Attitudes and Perceived Barriers to Research Among Residents in Obstetrics and Gynecology in Trinidad and Tobago: A National Multicenter Cross-sectional Study.

Objectives: High-quality research forms the basis of evidence-based practice and sets the foundation for trainees to develop critical thinking skills and approach clinical problems with an inquisitive mind. The attitudes to research however vary widely and there are significant barriers to conducting research relevant to each clinical discipline. Understanding both the attitudes of residents to research and the barriers to conducting research could allow for strategies to improve this core aspect of clinical development.

Diffusion-weighted MRI to detect early response to chemoradiation in cervical cancer: A systematic review and meta-analysis.

Objective: Diffusion-weighted magnetic resonance imaging (DWI) has shown promise in predicting response to therapy in several malignancies. This systematic review and meta-analysis aimed to evaluate DWI in the prediction of response to treatment in patients with cervical cancer.

Methods: A systematic search was conducted on PubMed, Web of Science, Cochrane and Google Scholar databases Studies that evaluated DWI and apparent diffusion coefficient (ADC) for response evaluation before, during and after treatment with a correlation to conventional response criteria were included.

A rare lung disease diagnosed by CT in a young pregnant woman.

Lymphangioleiomyomatosis (LAM) is an unusual lung disease which can be diagnosed by its characteristic appearance on a high-resolution CT, and may not always require a biopsy.

Feasibility of Targeting PIK3CA Mutations in Head and Neck Squamous Cell Carcinoma.

PIK3CA is the only frequently-mutated, directly druggable oncogene in head and neck squamous cell carcinoma (HNSCC). However, it is unclear if a molecularly-driven intervention trial can be launched successfully, particularly within a single-institution setting secondary to the infrastructure necessary for mutation detection, mutation prevalence, and patient willingness to participate. This study aimed to evaluate 1) local frequency of PIK3CA activating mutations in HNSCC, 2) timeliness of our mutation-profiling clinical pathway, and 3) patients' willingness to enroll in a novel neoadjuvant drug trial.

Laparoscopic staging for apparent early stage ovarian or fallopian tube cancer. First case series from a UK cancer centre and systematic literature review.

Objective: To describe the experience of laparoscopic staging of apparent early stage adnexal cancers.

Methods: Prospectively collected data on women who had laparoscopic staging for apparent early stage adnexal cancers from May 2008 to September 2012 was reviewed. All women had had a prior surgical procedure at which the diagnosis was made, without comprehensive staging.

Early diffusion weighted magnetic resonance imaging can predict survival in women with locally advanced cancer of the cervix treated with combined chemo-radiation.

Objectives: To assess the predictive value of diffusion weighted imaging (DWI) for survival in women treated for advanced cancer of the cervix with concurrent chemo-radiotherapy.

Methods: Twenty women treated for advanced cancer of the cervix were recruited and followed up for a median of 26 (range <1 to 43) months. They each had DWI performed before treatment, 2 weeks after beginning therapy (midtreatment) and at the end of treatment.

Functional imaging for assessing tumor response in cancer of the cervix.

Treatment options for carcinoma of the cervix are guided by tumor stage, and include radical surgery, in cases where the tumor is confined to the cervix, or concurrent chemotherapy and radiotherapy. In those cases treated with chemoradiation, the ability to monitor the response to treatment in order to adapt the management plan during its course may be beneficial. This approach has the potential to offer an individualized treatment plan, allowing for differences in behavior between tumors to be addressed early, rather than a 'one size fits all' treatment approach.

The clinically suspicious cervix--how often is it cancer?

Objective: To evaluate the outcome of women referred to colposcopy with the clinical finding of suspected cancer ("clinically suspicious cervix").

Materials And Methods: A prospective cohort study of women referred to a dedicated colposcopy clinic serving a regional population with a clinically suspicious cervix was conducted. All referral letters were reviewed, and women were identified prospectively when the letter stated "referral for a clinically suspicious cervix.

Use of new imaging techniques to predict tumour response to therapy.

Imaging of tumour response to therapy has steadily evolved over the past few years as a result of advances in existing imaging modalities and the introduction of new functional techniques. The use of imaging as an early surrogate biomarker of response is appealing, because it might allow for a window of opportunity during which treatment regimens can be tailored accordingly, depending on the expected response. The clinical effect of this would ultimately result in a reduction in morbidity and undue costs.

Novel imaging techniques as response biomarkers in cervical cancer.

The use of novel imaging techniques that have the ability to evaluate tumour biology and function shows a great deal of promise in providing early surrogate biomarkers of response to therapy which may allow for individualised or patient-specific regimes. This would have considerable clinical benefit in allowing for a treatment regimen tailored accordingly to meet the expected response, thereby reducing morbidity. Several of these imaging modalities such as dynamic contrast-enhanced MRI (DCE-MRI), diffusion-weighted MRI (DW-MRI), MR spectroscopy (MRS) and fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) are now being introduced into the field of gynaecological oncology, with the majority of work being performed on cervical tumours.

A combined pharmacokinetic and radiologic assessment of dynamic contrast-enhanced magnetic resonance imaging predicts response to chemoradiation in locally advanced cervical cancer.

Purpose: To investigate the combination of pharmacokinetic and radiologic assessment of dynamic contrast-enhanced magnetic resonance imaging (MRI) as an early response indicator in women receiving chemoradiation for advanced cervical cancer.

Methods And Materials: Twenty women with locally advanced cervical cancer were included in a prospective cohort study. Dynamic contrast-enhanced MRI was carried out before chemoradiation, after 2 weeks of therapy, and at the conclusion of therapy using a 1.

The genetic causes of the sequential occurrence of multiple primary malignancies in a young woman--5 years on.

The finding of three primary gynaecological malignancies in a young woman attending our unit was documented in 2001. We provide an update on this report as new events have prompted further discussion on the role of clinical guidelines in cancer management. The discovery of a genetic predisposition demonstrates the need for multidisciplinary input and heightened awareness in similar cases while the importance of treating each patient as an individual is emphasized.

Predicting the response of advanced cervical and ovarian tumors to therapy.

Unlabelled: The management of advanced cervical and ovarian cancers remains a significant challenge as many women fail to respond to recommended therapy, resulting in disease progression and ultimately patient death. Because of tumor heterogeneity, it is rare for all cancers of a particular type to respond to a specific therapy; and, as a result, many patients receive treatment from which they derive little or no benefit, leading to increased morbidity and undue costs. A marker that could rapidly predict or forecast disease outcome would clearly be beneficial in allowing the administration of a tailored regime for each patient while reducing toxicity and cost.

The risk of malignancy index for ovarian tumours in Northeast Scotland--a population based study.

Background And Aims: The Scottish Intercollegiate Guidelines Network (SIGN) recommends the use of the Risk of Malignancy Index (RMI) for ovarian tumours, a scoring system based on ultrasound findings, menopausal status and CA 125 level, in the pre-operative evaluation of pelvic masses. The aim of this study was to investigate the accuracy of this as a predictive method of discriminating benign from malignant disease.

Methods And Results: All women who underwent oophorectomy in 2004 at Aberdeen Royal Infirmary for suspected primary ovarian pathology were evaluated.

Magnetic resonance imaging in gynecological oncology.

Magnetic resonance imaging (MRI) has become an indispensable tool in the assessment of malignant disease. With increasingly sophisticated systems and technical advancements, MRI has continued to expand its role in providing crucial information regarding cancer diagnosis and management. In gynecological malignancies, this modality has assumed greater responsibility, particularly in the evaluation of cervical and endometrial cancers.

Diffusion-weighted magnetic resonance imaging in the early detection of response to chemoradiation in cervical cancer.

Objective: To investigate diffusion-weighted magnetic resonance imaging (DWI) as an early and reproducible response indicator in women receiving concurrent radiotherapy and chemotherapy (chemoradiation) for advanced cervical cancer.

Methods: Twenty women with advanced cervical cancer were included in a prospective cohort study. DWI was carried out prior to chemoradiation, repeated after 2 weeks of therapy and at the conclusion of therapy using a 1.

Treatment of advanced cervical cancer: a population-based study.

Chemoradiation is the standard treatment for locally advanced cervical cancer. We report how our population were treated over a 6-year period. Approximately 78.

Is this the end of the line for the moderate dyskaryotic smear?

Objective: The British Society for Clinical Cytology has recently proposed that the terminology for cervical smear reporting is to be changed from a 3-tier system (mild, moderate, severe dyskaryosis) to a 2-tier system of low-grade and high-grade dyskaryosis. This modification eliminates the central category of moderate dyskaryosis which would be incorporated into the high-grade group. The aim of this study was to investigate the role of the moderate dyskaryotic smear in clinical practice.

Isolated clear cell adenocarcinoma in scar endometriosis mimicking an incisional hernia.

Background: The development of a mass in association with a previous surgical scar can pose a diagnostic dilemma due to similarities in appearance to hernias, abscesses, hematomas, or desmoid tumors. Scar endometriosis is an uncommon cause of such a lump, but malignant change within this ectopic tissue is exceptionally rare.

Case: We present a case of a 55-year-old woman who was found to have an isolated clear cell adenocarcinoma in an area of scar endometriosis more than 30 years after an open tubal sterilization.

Auditing the use of colposcopy versus general gynecology clinics to investigate women with postcoital or intermenstrual bleeding: a case for a new outpatient service.

Objective: The aim of this audit was to determine whether initial referral to a general gynecology clinic (GOPD) or a colposcopy clinic is the most efficient means of managing women with postcoital (PCB) or intermenstrual (IMB) bleeding.

Materials And Methods: A prospective audit of women with PCB or IMB was conducted. Sixty referrals from primary care were note-logged and alternatively allocated to either clinic.

Expression of human telomerase reverse transcriptase, Survivin, DD3 and PCGEM1 messenger RNA in archival prostate carcinoma tissue.

Introduction: The wide spectrum of biological behavior displayed by prostate cancer (PCa) warrants investigation of potential PCa-specific biomarkers that could identify more aggressive tumor types and therefore provide prognostic value. Upregulation of expression of human telomerase reverse transcriptase (hTERT), Survivin, DD3 and PCGEM1 mRNAs in PCa lesions has recently been described. The purpose of this study was to evaluate the clinical value of detection of over-expression of these biomarkers in the diagnosis and prognosis of PCa.

Women's perceptions of decision-making about hysterectomy.

Objective: To explore women's views of decision-making relating to hysterectomy.

Design: Structured questionnaire and in-depth interview surveys.

Setting: A teaching hospital and a district general hospital in northeast Scotland.

Clonal diversity of methicillin-resistant Staphylococcus aureus in an acute-care institution.

Objective: To evaluate plasmid and chromosomal typing methods for differentiation of methicillin-resistant Staphylococcus aureus (MRSA).

Design: Comparison of relatedness of strains using epidemiologic features, phage typing, and antimicrobial susceptibility with blinded assessment by molecular typing methods. Molecular typing methods included AccI and ClaI restriction endonuclease fingerprinting of chromosomal DNA and plasmid typing.