@article {8031, title = {Hysteroscopic chasing for endometrial cancer in a low-risk population: risks of overinvestigation.}, journal = {Arch Gynecol Obstet}, year = {2015}, month = {2015 Aug 28}, abstract = {

PURPOSE: To evaluate the appropriateness of the indications for hysteroscopy done, in fertile and postmenopausal women, for the detection of endometrial cancer.

METHODS: A retrospective analysis of 2673 consecutive women who underwent office hysteroscopy chasing for endometrial cancer between January 2012 and June 2014. According to their medical history only low-risk women entered the study.

RESULTS: A total of 1070 patients entered the study. The main outcome measure was the appropriateness of the indications for hysteroscopy. Appropriateness was assessed on the basis of guidelines of scientific societies and histologic report. According to the algorithm developed for appropriateness, 44~\% of procedures resulted in being inappropriate. In reproductive-aged women 57~\% of hysteroscopies were inappropriate. In postmenopausal women inappropriate hysteroscopies were 45~\%. In reproductive-aged women, the reasons for inappropriateness were: absence of abnormal uterine bleeding (AUB) or AUB without a trial of progestin therapy. In postmenopausal women, the reasons for inappropriateness were: ultrasound report of endometrial thickening or polyp without bleeding.

CONCLUSIONS: Hysteroscopy is often recommended for inappropriate indications. More evidence is needed to identify the risks of overinvestigation, overdiagnosis, and related overtreatment and to better identify the threshold beyond which benefits are likely to outweigh harms.

}, issn = {1432-0711}, doi = {10.1007/s00404-015-3868-x}, author = {Scrimin, Federica and Wiesenfeld, Uri and Galati, Emanuele F and Monasta, Lorenzo and Ricci, Giuseppe} } @article {1860, title = {Human colostrum and breast milk contain high levels of TNF-related apoptosis-inducing ligand (TRAIL).}, journal = {J Hum Lact}, volume = {29}, year = {2013}, month = {2013 Feb}, pages = {23-5}, abstract = {

BACKGROUND: TNF-related apoptosis inducing ligand (TRAIL) is a pleiotropic cytokine, which plays a key role in the immune system as well as in controlling the balance of apoptosis and proliferation in various organs and tissues.

OBJECTIVE: To investigate the presence and levels of soluble TRAIL in human colostrum and milk.

METHODS: The levels of soluble human TRAIL were measured in human colostrum (day 2 after delivery) and breast milk (day 5 after delivery). The presence of TRAIL was also measured in infant formula.

RESULTS: Levels of soluble TRAIL in the colostrum and mature human milk were, respectively, at least 400 and 100 fold higher than those detected in human serum. No TRAIL was detected in formula.

CONCLUSION: Human soluble TRAIL is present at extremely high levels in human colostrum and human milk and might have a significant role in mediating the anti-cancer activity of human milk.

}, keywords = {Adult, Apgar Score, Colostrum, Female, Gestational Age, Humans, Infant Formula, Infant, Newborn, Milk, Human, TNF-Related Apoptosis-Inducing Ligand}, issn = {1552-5732}, doi = {10.1177/0890334412441071}, author = {Davanzo, Riccardo and Zauli, Giorgio and Monasta, Lorenzo and Vecchi Brumatti, Liza and Abate, Maria Valentina and Ventura, Giovanna and Rimondi, Erika and Secchiero, Paola and Demarini, Sergio} }