The malignant transformation of endometriosis: Is there a left lateral predisposition of ovarian clear cell and endometrioid carcinomas?

INTRODUCTION: Endometriosis affects 10% of women of reproductive age. There is evidence for a left lateral predisposition of endometriotic lesions and a 1.9-fold greater risk of ovarian cancer in endometriosis. The aim of this study is to determine whether a left lateral predisposition of ovarian clear-cell carcinoma (CCC) and endometrioid carcinoma (EC) exists. MATERIALS AND METHODS: A retrospective cohort study of all EC and CCC patients in Northern Ireland between March-2011 and June-2018. ANOVA was used to analyse preoperative prediction of stage, chi-squared (χ2) was used to compare left- and right-sided masses. Survival was estimated using Kaplan-Meier and log-rank test. A p-value <0.05 was considered significant. RESULTS: 158 patients were identified (95 EC, 55 CCC, 8 mixed). Mean age was 57.65 years with 69% presenting at stage 1. The mean CA125 was 559 U/mL (p = 0.850) and mean abdominal mass size was 14.12 cm (p = 0.732). The most common presenting symptom was an abdominal mass (37%). Despite 67% of patients having endometriosis on final pathology, only 8.9% had a known history pre-operatively. 51% of tumours were located on the left (p = 0.036). For unilateral tumours this was significant for EC (P = 0.002) but not for CCC (P = 0.555). The 1-, 3- and 5-year overall survival for all types/stages was 85%, 78% and 71% respectively. CONCLUSION: While CCC and EC are associated with endometriosis, only EC exhibits a left lateral predisposition. There is no association between preoperative CA125 or abdominal mass size and stage of disease.

Population-Based Mini-Mental State Examination Norms in Adults of Mexican Heritage in the Cameron County Hispanic Cohort.

BACKGROUND: Accurately identifying cognitive changes in Mexican American (MA) adults using the Mini-Mental State Examination (MMSE) requires knowledge of population-based norms for the MMSE, a scale which has widespread use in research settings. OBJECTIVE: To describe the distribution of MMSE scores in a large cohort of MA adults, assess the impact of MMSE requirements on their clinical trial eligibility, and explore which factors are most strongly associated with their MMSE scores. METHODS: Visits between 2004-2021 in the Cameron County Hispanic Cohort were analyzed. Eligible participants were ≥18 years old and of Mexican descent. MMSE distributions before and after stratification by age and years of education (YOE) were assessed, as was the proportion of trial-aged (50-85- year-old) participants with MMSE <24, a minimum MMSE cutoff most frequently used in Alzheimer's disease (AD) clinical trials. As a secondary analysis, random forest models were constructed to estimate the relative association of the MMSE with potentially relevant variables. RESULTS: The mean age of the sample set (n = 3,404) was 44.4 (SD, 16.0) years old and 64.5% female. Median MMSE was 28 (IQR, 28-29). The percentage of trial-aged participants (n = 1,267) with MMSE <24 was 18.6% overall and 54.3% among the subset with 0-4 YOE (n = 230). The five variables most associated with the MMSE in the study sample were education, age, exercise, C-reactive protein, and anxiety. CONCLUSION: The minimum MMSE cutoffs in most phase III prodromal-to-mild AD trials would exclude a significant proportion of trial-aged participants in this MA cohort, including over half of those with 0-4 YOE.

Diazinon in surface waters before and after a federally-mandated ban.

Samples collected from rural and urban streams in the City of Denton, Texas, USA were analyzed for the organophosphorus pesticide diazinon during the years preceding and following a United States Environmental Protection Agency ban on many diazinon uses. A network of 70 monitoring stations, based mainly on topography and hydrological considerations, were established within the three main watersheds of Denton. Monitoring stations were sampled monthly from March through August during periods of normal flow (baseflow), resulting in a total of 1243 samples collected during the years of 2001-2004. Pesticide concentrations were determined using commercially available enzyme-linked immunosorbent assays (ELISAs) specific for diazinon. Results from this temporally and spatially dense monitoring effort illustrated the impacts of a decrease in diazinon production during 2002, followed by a ban on most outdoor, non-agricultural diazinon retail sales imposed during 2003. The total number of samples exhibiting diazinon concentrations above the lower limits of detection (LLD) significantly decreased between 2001 through 2004 (Mantel-Haenszel Chi-Square test, p<0.0001, n=1243) and decreased significantly during the four monitoring years (Cochran-Armitage Trend test, z=-17.94, p<0.0001, n=1243). The total number of stations exhibiting at least one sample above the LLD during the four monitoring years showed similar patterns (Mantel-Haenszel Chi-Square test, p<0.0001; Cochran-Armitage Trend test, z=-3.21, p=0.0007; n=276). Results indicate that the phased reduction of outdoor, non-agricultural diazinon uses led to a highly significant decrease in surface water occurrences of this pesticide.

Chlorpyrifos in surface waters before and after a federally mandated ban.

Samples collected from rural and urban streams in the City of Denton, Texas, USA were analyzed for the organophosphorus pesticides diazinon and chlorpyrifos during the years preceding and following a United States Environmental Protection Agency ban on many chlorpyrifos uses. A network of 70 monitoring stations, based mainly on topography and hydrological considerations, were established within the three main watersheds of Denton. Monitoring stations were sampled monthly from March through August during periods of normal flow (baseflow), resulting in a total of 308 samples and 311 samples collected during 2001 and 2002, respectively. Pesticide concentrations were determined using commercially available enzyme-linked immunosorbent assays (ELISA) specific for each pesticide. Results from this temporally and spatially dense monitoring effort were used to illustrate the impacts of a ban on most chlorpyrifos sales that was imposed in December 2001. The total number of samples exhibiting concentrations above method lower limits of detection (LLD) decreased between 2001 and 2002 for both chlorpyrifos and diazinon. The total number of sites exhibiting at least one sample with concentrations above the LLD for chlorpyrifos, however, significantly decreased (Fisher's exact test, p<<0.0001, n=70) when comparing 2001 (before the ban) with 2002 (after the ban). Similar analyses indicated no significant difference (Fisher's exact test, p=0.50, n=70) in the number of sites exhibiting detectable diazinon concentration between 2001 and 2002. Our results indicate that the cessation of retail chlorpyrifos sales at the end of 2001 resulted in a highly significant decrease in the surface water occurrences of this pesticide during 2002.