Ultrasound and blind endometrial sampling for detection of endometrial cancer in women with postmenopausal bleeding.

This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To assess the diagnostic accuracy of endometrial sampling with histology in the diagnosis of endometrial cancer in women with postmenopausal bleeding and thickened endometrium on ultrasound. Diagnosis will be verified by the reference standards, hysteroscopy with histology, obtained by targeted (such as grasp biopsy of the endometrium or resection of focal pathology) or global sampling (with dilation and curettage), and histology of hysterectomy specimens.

Case report: Spontaneous remission of synchronous endometrial and ovarian cancers following pregnancy.

Introduction: Endometrial cancer is one of the most common malignancies affecting women. It is uncommonly diagnosed in young women, particularly in the absence of abnormal vaginal bleeding symptoms.

Case Presentation: A 28-year-old woman was referred to our department with lower abdominal pain.

Maximal-Effort Cytoreductive Surgery for Ovarian Cancer Patients with a High Tumor Burden: Variations in Practice and Impact on Outcome.

Background: This study aimed to compare the outcomes of two distinct patient populations treated within two neighboring UK cancer centers (A and B) for advanced epithelial ovarian cancer (EOC).

Methods: A retrospective analysis of all new stages 3 and 4 EOC patients treated between January 2013 and December 2014 was performed. The Mayo Clinic surgical complexity score (SCS) was applied.

Diffusion-weighted MR imaging of female pelvic tumors: a pictorial review.

Functional imaging is becoming increasingly important in the evaluation of cancer patients because of the limitations of morphologic imaging, particularly in the assessment of response to therapy. Diffusion-weighted magnetic resonance (MR) imaging has been established as a useful functional imaging tool in neurologic applications for a number of years, but recent technical advances now allow its use in abdominal and pelvic applications. Diffusion-weighted MR imaging studies of female pelvic tumors have shown reduced apparent diffusion coefficient (ADC) values within cervical and endometrial tumors.

Cervical endometriosis: a diagnostic and management dilemma.

Cervical endometriosis is usually a retrospective finding on histology. We describe the diverse symptomatology of the disease, wherein a suspicion of diagnosis may be raised. A series of five patients with cervical endometriosis confirmed on histology was identified.

Delayed delivery of second twin after chorioamnionitis and abortion of first twin at 21 weeks gestation.

Delayed delivery is a relatively new term used to describe the delivery of one fetus after premature delivery of the first fetus. We describe a case where we used tocolysis and antibiotics to prolong a twin pregnancy for 35 days with excellent fetal outcome, after chorioamnionitis had caused the abortion of the first twin at 21 weeks gestation.

Case report: serial serum HCG measurements in a patient with an ectopic pregnancy: a case for caution.

Improvements in the use of ultrasound in early pregnancy have resulted in improved diagnosis of miscarriage and ectopic pregnancy. There are still, however, a significant number of women with a suspected abnormal pregnancy, where transvaginal ultrasound is unable to locate the pregnancy. The concern is the possibility of ectopic pregnancy.

Hormonal regulation of HSP27 expression in human endometrial epithelial and stromal cells.

HSP27 has been analysed immunohistochemically in epithelium and stroma of premenopausal endometria obtained at different stages of the menstrual cycle and in endometria from postmenopausal women receiving oestrogens either alone or in combination with a progestin. The data indicate that HSP27 is increased by oestrogen and inhibited by progestins in glandular epithelium but not stroma. Oestrogen does not increase HSP27 in stromal cells and HSP27 is only present in stromal decidual cells seen in the late secretory phase where it continues to be detectable until the tenth week of gestation.

Presence of an oestradiol receptor-related protein in the skin: changes during the normal menstrual cycle.

Objective: To investigate the presence of an oestradiol receptor-related protein (P29) in skin and skin organelles, and to assess changes in its content during the normal menstrual cycle.

Design: An observational study.

Setting: King's College School of Medicine and Dentistry, London.

The effects of the addition of nomegestrol acetate to post-menopausal oestrogen therapy.

Progestogens are added to the oestrogen treatment for 10-12 days each cycle in order to prevent endometrial abnormalities. However, concern has been expressed about the safety of certain of the currently available progestogens because of the potential adverse metabolic effects. We have evaluated the effects of nomegestrol acetate - non-androgenic progestogen - for administration to post-menopausal oestrogen users.

Dietary intake of calcium and postmenopausal bone loss.

The use of calcium supplements to prevent postmenopausal bone loss and hence osteoporosis is widespread, but the evidence for their efficacy, either alone or in combination with other treatments, is contradictory. Skeletal measurements and dietary intake of calcium were determined in 59 healthy postmenopausal women, most of whom were within five years of the menopause. No correlation was found between current intake of calcium and either total calcium in the body or the density of trabecular or cortical bone in the forearm or vertebral trabecular bone.

Regional and total skeletal measurements in the early postmenopause.

In a cross-sectional study of 70 early postmenopausal women, regional bone measurements were compared with total body calcium (TBCa). Spinal and forearm trabecular bone were mainly related to age and time since menopause. In contrast, TBCa and forearm integral (cortical and trabecular) and cortical bone were unrelated to age, although the time since menopause also had some influence.

A simple method for determining the optimal dosage of progestin in postmenopausal women receiving estrogens.

Progestin is often added to regimens of estrogen therapy in postmenopausal women to reduce the risk of endometrial hyperstimulation, but it may cause undesirable metabolic effects. Therefore, a low dosage is recommended. At present, the only way to determine whether the dosage of progestin is causing the desired secretory transformation of the endometrium is by endometrial sampling, which is invasive.

Absorption and metabolism of oral progesterone when administered twice daily.

The absorption, metabolism, and clearance of progesterone (P) from the peripheral circulation were investigated in five postmenopausal women after oral administration of 100 mg at 9:00 A.M. and 200 mg at 9:00 P.

Oestriol with oestradiol verses oestradiol alone: a comparison of endometrial, symptomatic and psychological effects.

In a prospective, double-blind, randomized, cross-over trial, the effects of oral oestradiol, 2 mg daily, on the endometrial histology, frequency and severity of vaginal bleeding, and the symptomatic and psychological status of postmenopausal women were compared with those of oral oestradiol, 2 mg daily, plus oestriol, 1 mg daily. Both therapies were prescribed for 3 months on a cyclical basis. The addition of oestriol to oestradiol did not modify the endometrial response.

Endometrial responses to transdermal estradiol in postmenopausal women.

In prospective studies, we have determined the endometrial histologic characteristics and patterns of vaginal bleeding in 12 perimenopausal or postmenopausal women during administration of transdermal estradiol, 0.05 mg daily, given either alone or in combination with a progestogen. In the first study, we administered transdermal estradiol in cyclical fashion for 3 months.

Efficacy, acceptability, and metabolic effects of transdermal estradiol in the management of postmenopausal women.

Systemic side effects that result from oral administration of estrogens to postmenopausal women may be minimized by use of the transdermal route. We administered transdermal estradiol, 0.05 mg/day, cyclically for 3 months to 12 postmenopausal and perimenopausal women to study the efficacy, acceptability, and metabolic effects of this dosage form.