.100362","DOIUrl":"10.1016/j.eurox.2024.100362","url":null,"abstract":"<div><div>This review examines the emerging applications of machine learning (ML) and radiomics in the diagnosis and prediction of placenta accreta spectrum (PAS) disorders, addressing a significant challenge in obstetric care. It highlights recent advancements in ML algorithms and radiomic techniques that utilize medical imaging modalities like magnetic resonance imaging (MRI) and ultrasound for effective classification and risk stratification of PAS. The review discusses the efficacy of various deep learning models, such as nnU-Net and DenseNet-PAS, which have demonstrated superior performance over traditional diagnostic methods through high AUC scores. Furthermore, it underscores the importance of integrating quantitative imaging features with clinical data to enhance diagnostic accuracy and optimize surgical planning. The potential of ML to predict surgical morbidity by analyzing demographic and obstetric factors is also explored. Emphasizing the need for standardized methodologies to ensure consistent feature extraction and model performance, this review advocates for the integration of radiomics and ML into clinical workflows, aiming to improve patient outcomes and foster a multidisciplinary approach in high-risk pregnancies. Future research should focus on larger datasets and validation of biomarkers to refine predictive models in obstetric care.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100362"},"PeriodicalIF":1.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of physical activity during pregnancy with labor and delivery in nulliparous patients 无产患者孕期体力活动与分娩的关系。
IF 1.5 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-24 DOI: 10.1016/j.eurox.2024.100361
Shuqun Ren , Qian Zhao , Liyin Luo , Xiaohong You , Aihong Jin

Background

Physical activity during pregnancy is a positive behavior for improving pregnancy outcomes, yet the relationship between physical activity during pregnancy and labor is still debated.

Objective

This study aimed to test our hypothesis that a higher level of physical activity during pregnancy is associated with a shorter labor duration.

Study design

This was a prospective cohort study of pregnant women with singleton pregnancies and no contraindications to physical activity during pregnancy. physical activity according to type and intensity were evaluated with the Chinese version of the Pregnancy Physical Activity Questionnaire. This questionnaire categorizes physical activities into different types and intensities and quantifies them. The primary study outcome was labor duration. The secondary outcomes were delivery mode, conversion from vaginal delivery to cesarean section, prolonged second stage of labor, perineal tears, episiotomy, and postpartum hemorrhage within 24 hours. Generalized additive models were used to identify both linear and nonlinear relationships between physical activity during pregnancy and labor. A segmented linear model was employed to calculate the saturation effect. Stratified logistic regression was used for subgroup analysis.

Results

In total, 226 women participated in the physical activity survey during pregnancy and gave birth at our hospital. The energy expenditure of physical activity during pregnancy was 145.70 (111.92, 181.69) weekly energy expenditure (MET-h•wk-1). After full adjustment for covariates, a nonlinear relationship was observed between physical activity during pregnancy and the duration of the first stage of labor. Different correlations were observed when the energy expenditure of physical activity during pregnancy was 142.28 MET-h•wk-1. In the two-part regression model, the inflection point of physical activity during pregnancy was at 142.28 MET-h•wk-1. When the energy expenditure of physical activity during pregnancy exceeded 142.28 MET-h•wk-1, each standard deviation increase in physical activity was associated with a decrease of 149.85 minutes in the duration of the first stage of labor (β:-149.85, 95 % CI: −247.54 to −52.17, P = 0.0080).

Conclusions

A nonlinear relationship between physical activity during pregnancy and duration of the first stage of labor ha been identified.When physical activity exceeds 142.28 MET-h•wk-1, each additional standard deviation reduces the first stage of labor by 149.85 minutes. Physical activity is not limited to exercise programs; daily activities such as cleaning, shopping, and walking to and from work are effective ways to increase energy expenditure and help individuals achieve the recommended level of physical activity.
背景:孕期体育锻炼是改善妊娠结局的积极行为,但孕期体育锻炼与分娩之间的关系仍存在争议。目的:本研究旨在验证我们的假设,即怀孕期间较高水平的体力活动与较短的分娩时间有关。研究设计:这是一项前瞻性队列研究,研究对象为单胎妊娠且孕期无体育活动禁忌症的孕妇。采用中文版《孕期体力活动问卷》对孕妇进行体力活动类型和强度的评价。该问卷将体育活动分为不同的类型和强度,并进行量化。主要研究结果为分娩时间。次要结局为分娩方式、由阴道分娩转为剖宫产、第二产程延长、会阴撕裂、会阴切开术、24 小时内产后出血。使用广义加性模型来确定怀孕期间体力活动与分娩之间的线性和非线性关系。采用分段线性模型计算饱和效应。亚组分析采用分层逻辑回归。结果:共有226名妇女参加了在我院妊娠和分娩期间的体力活动调查。妊娠期体力活动能量消耗为145.70(111.92,181.69)周能量消耗(MET-h•周-1)。在充分调整协变量后,观察到怀孕期间身体活动与分娩第一阶段持续时间之间存在非线性关系。当孕期体力活动的能量消耗为142.28 MET-h•周-1时,观察到不同的相关性。在两部分回归模型中,孕期体力活动的拐点为142.28 MET-h•wk-1。当孕期体力活动的能量消耗超过142.28 MET-h•周-1时,体力活动每增加一个标准差,分娩第一阶段持续时间减少149.85 分钟(β:-149.85, 95 % CI: -247.54 ~ -52.17, P = 0.0080)。结论:孕期体力活动与分娩第一阶段持续时间之间存在非线性关系。当体力活动超过142.28 MET-h•周-1时,每增加一个标准差,第一阶段劳动时间就会减少149.85 分钟。体育活动并不局限于锻炼项目;清洁、购物、步行上下班等日常活动是增加能量消耗和帮助个人达到建议的身体活动水平的有效方法。
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引用次数: 0
Artificial womb technology – A more physiologic solution to treating extreme prematurity 人工子宫技术——一种治疗极端早产的更生理性的解决方案。
IF 1.5 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-15 DOI: 10.1016/j.eurox.2024.100359
Felix R. De Bie , Chase C. Binion , Ryan M. Antiel
Treatment of extreme premature infants (EPI) is limited by developmental immaturity primarily of the lung. A paradigm shift towards a more physiologic treatment of EPI as fetal neonates or fetonates, by keeping them in a womb-like environment to allow continued organ maturation, is the rationale for artificial womb technology. In this review, we discuss the artificial placenta and womb technology, it’s rationale, the history of its development, the most recent preclinical models described in the literature and finally pertinent ethical considerations.
极端早产儿(EPI)的治疗主要受到肺发育不成熟的限制。人工子宫技术的基本原理是将EPI作为胎儿新生儿或胎儿进行更生理的治疗,通过将其保持在子宫样环境中以允许器官持续成熟。在本文中,我们讨论了人工胎盘和子宫技术,它的基本原理,它的发展历史,最新的临床前模型在文献中描述,最后相关的伦理考虑。
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引用次数: 0
Epidemiological, economic and humanistic burden of cervical intraepithelial neoplasia in Europe: A systematic literature review
IF 1.5 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-12 DOI: 10.1016/j.eurox.2024.100360
Ugne Sabale , Miriam Reuschenbach , Jitender Takyar , Arju Dhawan , Adam Hall , D. Vittal , Gurkiran Saggu , Alessandro Ghelardi , Marta del Pino , Andrzej Nowakowski , Stefano Valente

Introduction

High-grade cervical intraepithelial neoplasia (CIN) is a premalignant lesion of the cervix caused by persistent human papillomavirus (HPV) infection, which can lead to cervical cancer. Despite ongoing primary prevention efforts, considerable burden of illness remains. This study assessed the epidemiological, economic, and humanistic burden associated with high-grade CIN among adult women in Europe.

Methods

Systematic literature reviews (SLRs) were conducted for epidemiological, economic, and humanistic burden, in adult women with high-grade CIN in the broader European region. Search strategies were aligned to Cochrane and PRISMA guidelines. Databases searched included Medline®, Embase®, and Cochrane databases (2012–2022). Conference proceedings were also searched (2018–2022). Outcomes of interest included incidence, prevalence, HPV genotype, cost burden, resource use and quality of life burden.

Results

Evidence from 41 epidemiological, 11 economic burden, and 8 humanistic burden studies was included. Incidence of high-grade CIN was 31–186/100,000 women-years in a screened population, with prevalence rates of 0.1–2.2 %. Incidence and prevalence of high-grade CIN peaked among women aged 25–39 years. In women with high-grade CIN, high-risk genotypes were among those most commonly identified, including HPV16/18 (57.0–58.7 %), HPV16 (47.4–52.0 %), HPV18 (4.0–15.0 %) and HPV 31/33/45 (38 %). Cost burden and healthcare resource utilization was higher for CIN3 vs. CIN2. High-grade CIN significantly impaired quality of life, across multiple domains vs. healthy population.

Conclusion

High-grade CIN was associated with considerable burden in Europe. These findings reveal the multifaceted nature of the impact incurred by women with high-grade CIN, and highlight some of the key areas of unmet need among this patient population.
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引用次数: 0
A new uterine endometrium preservation hysteroscopic myomectomy: Introduction of improved procedures and a retrospective analysis of 94 cases 新型子宫内膜保留宫腔镜子宫肌瘤剔除术:改进程序介绍和 94 例病例的回顾性分析
IF 1.5 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-14 DOI: 10.1016/j.eurox.2024.100354
Wataru Isono , Masanori Maruyama

Objective

To reduce the damage of uterine endometrium caused during hysteroscopic myomectomy (HM) for reproductive aged patients, a new uterine endometrium preservation hysteroscopic myomectomy (UEP-HM) has been developed. In this study, we introduced this technique with comparing to the conventional hysteroscopic myomectomy (C-HM).

Study Design

The data from 94 patients aged 42 or younger who underwent HM (38 cases with UEP-HM and 56 cases with C-HM) for treating single Type 1 or Type 2 submucosal leiomyoma (SL) were analysed retrospectively for comparing the characteristics of both patient and target SL. In this process, we defined the operation time 60 min or over as the longtime operation (LTO) and the SM sized 3 cm or over as the large submucosal leiomyoma (LSL) for detecting the influential factors, including this procedure, on the difficulty of HM. For assisting the prediction of operation time (OT), we investigated the relationship between the OT and the cube of average diameter (AD) of target SL referring with some past reports.

Results

Although when comparing UEP and control groups, parity, AD, the number of patients with Type 2 SL, OT, and the number of infertile patients showed significant difference, in the multivariate analysis only LSL showed the significant influence on the possibility of LTO. Next, we compared OT/Cube of AD, which calculated by dividing OT by the cube of AD for evaluating OT from the target SL size and confirmed that there was no difference in those 2 groups (3.7 ± 3.0 (95 %CI: 0.9 - 13.3, n = 38) vs. 3.9 ± 3.2 (95 %CI: 0.4 - 17.3, n = 56), p = 0.79).

Conclusions

The new UEP-HM can become an alternative method of C-HM without procedure-specific difficulty. In the future, to investigate the prognosis of this procedure, more patients and further analyses should be accumulated.
目的 为了减少宫腔镜子宫肌瘤剔除术(HM)对育龄患者子宫内膜的损伤,一种新的子宫内膜保留宫腔镜子宫肌瘤剔除术(UEP-HM)应运而生。研究设计回顾性分析了94例年龄在42岁或以下、接受宫腔镜子宫肌瘤剔除术(UEP-HM 38例,C-HM 56例)治疗单个1型或2型粘膜下子宫肌瘤(SL)的患者数据,以比较患者和目标SL的特征。在这一过程中,我们将手术时间在 60 分钟或以上的手术定义为长时间手术(LTO),将 3 厘米或以上的粘膜下大肌瘤定义为粘膜下大肌瘤(LSL),以检测包括该手术在内的影响 HM 难度的因素。为了帮助预测手术时间(OT),我们参考过去的一些报道,研究了 OT 与目标 SL 平均直径立方值(AD)之间的关系。结果虽然在比较 UEP 组和对照组时,奇偶数、AD、2 型 SL 患者人数、OT 和不孕患者人数均有显著差异,但在多变量分析中,只有 LSL 对 LTO 的可能性有显著影响。接下来,我们比较了OT/AD立方,即用OT除以AD立方来评估目标SL尺寸的OT,结果证实这两组没有差异(3.7 ± 3.0 (95 %CI: 0.9 - 13.3, n = 38) vs. 3.9 ± 3.2 (95 %CI: 0.4 - 17.3, n = 56), p = 0.79)。结论:新的 UEP-HM 可成为 C-HM 的替代方法,且无手术特异性困难。未来,为研究该手术的预后,应积累更多患者并进行进一步分析。
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引用次数: 0
Preterm birth recurrence after spontaneous preterm birth between 16-28 weeks: A national cohort study 16-28 周自然早产后的早产复发:全国队列研究
IF 1.5 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-14 DOI: 10.1016/j.eurox.2024.100356
Annabelle L. Van Gils , Anita C. Ravelli , Esmé I. Kamphuis , Brenda M. Kazemier , Eva Pajkrt , Martijn A. Oudijk , Marjon A. De Boer

Objective

To assess the risk of recurrent preterm birth following spontaneous extreme preterm birth between 16+0 - 27+6 weeks.

Methods

A nationwide retrospective cohort study was conducted with data from the Perinatal Registry of the Netherlands. We included nulliparous women with a singleton pregnancy that ended in spontaneous preterm birth between 16+0 and 27+6 weeks of gestation without congenital anomalies or antenatal death between 2010–2014 and had a subsequent pregnancy in the 5 years following (2010–2019). The primary outcome of this study was recurrent preterm birth < 37 weeks.

Results

In total, 1011 women with linked pregnancies were included. The risk of preterm birth < 37 weeks with prior spontaneous birth between 16+0-19+6, 20+0-23+6, and 24+0-27+6 weeks was respectively 19.0 %, 29.5 % and 27.6 %. The risk of subsequent preterm birth < 24 weeks was 5.8 %, 7.2 % and 4.3 %. A short interpregnancy interval of 0–3 months was associated with increased odds for recurrent preterm birth < 32 weeks (OR 2.3 95 % CI 1.4–3.7) and preterm birth < 37 weeks (OR 1.8 95 % CI 1.2–2.6).

Conclusion

Patients with previous spontaneous preterm birth from 16 weeks GA onwards are at high risk for recurrent preterm birth and should be regarded as such in the consideration of preventive measures to prevent recurrent adverse pregnancy outcomes.
方法 利用荷兰围产期登记处的数据开展了一项全国性回顾性队列研究。我们纳入了在 2010-2014 年间因妊娠 16+0 周至 27+6 周之间的自发性早产而结束妊娠且无先天性畸形或产前死亡的单胎妊娠且在此后 5 年(2010-2019 年)内再次妊娠的无子宫妇女。本研究的主要结果是复发性早产< 37周。结果共纳入了1011名有关联妊娠的妇女。37周早产的风险分别为19.0%、29.5%和27.6%,而之前在16+0-19+6周、20+0-23+6周和24+0-27+6周自然分娩的风险分别为19.0%、29.5%和27.6%。24 周后发生早产的风险分别为 5.8%、7.2% 和 4.3%。结论:曾在妊娠 16 周后发生过自然早产的患者是复发性早产的高危人群,因此在考虑采取预防措施以防止再次发生不良妊娠结局时,应将其视为高危人群。
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引用次数: 0
Analysing the gene expression profiles of the orphan nuclear receptors NR4A1, NR4A2 and NR4A3 in premalignant lesions of the cervix and cervicitis 分析宫颈癌前病变和宫颈炎中孤儿核受体 NR4A1、NR4A2 和 NR4A3 的基因表达谱
IF 1.5 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-13 DOI: 10.1016/j.eurox.2024.100355
Rosa P. Cruz-Nieves , Gladys E. Ramírez-Rosales , Javier González-Ramírez , Fausto Sánchez-Muñoz , Armando Ruiz-Hernández

Objective

The main objective of the present study was to evaluate the expression of nuclear orphan receptors in the development of Uterine Cervical Cancer (UCC). The principal cause of dysplastic changes in cervical epithelium is the presence of the human papilloma virus leading to the development of cervical intraepithelial neoplasia I (CIN I), high-grade lesions (CIN II and CIN III) and, finally, invasive cancer. Despite the existence of various treatments and vaccines, there is still a high mortality rate. There is evidence of the participation of a group of nuclear receptors called orphans in the development of various diseases, including cancer.

Study design

The expression levels of the orphan receptors NR4A1, NR4A2, and NR4A3 were measured using real-time polymerase chain reaction (RT-PCR) in samples obtained through colposcopy from forty-five patients who attended the Medical Oncology Specialties Unit (UNEME) in Mexicali, B.C.

Results

Forty-five cervical biopsy results were obtained, indicating cervicitis, CIN I, or CIN III, none of them CIN II. Our results showed that orphan receptors expressed in a specific manner depending on the degree of premalignant lesions. NR4A1 overexpressed in cervicitis (p < 0.05). NR4A3 was significantly expressed in CIN I (p < 0.05) and NR4A2 was expressed in both cervicitis and CIN III (p > 0.05).

Conclusion

Our data suggest, for the first time, that nuclear receptors might be involved in the various stages that precede the development of invasive UCC.
本研究的主要目的是评估核孤儿受体在子宫颈癌(UCC)发病过程中的表达。宫颈上皮发育不良的主要原因是人乳头状瘤病毒的存在,它可导致宫颈上皮内瘤变 I(CIN I)、高级别病变(CIN II 和 CIN III),最后发展为浸润性癌。尽管有各种治疗方法和疫苗,但死亡率仍然很高。有证据表明,一组被称为 "孤儿 "的核受体参与了包括癌症在内的各种疾病的发展。研究设计采用实时聚合酶链式反应(RT-PCR)方法测定了在不列颠哥伦比亚省墨西卡利市肿瘤内科专科(UNEME)就诊的 45 名患者通过阴道镜检查获得的样本中孤儿受体 NR4A1、NR4A2 和 NR4A3 的表达水平。我们的研究结果表明,孤儿受体以特定的方式表达,这取决于癌前病变的程度。NR4A1 在宫颈炎中过表达(p < 0.05)。我们的数据首次表明,核受体可能参与了侵袭性 UCC 发生前的各个阶段。
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引用次数: 0
What is the evidence? Updates in the use of antenatal corticosteroids for patients at risk of preterm birth 证据是什么?对有早产风险的患者使用产前皮质类固醇的最新进展
IF 1.5 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-13 DOI: 10.1016/j.eurox.2024.100352
Moti Gulersen , Cynthia Gyamfi-Bannerman
Antenatal corticosteroids have long been considered one of the most important antenatal therapies available for pregnant patients at risk of preterm birth based on the associated reduction of neonatal morbidity and mortality following their administration. However, despite decades of research since their incorporation into routine clinical practice, a number of key questions related to antenatal corticosteroid use remain. These include evaluating the impact of antenatal corticosteroids at gestational ages outside of the previously recommended window of 24 0/7–33 6/7 weeks of gestation, determining factors associated with optimal steroid timing in order to reduce unnecessary exposure, alterations in its dosing regimen, and their long-term impact. The purpose of this document is to review the latest evidence on antenatal corticosteroids and recent developments in emerging topics related to their use.
长期以来,产前皮质类固醇一直被认为是针对有早产风险的孕妇的最重要的产前疗法之一,因为使用皮质类固醇可以降低新生儿的发病率和死亡率。然而,尽管在将皮质类固醇纳入常规临床实践后进行了数十年的研究,但与产前使用皮质类固醇相关的一些关键问题仍然存在。这些问题包括:评估产前皮质类固醇在妊娠 24 0/7-33 6/7 周这一先前推荐的妊娠期以外的妊娠年龄段使用的影响、确定与最佳类固醇使用时机相关的因素以减少不必要的暴露、改变给药方案及其长期影响。本文件旨在回顾产前皮质类固醇的最新证据,以及与使用皮质类固醇相关的新课题的最新进展。
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引用次数: 0
期刊
European Journal of Obstetrics and Gynecology and Reproductive Biology: X
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