Tumor recurrence and tumor-related mortality in endometrial cancer: Analysis in 276 patients.

BACKGROUND: In this manuscript, we assessed tumor recurrence and tumor-related mortality in a clinical series of endometrial cancer patients. MATERIALS AND METHODS: A retrospective evaluation of 276 patients (mean age 64 years) with histologically confirmed endometrial cancer treated at a single hospital in Madrid (Spain) was conducted. The median follow-up was estimated using the inverse Kaplan-Meier method. RESULTS: Salient findings were endometrioid carcinoma (84.8% of cases), grade G1 (48.9%) and stages IB (35.1%) and IC (23.2%). Myometrial infiltration >50% was documented in 31.2% of cases and lymphovascular space invasion in 11.9%. After surgery, 52.5% of patients were classified into the low risk group, 21.4% into the intermediate risk group and 26.1% into the high risk group. Tumor recurrence occurred in 14.5% of patients, with an estimated median follow-up of 45 months (95% confidence interval (CI): 41.2-48.8), locoregional recurrence in 42.5% and distant recurrences in 57.5%. Furthermore, 40% of tumor recurrences developed during the first year after primary treatment and 90% over the first 3 years of follow-up. The tumor-related mortality rate was 15.9%. The estimated median follow-up was 46 months (95% CI: 43.0-49.0). Furthermore, 5.07% of death because of tumor developed during the first year after primary treatment and 13.77% over the first 3 years of follow-up. CONCLUSION: The rates of tumor-related death and tumor recurrence in endometrial cancer patients are low, with the highest percentages occurring within 3 years of primary treatment. Most of the recurrences occur outside the pelvis.

Histeroscopia en hiperplasia y cáncer de endometrio / Hysteroscopy in hyperplasia and endometrial cancer

La histeroscopia permite observar directamente el interior del útero, La hiperplasia endometrial definida como una proliferación de glándulas, de forma y tamaño irregular, no presenta patrón histeroscópico determinado para cada tipo de hiperplasia. Cuando valoramos eficacia y correlación del diagnostico clínico con el histológico, la eficacia diagnóstica para hiperplasia oscila entre el 56 y el 83%, La normalidad de imagen histeroscópica no excluye la posibilidad de patología. La sensibilidad es del 98% con una especificidad del 99.9% en determinados grupos especialmente entrenados, entre los que nos encontramos, en el adenocarcinoma endometrial hacen a la histeroscopia herramienta imprescindible. La afectación cervical es diagnosticada con una sensibilidad que oscila entre el 64-100%, especificidad 73-98%. El VPN es de 100% y un VPP entre el 38.4 y 93.3%. La histeroscopia es el método de elección en el diagnostico y manejo de la patología maligna endometrial, favoreciendo el hallazgo temprano y el estadiaje del cáncer endometrial. Precisa entrenamiento y aprendizaje para la obtención de su mejor rendimiento diagnostico. Con una elevada sensibilidad, especificidad

The hysteroscopy allows to observe the interior of the uterus directly. The endometrial hyperplasia defined as a proliferation of glands, of form and irregular size, it doesn’t present hysteroscopic patron certain for each hyperplasia type. When we value effectiveness and correlation of the diagnose clinical with the histology, the effectiveness diagnostic for hyperplasia oscillates between the 56 and 83%. The normality of image hysteroscopic doesn’t exclude the pathology possibility. The sensibility is of 98% with a specificity of 99.9% in certain specially trained groups, in those that we find ourselves , the carcinoma endometrial makes to the hysteroscopy indispensable tool. The cervical affectation is diagnosed with a sensibility that oscillates between 64-100%, specificity 73-98%. The VPN is of 100% and a VPP between the 38.4 and 93.3%. The hysteroscopy is the election method in the diagnose and manage of the pathology wicked endometrial, favoring the early discovery and the stage of the endometrial cancer. It is necessary a training and a learning for the obtainig of their best yield diagnose. With a high sensibility, specificity

[Effect of five fluoroquinolones on the bactericidal activity of human polymorphonuclear leukocytes against Staphylococcus aureus]. / Efecto de cinco fluoroquinolonas en la actividad bactericida de los leucocitos polimorfonucleares humanos contra Staphylococcus aureus.

It has been evaluated the effect of norfloxacin, ofloxacin, levofloxacin, fleroxacin and lomefloxacin of the respiratory burst of human polymorphonuclear leukocytes and their intracellular activity against Staphylococcus aureus. None of these agents significantly affected the superoxide and hydrogen peroxide radicals production by the polymorphonuclear leukocytes. All the quinolones except norfloxacin showed significant intracellular activity against S. aureus.

Effect of antimicrobial and antineoplastic drugs on the uptake of fluconazole by human neutrophils and tissue culture cells.

The effect of eight antimicrobial and three antineoplastic drugs on the uptake of fluconazole by human neutrophils and culture epithelial cells was evaluated. Fluconazole reached higher concentrations intracellularly than extracellularly (cellular to extracellular concentration ratio C/E > or = 1.3) in the presence of therapeutical concentrations of the antimicrobial and antineoplastic agents evaluated.

Uptake and intracellular activity of fluconazole in human polymorphonuclear leukocytes.

The penetration of fluconazole into human polymorphonuclear leukocytes (PMNs) and tissue culture epithelial cells (McCoy) was evaluated. At different extracellular concentrations (0.5 to 10 mg/liter), fluconazole reached cell-associated concentrations greater than the extracellular ones in either human PMNs (intracellular concentration to extracellular concentration ratio, > or = 2.2) or McCoy cells (intracellular concentration to extracellular concentration ratio, > or = 1.3). The uptake of fluconazole by PMNs was rapid and reversible but was not energy dependent. The intracellular penetration of fluconazole was not affected by environmental pH or temperature. Ingestion of opsonized zymosan and opsonized Candida albicans did not significantly increase the amount of PMN-associated fluconazole. At therapeutic extracellular concentrations, the intracellular activity of fluconazole against C. albicans in PMNs was significantly lower than that of amphotericin B. It was concluded that fluconazole reaches high intracellular concentrations within PMNs but shows moderate activity against intracellular C. albicans in vitro.