paywalled: Diathermy-Induced Injury May Affect Detection of Occult Tubal Lesions at Risk-Reducing Salpingo-Oophorectomy

Diathermy: In the natural sciences, the term diathermy means "electrically induced heat" and is commonly used for muscle relaxation. It is also a method of heating tissue electromagnetically or ultrasonically for therapeutic purposes in medicine.

Diathermy-Induced Injury May Affect Detection of Occult Tuba... : International Journal of Gynecological Cancer

Background: Electrosurgery-induced tubal thermal injury obscures cellular detail and hampers histomorphological assessment for occult pathology.

Objective: 

The objectives of this study were to report on diathermy-related thermal injuries to the fallopian tube observed at RRSO and explore its potential impact on the detection of occult tubal epithelial lesions.

Design: 

This study was composed of high-risk women from breast and/or ovarian cancer families attending a tertiary high-risk familial gynecologic cancer clinic. This was a retrospective case-control analysis of high-risk women who underwent RRSO. Cases were all women detected to have occult lesions (tubal atypia/carcinoma in situ/cancer) between January 2005 and December 2010. Control subjects were all women with normal tubal/ovarian histology between August 2006 and December 2007.

Conclusions: This report highlights the potential impact of electrosurgical thermal injury on detection of occult tubal pathology following RRSO. It is important for surgeons to avoid thermal injury to the distal end of the tube.

press release: OVARIAN CANCER (in) CANADA | Harris Decima survey shows Canadian women more aware of ovarian cancer (not so fast...)

Note: poorly written press release or;  was it the survey? the question/s ? the design?

Blogger's keypoints - in matters of full transparency:

* where are the results of the full survey? 

* demographics of repondents ?

the prior survey done in 2005 was not made available to the public either - yet funded with public/survivour funding

1) Randomized sampling = 1,010  in Canada
2) Canada's population est = 2011 - 34,409,066 

Blogger's Note: No explanation on the 51 years? exactly 51 years of age ?

"Other key study findings include:

• Awareness of ovarian cancer as a potentially fatal disease has increased (71% vs. 65%), particularly among women 51 years and older, who are at a greater risk of being diagnosed with ovarian cancer (71% vs. 58%)"

 

Correlation of macroscopic and microscopic pathology in risk reducing salpingo-oophorectomy: Implications for intraoperative specimen evaluation

Abstract Objective

A minority of risk-reducing salpingo-oophorectomy (RRSO) specimens from BRCA mutation carriers will contain clinically occult carcinoma that is detectable only using a specialized pathologic evaluation protocol. Although intraoperative detection of cancer may alter immediate surgical management, technical complications impairing pathologic diagnosis may result if fresh tissue dissection and frozen sections are performed on unselected RRSO specimens. We hypothesize that macroscopic specimen findings may predict which RRSO specimens contain cancer and therefore may guide selection of specimens for intraoperative pathologic evaluation. The aim of this study was to correlate the macroscopic and microscopic pathologic findings in RRSO.

 Research highlights

► Most occult carcinomas detected in RRSO specimens were not grossly visible.
► A minority of visible nodules >5 mm in the ovary or tube harbored occult carcinoma.
► No cancer was identified in any of the grossly visible cysts of the ovary or tube.

Characteristics and prognosis of coexisting adnexa malignancy with endometrial cancer: a single institution review of 51 cases

CONCLUSION:
Our results showed that OS and PFS of synchronous primary ovarian cancer in patients with endometrial cancer is better than those with ovarian metastasis patients. Pre- and intra-operative, intensive and careful assessment, and strict and continuous postoperative surveillance should pay attention to the endometrial cancer patients who preserved ovary for having possibility of coexisting occult ovarian lesions.

BSB4uD (Be Smart Before You Donate - see blog posting and income comparisons non-profit employees vs professional salaries) - note updated information on Canadian family physician salaries - average

Blogger Author's  Opinion:  based on these averages, most family physicians are underpaid

Family Physician salaries as per CMAJ April 9th 2010: $225,521. Cdn avg CMAJ

Update:  May 18th, 2010
A separate, unpublished CIHI indice which weights all payments — whether fee-for-service, salary or other form of capitation — for all services, against a national median indicates that Newfoundland and Labrador doctors essentially earn 6.78% less than a national median of $224 875 earned by doctors in 2007–08. On that scale, doctors in Alberta (7.22% above the median) were the highest paid in the country, followed by those in British Columbia (5.84% above), New Brunswick (4.6% above), Saskatchewan (4.24% above), Nova Scotia (1.68% above), Ontario (1.68% below) and Manitoba (4.88% below). Only doctors in Prince Edward Island (18.28% below) and Quebec (28.66% below) earned less than those in Newfoundland and Labrador.
http://www.cmaj.ca/cgi/content/full/182/8/E339?etoc

Postoperative Pulmonary Embolism Including Asymptomatic Case... : International Journal of Gynecological Cancer

Conclusions: A substantial number of postoperative PEs were occult, and identification of high-risk patients and routine SpO₂ level monitoring would reduce the diagnostic delay of PE after gynecologic surgery. Increasing age, longer operation time, and obesity were risks. The use of a perioperative intermittent pneumatic compression device in multimodal conditions might thus prevent PE. (pulmonary embolism/blood clot)

Occult ovarian cancers identified at risk-reducing salpingo-oophorectomy in a prospective cohort of BRCA1/2 mutation carriers.

"An unacceptably high proportion of pathologic examinations did not adequately examine ovaries and fallopian tubes obtained at RRSO."