ABSTRACT
Introduction and objectives: Henoch Schönlein purpura (HSP) and Kawasaki disease (KD) are two main inflammatory diseases among childhood vasculitis. Considering the anti-inflammatory effects of 25-hydroxyvitamin D3, we decided to investigate the association of serum 25-hydroxy vitamin D3 level with the type and severity of these conditions. Materials and methods: The present study was performed as a historical cohort of 254 affected children with KD and HSP vasculitis. The required data were extracted, using a researcher-made questionnaire from patients electronic file, and then they were analyzed after collecting information of the patients. Results: In HSP group, 54% of participants were boys. Similarly, in KD group, boys were more affected than girls. The comparative 25-hydroxyvitamin vitamin D3 level in HSP patients with and without renal involvement (P=0.02), hematuria (P=0.14), and in two groups with and without heart disease, and also with and without coronary artery dilatation in KD patients (P<0.001) were significant. Discussion and conclusions: The findings showed that insufficient level of vitamin D3 were significantly associated with the exacerbation of complications of both diseases, and therefore it seems that vitamin D deficiency can be an effective predictive factor of severity in HSP and KD patients.(AU)
Introducción y objetivos: La púrpura de Henoch-Schönlein (HSP) y la enfermedad de Kawasaki (EK) son dos patologías inflamatorias principales entre las vasculitis infantiles. Teniendo en cuenta los efectos antiinflamatorios de la 25-hidroxivitamina D3, decidimos investigar la asociación del nivel sérico de esta con el tipo y la gravedad de dichas afecciones. Materiales y métodos: El presente estudio se realizó como una cohorte histórica de 254 niños afectados con vasculitis por EK y HSP. Los datos requeridos se extrajeron mediante un cuestionario elaborado por un investigador del expediente electrónico de los pacientes y se analizaron después de recopilar la información de los usuarios. Resultados: En el grupo HSP, 54 y 46% de los participantes eran niños y niñas, respectivamente. De manera similar, en el grupo KD, los varones se vieron más afectados. El nivel comparativo de 25-hidroxivitamina D3 en pacientes con HSP con y sin afectación renal (p = 0,02), hematuria (p = 0,14), y en dos grupos con y sin enfermedad cardiaca, y en dos con y sin dilatación de la arteria coronaria en usuarios con EK (p < 0,001) fueron significativos. Discusión y conclusiones: Los hallazgos mostraron que los niveles insuficientes de vitamina D se asociaron significativamente con la exacerbación de las complicaciones de ambas enfermedades, por lo que parece que la deficiencia de vitamina D puede ser un factor predictivo eficaz de la gravedad en pacientes con HSP y EK.(AU
Subject(s)
Humans , Male , Female , Child , Mucocutaneous Lymph Node Syndrome/diagnosis , Vitamin D , Calcifediol , Rheumatology , Rheumatic Diseases , Cohort StudiesABSTRACT
INTRODUCTION AND OBJECTIVES: Henoch Schönlein purpura (HSP) and Kawasaki disease (KD) are two main inflammatory diseases among childhood vasculitis. Considering the anti-inflammatory effects of 25-hydroxyvitamin D3, we decided to investigate the association of serum 25-hydroxy vitamin D3 level with the type and severity of these conditions. MATERIALS AND METHODS: The present study was performed as a historical cohort of 254 affected children with KD and HSP vasculitis. The required data were extracted, using a researcher-made questionnaire from patients' electronic file, and then they were analyzed after collecting information of the patients. RESULTS: In HSP group, 54% of participants were boys. Similarly, in KD group, boys were more affected than girls. The comparative 25-hydroxyvitamin vitamin D3 level in HSP patients with and without renal involvement (P=0.02), hematuria (P=0.14), and in two groups with and without heart disease, and also with and without coronary artery dilatation in KD patients (P<0.001) were significant. DISCUSSION AND CONCLUSIONS: The findings showed that insufficient level of vitamin D3 were significantly associated with the exacerbation of complications of both diseases, and therefore it seems that vitamin D deficiency can be an effective predictive factor of severity in HSP and KD patients.
Subject(s)
IgA Vasculitis , Mucocutaneous Lymph Node Syndrome , Humans , IgA Vasculitis/blood , IgA Vasculitis/complications , Male , Female , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/blood , Child , Child, Preschool , Vitamin D Deficiency/complications , Vitamin D Deficiency/blood , Calcifediol/blood , Retrospective Studies , Hematuria/etiology , Adolescent , Infant , Vitamin D/blood , Vitamin D/analogs & derivatives , Vitamin D/therapeutic use , Severity of Illness IndexABSTRACT
BACKGROUND: Epithelial ovarian cancer is the leading cause of death from gynecology malignancy. The aim of this study was to assess the role of intraperitoneal chemotherapy with carboplatin, as a consolidative treatment, in reducing relapse and increasing survival of patients in advanced epithelial ovarian cancers, as well as evaluation of its toxicity. METHODS: This clinical trial was conducted on 30 patients with epithelial ovarian cancer in stages II-IV in Gynecology oncology department in Valiasr University Hospital, Tehran during 2005-2010. They were enrolled through non-random sequential selection. They divided into 18 cases as the intervention group (receiving intraperitoneal chemotherapy) and 12 patients as the control group (with only retrospective follow-up). The cases received 3 cycles of 400 mg/m2 intraperitoneal carboplatin every 21 days following intravenous chemotherapy. Mean survival of two and five years, progression-free interval, overall survival, relapse, demographic parameters, drug toxicities and pathologic types of cancers were coded in the two groups and compared using SPSS 14. RESULTS: The mean ages of cases and controls were 52.4 ± 8.6 and 55.1 ± 11.5 years. The mean duration of relapse-free survival was 13 ± 8.6 months for the cases and 9.5 ± 4.3 months for the control patients (not statistically different, P>0.05). The mean overall survival for cases and controls were 39 ± 16.5 and 30.8 ± 16.2 months, respectively (no significant difference, P>0.05). The frequency of drug toxicities in the cases was 5.6%, and consisted of mild-to-moderate abdominal pain, nausea and vomiting. CONCLUSION: consolidation therapy with intraperitoneal carboplatin may not increase overall survival, reduce relapse rate or decrease mortality, though it does not induce considerable side effects.
ABSTRACT
INTRODUCTION: Pelvic masses are among most the common causes of patient admission into gynecology clinics and one of the most common reasons for referral to gynecologic oncology departments due to the risk of uterine or ovarian malignancies. The aim of this study is to compare the four indices of the risk of malignancy index (RMI 1-4), as a combination of menstrual status, radiological findings, and serum CA125 concentration, for discrimination of benign from malignant pelvic masses. METHODS: This retrospective descriptive and analytic study was conducted on 200 patients with pelvic mass, post-surgery, and who were referred to the oncology department in Shahid Sadoughi hospital of Yazd (Iran) between June 2007 and September 2011. Data regarding demographics, pathology reports, paraclinical and clinical tests were analyzed. The four RMI indices were separately used for determination of benign vs. malignant masses using the optimized cutoff points, ROC curve, sensitivity, specificity, predictive value of positive and negative, and accuracy. Finally, p value for each index was calculated, and a final discrimination power was measured by using SPSS version 17 software. RESULTS: The calculated p values in the four RMI indices in ultrasound findings indicated statistical significance, and the RMI 2 showed the highest level of accuracy or diagnostic performance. RMI 2 had a cutoff point of 90, an under-chart area 86.7, 79.36% sensitivity, 78.95% specificity, 58.44%, positive predictive value, 90.08% negative predictive value, and 78.93% accuracy, and a p value of 0.004. However, this relationship was found not to be meaningful using CT scan images. CONCLUSIONS: Using RMI 2 for differentiation of malignant from benign pelvic masses is a reliable method with ultrasound findings.
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BACKGROUND AND AIM: Gestational trophoblastic disease (GTN) is one of the high-risk forms of pregnancy that requires a lot of attention in terms of research studies, considering its incidence and the importance of the disease in advanced form. The aim of this study was to investigate the risk factors and clinical procedure of patients with gestational trophoblastic disease from 2001 to 2002. METHOD OF STUDY: This is a retrospective descriptive study, which was carried out on 150 patients with trophoblastic disease. These patients' files were obtained from Shohadaye Kargar and Shahid Sadoughi hospitals and women's oncology offices of Yazd city. The patients were contacted one by one and their disease situation was determined. The data obtained were recorded in a questionnaire and analyzed by SPSS software. RESULT: The results indicated that the average age of the patients was 27.65 ± 8.22 with variations in age ranging from 15 to 35 year. In addition, majorities were in the age group of 20 to 40 years. 43.2 percent of the women were affected during their first gestation. 4% had molar gestation record, and 9.4% had positive family record. Mean time of survival was 93.38 ± 0.62 months (MIN ± SE), and only one died owing to chemotherapy complication. Vaginal bleeding (90%) was the most common symptom. 54.6 percent of the disease had complete mole, 30% had incomplete mole, 8.6% had invasive mole, 4.6% had choriocarcinoma and 2% had placenta site trophoblastic tumor (PSTT). Among the patients studied, 28.7% were benign in GTN group while 71.3 % were malignant in the GTN group. The malignant patients were divided into three groups per risk, and 41.2% were in the high-risk group. There was theca-lutein cyst in 54% of the patients, which had a significant relationship with the disease risk of persistent GTN. CONCLUSION: Choriocarcinoma and invasive mole is the most malignant pathology. There was significant relationship between disease interval and the beginning of chemotherapy, and theca lutein cyst and persistent GTN.
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INTRODUCTION: Infertility is as an important and common problem in couples necessitating assisted reproductive technology (ART) or drug therapy. Infertility is known as a risk factor for ovarian, breast and endometrial cancer. We aimed on evaluation of the history of primary infertility and previous ART in patients with the above-mentioned cancers. MATERIAL AND METHOD: In this retrospective study we evaluated all of the risk factors in patients with breast cancer, ovarian cancer and endometrial cancers who referred to the Gynecological Oncology Clinic in Shahid Sadoughi Hospital in Yazd, Iran from 2002 to 2012. We also investigated the history of primary infertility and ART in these patients before diagnosis of cancers. RESULTS: We gathered data from 92 patients with endometrial cancer, 84 patients with advanced epithelial ovarian cancer and 113 patients with breast cancer. There was history of infertility in 39.1% of patients with endometrial cancer who were obese (body mass index, BMI>29) and in 18.8% of patients with endometrial cancer and normal body mass index (BMI=25-29). ART had been performed in 7.3% of all patients with endometrial cancer. In patients with epithelial ovarian cancer, infertility was diagnosed in 28.4% and ART applied in 14.1%. Clomiphene with or without HCG and HMG was the most common drug used for patients with ovarian cancer. In patients with breast cancer, there was infertility in 16.5% and ART performed in 7.3%. CONCLUSION: Although infertility was present as an important and fairly common risk factor in some patients with endometrial, ovarian and breast cancer, but some other factors may be more important, including age, BMI and the etiology of infertility. Finding the association between ART and gynecological cancers needs long cohort studies with follow-up of infertile women who get the ART or drug therapy for over 15-20 years. We think BMI and age (in addition to infertility and ART) are contributing factors for development of gynecological cancers.
