Innovative laparoscopic surgery in gynecologic oncology.

Minimally invasive surgery has been performed since the early 1990s, and gynecologic oncology surgeons continue to improve their skills for this procedure. Advanced laparoscopic techniques are used to evaluate and treat cervical, endometrial, and ovarian malignancies. Laparoscopy has significant benefits in selected oncologic patients and may be a more useful technique than the abdominal approach.

Pregnancy rates after conservative treatment for borderline ovarian tumours: a systematic review.

Borderline ovarian tumours account for 10-15% of all ovarian cancers, and there have been numerous studies indicating their excellent long-term prognosis. As this disease commonly affects younger women, the issue of fertility-preserving surgery is increasingly important. A systematic review of the literature, searching the relevant electronic databases was performed analysing conservative surgery, borderline ovarian tumours and pregnancy rates/fertility outcome.

Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer.

Background: Epithelial ovarian cancer presents at an advanced stage in the majority of patients. These women require chemotherapy and surgery for optimal treatment. Conventional treatment is to perform surgery first and then give chemotherapy.

Screening and prevention of hereditary gynecologic cancers.

Endometrial and ovarian cancer are the fourth and fifth most common malignancies in women, with approximately 40,000 new endometrial and 25,000 new ovarian cancers expected to be diagnosed in the Unites States this year. While the majority of these cancers will occur in the absence of a family history, approximately 5% of endometrial cancers and 10% of ovarian cancers will be the result of inherited defects in high-penetrance cancer susceptibility genes. With the identification and subsequent availability of clinical genetic testing for mutations in the genes associated with hereditary breast-ovarian cancer and the Lynch/hereditary nonpolyposis colorectal cancer (HNPCC) syndrome, targeted risk-reduction using intensive screening, chemoprevention, and prophylactic surgery has become possible for women at inherited risk of gynecologic malignancies.

A survey of bovine colostrum composition and colostrum management practices on Pennsylvania dairy farms.

Colostrum composition and management were surveyed via sample and data collection from 55 dairy farms in Pennsylvania. Colostrum samples were analyzed for fat, protein, lactose, total solids, ash, Ig, lactoferrin, water- and fat-soluble vitamins, and minerals. Mean percentages of fat, protein, and lactose in colostrum were 6.

Management of minor cervical cytological abnormalities: a systematic review and a meta-analysis of the literature.

Background: A significant number of women are diagnosed with a low grade cytological abnormality on cervical screening. Many authorities recommend surveillance as spontaneous regression might occur. However, protracted attendance for cytological follow-up decreases with time and might put some women at risk of developing invasive disease.

Information and cervical screening: a qualitative study of women's awareness, understanding and information needs about HPV.

Objectives: To explore women's attitudes towards the information about human papilloma virus (HPV) provided during cervical screening and to describe women's HPV information needs.

Setting: Women with a range of screening results (normal, inadequate, borderline and abnormal) were identified by three screening centres in England. Two consecutive samples of women attending for colposcopy for the first time following screening were also approached.

Vaginal vault smears after hysterectomy for reasons other than malignancy: a systematic review of the literature.

Background: Vaginal vault smears are used to detect persisting neoplasia of the lower genital tract after hysterectomy. Recent data suggest both widespread use and uncertain evidence of their effectiveness.

Objectives: To identify and synthesise evidence on the use and effectiveness of vaginal vault smears and to assess the quality.

The Grb2/Mek pathway represses Nanog in murine embryonic stem cells.

The homeobox gene Nanog is a key intrinsic determinant of self renewal in embryonic stem (ES) cells, and its repression leads ES cells to selectively differentiate into primitive endoderm. Although Nanog repression occurs at the outermost layer of ES cell aggregates independent of the leukemia inhibitory factor (LIF)/STAT3 pathway, it is largely undetermined what external cues and intracellular signals cause the event. Of interest, addition of the tyrosine phosphatase inhibitor, sodium vanadate, selectively repressed Nanog transcription without any detectable changes in upstream transcriptional regulators Oct3/4 and Sox2.

Treatments for gynaecological cancers.

Gynaecological cancers account for a significant amount of morbidity and mortality in the world, with varying incidences and outcomes depending on the country. These malignancies consist of vulval, vaginal, cervical, endometrial, fallopian and ovarian cancers, and account for between 10 and 15% of women's cancers. Although mainly a disease of post-menopausal women, when affecting younger women, fertility-related consequences exist.

Batch solar disinfection inactivates oocysts of Cryptosporidium parvum and cysts of Giardia muris in drinking water.

Aim: To determine whether batch solar disinfection (SODIS) can be used to inactivate oocysts of Cryptosporidium parvum and cysts of Giardia muris in experimentally contaminated water.

Methods And Results: Suspensions of oocysts and cysts were exposed to simulated global solar irradiation of 830 W m(-2) for different exposure times at a constant temperature of 40 degrees C. Infectivity tests were carried out using CD-1 suckling mice in the Cryptosporidium experiments and newly weaned CD-1 mice in the Giardia experiments.

Solar disinfection of poliovirus and Acanthamoeba polyphaga cysts in water - a laboratory study using simulated sunlight.

Aims: To determine the efficacy of solar disinfection (SODIS) in disinfecting water contaminated with poliovirus and Acanthamoeba polyphaga cysts.

Methods And Results: Organisms were subjected to a simulated global solar irradiance of 850 Wm(-2) in water temperatures between 25 and 55 degrees C. SODIS at 25 degrees C totally inactivated poliovirus after 6-h exposure (reduction of 4.

Guidelines for gynecological cancer-an audit of current network documents in England and Wales.

The objective of this study was to assess the adequacy of network cancer guidelines paying particular attention to referral criteria, referral routes, tumor diagnosis, staging, and suggested management and care pathways for ovarian and endometrial cancer. Guidelines from 15 regions in England and Wales were analyzed quantitatively and qualitatively as a prospective audit of predefined data items and subsequently agreed management recommendations. Details of unit and center clinicians were included in a minority of documents (2 to 5/15).

Key clinical trials in gynaecological oncology.

Aims: To review the most important clinical trials which have impacted the management of gynaecological cancers, in conjunction with some ongoing studies of interest.

Methods: PubMed and Cochrane databases were searched to find clinical trials and meta-analyses in vulva, cervical, endometrial and ovarian cancers. Other pertinent literature was also used.

Transperitoneal laparoscopic pelvic and paraaortic lymphadenectomy in gynecologic cancers.

Laparoscopy, a minimally invasive surgery, may benefit select patients more than traditional abdominal approaches. The benefits of this procedure include low morbidity, shorter length of hospital stay, less blood loss, no significant increase in complications, and a shorter postoperative recovery period; this allows patients to begin adjuvant therapy more quickly. Laparoscopy has been used in gynecologic oncology since the early 1990s and has continued to grow and develop.

Use of a doula for labor coaching in a patient with indolent systemic mastocytosis in pregnancy.

Background: Few cases of pregnancy in women with systemic mastocytosis have been reported. The effects of this disease on pregnancy have not been well documented, nor have the benefits of doula services for labor been reported for mastocytosis.

Case: A 35-year-old woman with indolent systemic mastocytosis sought preconception counseling regarding the effects of her disease on pregnancy and the effects of drugs and anesthesia on her disease.

Adrenomedullin and tumour angiogenesis.

The angiogenic activity of peptide adrenomedullin (AM) was first shown in 1998 . Since then, a number of reports have confirmed the ability of AM to induce the growth and migration of isolated vascular endothelial and smooth muscle cells in vitro and to promote angiogenesis in xenografted tumours in vivo. In addition, knockout murine models point to an essential role for AM in embryonic vasculogenesis and ischaemic revascularisation.

Vaginal vault smears --'know more--do less': a questionnaire survey of primary health care practitioners.

Background: The vaginal vault smear is a test for cellular atypia in women who have undergone a hysterectomy. In asymptomatic women the test has poor sensitivity and specificity. Current guidelines recommend: vault smears should not be used after hysterectomy for benign pathology; two vault smears (6 and 12 months postsurgery) should be taken when there is evidence of completely excised CIN II/III in the specimen.

Advances in the management of cervical cancer.

This review presents key advances in the management of cervical cancer. Traditionally, cervical cancer is staged clinically and has been treated either by radical hysterectomy or by radiotherapy. Improvements in imaging have led to more accurate therapeutic decision making and treatment planning.

Effect of batch-process solar disinfection on survival of Cryptosporidium parvum oocysts in drinking water.

The results of batch-process solar disinfection (SODIS) of Cryptosporidium parvum oocysts in water are reported. Oocyst suspensions were exposed to simulated sunlight (830 W m(-2)) at 40 degrees C. Viability assays (4',6'-diamidino-2-phenylindole [DAPI]/propidium iodide and excystation) and infectivity tests (Swiss CD-1 suckling mice) were performed.

Solar and photocatalytic disinfection of protozoan, fungal and bacterial microbes in drinking water.

The ability of solar disinfection (SODIS) and solar photocatalytic (TiO(2)) disinfection (SPC-DIS) batch-process reactors to inactivate waterborne protozoan, fungal and bacterial microbes was evaluated. After 8 h simulated solar exposure (870 W/m(2) in the 300 nm-10 microm range, 200 W/m(2) in the 300-400 nm UV range), both SPC-DIS and SODIS achieved at least a 4 log unit reduction in viability against protozoa (the trophozoite stage of Acanthamoeba polyphaga), fungi (Candida albicans, Fusarium solani) and bacteria (Pseudomonas aeruginosa, Escherichia coli). A reduction of only 1.

Batch process solar disinfection is an efficient means of disinfecting drinking water contaminated with Shigella dysenteriae type I.

Aims: The mortality and morbidity rate caused by Shigella dysenteriae type I infection is increasing in the developing world each year. In this paper, the possibility of using batch process solar disinfection (SODIS) as an effective means of disinfecting drinking water contaminated with Sh. dysenteriae type I is investigated.