Saturday, October 26, 2013
Ovarian Masses in Children and Adolescents - An Analysis of 521 Clinical Cases
abstract
J Pediatr Adolesc Gynecol
OBJECTIVE:
To analyze the clinical characteristics of ovarian masses in children and adolescents.MATERIALS AND METHODS:
We performed a retrospective analysis of patients less than 20 years of age who were treated at the Obstetrics and Gynecology Hospital of Fudan (China) University between March 2003 and January 2012. Medical records were reviewed for age at operation, including presentation of symptoms and signs; the levels of tumor markers; imaging examinations; pathologic findings; the size of masses; treatment; and outcome. Data management and descriptive analyses were performed using SPSS 16.0.RESULTS:
A total of 521 patients were included in this study. Among them, 92 had non-neoplastic lesions, 382 had benign neoplasms, and 47 had malignant tumors. The mean age of the patients was 16.3 ± 2.2 years. The primary presenting symptoms and signs were abdominal pain (39.5%), menstrual disorder (31.1%), abdominal swelling (5.4%), and an enlarged abdominal perimeter (3.3%). Malignant tumors tended to be larger than benign neoplasms (17.3 ± 8.6 cm vs 9.0 ± 5.7 cm; P = .000). There was no age difference between patients with benign neoplasms (16.3 ± 2.1 y) and those with malignant tumors (15.7 ± 2.5 y). The operations included salpingo-oophorectomy, ovarian cystectomy, and oophorectomy. Two patients with malignant tumors had bilateral salpingo-oophorectomy, and 2 patients who had tumor metastasis underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Forty-one cases of malignant tumors received postoperative chemotherapy.CONCLUSIONS:
Germ cell tumors are the most common malignancy, and mature teratomas are the most common benign neoplasms in children and adolescents. Abdominal pain and menstrual disorder are the main reasons for doctor's visit. Although examination by ultrasound is the preferred auxiliary in the diagnosis of ovarian pathology, it could not distinguish between benign and malignant tumors. However, tumor size and tumor markers are helpful to identify the properties of masses. Surgery is usually better for treatment, and it is preferable to attempt conservative, fertility-sparing surgery in adolescents. Postoperative chemotherapy is necessary for malignant tumors.(18)F-FDG Is a Surrogate Marker of Therapy Response and Tumor Recovery after Drug Withdrawal during Treatment with a Dual PI3K/mTOR Inhibitor in a Preclinical Model of Cisplatin-Resistant Ovarian Cancer
abstract (small animal testing)
AIM:
Targeting the phosphoinositide 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) pathway is a potential means of overcoming chemoresistance in ovarian cancer. We investigated the capability of (18)F-fluororodeoxyglucose ((18)F-FDG) small-animal positron emission tomography (SA-PET) to predict the effects of a dual PI3K/mTOR inhibitor (BEZ-235) in a cisplatin-resistant ovarian cancer model.A prospective comparison of integrated FDG-PET/contrast-enhanced CT and contrast-enhanced CT for pretreatment imaging of advanced epithelial ovarian cancer
Abstract
Highlights
- •
- Compared to CT, PET/CT did not provide additional clinical value to preoperative treatment planning in this prospective study
- •
- Neither CT nor PET/CT are sensitive enough for an accurate estimation of disease in the abdominal cavity
- •
- PET/CT is more effective for the detection of extra-abdominal metastasis in patients with EOC
Objective
The
use of tumor debulking surgery in the management of epithelial ovarian
cancer (EOC), which is often disseminated in the peritoneal cavity at
the time of diagnosis, has a significant impact on prognosis. We
compared 18F-fluorodeoxyglucose (FDG) positron emission
tomography/contrast-enhanced computed tomography (PET/CT) to
contrast-enhanced CT for the detection of dissemination into the
abdominal cavity preventing successful primary debulking surgery.
Methods
Forty-one
women with EOC underwent preoperative whole-body low-dose FDG-PET/CT
followed by diagnostic high dose contrast-enhanced CT scan, and the
results were compared with systematically recorded surgical findings as a
reference standard. Both site-based and patient-based analyses were
conducted.
Results
FDG-PET/CT was superior to conventional CT for the detection of carcinomatosis in subdiaphragmatic peritoneal surfaces (p = 0.020) and in the bowel mesentery (p = 0.001).
Patient-based analysis of upper abdominal areas requiring extensive
surgical procedures showed no significant differences between the two
imaging methods. The sensitivity of PET/CT and CT was poor in certain
areas of the peritoneal cavity (64% vs. 27% in the small bowel mesentery
and 65% vs. 55% in the right upper abdomen). Extra-abdominal disease
spread was detected by PET/CT in 32 patients and by CT in 25 patients.
Conclusions
PET/CT
was not superior to CT for the detection of intra-abdominal disease
spread. Patients with suspected EOC should be referred for upfront
radical surgery regardless of the results of preoperative imaging
studies. PET/CT is more effective for the detection of extra-abdominal
disease than CT, but the clinical significance of this finding is
unclear.
Aspirin Blocks EGF-stimulated Cell Viability in a COX-1 Dependent Manner in Ovarian Cancer Cells
Abstract
open access (full paper)
Objective: Although aspirin has been associated with a reduction of the risk of cancer when used as a nonsteroidal anti-inflammatory drug, its use to reduce the risk of ovarian cancer is controversial. Ovarian cancer cells usually express high levels of cyclooxygenase-1 (COX)-1. Because aspirin is a rather selective inhibitor of COX-1, the ability of aspirin to reduce the risk of ovarian cancer may be dependent on the level of COX-1 expression in those cells. Furthermore, epidermal growth factor receptor (EGFR) is frequently overexpressed in the malignant phenotype of ovarian cancer leading to increased cell proliferation and survival. Here we investigated if aspirin attenuates EGFR-activated ovarian cancer cell growth in a COX-1 dependent manner.
Conclusions: Taken together, aspirin inhibits viability of ovarian cancer cells by blocking phosphorylation of Akt and Erk activated by EGF. Thus it may potentiate the therapeutic efficacy of drugs used to treat COX-1 positive ovarian cancer subsets.
Vitamin D receptor rs2228570 polymorphism and susceptibly to ovarian cancer: a meta-analysis
abstract
The role of vitamin D receptor (VDR) rs2228570 polymorphism on the risk of ovarian cancer has been studied in many studies, but the relationship between VDR rs2228570 polymorphism and ovarian cancer is still unclear. We thus performed a meta-analysis of published studies to provide a comprehensive assessment of the association. Fourteen individual studies with a total of 10,964 subjects were finally included into the meta-analysis. We assessed the association by calculating the pooled odds ratio (OR) with 95 % confidence intervals (95 % CI). There was no heterogeneity among those included studies. Meta-analysis of 14 studies showed that the VDR rs2228570 polymorphism was associated with risk of ovarian cancer under three main comparison models (T versus C: OR = 1.09, 95 % CI 1.03 to 1.15, P = 0.004; TT versus CC: OR = 1.17, 95 % CI 1.04 to 1.32, P = 0.01; and TT/CT versus CC: OR = 1.12, 95 % CI 1.03 to 1.21, P = 0.007). Subgroup analysis in Caucasians further identified the obvious association. There was no evidence of publications bias. These data from the meta-analysis suggest that VDR rs2228570 polymorphism is associated with risk of ovarian cancer in Caucasians. More studies are warranted to assess the association between the VDR rs2228570 polymorphism and ovarian cancer in Asians and Africans.
The impact of pelvic retroperitoneal invasion and distant nodal metastases in epithelial ovarian cancer
abstract
Background
The absence of
disease after debulking surgery is the most important prognostic factor
in the treatment of advanced epithelial ovarian cancer (EOC).
Occasionally, the presence of extra-abdominal disease complicates the
ability to obtain a complete surgery, considering some locations of the
metastatic disease as unresectable. The objective of the study was to
estimate the survival impact of pelvic retroperitoneal invasion and
extrapelvic and aortic distant nodal metastases in EOC patients. The
anatomical landmarks of primary cytoreductive surgery will be discussed.
Material and methods
we
reviewed data from 116 consecutive Mayo Clinic patients with epithelial
ovarian cancer (EOC) stage IIIC and IV, undergoing primary
cytoreduction surgery between 1996 and 2000. Univariate and multivariate
analysis for patients with positive distant nodes and pelvic
retroperitoneal invasion was performed, including 57 patients with no
residual disease after surgery. Kaplan-Meier curves were used to
estimate the probability of survival.
Results
the
median patient's age was 65 years (range 24-87 years). The 5 years
overall survival was 44.8% (range 30.1-57.9 months) and the median
length of survival was 39.9 months (range 0.13-60 months, 95% confidence
interval: 30.1-57.9). Pelvic retroperitoneal invasion was present in 22
EOC patients (18.9%) and distant positive nodes were noted in 11
(9.5%): suprarenal/celiac (5.2%), inguinal (4.3%) and supraclavicular
(0.9%). Univariate and multivariate Cox regression analysis, identified
distant positive lymph nodes and pelvic retroperitoneal invasion as
factors statistically associated with overall survival (p=0.002 and
p=0.025, respectively).
Conclusions
metastatic
distant nodes and pelvic retroperitoneal invasion are independent
prognostic factors for survival in patients with advanced EOC.
A multicentric trial (Olympia–MITO 13) on the accuracy of laparoscopy to assess peritoneal spread in ovarian cancer
Abstract
Objective
The
objective of the study was to prospectively evaluate the accuracy of
laparoscopy performed in satellite centers (SCs) to describe
intraabdominal diffusion of advanced ovarian cancer (AOC).
Study Design
Patients
with a clinical/radiological suspicion of AOC were included in the
protocol. SCs were selected among those surgeons, spending a short
intensive training period at the coordinator center (CC) to learn the
application of staging laparoscopy (S-LPS) in AOC. All women underwent
S-LPS at the SCs, and the surgical procedure was recorded and blindly
reviewed at the CC.....
Results
One
hundred sixty-eight cases were considered eligible for the study. A
per-protocol analysis was performed on 120 cases. The worst laparoscopic
assessable feature was mesenteric retraction, whereas the remaining
variables ranged from 99.2% (peritoneal carcinomatosis) to 90% (bowel
infiltration). All but 1 SC (SC number 4) reached an accuracy rate of
80% or greater for both single parameters and overall score.....
Conclusion
S-LPS
allows an accurate and reliable assessment of intraperitoneal diffusion
of disease in AOC patients in trained gynecological oncology centers.
audio 15:55 min: Implementing Patient-Centered Outcomes in Cancer Trials
audio
oday
we are speaking with Dr. Ethan Basch, an oncologist who also does
research on health services and drug regulatory policy at the University
of North Carolina Comprehensive Cancer Center and the UNC School of
Public Health. In a recent editorial in the New England Journal of
Medicine, Dr. Basch wrote about a path toward including patient-reported
outcomes, such as symptoms, in both labels for cancer drugs and in the
published papers of trial outcomes. Dr. Basch is joining us to discuss
his own experience with treating cancer patients, why patient-centered
research is important, and why this type of information is frequently
ignored. - See more at:
http://www.cancernetwork.com/podcasts/implementing-patient-centered-outcomes-cancer-trials?GUID=59A6C40A-05D9-4E87-A0FC-1850E2FF60E0&rememberme=1&ts=25102013#sthash.oxrpW8On.dpuf
oday
we are speaking with Dr. Ethan Basch, an oncologist who also does
research on health services and drug regulatory policy at the University
of North Carolina Comprehensive Cancer Center and the UNC School of
Public Health. In a recent editorial in the New England Journal of
Medicine, Dr. Basch wrote about a path toward including patient-reported
outcomes, such as symptoms, in both labels for cancer drugs and in the
published papers of trial outcomes. Dr. Basch is joining us to discuss
his own experience with treating cancer patients, why patient-centered
research is important, and why this type of information is frequently
ignored. - See more at:
http://www.cancernetwork.com/podcasts/implementing-patient-centered-outcomes-cancer-trials?GUID=59A6C40A-05D9-4E87-A0FC-1850E2FF60E0&rememberme=1&ts=25102013#sthash.oxrpW8On.dpuf
oday
we are speaking with Dr. Ethan Basch, an oncologist who also does
research on health services and drug regulatory policy at the University
of North Carolina Comprehensive Cancer Center and the UNC School of
Public Health. In a recent editorial in the New England Journal of
Medicine, Dr. Basch wrote about a path toward including patient-reported
outcomes, such as symptoms, in both labels for cancer drugs and in the
published papers of trial outcomes. Dr. Basch is joining us to discuss
his own experience with treating cancer patients, why patient-centered
research is important, and why this type of information is frequently
ignored. - See more at:
http://www.cancernetwork.com/podcasts/implementing-patient-centered-outcomes-cancer-trials?GUID=59A6C40A-05D9-4E87-A0FC-1850E2FF60E0&rememberme=1&ts=25102013#sthash.oxrpW8On.dpuf
Avastin 25mg/ml concentrate for solution for infusion
Avastin
On 15 May 2013, safety information on Avastin was issued. Necrotising
fasciitis, including fatal cases, has been reported in patients
receiving Avastin in both clinical trials and in the post-marketing
setting. It is recommended that Avastin is discontinued and appropriate
therapy initiated promptly upon diagnosis of necrotising fasciitis.
Further information is available on the MHRA website.
Further information is available on the MHRA website.
Table of Contents
- 1. Name of the medicinal product
- 2. Qualitative and quantitative composition
- 3. Pharmaceutical form
- 4. Clinical particulars
- 4.1 Therapeutic indications
- 4.2 Posology and method of administration
- 4.3 Contraindications
- 4.4 Special warnings and precautions for use
- 4.5 Interaction with other medicinal products and other forms of interaction
- 4.6 Fertility, pregnancy and lactation
- 4.7 Effects on ability to drive and use machines
- 4.8 Undesirable effects
- 4.9 Overdose
- 5. Pharmacological properties
- 5.1 Pharmacodynamic properties
- 5.2 Pharmacokinetic properties
- 5.3 Preclinical safety data
- 6. Pharmaceutical particulars
- 6.1 List of excipients
- 6.2 Incompatibilities
- 6.3 Shelf life
- 6.4 Special precautions for storage
- 6.5 Nature and contents of container
- 6.6 Special precautions for disposal and other handling
- 7. Marketing authorisation holder
- 8. Marketing authorisation number(s)
- 9. Date of first authorisation/renewal of the authorisation
- 10. Date of revision of the text
Breast cancer in BRCA mutation carriers: breast-conserving therapy or bilateral mastectomy?,
abstract
SUMMARY BRCA mutation carriers who are diagnosed with breast cancer can be overwhelmed with decisions. The choice between breast-conserving therapy, mastectomy or a bilateral mastectomy is often the first to be made by patients. Those who choose breast-conserving therapy are faced with an increased risk of ipsilateral breast tumor recurrence and contralateral breast cancer; however, choosing more extensive surgery increases surgical morbidity without a proven survival advantage. Additional factors that influence surgical decision-making are the use of adjuvant therapy, the role of risk-reducing salpingo-oophorectomy and the biology of the breast cancer. Advances in surgical techniques, breast reconstruction and screening must also be considered when choosing the surgical treatment for breast cancer patients with a BRCA mutation.
Friday, October 25, 2013
Improvements to the FIGO staging for ovarian cancer: reconsideration of lymphatic spread and intraoperative tumor rupture
open access
Conclusion
The modified FIGO staging for ovarian carcinoma appears superior to
the current staging for discriminating survival outcomes of patients
with surgical spillage, retroperitoneal LN metastasis without
extrapelvic peritoneal involvement, or distant metastasis to
supraclavicular LNs.
See the editorial "Staging of ovarian cancer: time to subdivide more?" in volume 24 on page 293
Editorial: Staging of ovarian cancer: time to subdivide more?
Editorial: open access
2013. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology
See the article "Improvements to the FIGO staging for ovarian cancer: reconsideration of lymphatic spread and intraoperative tumor rupture. J Gynecol Oncol. 2013 October; 24(4); 352" in volume 24 on page 352
Editorial :: Cochrane and Wikipedia: the collaborative potential for a quantum leap in the dissemination and uptake of trusted evidence
Editorial: Cochrane and Wikipedia
October 22, 2013
The Cochrane Collaboration has played a pioneering role over the past 20 years in the production and dissemination of high-quality, timely, synthesised research evidence across many areas of health care. However, in order to fully realise Cochrane's vision of a world where this can lead to better health for everyone, proactive strategic alliances are needed to ensure wider dissemination of Cochrane evidence in a manner that better meets the needs of users worldwide.
Wikipedia, the web-based, multilingual, free-content encyclopaedia, is the sixth most visited site, and the most used medical resource, on the Internet.[1,2] In the 12 years since its creation, Wikipedia has grown into one of the largest reference websites, attracting over 500 million unique visitors monthly.[3] With more than 80,000 active voluntary contributors working on over 26 million articles in 285 languages, the potential for Cochrane to reach previously unreached audiences by forging a strategic partnership with Wikipedia is enormous.
There are remarkable similarities in the vision, mission, principles, and strategic goals of the Wikimedia Foundation (the not-for-profit, charitable organisation that manages Wikipedia) and Cochrane. This sets the stage for a working partnership that could help realise the aspirations of both organisations. Wikimedia Foundation's vision of "a world in which every single human being can freely share in the sum of all knowledge,"[4] echoes the altruism and hope enshrined in Cochrane's vision, and its values of freedom, accessibility and quality, independence, commitment to openness and diversity, transparency, and community as an asset mirror many of Cochrane's founding principles.[5,6] The core policies governing Wikipedia content are that articles should state a neutral point of view (be unbiased); be verifiable (supported by high-quality secondary sources), and contain no original research.[7].....
Researchers Spar Over Tests for Breast Cancer Risks | Science/AAAS | News
Science/AAAS | News
"A heated discussion broke out here today at the annual meeting of the American Society of Human Genetics over a hot-button topic: When will we know enough about rare cancer risk genes to begin routinely testing for them in patients with a family history of cancer?
On one side of the debate was a team led by breast cancer geneticist Mary-Claire King, who discovered the first inherited breast cancer risk gene, BRCA1. King’s group now wants to routinely test certain women for other cancer-linked genes. Other researchers, however, argued that it is premature to test for these other genes, which are less well understood.....
BROCA sequencing approach evaluates all 24 genes implicated in breast cancer (and ovarian)
press release
"Carriers of mutations in some of the genes were at significantly increased risk of ovarian cancer for women and increased risk of breast cancer in men as well as in women."
Compliance Rates and Outcomes Associated with a Restrictive Transfusion Policy in Gynecologic Oncology Patients
abstract
Objectives
Blood products are
scarce but essential medical resources. Initially transfusions showed
increased perioperative complications, prolonged hospitalizations, and
higher mortality. Recently developed restrictive transfusion policies
have not shown those adverse affects in critically ill patients.
Hospitals adopted these policies to guide blood product administration.
The objective of this study is to determine compliance with a
restrictive transfusion policy in gynecologic oncology patients.
Methods
A
retrospective chart review of gynecologic oncology patients undergoing
transfusion with packed red blood cells (pRBCs) from 12/2008-9/2011 was
performed. Cancer type and stage, surgical procedure, hemoglobin values,
pRBC transfusions, intraoperative blood loss, and postoperative
complications were collected. Each transfusion was classified as
compliant or noncompliant.
Results
582
patients requiring 2,276 blood transfusions were identified. The mean
age was 55.9 years. Ovarian and endometrial cancers were the most common
malignancies. Gynecologic oncologists were 81.1% compliant with the
restrictive transfusion policy; 59.0% of transfusions were secondary to
exceptions. Noncompliant transfusions were commonly given on the day of
surgery when intraoperative blood loss was < 1500 cc and for
asymptomatic anemia. Only 64.7% of the transfusions were ordered in
single unit increments. There was no significant difference in
postoperative infections, thrombotic events, and mortality between
compliant and noncompliant transfusions.
Conclusion
The
majority of gynecologic oncology patients receive transfusions
compliant with the restrictive transfusion policy. Morbidity and
mortality are not increased with a restrictive transfusion policy.
Efforts to improve compliance should focus on limiting transfusions when
the hemoglobin is ≥ 7 g/dL and transfusing in single pRBCs unit
increments.
Thursday, October 24, 2013
Ontario Hospital Association: 1 day conference ($499.00) Patient Experience
Event Detail
Join the OHA on February 7, 2014 for Patient Experience, a one-day conference that will bring together key researchers, policy-makers and health care providers. Learn about patient perceptions of care, a key indicator in assessing the quality of service provided in health care organizations. Read more
Monitoring patient perceptions of care is a key indicator of the quality of services provided in health care organizations. Organizations are looking at new and innovative ways to survey or obtain feedback from their patients to achieve a seamless patient experience, supported by the availability of the right mix of health care services and technology.
Join the Ontario Hospital Association (OHA) on February 7, 2014 for Patient Experience, a one-day conference that will bring together key researchers, policy-makers and health care providers to learn about and help advance work in this area.
Areas of focus include the sharing of data from across the province, collaboration to measure patient experience throughout the continuum, examples of excellence and barriers to local innovation.
For more information and to register, click here.
Who Should Attend?
The
target audiences include those working in all areas within the hospital
– senior and mid-management, clinical leaders and department heads,
quality and decision-support staff, utilization management staff,
patient experience officers – as well as individuals working at other
health care organizations such as Community Care Access Centres (CCACs),
the Ministry of Health and Long- Term Care (MOHLTC) and Local Health
Integration Networks (LHINs).
- See more at: http://www.oha.com/Education/EventCalendar/Pages/EventDetail.aspx?eventid=E1%20376#sthash.EoiHtVyB.dpufPatient Experience
Event Date:
2014/02/07
Location:
Radisson Admiral Hotel Toronto-Harbourfront
249 Queen’s Quay West
Toronto, Ontario
Monitoring
patient perceptions of care is a key indicator of the quality of
services provided in health care organizations. Organizations are
looking at new and innovative ways to survey or obtain feedback from
their patients to achieve a seamless patient experience, supported by
the availability of the right mix of health care services and
technology.
Join us on February 7, 2014 for a one-day patient experience conference that will bring together key researchers, policy-makers and health care providers to learn about and help advance work in this area. Areas of focus include the sharing of data from across the province, collaboration to measure patient experience throughout the continuum, examples of excellence and barriers to local innovation.
Registration
Please register for this program online. For more information, visit: www.oha.com/conferences.
Please note: space is not guaranteed unless payment is received prior to the event.
Registration Fee
Fee: $499 + HST
Discount PolicyThe first registrant must pay the full registration fee. If more than one full registration is received from the same organization, a 15% discount (+ HST) will apply to each additional registration received. All group registrations must be received at the same time. This discount is not valid with other program promotions.
Discounted fee for each additional registrant:
Discounted Fee: $424.15 + HST
Payment Methods
Payment can be made by Credit Card (American Express/VISA/Mastercard) or Cheque. Please note, for transactions less than $200 before taxes, payment must be made by credit card.
Badge Pick-Up
Registration badges can be picked-up on Thursday, February 6, 2013 at 8:30am at Radisson Hotel Admiral Toronto-Harbourfront, 249 Queen’s Quay West, Toronto, Ontario.
Cancellation PolicyA $200.00 (+ HST) processing fee per registrant will apply to cancellation refunds received in writing up to five business days prior to the event. No refunds will be given for cancellations received less than five business days prior to the event. Substitutions are welcome. The OHA reserves the right to cancel or reschedule an event.
Join us on February 7, 2014 for a one-day patient experience conference that will bring together key researchers, policy-makers and health care providers to learn about and help advance work in this area. Areas of focus include the sharing of data from across the province, collaboration to measure patient experience throughout the continuum, examples of excellence and barriers to local innovation.
Registration
Please register for this program online. For more information, visit: www.oha.com/conferences.
Please note: space is not guaranteed unless payment is received prior to the event.
Registration Fee
Fee: $499 + HST
Discount PolicyThe first registrant must pay the full registration fee. If more than one full registration is received from the same organization, a 15% discount (+ HST) will apply to each additional registration received. All group registrations must be received at the same time. This discount is not valid with other program promotions.
Discounted fee for each additional registrant:
Discounted Fee: $424.15 + HST
Payment Methods
Payment can be made by Credit Card (American Express/VISA/Mastercard) or Cheque. Please note, for transactions less than $200 before taxes, payment must be made by credit card.
Badge Pick-Up
Registration badges can be picked-up on Thursday, February 6, 2013 at 8:30am at Radisson Hotel Admiral Toronto-Harbourfront, 249 Queen’s Quay West, Toronto, Ontario.
Cancellation PolicyA $200.00 (+ HST) processing fee per registrant will apply to cancellation refunds received in writing up to five business days prior to the event. No refunds will be given for cancellations received less than five business days prior to the event. Substitutions are welcome. The OHA reserves the right to cancel or reschedule an event.
Who Should Attend?
The
target audiences include those working in all areas within the hospital
– senior and mid-management, clinical leaders and department heads,
quality and decision-support staff, utilization management staff,
patient experience officers – as well as individuals working at other
health care organizations such as Community Care Access Centres (CCACs),
the Ministry of Health and Long- Term Care (MOHLTC) and Local Health
Integration Networks (LHINs).
Contact
Arlene Robinson
Educational Services, Ontario Hospital Association
200 Front Street West, Suite 2800
Toronto, ON M5V 3L1
P: 416-205-1534
F: 416-205-1340
Patient Experience
Event Date:
2014/02/07
Location:
Radisson Admiral Hotel Toronto-Harbourfront
249 Queen’s Quay West
Toronto, Ontario
Monitoring
patient perceptions of care is a key indicator of the quality of
services provided in health care organizations. Organizations are
looking at new and innovative ways to survey or obtain feedback from
their patients to achieve a seamless patient experience, supported by
the availability of the right mix of health care services and
technology.
Join us on February 7, 2014 for a one-day patient experience conference that will bring together key researchers, policy-makers and health care providers to learn about and help advance work in this area. Areas of focus include the sharing of data from across the province, collaboration to measure patient experience throughout the continuum, examples of excellence and barriers to local innovation.
Registration
Please register for this program online. For more information, visit: www.oha.com/conferences.
Please note: space is not guaranteed unless payment is received prior to the event.
Registration Fee
Fee: $499 + HST
Discount PolicyThe first registrant must pay the full registration fee. If more than one full registration is received from the same organization, a 15% discount (+ HST) will apply to each additional registration received. All group registrations must be received at the same time. This discount is not valid with other program promotions.
Discounted fee for each additional registrant:
Discounted Fee: $424.15 + HST
Payment Methods
Payment can be made by Credit Card (American Express/VISA/Mastercard) or Cheque. Please note, for transactions less than $200 before taxes, payment must be made by credit card.
Badge Pick-Up
Registration badges can be picked-up on Thursday, February 6, 2013 at 8:30am at Radisson Hotel Admiral Toronto-Harbourfront, 249 Queen’s Quay West, Toronto, Ontario.
Cancellation PolicyA $200.00 (+ HST) processing fee per registrant will apply to cancellation refunds received in writing up to five business days prior to the event. No refunds will be given for cancellations received less than five business days prior to the event. Substitutions are welcome. The OHA reserves the right to cancel or reschedule an event.
Join us on February 7, 2014 for a one-day patient experience conference that will bring together key researchers, policy-makers and health care providers to learn about and help advance work in this area. Areas of focus include the sharing of data from across the province, collaboration to measure patient experience throughout the continuum, examples of excellence and barriers to local innovation.
Registration
Please register for this program online. For more information, visit: www.oha.com/conferences.
Please note: space is not guaranteed unless payment is received prior to the event.
Registration Fee
Fee: $499 + HST
Discount PolicyThe first registrant must pay the full registration fee. If more than one full registration is received from the same organization, a 15% discount (+ HST) will apply to each additional registration received. All group registrations must be received at the same time. This discount is not valid with other program promotions.
Discounted fee for each additional registrant:
Discounted Fee: $424.15 + HST
Payment Methods
Payment can be made by Credit Card (American Express/VISA/Mastercard) or Cheque. Please note, for transactions less than $200 before taxes, payment must be made by credit card.
Badge Pick-Up
Registration badges can be picked-up on Thursday, February 6, 2013 at 8:30am at Radisson Hotel Admiral Toronto-Harbourfront, 249 Queen’s Quay West, Toronto, Ontario.
Cancellation PolicyA $200.00 (+ HST) processing fee per registrant will apply to cancellation refunds received in writing up to five business days prior to the event. No refunds will be given for cancellations received less than five business days prior to the event. Substitutions are welcome. The OHA reserves the right to cancel or reschedule an event.
Who Should Attend?
The
target audiences include those working in all areas within the hospital
– senior and mid-management, clinical leaders and department heads,
quality and decision-support staff, utilization management staff,
patient experience officers – as well as individuals working at other
health care organizations such as Community Care Access Centres (CCACs),
the Ministry of Health and Long- Term Care (MOHLTC) and Local Health
Integration Networks (LHINs).
Contact
Arlene Robinson
Educational Services, Ontario Hospital Association
200 Front Street West, Suite 2800
Toronto, ON M5V 3L1
P: 416-205-1534
F: 416-205-1340
Patient Experience
Event Date:
2014/02/07
Location:
Radisson Admiral Hotel Toronto-Harbourfront
249 Queen’s Quay West
Toronto, Ontario
Monitoring
patient perceptions of care is a key indicator of the quality of
services provided in health care organizations. Organizations are
looking at new and innovative ways to survey or obtain feedback from
their patients to achieve a seamless patient experience, supported by
the availability of the right mix of health care services and
technology.
Join us on February 7, 2014 for a one-day patient experience conference that will bring together key researchers, policy-makers and health care providers to learn about and help advance work in this area. Areas of focus include the sharing of data from across the province, collaboration to measure patient experience throughout the continuum, examples of excellence and barriers to local innovation.
Registration
Please register for this program online. For more information, visit: www.oha.com/conferences.
Please note: space is not guaranteed unless payment is received prior to the event.
Registration Fee
Fee: $499 + HST
Discount PolicyThe first registrant must pay the full registration fee. If more than one full registration is received from the same organization, a 15% discount (+ HST) will apply to each additional registration received. All group registrations must be received at the same time. This discount is not valid with other program promotions.
Discounted fee for each additional registrant:
Discounted Fee: $424.15 + HST
Payment Methods
Payment can be made by Credit Card (American Express/VISA/Mastercard) or Cheque. Please note, for transactions less than $200 before taxes, payment must be made by credit card.
Badge Pick-Up
Registration badges can be picked-up on Thursday, February 6, 2013 at 8:30am at Radisson Hotel Admiral Toronto-Harbourfront, 249 Queen’s Quay West, Toronto, Ontario.
Cancellation PolicyA $200.00 (+ HST) processing fee per registrant will apply to cancellation refunds received in writing up to five business days prior to the event. No refunds will be given for cancellations received less than five business days prior to the event. Substitutions are welcome. The OHA reserves the right to cancel or reschedule an event.
Join us on February 7, 2014 for a one-day patient experience conference that will bring together key researchers, policy-makers and health care providers to learn about and help advance work in this area. Areas of focus include the sharing of data from across the province, collaboration to measure patient experience throughout the continuum, examples of excellence and barriers to local innovation.
Registration
Please register for this program online. For more information, visit: www.oha.com/conferences.
Please note: space is not guaranteed unless payment is received prior to the event.
Registration Fee
Fee: $499 + HST
Discount PolicyThe first registrant must pay the full registration fee. If more than one full registration is received from the same organization, a 15% discount (+ HST) will apply to each additional registration received. All group registrations must be received at the same time. This discount is not valid with other program promotions.
Discounted fee for each additional registrant:
Discounted Fee: $424.15 + HST
Payment Methods
Payment can be made by Credit Card (American Express/VISA/Mastercard) or Cheque. Please note, for transactions less than $200 before taxes, payment must be made by credit card.
Badge Pick-Up
Registration badges can be picked-up on Thursday, February 6, 2013 at 8:30am at Radisson Hotel Admiral Toronto-Harbourfront, 249 Queen’s Quay West, Toronto, Ontario.
Cancellation PolicyA $200.00 (+ HST) processing fee per registrant will apply to cancellation refunds received in writing up to five business days prior to the event. No refunds will be given for cancellations received less than five business days prior to the event. Substitutions are welcome. The OHA reserves the right to cancel or reschedule an event.
Who Should Attend?
The
target audiences include those working in all areas within the hospital
– senior and mid-management, clinical leaders and department heads,
quality and decision-support staff, utilization management staff,
patient experience officers – as well as individuals working at other
health care organizations such as Community Care Access Centres (CCACs),
the Ministry of Health and Long- Term Care (MOHLTC) and Local Health
Integration Networks (LHINs).
Contact
Arlene Robinson
Educational Services, Ontario Hospital Association
200 Front Street West, Suite 2800
Toronto, ON M5V 3L1
P: 416-205-1534
F: 416-205-1340
Efficacy and safety of bevacizumab in recurrent sex cord-stromal ovarian tumors
abstract
BACKGROUND
The
Gynecologic Oncology Group conducted this phase 2 trial to estimate the
antitumor activity of bevacizumab and to determine the nature and
degree of toxicity in patients with recurrent sex cord-stromal tumors of
the ovary.
METHODS
A
prospective, multi-institutional cooperative group trial was performed
in women with recurrent, measurable ovarian stromal tumors. Patients
were allowed to have unlimited prior therapy, excluding bevacizumab.
Bevacizumab 15 mg/kg was administered intravenously on day 1 of every
21-day cycle until patients developed disease progression or adverse
effects that prohibited further treatment. The primary endpoint was the
response rate (RR). Inhibin A and B levels were measured before each
cycle, and the values were examined in relation to response and
progression.
RESULTS
Thirty-six
patients were enrolled, and all were eligible and evaluable. Patients
received a median of 9 cycles of treatment (range, 2-37 cycles). Six
patients (16.7%) had partial responses (90% confidence interval,
7.5%-30.3%), 28 patients (77.8%) had stable disease, and 2 patients
(5.6%) had progressive disease. This met the criterion for declaring the
regimen active. The median progression-free survival was 9.3 months,
and the median overall survival was not reached in during reporting
period. Two grade 4 toxicities occurred, including hypertension and
proteinuria; and the most common grade 3 toxicities were hypertension
(n = 5) and pain (n = 5). Inhibin A and B values were lower in patients
who responded to treatment.
CONCLUSIONS
Bevacizumab has activity in the treatment of recurrent sex cord-stromal tumors of the ovary, and its toxicity is acceptable.No link between depression and cancer risk: study- Reuters
Reuters
....Still, researchers worry that despite a lack of clear evidence, some cancer patients may blame themselves for somehow causing or worsening their disease by being depressed.
"Many people are convinced when they develop cancer that they know exactly what caused it," said James Coyne, a health psychology professor at University Medical Center in Groningen, the Netherlands.
Coyne was not involved in the French study, but has investigated connections between depression and cancer.
"I get particularly concerned if patients are left with the idea that they can control the course of cancer through psychological training," Coyne told Reuters Health.....
Putting A Price On Human Life - Forbes
Blogger's Note: not about ovarian/cancer but about healthcare and access
Forbes (worth reading)
"..Dr. Shetty and accompanying him (Dr. Shetty ) to the Stanford Graduate School of Business where he gave an inspiring talk called “Putting a Price on Human Life.”"
Editorial/Reference: Informative Reporting of Systematic Reviews in Radiology
abstract/reference
extract/editorial:
When we read reports of finished studies
in the medical literature, we want more than just the bottom line, the
take-home
message, and the conclusions from the authors. As
fellow researchers and as health care professionals, we also want to see
the actual study results and learn about the
methods used to generate them. Researchers need this information to
replicate
critical studies. Decision makers need details
about the methods and results for critical appraisal and to evaluate the
validity
and the applicability of the study findings.
As evident as this may seem, complete and
transparent reporting to achieve all this is still far from standard
practice. Multiple
studies have documented shortcomings in disclosing
necessary information for appreciating studies and their findings.
Authors
sometimes fail to report details on how and where
study participants were recruited (eg, how eligibility was evaluated).
They
do not always present the proper analyses and often
misinterpret the implications from their findings.
To assist in making the reporting of
studies more informative and more complete, several groups have
developed simple checklists.
The first to do so was the Consolidated Standards
of Reporting Trials group, who targeted the reporting of randomized
clinical
trials (1). Other
initiatives have followed that example. The Standards for Reporting of
Diagnostic Accuracy statement was prepared
for the reporting of test accuracy studies, that
is, studies comparing medical tests against a clinical reference
standard
for classifying patients as having the target
condition (2). The Strengthening the Reporting of Observational …
Related articles
Abstract
Completeness of reporting is associated with quality of systematic reviews and meta-analyses in major radiology journals with a few deficient areas; complete reporting has improved modestly since publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and it is strongly correlated with study quality in these journals.......Triple simultaneous primary invasive gynecological malignancies: A case report
abstract
Double gynecologic cancer (primary cancers in two organs) is relatively rare. However, triple gynecologic cancer (primary cancers in three organs) is extremely rare. We experienced a case of triple cancer, with primary cervical, endometrial and ovarian cancers, each showing different histopathological features. A 50-year-old woman with a preoperative diagnosis of cervical cancer stage Ib1 with a pathological diagnosis of mucinous adenocarcinoma underwent radical hysterectomy. The pathological diagnoses of the extracted masses were endometrioid adenocarcinoma in the uterine corpus and serous adenocarcinoma in the left ovary. Consequently, triple cancer was diagnosed. After the operation, six cycles of a paclitaxel/carboplatin regimen were administered, and no relapse of the cancers has been observed to date. To our knowledge, this is only the second case report in the international literature of concurrent gynecologic triple cancers of epithelial origin; that is, invasive cervical, endometrial and ovarian cancers, each with different histopathological features.
Novel para-aortic lymphadenectomy technique for gynecological malignancies prevents postoperative bowel obstruction
open access
Abstract
Aim
The
aim of this study was to evaluate the effect of our novel technique on
the prevention of postoperative ileus in patients undergoing systematic
para-aortic lymphadenectomy (PALN).
Material and Methods
PALN
was performed in 135 gynecological cancer patients (67 with ovarian
cancer, 58 with endometrial cancer, 8 with serous surface papillary
adenocarcinoma (SSPC) and 2 with fallopian tube cancer) between 2006 and
2011. To prevent postoperative ileus, we performed our novel technique
wherein the small bowel and colon are released from pressure and soaked
in 2 L of physiological saline for 1 min every 20 min during the
lymphadenectomy. We indicated our novel PALN technique and
retrospectively analyzed the outcomes of the surgical procedure in terms
of the surgical data, and postoperative incidence of gastrointestinal
dysfunction in patients with gynecological malignancies.
Results
The
mean blood loss was 641.2 ± 800.3 mL in the PALN group and
313.9 ± 278.9 mL in the pelvic lymphadenectomy (PLN) without PALN group (P
< 0.0001). There was no difference in the first passage of flatus
between the PALN group and the PLN group (1.8 ± 0.7 days vs 1.6 ± 0.7
days). The mean time to tolerance of a regular diet was significantly
longer in the PALN group than in the PLN group (P < 0.0001),
whereas the incidence of vomiting was similar in both groups.
Surprisingly, there were no cases of postoperative ileus in either
group.
Conclusion
Our
novel technique is a safe and effective way to prevent the incidence
and decrease the severity of postoperative ileus after PALN for
gynecological malignancies.
Introduction
Systematic
para-aortic lymphadenectomy (PALN) is a common procedure used to stage
and treat many primary gynecological cancers. Systematic
lymphadenectomy, including PALN, has a prognostic role, and is used to
decide the stage of disease in early ovarian cancer. Moreover, many
studies have reported that a significant survival impact for systematic
lymphadenectomy, including PALN, was observed in patients without
residual disease.[1-4]
The current recommendations for the surgical management of ovarian
cancer include complete resection of all visible intraperitoneal tumors
and systematic lymphadenectomy, including PALN.....
FGFR signalling in women's cancers
abstract
FGFs, in a complex with their receptors (FGFRs) and heparan sulfate (HS), are responsible for a range of cellular functions, from embryogenesis to metabolism. Both germ line and somatic FGFR mutations are known to play a role in a range of diseases, most notably craniosynestosis dysplasias, dwarfism and cancer. Because of the ability of FGFR signalling to induce cell proliferation, migration and survival, FGFRs are readily co-opted by cancer cells. Mutations in, and amplifications of, these receptors are found in a range of cancers with some of the most striking clinical findings relating to their contribution to pathogenesis and progression of female cancers. Here, we outline the molecular mechanisms of FGFR signalling and discuss the role of this pathway in women's cancers, focusing on breast, endometrial, ovarian and cervical carcinomas, and their associated preclinical and clinical data. We also address the rationale for therapeutic intervention and the need for FGFR-targeted therapy to selectively target cancer cells in view of the fundamental roles of FGF signalling in normal physiology.
Kentucky first lady, UK Markey Cancer Center doctors promote ovarian cancer screening - media
Kentucky
....The Ovarian Cancer Screening Program is open to women age 50 or older, or women over the age of 25 who have a family history of ovarian cancer. Screening is free. For more information, call 859-323-4687 or 800-766-8279.
Barriers to Study Enrollment in Patients With Advanced Cancer Referred to a Phase I Clinical Trials Unit
abstract
Background. We conducted this retrospective study to identify reasons that patients referred to a phase I clinical trial failed to enroll or delayed enrollment onto the trial.
Materials and Methods. Outcome
analyses were conducted independently on data collected from electronic
medical records of two sets of consecutive
patients referred to a phase I clinical trial
facility at MD Anderson Cancer Center. Data from the first set of 300
patients
were used to determine relevant variables affecting
enrollment; data from the second set of 957 patients were then analyzed
for these variables.
Results. Results
from the two sets of patients were similar. Approximately 55% of
patients were enrolled in a phase I trial. Patients
referred from within MD Anderson were more likely
to be enrolled than patients seen originally outside the institution (p = .006); black patients were more likely than white patients to enroll (69% vs. 43%; p
= .04). The median interval from the initial visit to initiation of
treatments was 19 days. Major reasons for failure to
enroll included failure to return to the clinic
(36%), opting for treatment in another clinic (17%), hospice referral
(11%),
early death (10%), and lack of financial clearance
(5%). Treatment was delayed for three weeks or more in 250 patients; in
85 patients (34%), the delay was caused by
financial and insurance issues.
Conclusion. Failure to return to the clinic, pursuit of other therapy, and rapid deterioration were the major reasons for failure to enroll;
lengthy financial clearance was the most common reason for delayed enrollment onto a phase I trial.
Post-operative bathing and showering to prevent wound complications - Cochrane Summaries plain english/abstract
abstract/plain english summary
Many
people undergo surgical operations during their life-time. After an
operation the surgical wound is closed using stiches, staples, tape
(steri-strips) or an adhesive glue. Usually, towards the end of the
surgical procedure and before the person leaves the operating theatre,
the surgeon covers the closed surgical wound using gauze and adhesive
tape, or an adhesive tape containing a pad that covers the surgical
wound. This is called a wound dressing. There is currently no guidance
about when wounds can be made wet by bathing or showering
post-operatively. Early bathing may encourage the person to move about,
which is good after most types of surgery. Avoiding post-operative
bathing or showering for two to three days may result in the
accumulation of sweat and dirt on the body, but early washing of the
wound may have a bad effect on healing by irritating the wound and
disturbing the healing environment. We reviewed all the available
evidence from the medical literature (up to July 2013) on this issue. In
particular, we sought information from randomised controlled trials,
which, if conducted well, provide the most accurate information.
We identified only one randomised controlled trial. This trial was at high risk of bias, i.e. there were flaws in the way it was conducted that could have given incorrect results.
We identified only one randomised controlled trial. This trial was at high risk of bias, i.e. there were flaws in the way it was conducted that could have given incorrect results.
Patients’ and professionals’ evaluations of quality of care in oncology outpatient clinics
abstract
Purpose
The purpose of this
study is to compare patients' and professionals' evaluations of the
quality of care in oncology outpatient clinics.
Methods
The data were drawn
from a 2011 survey of 1,379 patients and 155 professionals conducted in
15 % of oncology outpatient clinics in Quebec, Canada. Respondents
completed self-administered questionnaires that addressed the aspects of
timeliness (TIM), patient-centred care (PCC), communication (COM),
quality of the physical environment (QPE), and continuity (CONT).
Patients’ and professionals’ mean scores (maximum = 4) for each aspect
were compared using mixed model analysis.
Results
Patients’ and
professionals’ perceptions of quality of care were largely positive,
with mean scores for all items of 3.66 and 3.37, respectively. However,
for the majority of aspects of quality, the professionals' scores were
lower than those of patients. The aspects rated most positively by both
groups were PCC, COM and CONT. Timeliness was the least positively
evaluated, with mean scores of 3.34 for patients and 3.16 for
professionals.
Conclusions
In many respects,
cancer patients and professionals share relatively common views about
the most and least positive aspects of the quality of care, although
professionals tend to be more critical. Aspects evaluated less
favourably by both groups and those on which opinions differ are good
candidates for improvements. Some ideas for solutions are proposed.
Positive patient feedback is especially important in cancer care, where
attraction and retention of professionals is a key concern.
Neuroendocrine tumors of the gynecologic tract
abstract
"Tumors of the diffuse neuroendocrine cell system (DNES) may arise in any component of the gynecologic tract, including the vulva, vagina, cervix, endometrium, and ovary. Overall such tumors in the gynecologic tract are rare, constituting only 2% of gynecologic cancers, comprising a spectrum of tumors of variable biologic potential. Due to the rarity of such tumors, pathologists experience may be limited and these may present diagnostic challenges. Currently the nomenclature employed is still that of the pulmonary classification systems, carcinoid, atypical carcinoid, small and large cell neuroendocrine carcinoma that broadly correlates to low/grade 1, intermediate/grade 2, and high grade/grade 3 of the WHO gastroenteropancreatic neuroendocrine tumors classification. Furthermore in keeping with the lung, proliferative rate is assessed based on mitotic index rather than Ki-67 staining. In this review we cover select neuroendocrine tumors of the gynecologic tract."
search=ovarian+Neuroendocrine+tumors
2013 Results for Surgical Specialists. - (Canada) National Physician Survey
National Physician Survey
The following questions were presented to and completed by
physicians (family physicians and all other specialists) in Canada in
2013. Questions marked “FP”, were asked of family physicians/general
practitioners only, while those marked “SP” were only asked of all other
specialist physicians.
(Cardio-vascular/Thoracic Surgeons, General Surgeons, Neurosurgeons, Obstetricians/Gynecologists, Ophthalmologists, Orthopedic Surgeons, Otolaryngologists, Plastic Surgeons, Urologists.).....
(Cardio-vascular/Thoracic Surgeons, General Surgeons, Neurosurgeons, Obstetricians/Gynecologists, Ophthalmologists, Orthopedic Surgeons, Otolaryngologists, Plastic Surgeons, Urologists.).....
BRCA1/2 and clinical outcome in a monoinstitutional cohort of women with hereditary breast cancer
abstract
The clinical outcome of BRCA mutation carriers and non-carriers still remains a topic of discussion. In order to interpret controversial data, in the present study, we analyzed a large consecutive monoinstitutional series of breast cancer patients and relatives with familial features carrying or not carrying BRCA mutations. The intense research in recent years regarding the clinical genetics of patients with breast or ovarian cancer and their relatives has allowed the organization of a unique database comprising anamnestic, clinical, pathological and molecular data.
Families with two or more cases of breast cancer under the age of 50 years, or with three cases at any age, were identified. From June, 2003 to June, 2010, a total of 202 patients (136 probands + 66 relatives) from 45 families were included in the analysis. A total of 136 (49 carrier and 87 non-carrier) cases had a cancer diagnosis at the time of their genetic testing. Twenty and 24 events were observed in the carrier and control group, respectively.
The 10-year disease-free suvival rate was 57% for patients in the control group compared with 50% for patients carrying a BRCA mutation (P=0.15 by log-rank test). Finally, 66 (32 genetic and 34 control) cases were unaffected at the time of molecular analysis, and 6 new cases of cancer were observed in the carriers, while no new cases were detected in the control cohort. Thus, at age 50, 40% of carriers had a high risk of disease (P=0.0069 by log-rank test). Our data support the hypothesis that the presence of BRCA mutations does not alter the clinical outcome for hereditary breast cancer patients. Conversely, BRCA mutations are proven to be crucial for prediction of risk in healthy relatives from carrier families.
Wednesday, October 23, 2013
Paraneoplastic cerebellar degeneration caused by ovarian clear-cell carcinoma - case report
abstract
Keywords:
- ovarian cancer;
- paraneoplastic cerebellar degeneration;
- paraneoplastic neurological syndrome;
- tacrolimus hydrate;
- Yo antibody
Paraneoplastic
cerebellar degeneration is a paraneoplastic neurological syndrome
caused by the remote effect of certain systemic cancers and is
characterized by subacute cerebellar symptoms. A 62-year-old woman
suffering from unidentified cerebellar symptoms was admitted to our
hospital. Paraneoplastic cerebellar degeneration was suspected and
ovarian cancer was detected after the systemic examination for
malignancy. The symptoms of vertigo and dysarthria were improved a
little after surgical operation and treatments of γ-globulin, steroid
pulse and tacrolimus hydrate. The cerebellar symptoms of paraneoplastic
cerebellar degeneration are often evident prior to detection of
malignancy. It is important to perform systemic examination for
malignancy in case of unidentified cerebellar symptoms.
Tuesday, October 22, 2013
American Public Health Association - Women’s Health Initiative View of Estrogen Avoidance and All-Cause Mortality
Abstract (requires $$ to view full article)
"In a recent article, Sarrel et al.1
assert that estrogen avoidance since 2002 has caused tens of thousands
of premature deaths among posthysterectomy women aged 50 to 59 years in
the United States. They fault Women’s Health Initiative (WHI)
investigators for inadequate efforts to communicate the benefits of
unopposed estrogen and to contrast (unopposed) estrogen findings from
those for estrogen plus progestin in reporting on the WHI randomized
controlled trials.2–5"
Read More: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2013.301604
UMD-MLH1/MSH2/MSH6 databases: description and analysis of genetic variations in French Lynch syndrome families
Blogger's Note: this is information concerning a French database for Lynch Syndrome
open access
'We examined MLH1/MSH2/MSH6 variations collected by the 16 licensed laboratories located in France and belonging to the French MMR network during the past 18 years. Updates on new variations or new samples found to carry MMR variations are done twice a year. In June 2012, a total of 7047 variations were provided for registration, and 6480 could be integrated by the UMD software for further analyses. They represent 1174 different variations corresponding to 467 truncating mutations (40%) and 707 VUS (60%). Entries correspond to all variations found through a complete exon screening of the three genes not only in index cases but also in those relatives that were genetically screened and found to be mutation carriers. This nation-wide and systematic registration should improve the prevalence estimate of germline MMR mutations in France....
Tiny, short-term hair growing experiment grows huge news coverage
healthnewsreviews
A paper in the Proceedings of the National Academy of Sciences describes a technique to grow hairs on human skin grafted onto mice.
New hair follicles appeared on 5 of 7 transplants attempted. The longest duration of any graft in the study was 6 weeks; so no long-term followup.
That’s right. 5 successful attempts. Yet this dominated the news.....
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