ABSTRACT
INTRODUCTION: Endometrial cancer (EC) known prognostic factors are not sufficient to predict either outcome or recurrence rate/site: to investigate EC recurrence patterns according to ESMO-ESGO-ESTRO risk classes, could be beneficial for a more tailored adjuvant treatment and follow-up schedule. METHODS: 758 women diagnosed with EC, and a 5-years follow-up, were enrolled: they were divided into the ESMO-ESGO-ESTRO risk classes (low LR, intermediate IR, intermediate-high I-HR, and highrisk HR) and surgically treated as recommended, followed by adjuvants therapies when appropriate. RESULTS: Higher recurrence rate (RR) was significantly detected (p < 0,001) in the HR group (40,3%) compared to LR (9,6%), IR (16,7%) and I-HR (17,1%). Recurrences were detected more frequently at distant sites (64%) compared to pelvic (25,3%) and lymph nodes (10,7%) recurrences (p < 0,0001): only in LR group, no differences were detected between local and distant recurrences. 5-Year distant-free (LR 99%, IR 94%,I-HR 86%, HR 88%) and local-free survivals (LR 99%, IR 100%,I-HR 98%, HR 95%) significantly differ between groups (p < 0,0001 and p = 0,003, respectively). Adjuvant therapy modifies RRs only in LR group (p = 0,01). CONCLUSION: To identify biological factors to stratify patients at higher risk of relapse is needed. Distant site relapse could be the main reason of endometrial cancer failure follow-up, independently or in addition to their risk class prognosis.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Endometrioid/therapy , Endometrial Neoplasms/therapy , Lymph Nodes/pathology , Neoplasm Metastasis , Neoplasm Recurrence, Local/epidemiology , Adenocarcinoma, Clear Cell/pathology , Adenocarcinoma, Clear Cell/therapy , Adult , Aged , Aged, 80 and over , Anthracyclines/administration & dosage , Brachytherapy , Carcinoma, Adenosquamous/pathology , Carcinoma, Adenosquamous/therapy , Carcinoma, Endometrioid/pathology , Chemoradiotherapy, Adjuvant , Disease-Free Survival , Endometrial Neoplasms/pathology , Female , Humans , Hysterectomy , Laparoscopy , Lymph Node Excision , Lymphatic Metastasis , Middle Aged , Neoplasm Invasiveness , Neoplasms, Cystic, Mucinous, and Serous/pathology , Neoplasms, Cystic, Mucinous, and Serous/therapy , Omentum , Peritoneal Lavage , Platinum Compounds/administration & dosage , Radiotherapy, Adjuvant , Retrospective Studies , Risk Assessment , Robotic Surgical Procedures , Salpingo-oophorectomy , Taxoids/administration & dosageABSTRACT
INTRODUCTION: Shoulder pain in spinal cord injury (SCI) is common due to the repetition of the wheelchair propulsion and the increased intra-articular pressure during transfers. Known risk factors for the onset of shoulder pain are age and level of SCI. Aims of this study were to assess how body mass index affects the onset of shoulder pain and to evaluate the relationship between the age at the moment of SCI and the number of years between SCI and the onset of shoulder pain. METHODS: A retrospective study was performed including subjects with SCI between C5 and S3. Excluding criteria were spina bifida and subjects not using manual wheelchair or presenting with shoulder pain before SCI. Patients in the two spinal cord units were reviewed with a self-made questionnaire, and patients were also enrolled during sport events. Age at the moment of SCI, current age and number of years between SCI and the onset of shoulder pain were recorded. RESULTS: Ninety-six patients were enrolled: 77 men and 19 women; 46.4 % reported shoulder pain. Overweight patients who do more than 12 transfers per day showed an increased incidence of shoulder pain (p = 0.0434). A linear regression showed a significant relationship between the age of the subject at the moment of SCI and the number of years between the SCI and the onset of pain. CONCLUSION: Our study confirms that age and level of SCI are risk factors for shoulder pain, but we demonstrated also that overweight patients who do more than 12 transfers per day have higher chances of having shoulder pain.
Subject(s)
Body Mass Index , Shoulder Pain/etiology , Spinal Cord Injuries/complications , Wheelchairs/adverse effects , Adult , Age Factors , Athletes , Cumulative Trauma Disorders/complications , Female , Humans , Male , Middle Aged , Overweight/complications , Retrospective Studies , Risk Factors , Sports , Surveys and QuestionnairesABSTRACT
In a young woman with rheumatoid arthritis misoprostol induced urinary incontinence. The urodynamic study described here revealed a deficiency in urethral resistance which may explain the phenomenon. This side-effect may be more common than expected, and misoprostol should be administered with caution to patients suffering from urinary stress incontinence.
Subject(s)
Misoprostol/adverse effects , Urinary Incontinence, Stress/chemically induced , Adult , Female , Humans , UrodynamicsABSTRACT
Twenty patients (2 males, 18 females, age range 33-69, average 55.85 years) with diagnoses of variously localized osteoarthritis (18 cases) or acute joint pain (2 cases) were studied. All patients were given one 1-g tablet of nabumetone every evening before going to bed, for 8 days. In three cases treatment was withdrawn immediately after the first dose due to the onset of allergic (2 cases) or dyspeptic (1 case) symptoms. Initially, all patients complained of considerable pain, both at rest and during active and passive movements with correlated functional limitation of the joints involved. Treatment resulted in considerable subsidence of symptoms from the very first days of therapy. Statistical calculation of the score showed significant improvement. Parameters of tolerability did not show significant changes from baseline. Local tolerability was generally good. The fact of the single daily dose has certainly contributed to the patients' good compliance.
