Minerva medica
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Endometriosis is a common, estrogen-dependent condition, defined as the presence of endometrial-like tissue outside of the uterus, associated with often chronic and inflammatory reaction. The association of endometriosis with cancer is unclear, although endometriosis and cancer present some molecular similarities. Survinin, encoded by the BIRC5 gene, is a protein that controls cell division, inhibits apoptosis and promotes angiogenesis. Here we aimed to summarize and to discuss the main findings of studies that addressed the involvement of survivin in the pathogenesis of endometriosis. ⋯ The studies provided the basis for the involvement of survivin in the pathogenesis of the disease by several and independent pathways.
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Comparative Study
Ultrasound-guided intra-articular injection: efficacy of hyaluronic acid compared to glucocorticoid in the treatment of knee osteoarthritis.
Osteoarthritis (OA) is a degenerative joint disease which causes pain and functional impairment in adults over 50 years old with consequent important disability. Unfortunately, there is no definitive cure for OA, thus the approach is characterized by multiple treatments that can manage its symptoms. Even though data from randomized controlled trials and meta-analyses indicate that intra-articular hyaluronic acid (IAHA) offers the best benefit/risk balance among the various pharmacologic treatments to improve OA-related knee pain, there is a lack of agreement among national and international guidelines about such uses of IAHA for the medical management of symptomatic knee OA. To minimize confounding factors and biases, the aim of our study was to evaluate the efficacy of the different weight and concentration of IAHA treatment in patients suffering from knee OA comparing to glucocorticoids (GC) joint injections. Furthermore, to make the procedure more accurate and assessment more objective, we use ultrasonography (US) with power Doppler (PWD) to help us differentiate between active and inactive inflammation within joints and periarticular soft tissues. ⋯ This study demonstrated the efficacy of OA treatment with medium molecular weight HA in favor of the higher concentration of HA that may affect the reduction of pro-inflammatory mediators. Furthermore, US monitoring allowed to evaluate aspects related to synovial involvement, which cannot be appreciated with standard imaging.