[Analgesia and renal insufficiency].

Chronic kidney disease (CKD) prevalence increases with population aging and makes drugs prescription more difficult. Only a few studies have reported drug dosing adjustment in CKD patients, even in the important field of pain management. We propose an algorithm based on the current literature that helps in selecting right analgesic according to the degree of renal failure.

[Laparoscopy in the management of endometrial cancer].

Recent advance in laparoscopy have changed the surgical approach of endometrial cancer patients. The Swissendos Center, Fribourg, in collaboration with AGO (Groupe de travail pour la gynécologie oncologique) and AGE (groupe de travail pour la gynécologie endoscopique) have established a consensus based on the available evidence for the use of laparoscopy in the management of patients with endometrial cancer The main objective was to define Swiss clinical practice guidelines appropriate to the country and consistent with the needs of the physicians.

Outcome of uterine clear cell carcinomas compared to endometrioid carcinomas and poorly-differentiated endometrioid carcinomas.

Objectives: Our aim was to compare the survival between patients with clear cell carcinoma (CC) and patients with endometrioid carcinoma (EC).

Methods: Through the population-based Geneva Cancer Registry, we identified 1,380 resident women diagnosed with uterine cancer between 1970 and 2000. We excluded those with papillary serous endometrial carcinoma and uterine sarcomas.

[What's new in gynecology and obstetrics?].

Among the improvements in gynecology reported in 2007, we highlight those in the field of cervical cancer. A randomized trial showed that HPV testing has higher sensitivity compared to the screening based on Papanicolaou smears. The recent availability of a HPV vaccine is also an important event.

[Proper usage of procalcitonin].

In the last fifteen years, procalcitonin measurement has been evaluated as a rapid diagnostic aid for suspected infection. Procalcitonin is now widely used in any febrile patient despite the lack of evidence supporting that practice. Indeed, procalcitonine has proven effective in the intensive care setting, as a diagnostic aid for septic shock, as a prognostic instrument and to tailor the duration of antibiotic treatment.

The attitude and knowledge of cervical cancer by Cameroonian women; a clinical survey conducted in Maroua, the capital of Far North Province of Cameroon.

This study was conducted to assess the knowledge, attitudes, and assumption of cervical cancer by women living in Maroua, the capital of the Far North Province of Cameroon. In a 1-month period, 171 women were surveyed as to their socioeconomic status, sexual habits, prior knowledge of cervical cancer, its prevention, and their attitudes toward cervical cancer. Of 171 women, 48 (28%) had prior knowledge of cervical cancer; they were classified as the "aware group" compared with 123 of 171 (72%) women who were uninformed about cervical cancer and they were classified as the "unaware group" (UG).

[Diagnosis and management of vulvar intraepithelial neoplasias and invasive vulvar cancers].

Objective: Update on the diagnosis and management of vulvar intraepithelial neoplasia (VIN) and vulvar carcinoma.

Method: Review of the literature.

Results: The classification of VIN is leaning towards the development of two distinct anatomoclinical models.

[What's new in gynecology in 2006?].

There were two good news in gynecologic oncology in 2006: intraperitoneal (IP) chemotherapy and the prophylactic vaccines for human papilloma virus (HPV). The ovarian cancer is usually limited to the peritoneal cavity and IP chemotherapy is associated with increased local concentrations. A benefit of this approach on survival was shown in three randomized trials and justifies the recommendation of this treatment for women with a Stage III ovarian cancer, after optimal surgery.

Are self-collected samples comparable to physician-collected cervical specimens for human papillomavirus DNA testing? A systematic review and meta-analysis.

Objective: To compare the detection rate of genital human papillomavirus (HPV) infection in self- and physician-obtained samples.

Design: Systematic review and meta-analysis.

Data Sources: Studies published between 1966 and November 2005 identified through Medline and Embase that compared both sampling methods.

Should intraperitoneal chemotherapy be considered as standard first-line treatment in advanced stage ovarian cancer?

Current standard therapy for patients with advanced stage epithelial ovarian cancer is cytoreductive surgery followed by combination chemotherapy with paclitaxel and carboplatin. Intraperitoneal (IP) chemotherapy has demonstrated improved outcome compared to standard intravenous treatment in three large randomized phase III trials and confirmed by Cochrane meta-analysis. Although compelling evidence suggests that IP therapy provides survival benefit in a selected group of ovarian cancer patients, it remains unclear which group of patients will really benefit from IP therapy, which is the optimal drug, dose and combination, and what is the real benefit of IP treatment alone.

Long-term survival of patients with apparent early-stage (FIGO I-II) epithelial ovarian cancer: a population-based study.

Background: Women with presumed early-stage epithelial ovarian cancer (EOC) who have not received comprehensive surgical staging are at risk for recurrence. The aim of our study was to analyze the overall long term survival of EOC patients with a presumed early stage EOC.

Methods: A population-based cancer registry was used to identify patients with an early-stage EOC cancer diagnosed between 1989 and 1997.

Expression of matrix metalloproteinase-2 and mutant p53 is increased in hydatidiform mole as compared with normal placenta.

Matrix metalloproteinases (MMPs) are group of enzymes thought to play an important role in trophoblastic and tumor invasion. The aim of our study was to investigate the trophoblastic expression of MMPs and p53 in normal trophoblast and hydatidiform moles (HM). Paraffin sections of 45 specimens, including 14 complete hydatidiform moles (CM), 15 partial hydatidiform moles (PM), 8 atypical partial hydatidiform moles (aPM), and 8 controls were selected.

[Cervical cancer screening: current status and perspectives].

Cervical cancer screening with Pap cytology has effectively reduced the incidence of morbidity and mortality from invasive cervical cancer. However, Pap cytology has important limitation and is not completely protective. Invasive cervical cancers are still diagnosed and main reasons are an insufficient coverage rate and presence of false-negative results.

Enhanced detection and typing of human papillomavirus (HPV) DNA in anogenital samples with PGMY primers and the Linear array HPV genotyping test.

The Roche PGMY primer-based research prototype line blot assay (PGMY-LB) is a convenient tool in epidemiological studies for the detection and typing of human papillomavirus (HPV) DNA. This assay has been optimized and is being commercialized as the Linear Array HPV genotyping test (LA-HPV). We assessed the agreement between LA-HPV and PGMY-LB for detection and typing of 37 HPV genotypes in 528 anogenital samples (236 anal, 146 physician-collected cervical, and 146 self-collected cervicovaginal swabs) obtained from human immunodeficiency virus-seropositive individuals (236 men and 146 women).

Women's health 18 years after rupture of the anal sphincter during childbirth: I. Fecal incontinence.

Objective: We studied the long-term outcome after an anal sphincter tear.

Study Design: From a cohort of 4569 women who gave birth in 1982 to 1983, we identified 445 (9.7%) who sustained a sphincter tear and 445 controls.