Evaluation of genes and molecular pathways involved in the development of cardiovascular disease in preeclampsia patients: biological system and bioinformatics analysis approach

Abstract Background: Hypertension in preeclampsia (PE) is one of the most important complications in these patients, which increases the risk of cardiovascular disease (CVD). Bioinformatics analysis can identify the signaling pathways, genes and microRNAs involved in the development of CVD due to hypertension; it can also reduce the risk of developing PE by providing appropriate target therapies.Method: In this study, after collecting data and determining the gene list, changes in gene expression in patients with severe and non-severe forms of PE were compared. Protein-Protein interaction (PPI) and pathway enrichment analysis were also used to evaluate the common genes and pathways between the two cited forms of PE. Result: FGF, TNF, Adherent junction, metabolic signaling pathway, GATA3-mediated activation pathways of Th2, EGF / EGFR signaling pathway and Rab GTPase among the most important signaling pathways are effective in CVD development. HLTF, SUMO1, KDR, SNRPD3, DERL2, VCP, EIF4B, NOTCH1, SOCS3, CBL, ICAM-1, ITGB2, STRN, MEF2A and PTPRC are the most important genes and miR-3135-3P, miR-505, miR-6088, miR-451, miR-4637-3P, miR-1281-3P, miR-4304-3P, miR-323-3P, miR-3150-3p.1, miR-4718, miR-151-5p, miR-3117-5p.2, miR-3613, miR-1278- 3P, miR-4467, miR-4730 , miR-190b-3p , miR-610-5p, miR-3648-3p , miR-4796-3p, miR-2277-3P, miR-325, miR- 6807-3p , miR-551a-3p, and miR-3131-3P have been also effective in the development of CVD by hypertension in PE patients. Conclusion: Finally, it was concluded that identification of common signaling pathways, genes and microRNAs between severe and non-severe forms of PE can be effective to design preventive and treatment strategies for CVD caused by hypertension.</jats:p

Effect of Endometrial Ablation by Thermal Balloon vs. Hysteroscopy Ablation on Amenorrhea Rates in Patients with Abnormal Uterine Bleeding: A Randomized Clinical Trial

Background: Abnormal uterine bleeding (AUB) that is any irregularity in menstrual cycles causes women to refer to clinics. This study aimed to compare the efficacy, safety, and complications of endometrial ablation by the thermal balloon (Cavaterm) method with the hysteroscopy loop resection method in the treatment of AUB.Materials and Methods: The present study is an open-label, randomized clinical trial that was performed in the two hospitals, Shahid Akbarabadi and Hazrat Rasoul Akram, of Tehran, Iran, from December 2019 to October 2020. Patients were randomly allocated to the two groups of interventions by a simple randomization method. The proportion of amenorrhea (as primary outcome) and consequent hysterectomy and patient satisfaction (as secondary outcomes) was assessed using the Chi-square test and independent t test.Results: There was no significant difference between the two groups in the baseline characteristics. The percentage of intervention failure was statistically higher in the hysteroscopy group (24%) in comparison with the Cavaterm group [8.2%, P=0.03, relative risk (RR)=1.63, 95% confidence interval (CI): 1.13-2.36]. Mean ± standard deviation of satisfaction based on the Likert score in the Cavaterm group and hysteroscopy group were 4.3 ± 1.21 and 3.7 ± 1.56, respectively, that showed a significant difference (P=0.04). Assessing the procedural complications, the rate of spotting, bloody discharge, and malodor discharge was significantly higher in the Cavaterm group. In contrast, postoperative dysmenorrhea is more common in the hysteroscopy group.Conclusion: Cavaterm ablation is accompanied by a higher success rate of amenorrhea and patients’ satisfaction than hysteroscopy ablation (registration number: IRCT20220210053986N1)