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Background Endometriosis is currently considered a systemic inflammatory disease and different non-invasive inflammatory markers, such as cell-free DNA (cfDNA), have recently been evaluated. Hormonal treatments are frequently prescribed as first-line treatments to improve symptoms, reduce lesions and improve the quality of life of patients with endometriosis. The most frequently used hormonal treatments are estroprogestins and progestins due to their effectiveness and well-tolerated clinical profile. However, the impact these hormonal treatments may have on these markers has yet to be determined. The aim of this study was to assess whether cfDNA levels are modified under the two main first-line hormonal treatments in patients with deep endometriosis (DE). Methods Ninety patients diagnosed with DE were analyzed in this prospective, observational study. Forty-five received daily oral treatment with dienogest 2 mg, and 45 with 2 mg dienogest/30 μg ethinylestradiol. Plasma cfDNA levels were evaluated by fluorescent assay prior to initiation of treatment and at 6 and 12 months of treatment. Results An increase in cfDNA levels was observed during the follow-up at 6 and 12 months. However, these higher levels were only statistically significant at 12 months of treatment. The increase of cfDNA levels was similar with both treatments. Conclusion Higher cfDNA levels were observed in DE patients at 12 months of oral hormonal treatment showing similar results with dienogest or dienogest/ethinylestradiol. This increase could be explained by apoptosis of the endometriosis foci due to the treatment.

The aim of this study was to evaluate the feasibility, efficacy, and morbidity of laparoscopic ovarian transposition on the preservation of hormonal function in patients younger than 45 years operated for early cervical cancer. According to risk factors on pathologic evaluation of the specimen, some of them will receive postoperative pelvic radiotherapy. This subset of patients could benefit from taking the ovaries away from the irradiation field in an effort to preserve their functionality. This prospective study included 28 FIGO stage IB1 cervical cancer patients, 45 years old or younger, maintaining menstrual cycles, who were considered suitable for conservation of the ovaries. The ovarian transposition was performed by laparoscopy as a part of the same celio-Schauta operation. Twelve patients underwent adjuvant pelvic radiotherapy. No intraoperative or postoperative morbidity related to the ovarian transposition was observed, and the procedure only entailed a minimum delay of the operative time. There were no cases of ovarian metastasis. At a mean follow-up of 44 months, 63.6% of patients receiving radiotherapy and 93% of those who nonirradiated maintained normal ovarian function. Two patients developed benign ovarian cysts, requiring oophorectomy, but no other long-term adverse effects of the transposition were identified. To the best of our knowledge, this is the largest series of the laparoscopic procedure reported to date in this setting. According to our results, laparoscopic ovarian transposition is a safe and effective procedure for the preservation of ovarian function in young patients with early cervical cancer undergoing adjuvant radiotherapy after surgery

Sclerosing peritonitis is a peritoneal subserosal fibrosis that has been associated with luteinized thecomas of the ovary. Ascites, peritoneal thickening and adnexal masses were found in a 38-year-old woman. She had been an intravenous drug abuser and had systemic lupus erytematosus. At laparotomy the association of peritoneal diffuse fibrosis and bilateral luteinized fibrothecomas was diagnosed. The postoperative course was fatal due to small bowel obstruction. The concomitant finding of ascites, peritoneal thickening and adnexal masses suggested the diagnosis of ovarian cancer. Although the patogenesis is unknown, predisposing causes of sclerosing peritonitis have been described such as intravenous drug abuse and systemic lupus erithematosus.[PUBLICATION ABSTRACT]

The purpose of this work is to address an environmental problem in Mexico, which uses significant amounts of water for agricultural activities, where atrazine is frequently used as a pesticide for weed control. Currently, there is no law prohibiting its use, even though it is considered an endocrine disruptor in some mammals and harmful to health. Due to the difficulty in the direct quantification of several herbicides, which present a low concentration in water, the present work aims to develop the optimization and validation of the preconcentration with magnetic stir bars (SBSE) in aqueous samples for the quantification of atrazine and two of its metabolites: 2-hydroxyatrazine (2-HA) and desethylatrazine (DEA), coupled to High-Performance Liquid Chromatography (HPLC-UV/DAD). For the optimization of the preconcentration technique, the nature and quantity of the solvents used in each step, contact time for retention and quantitative extraction of the analyte, as well as the effect of the concentration of the analyte on its retention on the bar were considered. Finally, it was determined that the presence of the metabolites 2-HA and DEA does not affect the sorption of atrazine on the sorption bar used. The analytical methodology can be considered as an efficient method of atrazine preconcentration for subsequent quantification via HPLC-UV/DAD in the range of 0.03 to 0.25 mg/L and in the absence of matrix interferences; its limits of detection and quantification are respectively 0.0014 mg/L and 0.0016 mg/L.

Oocytes form before birth and remain viable for several decades before fertilization 1 . Although poor oocyte quality accounts for most female fertility problems, little is known about how oocytes maintain cellular fitness, or why their quality eventually declines with age 2 . Reactive oxygen species (ROS) produced as by-products of mitochondrial activity are associated with lower rates of fertilization and embryo survival 3 – 5 . Yet, how healthy oocytes balance essential mitochondrial activity with the production of ROS is unknown. Here we show that oocytes evade ROS by remodelling the mitochondrial electron transport chain through elimination of complex I. Combining live-cell imaging and proteomics in human and Xenopus oocytes, we find that early oocytes exhibit greatly reduced levels of complex I. This is accompanied by a highly active mitochondrial unfolded protein response, which is indicative of an imbalanced electron transport chain. Biochemical and functional assays confirm that complex I is neither assembled nor active in early oocytes. Thus, we report a physiological cell type without complex I in animals. Our findings also clarify why patients with complex-I-related hereditary mitochondrial diseases do not experience subfertility. Complex I suppression represents an evolutionarily conserved strategy that allows longevity while maintaining biological activity in long-lived oocytes. Oocytes prevent the production of reactive oxygen species by remodelling the mitochondrial electron transport chain through elimination of complex I, a strategy that enables their long-term viability.

Nowadays, combined oral contraceptives (COCs) are successfully employed for the treatment of endometriosis (END) and adenomyosis (AD) in a large proportion of patients. However, literature focusing on the clinical and sonographic response to treatment in the long-term follow-up of patients with deep endometriosis (DE) and AD is scarce. The aim of this study was to evaluate the changes in the symptoms and the sonographic exams at 12 and 24 months of follow-up in patients who had received a flexible extended COC regimen containing 2 mg of dienogest/30 μg ethinyl estradiol. This prospective, longitudinal, observational study included women diagnosed with DE and AD presenting no surgical indication and were candidates to treatment with COCs. The presence and severity of dysmenorrhea, non-menstrual pelvic pain, deep dyspareunia, dyschezia and dysuria were evaluated using the Numerical Rating Scale (NRS) at baseline, and at 12 and 24 months of treatment. Transvaginal ultrasound was also performed at these check points searching for criteria of AD and reporting the size of the DE nodules and ovarian endometriomas (OE). Sixty-four patients were included. A significant decrease in the number of patients with severe dysmenorrhea and non-menstrual pelvic pain was reported during follow-up. The mean NRS score for dysmenorrhea, non-menstrual pelvic pain, deep dyspareunia, dyschezia and dysuria was also significantly lower at follow-up. There was a significant reduction in the sonographic number and type of AD criteria during follow-up after treatment. Similarly, a significant decrease in the size of OE and uterosacral ligament involvement in DE was observed at the 12-month follow-up, with a further, albeit not statistically significant, decrease in the 12- to 24-month follow-up. Additionally, torus and rectosigmoid DE decreased in size, although the reduction was not statistically significant at any study point. This prospective study suggests a clinical and sonographic improvement after a flexible extended COC regimen in DE and AD patients, which was significant at 12 months of follow-up. The improvement was more evident in AD and OEs compared with DE. Further research with a longer follow-up, larger sample size and comparison with other treatments is needed.

Brassinosteriods (BRs) have increasingly been used to improve the yields and quality of various crops. In this work we studied the effect of two brassinosteroids, BB16 and EP24, on the growth promotion of Fragaria ananassa plants under normal conditions or exposed to water or saline stress. The influence of both BRs on the plant development and fruit quality was evaluated when cultivated in semi-hydroponic conditions. A marked growth-promoting effect was observed with both compounds when plants were cultivated under normal irrigation conditions and under saline and water stresses. BB16 and EP24 yielded plants with a higher dry weight, root length and surface, a higher number and area of leaves, a higher total weight of fruits per plant, and a higher percentage of fruits of commercial quality. Additionally, a higher content of chlorophyll, number of leaves, and increased dry weight was detected in plants treated with both BRs and exposed to water and saline stresses. Finally, when evaluating the production and quality of fruits obtained under semi-hydroponic conditions, we observed that the pre-harvest treatment with both compounds induced a higher fruit production and better quality of fruits. These results suggest the potential of these compounds to achieve a more sustainable management of strawberry cultivation.

Brassinosteroids (BRs) are steroidal compounds involved in plant growth and development. The aim of this work was to evaluate the effect of 24-epibrassinolide (EP24) and a brassinosteroid spirostanic analogue DI-31 (BB16) on growth promotion, defense and fruit quality of strawberry (Fragaria x ananassa). Results showed that both BRs cause an increase in the leaf greenness, number of leaves and stolons, and the foliar area as compared to control plants. However, whereas plants treated with BB16 exhibited a dry weight increase, plants treated with EP24 did not show significant differences with respect to control plants. The effect of both BRs on the activation of a defense response was also evaluated in strawberry plants, and results revealed that both BRs exert a protective effect against Botrytis cinerea the causal agent of the gray mold disease. The effect of both BRs was also evaluated on strawberry fruits. Results showed that both BRs also reduced the incidence of postharvest infection due to native pathogens. It was further observed that both BRs were more effective at lower concentration (i.e. 0.1 mg l−1). When analyzing the influence of BB16 and EP24 on the quality of the postharvest fruit, it was found that the treatment with both BRs yield fruits with lower acidity, and higher content of soluble solids on the third day after treatment. In addition, lower weight loss, and higher colour quality (i.e. lightness and intensity) were observed in treated fruits as compared with control fruits. These results suggest that BRs could be used as a new crop management strategy, and as alternative to agrochemicals.

BackgroundPregnancy complications and poor obstetric prognosis are part of the manifestations of APS. The obstetric APS (O-APS) includes 3 or more early miscarriages, 1 or more intrauterine foetal deaths, prematurity secondary to preeclampsia or placental insufficiency, intrauterine growth retardation and HELLP syndrome among others. There is disagreement among different published studies regarding the need of preconceptional or primary thromboprophylaxis (treating with anticoagulant/antiaggregant drugs in the presence of specific autoantibodies but without previous clinical events) and the most effective and safest drug to use, as well as which treatment should be chosen in the case of secondary thromboprophylaxis (treating in the presence of autoantibodies and recurrent miscarriages or previous obstetric complications).ObjectivesTo evaluate the available scientific evidence on which treatments are the most effective and safest in O-APS.MethodsA systematic review (SR) was performed to evaluate the efficacy and safety of different interventions (Aspirin (ASA), Heparin, Antimalarials, Immunoglobulin IV (IVIG), others) in pregnant women with O-APS. We included SR, randomised clinical trials (RCTs) and comparative cohort studies. Result measures on morbidity (prematurity, low birth weight, need for intensive care, impaired cognitive development, preeclampsia, eclampsia, HELLP, abruptio placentae) and mortality included both the newborn and the pregnant woman. A peer review selection and analysis of the studies was carried out (SP,H; NA, MB).Results788 citations were identified (Medline, EMBASE, CENTRAL. May 2017). We included 17 studies: 5 SR, 5 RCTs and 7 cohort studies. Results are shown on the table 1 below:Abstract AB0515 – Table 1DrugsEficacyLevel of evidence ASA vs placeboInconclusive1+ASA +HeparinThe combination is more effective than ASA on its own in order to achieve better obstetric results in women with O-APSOne SR and one RCT did not found added benefits with the combination compared to ASA monotherapy1+, 1+,1-,2+ 1+, 2+IVIGInconclusive, but:Comparing IVIG with ASA+heparin is favourable to this combination: it is easier to use and has a lower costIVIG compared with prednisone could be a better option to decrease maternal complications in patients with O-APS1+1+,1-,2+ 2-CorticoidsThere is not enough evidence available.1+, 2-StatinsThere is not enough evidence available.2+ConclusionsIn women with O-APS:Secondary thromboprophylaxis: The combination of ASA +Heparin is more effective than ASA monotherapy.With regards to the use of IVIG, corticosteroids and statins: NO representative conclusions can be drawn from published studiesPre-conceptional thromboprophylaxis, primary thromboprophylaxis: NO representative conclusions can be drawn from published studies.AcknowledgementsThis review is part of the preparation of SER Recommendations on Primary APS treatment. Disclosure of InterestNone declared

IntroductionShared Decision-Making Tools (SDMTs) play a pivotal role in facilitating active involvement in health-related decisions by integrating scientific evidence with individual preferences and values.MethodsWe designed an SDMT for professionals and patients with endometriosis, adhering to the International Patient Decision Aid Standards (IPDAS).1 The development involved various stakeholders, including the Agency for Health Quality and Assessment of Catalonia (AQuAS), primary and specialized care gynecologists, patient-experience experts, patients and patient associations. An expert patient and the Catalan Society of Obstetrics and Gynecology performed the final validation.The number of web visits were followed-up and user experience was analyzed through a questionnaire.ResultsThe co-creation process engaged 9 endometriosis experts, 2 shared decision-making experts, 1 patient experience expert, 11 patients and 2 patient associations (Endocat and ADAEC). Launched in July 2023, the tool comprises sections on general information, treatment options, option comparison, preference questionnaires on hormone and surgical treatments, personal stories, and frequently asked questions. The tool was published in Catalan and Spanish on https://decisionscompartides.gencat.cat/ and was presented through a webinar. Within five months of publication, it garnered 12,462 users, with a satisfaction rate averaging 3.4 out of 5 and 30% of users assigning the highest score.DiscussionThe co-creation process, involving both professionals and patients, ensures a comprehensive approach, addressing the needs of all stakeholders. The tool’s presentation in webinars, patient associations, and scientific congresses significantly enhanced its visibility and contributed to its widespread dissemination. Currently, we are working on an Implementation Guide and an evaluation strategy to assess the tool’s utility for both professionals and patientsConclusionsThe development and publication of the SDMT for endometriosis received positive feedback from the users. The ongoing development of an Implementation Guide and evaluation strategy aims to expand the tool’s usage within Catalonia’s healthcare system, providing valuable insights for continuous improvement.Referencehttp://ipdas.ohri.ca/