PRA:PRB ratio is similar in normal myometrium and leiomyomas. p53 and p21 mRNA and protein levels are increased in leiomyomas.

Background: Leiomyomas are the most common tumors of the female reproductive tract and a major public health problem. The mechanism of tumorigenesis is unknown, but evidence suggests that estrogens regulate cell proliferation and myoma growth. This effect might be due to different amounts of estrogen receptors (ERα and ERβ) in normal and myoma tissues and overexpression of aromatase P450 in myomas. Purpose: To assess protein expression of ERs and aromatase in leiomyomas and normal adjacent myometrium of premenopausal women. Methods: Samples were collected from 12 premenopausal women admitted for abdominal hysterectomy due to fibroids. Results: The protein expression of ERα, ERβ and aromatase was similar in leiomyoma and normal myometrium (p = 0.239, p = 0.695 and p = 0.203, respectively). Conclusions: In this analysis of 12 matched leiomyoma and myometrial samples, the data do not support the theory that overexpression ERα, ERβ and aromatase in uterine leiomyomas compared to adjacent myometrium are the cause of tumor growth. The estrogens may exert their growth-stimulatory effects on leiomyomas intermediated by other elements, such as cytokines and growth or apoptosis factors. The effect of estrogen on the growth and development of fibroids is complex and far from being completely understood.

Antibiotic misuse is associated with emergence of resistance and high expenditures. Fluoroquinolones (FQ) and carbapenems (CP) are drugs with considerable potential of resistance development and its disseminated use is a concern. We undertook a prospective clinical audit to evaluate prescriptions of FQ and CP in a multistep process. Each prescription was unfolded in the following steps: indication for antimicrobial therapy; adequacy of initial prescription, dosage and route; previous cultures; and parenteral-oral transition. There was no antibiotics indication in 8.9% of FQ and 1.5% of CP group (p = 0.07). In CP 25.8% of initial schemes were inappropriate (21% in FQ). Lack of switch to oral therapy comprised 25% of monthly costs of FQ. Inadequacy in initial choice accounted for 13.6% of CP expenses. We concluded that, in spite of infection control restrictive policies, inappropriateness of antibiotic usage is worrisome. Clinical audit in a multistep approach may identify possible flaws in this process.

Os autores relatam o caso de urna criança de 2 anos e 4 meses com queixas ginecológicas (secreção vaginal branca), dor abdominal difusa e pseudopuberdade precoce (telarca). Iniciada investigação em Unidade de Saúde PSF de Porto Alegre, sendo referenciada ao nível secundário onde foi diagnosticada neoplasia ovariana (Tumor de Células da Granulosa Juvenil).