The role of shear wave elastography in predicting endometrial cancer in patients presenting with abnormal uterine bleeding.

OBJECTIVE: Shear Wave Elastography (SWE) is an objective quantitative ultrasound elastography technique that can demonstrate the stiffness of anatomical structures to aid in their detection and characterization. We aimed to evaluate the role of shear wave elastography in differentiating endometrial carcinoma from benign uterine pathologies in women with abnormal uterine bleeding. PATIENTS AND METHODS: This prospective study was conducted at our institution from January 2020 to April 2020. A hundred patients with endometrial sampling planned and SWE due to abnormal uterine bleeding were included in the study. According to the histopathological results of the patients, those with normal and atrophic endometrium results were defined as group I (control group), those with benign results such as polyps and endometrial hyperplasia were defined as group II, and those with endometrial cancers were defined as group III. RESULTS: After adjustment for age, a statistically significant difference was found in Emean (mean and adjusted mean) value between the study groups (F2.96=86.37, p<.001, η2=0.64). The post-hoc analysis was performed with a Bonferroni adjustment. The mean Emean value was found to be statistically significantly higher in group III (17.14±0.40) compared to group I (10.39±0.26) and group II (11.49±0.32) (p<0.001). In addition, a statistically significant difference was found between the benign and normal groups. CONCLUSIONS: As a new diagnostic technique in gynecology, elastography appears to be a valuable tool in differentiating malign endometrial pathologies from normal or benign endometrial pathologies in females with abnormal uterine bleeding.

Comparación del valor pronóstico de diferentes criterios de respuesta metabólica determinados por PET/TC en pacientes con cáncer de mama metastásico en tratamiento con inhibidores de CDK 4/6 / Comparison of prognostic value of different metabolic response criteria determined by PET/CT in patients with metastatic breast cancer under CDK 4/6 inhibitor treatment

Objetivo Este estudio evalúa el papel pronóstico de diferentes criterios de respuesta metabólica de la PET/TC con [18F]FDG en pacientes con cáncer de mama metastásico (CMM) tratadas con inhibidores de la cinasa dependiente de ciclina 4/6 (CDK 4/6). Materiales y métodos Evaluamos retrospectivamente los datos de pacientes con CMM tratados con inhibidores de CDK 4/6 a los que se les realizó una [18F]FDG PET/TC antes de iniciar y durante el tratamiento. La respuesta de [18F]FDG PET/CT se evaluó con la Organización Europea para la Investigación y el Tratamiento del Cáncer, los criterios de respuesta de PET en tumores sólidos (PERCIST) y los criterios de glucólisis de lesión total de cuerpo entero (WBTLG). Fleiss kappa se calculó para evaluar la concordancia entre los criterios de respuesta metabólica. El criterio de valoración del estudio fue la supervivencia libre de progresión (PFS). Los datos de SLP se analizaron mediante el método de Kaplan-Meier y se compararon mediante la prueba de rango logarítmico. Resultados El estudio incluyó a 16 pacientes con CMM que recibieron terapia con inhibidores de CDK 4/6. Según PERCIST, se encontró respuesta metabólica parcial (PMR) en siete pacientes, enfermedad metabólica estable (SMD) en siete pacientes y enfermedad metabólica progresiva (PMD) en dos pacientes. Según la Organización Europea para la Investigación y el Tratamiento del Cáncer, se detectó PMR en ocho pacientes, SMD en siete pacientes y PMD en un paciente. Según WBTLG, se encontró PMR en 10 pacientes, SMD en cuatro pacientes y PMD en dos pacientes. Hubo un acuerdo justo entre los tres criterios. Si bien se detectó progresión en siete de los pacientes durante el seguimiento, no se detectó progresión en nueve de ellos. El análisis de Kaplan-Meier reveló que los que respondieron según WBTLG mostraron una SLP significativamente más larga que los que no respondieron (AU)

Purpose This study evaluates the prognostic role of different [18F]FDG PET/CT metabolic response criteria in metastatic breast cancer (MBC) patients treated with cyclin-dependent kinase 4/6 inhibitors (CDK 4/6). Materials and methods We retrospectively evaluated the data of MBC patients treated with CDK 4/6 inhibitors who underwent an [18F]FDG PET/CT scan before starting and during treatment. [18F]FDG PET/CT response was assessed with the European Organization for Research and Treatment of Cancer, PET response criteria in solid tumors (PERCIST), and whole-body total lesion glycolysis (WBTLG) criteria. Fleiss kappa was computed to assess the agreement between metabolic response criteria. The endpoint of the study was progression-free survival (PFS). PFS data were analyzed by the Kaplan–Meier method and compared using the log-rank test. Results The study included 16 MBC patients who received CDK 4/6 inhibitors therapy. According to PERCIST, partial metabolic response (PMR) was found in seven patients, stable metabolic disease (SMD) in seven patients, and progressive metabolic disease (PMD) in two patients. According to the European Organization for Research and Treatment of Cancer, PMR was detected in eight patients, SMD in seven patients, and PMD in one patient. According to WBTLG, PMR was found in 10 patients, SMD in four patients, and PMD in two patients. There was a fair agreement between the three criteria. While progression was detected in seven of the patients during follow-up, no progression was detected in nine of them. Kaplan–Meier analysis revealed that the responders according to WBTLG showed significantly longer PFS than non-responders. Conclusion Treatment response according to WBTLG criteria during treatment appears to be associated with prolonged PFS in patients treated with CDK 4/6 inhibitors for MBC (AU)

Effects of primary Sjögren's syndrome on hearing and vestibular systems.

OBJECTIVE: This study aimed to evaluate primary Sjögren's syndrome patients in terms of hearing and vestibular functions. METHODS: The patient group consisted of 35 individuals diagnosed with primary Sjögren's syndrome and a control group of 35 healthy individuals similar in terms of age and gender. RESULTS: The rate of hearing loss in the patient group was significantly higher than in the control group (p = 0.021). The N1 latency value for the ocular vestibular-evoked myogenic potentials test was significantly longer in the patient group than in the control group (p = 0.037). Additionally, the posterior semicircular canal and lateral semicircular canal vestibulo-ocular reflex gain values were significantly lower than in the control group (p = 0.022 and p < 0.001, respectively). CONCLUSION: These results indicate subclinical vestibular involvement and hearing loss in primary Sjögren's syndrome patients. Vestibular-evoked myogenic potentials and video head impulse tests can be used to detect vestibular involvement in primary Sjögren's syndrome patients.