RESUMO
Accurate terminology to allow meaningful understanding of aetiology, diagnosis and management of vulval pain continues to evolve. The most recent classification has been endorsed by the International Society for the Study of Vulvovaginal Disease, and is discussed. In theory, we should replace 'vulvodynia' by 'aidoiodynia', as per this issue's associated Editorial.
Assuntos
Vulvodinia/diagnóstico , Feminino , Humanos , Terminologia como AssuntoRESUMO
Pakistan has one of the worst maternal mortality ratios worldwide: 260-490 women die for every 100,000 live births in Pakistan. The Pakistan Liaison Group (PLG) was formed to work with and through the international office of the Royal College of Obstetricians and Gynaecologists (RCOG). It works with the RCOG representative committee in Pakistan to improve the health of women. It aims to contribute to improving maternal morbidity and mortality through strategies directed at improving the education and training of health professionals. In addition, the PLG aims to promote changes in the legislature to allow for the notification of maternal deaths so that accurate figures can be obtained, and so that health parameters can be accurately assessed and, in the long term, a confidential enquiry into maternal deaths can be initiated.
Assuntos
Atestado de Óbito/legislação & jurisprudência , Atenção à Saúde/organização & administração , Educação Médica Continuada/organização & administração , Mortalidade Materna , Obstetrícia , Sociedades Médicas/organização & administração , Emergências , Feminino , Ginecologia , Humanos , Tocologia/educação , Paquistão , Médicos , Gravidez , Reino Unido/epidemiologiaRESUMO
PURPOSE: For patients with epithelial ovarian cancer (EOC) cytoreduction, with a combination of taxane and platinum, is the standard of care. Despite this, approximately 50% of patients with advanced disease will relapse and moreover 15-20% of cases of EOC are resistant to platinum based chemotherapy. Vascular Endothelial Growth Factor (VEGF), an angiogenic factor, is associated with poor prognosis. This study was undertaken to examine whether there is an association between VEGF-A expression in the tumour of EOC patients and their response to platinum based chemotherapy. METHODS: The study cohort consisted of 66 patients with advanced stage EOC (FIGO III-IV). Ovarian cancer tissue was analysed for VEGF-A expression immunohistochemically. Protein expression was measured and correlated, with platinum sensitivity and overall patient survival. RESULTS: Median age of patients was 53 years, 45 patients had platinum sensitive disease (68%), the remaining patients being platinum resistant (32%). Of the platinum resistant group, 18 (86%) patients had high VEGF score compared to only 1 (2%) with high VEGF score in the platinum sensitive group. Median survival was 11 months in the patient group with high VEGF score versus 32 months in that cohort with low VEGF score. VEGF expression was significantly inversely correlated with overall survival (P < 0.0001). CONCLUSION: We demonstrated that tumours of patients with platinum resistant EOC exhibit higher levels of VEGF expression compared to the platinum sensitive group. VEGF in EOC, may be of clinical and therapeutic relevance and suggests a role for first line anti-angiogenic therapy.
Assuntos
Neoplasias Epiteliais e Glandulares/tratamento farmacológico , Neoplasias Epiteliais e Glandulares/metabolismo , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/metabolismo , Platina/uso terapêutico , Fator A de Crescimento do Endotélio Vascular/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Epitelial do Ovário , Demografia , Feminino , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias Ovarianas/patologia , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVES: The aim of this study was to examine the prognostic significance of vascular endothelial growth factor (VEGF) in epithelial ovarian cancer (EOC). METHODS: Surgical specimens of 105 patients with primary EOC FIGO Stages 1 to 4, who underwent surgical staging, were investigated. Expression of VEGF was evaluated by immunohistochemical staining using related monoclonal antibodies. The correlation of this data with survival and established prognostic factors such as histological grade, FIGO stage and residual tumour status was evaluated. Multivariate analysis and correlation tests were performed. RESULTS: The results of VEGF expression were correlated with clinicopathological variables and overall survival. No correlation between the VEGF expression and clinicopathological factors was identified. However, VEGF expression was found to be significantly correlated to survival, and a prognostic factor independent of the stage of disease and residual tumour status (p < 0.0001). CONCLUSION: High intratumoral VEGF expression, a marker of angiogenesis, appeared to be an independent prognostic factor for overall survival in women with EOC. Angiogenic evaluation of patients with EOC may play a role in predicting a subgroup of patients with aggressive disease. These patients could be the target of front-line molecular targeted therapy with anti-angiogenic agents.
Assuntos
Carcinoma/metabolismo , Neovascularização Patológica/metabolismo , Neoplasias Ovarianas/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Adulto , Idoso de 80 Anos ou mais , Carcinoma/mortalidade , Carcinoma/patologia , Feminino , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neovascularização Patológica/mortalidade , Neovascularização Patológica/patologia , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/patologia , Ovário/metabolismo , Ovário/patologia , PrognósticoRESUMO
OBJECTIVE: To assess the natural history of cervical dysplasia during pregnancy and determine the rates for progression or regression post-partum by the severity of the lesion. METHOD: This was a retrospective study of 100 patients screened by PAP smear. Lesions were graded by colposcopy and biopsy, and followed post-partum. RESULTS: Lesions were graded as ASCUS, LGSIL, and HGSIL. The majority of lesions showed a tendency to regress post-partum (approximately 64%), a trend that was statistically significant (P < .003). A substantial minority (approximately 34%) showed no change in severity of the lesion. The tendency for lesions to progress in severity was very low (approximately 3%). No patient had microinvasive disease. Of patients who had CIS, persistence of this lesion post-partum was present in 67%. CONCLUSION: Patients with cervical dysplasia in pregnancy may be followed conservatively with colposcopy and biopsy.
Assuntos
Período Pós-Parto , Complicações Neoplásicas na Gravidez/patologia , Displasia do Colo do Útero/patologia , Neoplasias do Colo do Útero/patologia , Adolescente , Adulto , Biópsia , Colposcopia , Progressão da Doença , Feminino , Humanos , Teste de Papanicolaou , Gravidez , Remissão Espontânea , Estudos Retrospectivos , Esfregaço VaginalAssuntos
Ampicilina/uso terapêutico , Bronquite/tratamento farmacológico , Cloranfenicol/uso terapêutico , Doença Aguda , Idoso , Ampicilina/efeitos adversos , Bronquite/complicações , Cloranfenicol/efeitos adversos , Doença Crônica , Diarreia/induzido quimicamente , Toxidermias/etiologia , Humanos , Injeções Intramusculares , Náusea/induzido quimicamente , Supuração/tratamento farmacológico , Supuração/etiologia , Vômito/induzido quimicamenteAssuntos
Anti-Infecciosos/uso terapêutico , Bronquite/tratamento farmacológico , Antagonistas do Ácido Fólico/uso terapêutico , Pirimidinas/uso terapêutico , Sulfametoxazol/uso terapêutico , Tetraciclina/uso terapêutico , Doença Aguda , Bronquite/microbiologia , Doença Crônica , Ensaios Clínicos como Assunto , Humanos , Escarro/microbiologia , Trimetoprima/uso terapêuticoAssuntos
Resistência Microbiana a Medicamentos , Etambutol/uso terapêutico , Rifampina/uso terapêutico , Tuberculose Pulmonar/tratamento farmacológico , Adulto , Idoso , Antibacterianos/uso terapêutico , Antituberculosos/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/efeitos dos fármacosRESUMO
Experience in treating 81 patients with severe bronchial infection with Pseudomonas aeruginosa is described. For those who were desperately ill high doses of intravenous carbenicillin (18g. or more daily) were successful, even when initial carbenicillin resistance was present. For those who were less desperately ill lower doses of carbenicillin together with high doses of gentamicin (given both intramuscularly and by aerosol) comprised the treatment of choice. Gentamicin alone or colistin gave little or no benefit and cannot be recommended.