Racial Differences in Associations of Cognitive Health Status With Happiness, Helplessness, and Hopelessness Among Older Adults: An Exploratory Study.

Background: The relationship between healthy and positive aging and dementia and cognitive impairment has received limited attention in the field of aging. Affect impacts cognitive changes and processes, and cognitive impairment is associated with affective comorbidities. The purpose of the study was to examine (a) whether happiness, helplessness, and hopelessness are linked to cognitive health status, and (b) whether these associations differ by race.

Prophylactic Negative Pressure Wound Therapy After Laparotomy for Gynecologic Surgery: A Randomized Controlled Trial.

Objective: To estimate the effectiveness of prophylactic negative pressure wound therapy in patients undergoing laparotomy for gynecologic surgery.

Methods: We conducted a randomized controlled trial. Eligible, consenting patients, regardless of body mass index (BMI), who were undergoing laparotomy for presumed gynecologic malignancy were randomly allocated to standard gauze or negative pressure wound therapy.

Robotic-assisted total laparoscopic hysterectomy and staging for the treatment of endometrial cancer: a comparison with conventional laparoscopy and abdominal approaches.

The treatment of endometrial cancer using a minimally invasive approach provides benefits to the patient; however, there are currently few papers comparing robotic total laparoscopic hysterectomy with staging to conventional laparoscopic and abdominal approaches. Analyses of 102 consecutive patients undergoing robotic total hysterectomy were compared to historical cohorts of 104 patients undergoing laparoscopic total hysterectomy and 78 patients undergoing abdominal total hysterectomy (laparotomy). The majority of all patients were FIGO'88 stage IB.

Pegfilgrastim dosing on same day as myelosuppressive chemotherapy for ovarian or primary peritoneal cancer.

According to the prescribing information, pegfilgrastim should not be administered within 14 days prior to, or within 24 hours after, the administration of cytotoxic chemotherapy. However, few data exist to support this recommendation. A single-institution retrospective review was conducted of all patients with ovarian or primary peritoneal cancer who received prophylactic pegfilgrastim on the same day as myelosuppressive chemotherapy from May 2003 to June 2006.

A case matched analysis of robotic radical hysterectomy with lymphadenectomy compared with laparoscopy and laparotomy.

Objective: To compare robotic radical hysterectomy to laparoscopic and radical abdominal hysterectomy in the treatment of cervical cancer.

Methods: Prospective analyses of thirty-two consecutive patients undergoing robotic radical hysterectomy were compared to 17 patients undergoing laparoscopic radical hysterectomy and 14 patients undergoing radical abdominal hysterectomy.

Results: Operative time for the robotic group was 2.

A phase I study of docetaxel as a radio-sensitizer for locally advanced squamous cell cervical cancer.

Objectives: This study was designed to determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of weekly docetaxel with concurrent radiotherapy (RT) for the primary treatment of locally advanced squamous cell carcinoma of the cervix.

Methods: Eligible patients included those with locally advanced squamous cell cervical cancer without para-aortic lymph node involvement. Docetaxel dose levels were 20 mg/m(2), 30 mg/m(2) and 40 mg/m(2) given intravenously weekly for 6 cycles.

Formation of functional neovagina with vertical rectus abdominis musculocutaneous (VRAM) flap after total pelvic exenteration.

Background: Pelvic exenteration may be the only curative option for women with recurrent pelvic malignancies. After total pelvic exenteration, the resultant perineal defect heals slowly if left to do so by secondary intention. Reconstruction with the vertical rectus abdominis musculocutaneous (VRAM) flap brings a generous bulk of healthy tissue into the defect, speeding recovery by facilitating primary healing.

Metastatic choriocarcinoma to the pancreas.

Gestational choriocarcinoma is a highly metastatic neoplasm derived from placental tissue, occurring in approximately 1:20,000 - 40,000 pregnancies. Although gestational choriocarcinoma may follow any gestational event, it most commonly follows molar pregnancies. We report a case of a 24-year-old Hispanic woman with persistent trophoblastic disease who, after failing to respond to chemotherapy, was found to have metastasis to the liver and pancreas.

Sigmoid impaction secondary to urinary stones: case report and review of literature.

Background: This is the first case report of a Miami pouch sigmoid fistula developing passage of urinary stones resulting in the presentation of constipation secondary to impaction.

Case Report: A 49-year-old woman who developed a recurrence of invasive squamous cell cervical carcinoma 1 year after pelvis radiation. She then underwent anterior pelvic exenteration and creation of a Miami pouch.

Conversion of an incontinent urinary conduit to a continent urinary reservoir (Miami Pouch).

Objective: External urinary or gastrointestinal appliances can impair a patient's quality of life. We report on the feasibility of converting an incontinent colonic urinary diversion to a continent urinary reservoir (Miami Pouch).

Case: We describe the case of a 66-year-old white female with a history of stage Ib(2) cervical cancer treated by radical abdominal hysterectomy and adjuvant radiation therapy.

Optimal surgical cytoreduction in patients with Stage III and Stage IV endometrial carcinoma: a study of morbidity and survival.

Objective: To evaluate the survival impact of residual disease at the time of primary surgery for patients with Stage III and IV endometrial carcinoma; to assess morbidity associated with surgical cytoreduction.

Method: All patients with endometrial carcinoma who underwent primary surgical therapy at the University of Miami between January 1, 1990 and June 1, 2002 were identified. Patients meeting FIGO criteria for Stage III or IV disease were selected.

Continent ileocolonic urinary reservoir (Miami pouch): the University of Miami experience over 15 years.

Objective: A patient with a recurrent central pelvic malignancy after radiation will require urinary diversion as part of the reconstructive phase of the pelvic exenteration. The aim of our study was to assess the result of our 15-year experience with a continent ileocolonic urinary reservoir, which is known as the Miami pouch.

Study Design: Since 1988, all patients who received a continent ileocolonic urinary reservoir in the Division of Gynecologic Oncology, University of Miami School of Medicine, were included in the study.

The safety of incidental appendectomy at the time of abdominal hysterectomy.

Objective: The purpose of this study was to assess the complication rates of incidental appendectomies in women who undergo benign gynecologic procedures.

Study Design: This was a retrospective case-controlled study of patients who did (n=100 women) or did not (n=100 women) undergo incidental appendectomies at the time of an abdominal hysterectomy between June 1995 and January 2001. Information was abstracted from hospital and clinic records and a gynecologic oncology database.

Papillary squamous cell carcinoma of the uterine cervix: an immunophenotypic appraisal of 12 cases.

Objective: The objective was to evaluate the role of human papillomavirus (HPV) in the pathogenesis of papillary squamous cell carcinoma (PSCC) of the cervix and to determine cell proliferative activity and p53 abnormalities in these rare variants of cervical cancer.

Methods: Twelve examples of PSCC of the cervix were diagnosed between 1990 and 1999. Formalin-fixed paraffin sections of each tumor were stained by immunoperoxidase method using antibodies to p53 gene product (CM-10) and Ki-67 (MIB-1).

Ovarian cancer in elderly women.

The incidence of ovarian carcinoma increases with advancing age, peaking during the 7th decade of life and remaining elevated until age 80 years. Despite the high prevalence of ovarian cancer in the elderly, the management of these patients is often less aggressive than that of their younger counterparts. As a result, many elderly cancer patients receive inadequate treatment.

Vaginal reconstruction at the time of pelvic exenteration: a surgical and psychosexual analysis of techniques.

Objectives: Vaginal reconstruction following pelvic exenteration is an important aspect of the physical and psychological rehabilitation of women after radical surgery for pelvic malignancies. The choice of techniques is vast, and proper patient and surgical selection is important for obtaining satisfactory functional and aesthetic results. The objective of this retrospective study is to review different techniques for vaginal reconstruction and report the complications and patient satisfaction associated with the different procedures.

Malignant peripheral nerve sheath tumor of the vulva: a multimodal treatment approach.

Background: Malignant peripheral nerve sheath tumors (MPNSTs) are rare in the gynecological population and have a high risk for local and distant failures. Multimodal management of a patient with MPNST of the vulva and review of the literature are outlined.

Case: A 34-year-old woman presented with a complaint of a rapidly increasing pelvic mass, pain, and difficulty ambulating.