Characteristics of Vaginal Microbiome in Women with Pelvic Inflammatory Disease in Korea

Human vaginal microorganisms play an important role in maintaining good health throughout the human life cycle. An imbalance in the vaginal microbiota is associated with an increased risk of pelvic inflammatory disease (PID). This study aimed to characterize and compare vaginal microbial profiles of premenopausal Korean women with and without PID. 74 Korean premenopausal female vaginal samples were obtained; 33 were from healthy women (a control group) and 41 from PID patients. Vaginal fluid samples were collected from the vaginal wall and posterior cervix and then analyzed by 16S ribosomal ribonucleic acid (rRNA) gene-based amplicon sequencing. Results showed a significant difference between the vaginal microbial communities of the two groups (Jensen-Shannon, p = 0.014; Bray-Curtis, p = 0.009; Generalized UniFrac, p = 0.007; UniFrac, p = 0.008). Lactobacillus accounted for the highest percentage (61.0%) of the control group but was significantly decreased (34.9%) in PID patients; this was the most significant difference among all bacterial communities (p = 0.028, LDA effect size = 5.129). In addition, in the PID patient group, species diversity significantly increased (Simpson, p = 0.07) as the proportion of various pathogens increased evenly, resulting in a polymicrobial infection. Similarly, lactate, which constituted the highest percentage of the organic acids in the control group, was significantly decreased in the PID patient group (p = 0.04). The present study’s findings will help understand PID from the microbiome perspective and are expected to contribute to the development of more efficient PID diagnosis and treatment modalities.

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Clinical Effect Analysis of Acupuncture Combined with Cupping Exercise in The Treatment of Chronic Pelvic Inflammatory Disease

Tobacco Regulatory Science ◽

10.18001/trs.7.6.121 ◽

2021 ◽

Vol 7 (6) ◽

pp. 6460-6468

Author(s):

Xijing Yu ◽

Xiuwu Hu ◽

Shuisheng Hua ◽

Rong Guo ◽

Xiaoyan Zhu

Keyword(s):

Pelvic Inflammatory Disease ◽

Inflammatory Disease ◽

Clinical Effect ◽

Abdominal Distension ◽

Plasma Viscosity ◽

Inflammatory Factors ◽

Control Group ◽

Study Group ◽

Clinical Effects ◽

Significant Difference

Objective: To explore the clinical efficacy of acupuncture combined with cupping exercise in the treatment of chronic pelvic inflammation. Methods: The subjects of this study were all patients with chronic pelvic inflammation who visited our hospital from November 2018 to November 2019, a total of 90 cases. The patients were divided into control group and research group according to the single and double numbers of the beds, 45 cases in each group. The patients in the control group were treated with conventional Western medicine, while the patients in the study group were treated with acupuncture and cupping exercise, and the clinical effects of the two treatment methods were compared. Results: The total effective rate was 95.56% in the study group and 84.44% in the control group, which was significantly higher in the study group than in the control group. The data between the two groups were statistically significant (P<0.05). The scores of menstrual disorder, abdominal distension, abnormal leucorrhea and lumbosacral pain in the two groups were significantly lower than those before treatment (P<0.05), and the corresponding scores of syndromes in the study group after treatment were (1.05+0.40), (0.73+0.38), (0.74+0.24) and (0.53+0.16), which were significantly lower than those in the control group (P<0.05). The plasma viscosity and hematocrit in both groups were significantly lower than those before treatment (P<0.05). The plasma viscosity and hematocrit in the study group after treatment were (1.14+0.32) mPa * s and (0.41+0.06) %, respectively, which were significantly lower than those in the control group (P<0.05). There was no significant difference in the levels of inflammatory factors between the two groups before treatment (P>0.05). The level of inflammatory factors in the study group after treatment was (5.74 + 2.35) mg/L, which was significantly lower than that in the control group after treatment, and the difference between tne groups was statistically significant (P < 0.05). Conclusion: Acupuncture combined with cupping exercise has a very significant clinical effect in the treatment of chronic pelvic inflammatory disease, can effectively improve the TCM syndrome score of patients, and improve the hemorheology and inflammation level of patients, so it can be widely used in clinical practice.

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Therapeutic Impact of Initial Treatment for Chlamydia trachomatis Among Patients With Pelvic Inflammatory Disease: A Retrospective Cohort Study Using a National Inpatient Database in Japan

Clinical Infectious Diseases ◽

10.1093/cid/ciy862 ◽

2018 ◽

Vol 69 (2) ◽

pp. 316-322

Author(s):

Daisuke Shigemi ◽

Hiroki Matsui ◽

Kiyohide Fushimi ◽

Hideo Yasunaga

Keyword(s):

Chlamydia Trachomatis ◽

Propensity Score ◽

Pelvic Inflammatory Disease ◽

Propensity Score Matching ◽

Inflammatory Disease ◽

Initial Treatment ◽

Primary Outcome ◽

Control Group ◽

Short Term ◽

Significant Difference

Abstract Background Pelvic inflammatory disease (PID) is common among women of reproductive age and can be complicated by tuboovarian abscess (TOA), which is a serious and potentially life-threatening disease. However, recent mortality rates from PID on hospital admission and the short-term therapeutic usefulness of initial treatment for Chlamydia trachomatis remain unknown. Methods Using the Diagnosis Procedure Combination database, we identified patients who were diagnosed with PID on admission from July 2010 to March 2016 in Japan. We excluded patients who were pregnant, had cancer, or had missing data. Propensity score–adjusted analyses were performed to compare short-term outcomes between patients administered initial treatment for C. trachomatis and those without this treatment. The primary outcome was surgical intervention (laparotomy, laparoscopic surgery, and/or drainage procedure) during hospitalization. Results In total, 27841 eligible patients were identified. Of these patients, 2463 (8.8%) had TOA on admission. Mortality during hospitalization was 0.56% and 0.28% in the groups without and with TOA, respectively. Propensity score matching created 6149 pairs. A significant difference was observed in the primary outcome between those receiving initial treatment for C. trachomatis and the control group after propensity score matching (11.5% vs 13.4%; risk difference, −1.9%; 95% confidence interval, −3.1 to −0.7). The group that received initial treatment for C. trachomatis also had a significantly lower mortality rate. Conclusions In this retrospective nationwide study, initial treatment for C. trachomatis among hospitalized patients diagnosed with PID had clinical benefits in terms of improved short-term outcomes.

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Peritoneal Fluid and Plasma Fibrinolytic Activity in Women with Pelvic Inflammatory Disease

Thrombosis and Haemostasis ◽

10.1055/s-0038-1656331 ◽

1992 ◽

Vol 68 (02) ◽

pp. 102-105 ◽

Cited By ~ 15

Author(s):

P J Dörr ◽

E J P Brommer ◽

G Dooijewaard ◽

H M Vemer

Keyword(s):

Pelvic Inflammatory Disease ◽

Inflammatory Disease ◽

Peritoneal Fluid ◽

Fibrinolytic Activity ◽

Degradation Products ◽

Adhesion Formation ◽

High Rate ◽

Control Group ◽

The Difference ◽

Fibrinolytic Parameters

SummaryPrevious studies have shown that the fibrinolytic activity of peritoneum is depressed in local inflammation. We measured fibrinolytic parameters in peritoneal fluid and in plasma of 10 women with pelvic inflammatory disease (PID). Nine women, in whom laparoscopy for sterilisation was performed, served as a control group.In the peritoneal fluid of women with PID, PAI-Ag, t-PA-Ag and u-PA-Ag were many times higher than in the control group. In contrast to the antigens which may be present in inert complexes, the potentially active compounds, measured as t-PA activity and plasmin-activable scu-PA, were not significantly different in the two groups, and in none of the samples was the active enzyme tcu-PA detectable. Nevertheless, the mean peritoneal fluid TDP and FbDP concentrations were about twenty times higher in the PID group than in the control group. In plasma of PID patients, none of the parameters except u-PA-Ag differed from those in the control group. The difference between control and patient plasma u-PA-Ag was statistically significant, but too small to attach any relevance to the observation.Our data suggest that, in contrast to the classical concept of decreased fibrinolytic activity as a cause of adhesion formation, intraperitoneal fibrinolysis is enhanced in peritoneal inflammation through stimulation of the local production of t-PA and u-PA. Despite concomitant production of PAI, fibrinolysis occurs at a high rate, resulting in high levels of fibrin degradation products. Since this activated fibrinolysis does not meet the demand, therapeutic enhancement should be considered to prevent adhesions.

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Ultrafine particles altered gut microbial population and metabolic profiles in a sex-specific manner in an obese mouse model

Scientific Reports ◽

10.1038/s41598-021-85784-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kundi Yang ◽

Mengyang Xu ◽

Jingyi Cao ◽

Qi Zhu ◽

Monica Rahman ◽

...

Keyword(s):

Ultrafine Particles ◽

Microbial Population ◽

Phosphate Buffer Solution ◽

Biodiesel Fuel ◽

Control Group ◽

Obese Mouse ◽

Rrna Gene ◽

Obese Mice ◽

Microbial Composition ◽

Increased Risk

AbstractEmerging evidence has highlighted the connection between exposure to air pollution and the increased risk of obesity, metabolic syndrome, and comorbidities. Given the recent interest in studying the effects of ultrafine particle (UFP) on the health of obese individuals, this study examined the effects of gastrointestinal UFP exposure on gut microbial composition and metabolic function using an in vivo murine model of obesity in both sexes. UFPs generated from light-duty diesel engine combustion of petrodiesel (B0) and a petrodiesel/biodiesel fuel blend (80:20 v/v, B20) were administered orally. Multi-omics approaches, including liquid chromatography–mass spectrometry (LC–MS) based targeted metabolomics and 16S rRNA gene sequence analysis, semi-quantitatively compared the effects of 10-day UFP exposures on obese C57B6 mouse gut microbial population, changes in diversity and community function compared to a phosphate buffer solution (PBS) control group. Our results show that sex-specific differences in the gut microbial population in response to UFP exposure can be observed, as UFPs appear to have a differential impact on several bacterial families in males and females. Meanwhile, the alteration of seventy-five metabolites from the gut microbial metabolome varied significantly (ANOVA p < 0.05) across the PBS control, B0, and B20 groups. Multivariate analyses revealed that the fuel-type specific disruption to the microbial metabolome was observed in both sexes, with stronger disruptive effects found in females in comparison to male obese mice. Metabolic signatures of bacterial cellular oxidative stress, such as the decreased concentration of nucleotides and lipids and increased concentrations of carbohydrate, energy, and vitamin metabolites were detected. Furthermore, blood metabolites from the obese mice were differentially affected by the fuel types used to generate the UFPs (B0 vs. B20).

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A gender-specific association of interleukin 1 receptor antagonist polymorphism with schizophrenia susceptibility

Acta Neuropsychiatrica ◽

10.1017/neu.2012.32 ◽

2013 ◽

Vol 25 (6) ◽

pp. 349-355 ◽

Cited By ~ 6

Author(s):

Mouna Ben Nejma ◽

Ines Zaabar ◽

Ferid Zaafrane ◽

Sihem Thabet ◽

Anouar Mechri ◽

...

Keyword(s):

Genetic Polymorphism ◽

Receptor Antagonist ◽

Patient Group ◽

Interleukin 1 ◽

Tunisian Population ◽

Control Group ◽

Altered Level ◽

Interleukin 1 Receptor Antagonist ◽

Increased Risk ◽

Intron 2

ObjectiveRecent genetic studies have revealed that the interleukin (IL) 1 gene complex is associated with schizophrenia in the Caucasian population; however, data from the North African population are limited. To further assess the role of interleukin 1 receptor antagonist protein (IL1Ra) in schizophrenia, we examined a functional multiallelic polymorphism localised in intron 2 of this receptor gene associated with an altered level of IL1Ra.MethodsIn the present case–control study, we have analysed the (86 bp)npolymorphism of the interleukin 1 receptor antagonist (IL1RN) gene (RS 1794068) by polymerase chain reaction genotyping in 259 patients with schizophrenia and 178 healthy controls from the Tunisian population.ResultsWe showed that the frequencies of the IL1RN*2/2 genotype and allele 2 were higher in the patient group compared with the control group, and the difference was statistically significant [13.5% vs. 5.6%,p= 10−3, odds ratio (OR) = 3.2% and 32.8% vs. 21.9%,p= 3 × 10−4, OR = 1.76, respectively). When we evaluated the association between this genetic polymorphism and the clinical variables of schizophrenia, we found that the frequencies of the 2/2 genotype and allele 2 were significantly higher in the male patient group (p= 10−4and 10−5, respectively) compared with the male control group, indicating a substantially increased risk for sex-onset schizophrenia with inheritance of the IL1RN2 allele. When the association between the genotypes and outcome was evaluated by multiple logistic regression analysis, the adjusted OR for the IL1RN genotypes remained statistically significant [1.39; 95% confidence interval (CI) = 1.11–1.73;p= 0.003].ConclusionThe intron 2 polymorphism in IL1RN or a genetic polymorphism at proximity seems to be associated specifically with schizophrenia in the Tunisian male population.

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Impaired atrial electromechanical coupling in lichen planus patients

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.109 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

I Jafaripour ◽

Z Aryanian ◽

S Hosseinzadeh ◽

R Pourkia ◽

MM Ansari Ramandi ◽

...

Keyword(s):

Lichen Planus ◽

Electromechanical Coupling ◽

Wave Dispersion ◽

Tissue Doppler ◽

P Wave ◽

Control Group ◽

P Value ◽

P Wave Dispersion ◽

Increased Risk ◽

Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Lichen planus (LP) which is a chronic inflammatory disease can cause impaired atrial electromechanical coupling, leading to increased risk of atrial fibrillation. Purpose The present study aimed to evaluate atrial electromechanical coupling in LP patients by using electrocardiography (ECG) and echocardiography. Methods Forty-six LP patients were investigated in this cross-sectional case-control study. The control group comprised healthy individuals selected in age and gender-matched manner. Echocardiography and ECG were done for all patients to show inter and intra-atrial electromechanical delays and P wave dispersion respectively. The electromechanical delays were calculated by using the difference between the delays from the onset of the P wave on ECG to the onset of A wave on tissue Doppler recordings of the different areas. Results The baseline characteristics of the case and control group were similar and did not differ significantly. The P wave dispersion was 45.63 ± 3.48 milliseconds in the LP group in comparison to 36.56 ± 2.87 milliseconds in the control group (p < 0.001). As shown in the table, the intra and inter-atrial electromechanical delays were also significantly prolonged in LP patients when compared to the control group (p < 0.001). There was no significant difference between the left and right ventricular systolic function and diastolic function of the two groups. Conclusion The results of the study indicate the presence of significant impaired atrial electromechanical coupling in patients with LP confirmed by both electrocardiographic and echocardiographic tools. Electromechanical delays Case N = 46 (mean ± SD) Control N = 46 (mean ± SD) P value Septal - PA (msec) 59.71 ± 13.24 44.39 ± 11.07 0.002 Lateral - PA (msec) 55.71 ± 13.26 48.89 ± 11.21 0.009 Tricuspid - PA (msec) 52.37 ± 13.12 43.28 ± 10.58 0.002 Inter-atrial delay (msec) (lateral PA−RV PA) 8.47 ± 1.62 6.37 ± 1.36 <0.001 Intra-atrial delay (msec) (LA) [lateral PA−septal PA] 4.80 ± 1.48 3.83 ± 0.82 <0.001 Intra-atrial delay (msec) (RA) [septal PA−RV PA] 3.91 ± 0.96 2.02 ± 0.71 <0.001 PA Delay from the onset of the P wave on ECG to the onset of A wave on tissue Doppler, N: number, SD: Standard Deviation, LA: Left Atrium, RA: Right Atrium, RV: Right Ventricle

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Suppressor T lymphocyte function in Graves' disease

Acta Endocrinologica ◽

10.1530/acta.0.1010354 ◽

1982 ◽

Vol 101 (3) ◽

pp. 354-358 ◽

Cited By ~ 8

Author(s):

Bengt Hallengren ◽

Arne Forsgren

Keyword(s):

Patient Group ◽

T Lymphocyte ◽

Pokeweed Mitogen ◽

Control Group ◽

Graves Disease ◽

Lymphocyte Function ◽

Euthyroid State ◽

Hyperthyroid State ◽

Significant Difference ◽

Suppressor T Lymphocyte

Abstract. To explore suppressor T lymphocyte function in Graves' disease, studies were performed in one group of patients in the hyperthyroid state and in another group in the euthyroid state after treatment. Peripheral blood lymphocytes were cultured for 1–7 days., Pokeweed mitogen (PWM; 1.25 μg/ml) was added at the initiation of the cultures or after 24 h. The degree of lymphocyte activation was assessed by measurements of the cellular uptake of [3H]thymidine and expressed in counts per minute (cpm). The suppressor lymphocyte function was estimated by a quotient between the maximum cpm values from cultures with and without pre-incubation. For the hyperthyroid group (n = 15) the quotient was 1.00 ± 0.07 (mean ± sem), for the euthyroid patient group (n = 21) 1.12 ± 0.05 and for the healthy control group (n = 21) 1.37 ± 0.08. There was a significant difference between the quotients for the control group and the hyperthyroid (P < 0.01) as well as the euthyroid (P < 0.05) patient group. The quotients for the two groups of patients did not differ significantly. In conclusion, the present study supports the view of a defect in suppressor T lymphocyte function in patients with Graves' disease in the hyperthyroid state and indicates that this defect can persist in the euthyroid state after treatment.

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MOLECULAR GENETIC STUDY OF THE IMPACT OF SNP C677T OF THE GENE MTHFR IN THE DEVELOPMENT OF CONGENITAL ISOLATED CLEFT LIP AND PALATE

Kuban Scientific Medical Bulletin ◽

10.25207/1608-6228-2018-25-5-104-110 ◽

2018 ◽

Vol 25 (5) ◽

pp. 104-110

Author(s):

V. S. Uchaeva ◽

Yu. A. Vasiliev ◽

A. S. Gracheva ◽

O. V. Gulenko ◽

I. G. Udina

Keyword(s):

Genetic Study ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Control Group ◽

Population Genetic Study ◽

Molecular Genetic Study ◽

Increased Risk ◽

Significant Difference ◽

Congenital Cleft ◽

The Impact

Aim. This research was designed to conduct an associative population genetic study for the consideration of the impact of SNP C677T of the gene MTHFR in the congenital maxillofacial developmental anomalies (CMDA): congenital cleft lip (CCL), congenital cleft palate (CCP), congenital cleft lip and palate (CCLP) in the Krasnodar territory. The aim of the study is to establish the associations between SNP C677T of the gene MTHFR and the development of congenital cleft lip and/ or palate.Materials and methods. In this research, the peculiarities of distribution of SNP C667T of the gene MTHFR in children with congenital cleft lip and/or palate (n=223) and their mothers (n=78) in comparison with the control group (n=124) were studied in the Krasnodar territory. The genetic demographic questionnaires were gathered for children with CMDA, the information about diagnosis was obtained from the medical records. The biological samples, including blood or scrapings of oral mucosa, were collected from children with the pathology and their mothers. The DNA was extracted from the samples by the standard method. The study of the peculiarities of distribution of alleles of SNP C677T of the gene MTHFR was performed by PCR-PFLP with endonuclease Hinf I or by tetra-primer ARMS-PCR method in children with CCL, CCP, CCLP, their mothers and the control group. Statistical processing of the obtained data was performed by the algorithms of the “Statistica” program.Results. While comparing the profiles of frequencies of SNP C677T in children with CCL, CCP and CCLP with the control group, there were identified no significant differences in the frequency of this SNP and no peculiarities of genotypes distribution. There was identified a significant difference in the peculiarities of genotypes distribution with the control group (G=19,5232, d.f.=1, p<0,001) as well as united genotypes (С/C и С/T) in accordance to T/T (G=10,4657, d.f.=1; p<0,001) and united genotypes (C/T и T/T) in accordance to C/C (G=15,1896, d.f.=1, p<0,001) for the mothers of children with CCL, CCP and CCLP.Conclusion. As a result of the study, we established the association of SNP C677T of the MTHFR gene with the development of congenital cleft lip and/or palate: mothers’ T/T genotype is associated with the increased risk of giving birth to a child with CCL, CCP and CCLP (in comparison with mothers with C/C+C/T genotype): odds ratio [OR]=16,63, 95% CI: 3,86-71,71; p=0,0003 and also for mothers with genotypes (C/T+T/T) in comparison with mothers with genotypes C/C: OR=3,22, CI:1,71-6,08; p=0,0002. The amount of risk is not significant in children with CMDA for T/T genotype. So it is possible to make a conclusion about the impact of C677T of the gene MTHFR in the development of CCL, CCP and CCLP only in mother’s genotype.

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Evaluation of balance, fall risk, and related factors in patients with fibromyalgia syndrome

Turkish Journal of Physical Medicine and Rehabilitation ◽

10.5606/tftrd.2021.6273 ◽

2021 ◽

Vol 67 (4) ◽

pp. 409-415

Author(s):

Köksal Sarıhan ◽

Hülya Uzkeser ◽

Akın Erdal

Keyword(s):

Social Isolation ◽

Fall Risk ◽

Nottingham Health Profile ◽

Risk Index ◽

Control Group ◽

Healthy Individuals ◽

Increased Risk ◽

Study Results ◽

Significant Difference ◽

Risk Of Falls

Objectives: In this study, we aimed to evaluate whether fibromyalgia patients had a higher fall risk compared to healthy individuals and to identify its relationship, if there was an increase, with clinical features. Patients and methods: Between March 2018 and September 2018, a total of 50 consecutive female patients with fibromyalgia (median age: 35 years; interquantile range [IQR], 27 to 40 years) and 50 healthy female volunteers (median age: 30 years; IQR, 23 to 40 years) were included in the study. Pain was evaluated with the Visual Analog Scale (VAS), life quality with the Nottingham Health Profile (NHP), balance functions with the Berg Balance Test (BBT), and the risk of falls with a posturography device. Disease activity of fibromyalgia patients was evaluated with the Fibromyalgia Impact Questionnaire (FIQ). Results: The mean fall risk index of the fibromyalgia patients was 45%. The fall risk index was significantly higher (p=0.010) and the BBT scores were significantly lower in the patient group (p<0.001). There was a significant difference in terms of fall risk between the control group and drug-free fibromyalgia patients; however, no significant difference was found between the balance scores of the two groups. In the fibromyalgia group, a weak positive relationship was determined between the fall risk index and the social isolation subscale of the NHP. Conclusion: Our study results showed an increased risk of loss of balance and falls in fibromyalgia patients, compared to healthy individuals. This fall risk increase was also detected in fibromyalgia patients who did not use drugs. These findings suggest a possible relationship between social isolation and an increased risk of falls.

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The Connection of the Level of Estradiol in Serum and Obesity with the Endometrial Bleeding in Postmenopausal Women

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.079 ◽

2019 ◽

Vol 7 (1) ◽

pp. 88-91 ◽

Cited By ~ 1

Author(s):

Valentina Tofiloska ◽

Maria Krstevska ◽

Ana Daneva-Markova ◽

Viktorija Jovanovska

Keyword(s):

Endometrial Cancer ◽

Statistical Significance ◽

Abnormal Uterine Bleeding ◽

Control Group ◽

Prospective Clinical Study ◽

Study Group ◽

Gynecology And Obstetrics ◽

Increased Risk ◽

Significant Difference ◽

Post Menopausal

BACKGROUND: Postmenopausis is a period that begins one year after the last menstrual period. Abnormal uterine bleeding could be of different origins. AIM: This study aimed to determine the association of serum estrogen hormone levels and obesity with the occurrence of endometrial bleeding in post-menopausal women. MATERIAL AND METHODS: Prospective clinical study involving 120 postmenopausal patients treated at the University Clinic for Gynecology and Obstetrics-Skopje, divided into two groups: control and study. The control group consisted of 40 postmenopausal patients without endometrial bleeding, hospitalised and operated due to urogenital pathology. The study group consisted of 80 patients with endometrial bleeding who were divided into three subgroups according to the thickness of the endometrium: from 5-8 mm, 8-11 mm and above 11 mm. In all subjects, estradiol and BMI was determined. RESULTS: Estradiol levels were statistically higher in the study group compared to control while statistically significant difference among the three subgroups according to the thickness of the endometrium about the levels of estradiol in blood is not found. About BMI, the results showed that there was no statistical significance between the two examined groups. CONCLUSION: Patients with endometrial bleeding have increased levels of estradiol and are at increased risk of endometrial cancer about controls, the likelihood of endometrial cancer significantly increases by 1,108 times.

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