The number of gynecological cancer survivors has grown significantly in recent decades, especially among those diagnosed with an early disease. We recommend screening all gynecological cancer survivors for sexual dysfunction and offer therapeutic suggestions to interested patients.
CONCLUSION
Vulvar cancer is the fourth most common gynecological cancer, with approximately 5000 women expected to be diagnosed in 2015[106]. As vulvar cancer has increased among younger women who often have less advanced disease, a trend toward less radical surgery has emerged.
Associations between exercise, body weight, and quality of life in a population-based sample of endometrial cancer survivors. Impact of BMI on quality of life in obese endometrial cancer survivors: does size matter.
Abstract
REVIEW
Cancer stem cells and early stage basal-like breast cancer
The recent identification and characterization of cancer stem-like cells in BL-DCIS advance the understanding of BL-DCIS and their potential role in driving the progression of BL-DCIS to basal-like invasive breast cancer. These findings provide critical implications for the development of therapies that prevent the progression of BL-DCIS.
INTRODUCTION
These basal-like DCIS (BL-DCIS) tumors are assumed to be precursors to basal-like IDC (BL-IDC)[39,44]. This review summarizes the recent investigation of the characteristics of BL-DCIS and the possible precursor relationship between BL-DCIS and invasive basal-like carcinoma of the breast.
EXISTENCE AND FEATURES OF BASAL- LIKE-DCIS
This article will review recent developments in these topics and their translational implications for the prognosis and prevention of BL-DCIS progression to invasive basal-like breast cancer. One plausible explanation for the slightly higher frequency of basal-like expression in high-grade invasive versus in situ tumors is that BL-DCIS lesions progress rapidly, leading to the lower identifiable frequency, or that the basal-like phenotype is acquired during invasive tumors. progression.
CSCS AND BASAL-LIKE-DCIS
According to studies by Tamimi et al[42], the frequency (7.7%) of BL-DCIS in diagnosed DCIS cases is slightly lower than (10.7%) of BL-IDC in diagnosed invasive breast cancer cases. Given that p63 alone and p63/Her2/neu co-expression are both associated with microinvasion and relapse of clinical comedo-DCIS, the p63/Her2/neu-expressing precursor intermediate is considered a cellular basis for the emergence of p63+ /Her2/ neu- or p63+/Her2/.
DEREGULATED FACTORS INVOLVED IN THE GENERATION OF CSCS AND THE
Furthermore, restoration of miR-140 expression in MCF10DCIS.COM cells suppressed CSC self-renewal, invasion and tumorigenicity in vivo[ 78 ]. To address the role of SIM2s in DCIS-to-IDC transition, Scribner et al[ 87 ] analyzed the expression of SIM2s in MCF10DCIS.COM and found that it is upregulated in this DCIS cell model when compared to non-cancerous MCF10A cells .
THE IMPACTS OF THE TISSUE
To address the role of lipogenesis in DCIS CSCs, Pandey et al [61] used the cell surface marker profile (CD44+/ESA+/CD24-) to isolate CSCs from the MCF10DCIS.COM cell line for expression analysis of lipogenic genes. To further investigate the role of sterol regulatory element-binding protein-1 (SREBP1), the major transcriptional activator of lipogenic genes, in CSCs, SREBP1 was ectopically overexpressed in MCF10A stem-like cells.
MICROENVIRONMENT ON CSCS OF BL- DCIS
By studying the effect of ECM on an immortalized basal-like mammary epithelial cell line, Wang et al[104] identified the ECM-dependent TGFBR3 (transforming growth factor β receptor 3)-JUND (jun D proto-oncogene)-KRT5 (keratin 5) regulatory circuitry that generates heterogeneous gene expression among ECM-associated mammary cells. Disruption of this regulatory circuit in mammary epithelial cells can lead to the formation of aberrant tissue lesions similar to high-grade DCIS[104].
THE IMPLICATIONS OF CSCS IN PROGNOSIS AND PREVENTION OF
Ductal carcinoma in situ with basal-like phenotype: a possible precursor of invasive basal-like breast cancer. Ductal carcinoma in situ associated with triple negative invasive breast cancer: evidence for a precursor-product relationship.
Risks and guidelines for the consumption of alcohol during pregnancy
Daily average alcohol intake during pregnancy has been consistently associated with short-term adverse outcomes such as miscarriage, preterm birth and intrauterine growth restriction, a wide variety of malformations, as well as long-term adverse outcomes. During American Prohibition in the 1920s and 1930s, alcohol was less readily available, and after Prohibition, the potentially harmful effects of alcohol consumption during pregnancy were hardly an issue.
THE DAMAGING EFFECTS OF ALCOHOL DURING PREGNANCY - WHAT IS THE
At lower levels of intake, intake of ≥ 3 drinks/day on average was associated with craniofacial and genitourinary malformations [40, 41], and intake of ≥ 1-2 drinks/day on average was associated with musculoskeletal and genital malformations and inguinal hernias [40,42]. A single study found an increased risk of cryptorchidism among boys or women who reported an intake of ≥ 5 drinks/week on average, with increased risk up to ≥ 9 drinks/week on average [43].
BINGE DRINKING INDEPENDENTLY OF HIGH DAILY AVERAGE INTAKE
A recent study on behavior not included in the meta-analysis showed no effect of average weekly alcohol intake on behavior in 5-year-old children[62]. In conclusion, average daily alcohol intake during pregnancy has been associated with intrauterine growth restriction, preterm birth, fetal death throughout pregnancy, malformations, poor neurocognitive development and may cause deficits in psychomotor function, attention, memory, executive function, intelligence, behavior and learning.
RECOMMENDATIONS
A systematic review of the effects of alcohol abuse suggested that prenatal drinking may be associated with impaired neurodevelopment [68]. Based on five studies with different definitions of binge drinking, another systematic review concluded that the issue of whether prenatal alcohol binge drinking might be associated with motor dysfunction in children was uncertain [59].
OFFICIAL RECOMMENDATIONS
These questions were updated in a recent meta-analysis including nine outcomes (visual and motor function, attention, memory, executive function, cognition, behavior, language and verbal, academic reading achievement and academic mathematics achievement)[60]: When including all eligible studies regardless of quality , a significant detrimental association was observed between binge drinking and children's cognition (Cohen's d -0.13; 95% CI. In conclusion, prenatal alcohol binge drinking, independent of high average daily intake, does not appear to be systematically associated with short- or long-term adverse outcomes to a clinically relevant degree.
ACTUAL RECOMMENDATIONS FROM HEALTH PROFESSIONALS
Two subsequent studies not included in the above systematic review[68] showed no association between binge drinking and cryptorchidism[43] or between the number or timing of binge episodes and congenital heart defects, particularly atrial and ventricular septal defects [70]. The fact that many doctors do not provide information to pregnant women in accordance with official recommendations seems to be consistent with the attitudes of many doctors.
ARGUMENTS FOR AND AGAINST DIFFERENT RECOMMENDATIONS
American gynecologists have been shown not to consider an average consumption of 4-5 drinks/week to be harmful[82], and only 51% of Danish GPs believed that pregnant women should completely abstain from alcohol[81]. Danish midwives have reported attitudes and informative practices comparable to GPs: Thus, in 2009, only 46% recommended abstinence, even though more than 90% knew the official abstinence recommendation and only 48% believed they were pregnant.
ALCOHOL DRINKING AMONG PREGNANT WOMEN
A large, prospective cohort study from the same period showed that only 27% of pregnant women in Denmark reported binge eating in early pregnancy[97], but the participation rate was lower, approximately 30%[97,98]. While the former study used in-person interviews, the latter used telephone interviews, but the questions about binge drinking were essentially identical.
CHARACTERISTICS OF ALCOHOL DRINKERS DURING PREGNANCY
Interestingly, while 25% in Denmark reported consuming 2 or more drinks on a single occasion in the 2nd trimester in the late 1990s[86], none did so in Sweden[88]. For example, the above study showing that almost 70% of pregnant women drink alcohol during pregnancy and that 50% binge drink in early pregnancy was based on a sample of 92% of eligible pregnant women[86].
ATTITUDES AND COMPLIANCE WITH OFFICIAL RECOMMENDATIONS
Interestingly, it is difficult to find new up-to-date information on the prevalence of alcohol consumption. Most Danish women had received information about alcohol from mass media or relatives, but most women believed that information about alcohol during pregnancy could best be conveyed to them by health professionals[102].
THE ROLE OF RANDOM ERROR AND BIAS
One third had discussed alcohol with their GP or midwife, but these women were mostly advised that some alcohol was acceptable [102].
DISCUSSION
Moderate alcohol intake during pregnancy and the risk of stillbirth and death in the first year of life. Maternal alcohol use during pregnancy and physical outcomes up to age 5 years: a longitudinal study.
MINIREVIEWS
Advantages of laparoscopic surgery include shorter hospital stays, lower rates of wound infection and reduced bowel function time. This brief review highlights studies comparing laparoscopic surgery with the open approach in common clinical scenarios.
Laparoscopic surgery in pregnancy
The advantages of laparoscopic surgery include reduced length of stay, lower rates of wound infection and ventral hernia also apply to pregnant patients. This review article will evaluate the benefits and use of laparoscopic surgery in pregnancy compared to contemporary approaches.
RESEARCH
The physical examination of a pregnant woman changes with gestational age and the usual work-up of a surgical abdomen using laboratory tests and imaging is also of limited value given the physical and chemical changes that occur during pregnancy [2]. To understand and avoid the concerns and risks of laparoscopic surgery during pregnancy, one must be familiar with the difference in physiology and anatomy in a pregnant patient.
DIFFERENCES IN ANATOMY AND PHYSIOLOGY
LAPAROSCOPIC SURGERY IN PREGNANCY
Several retrospective studies consistently demonstrated the safety of using the laparoscopic approach with very low rates of preterm birth and, in most series, no reports of fetal death[16]. based series evaluated laparoscopic vs open approach for pregnant patients with suspected acute appendicitis, where the authors concluded that laparoscopy is a safe, feasible and effective approach for pregnant women[25]. launched in 2008 using 27 studies that examined 637 women undergoing laparoscopic appendectomy and 4193 women undergoing open appendectomy. A population-based study published in 2007 by McGory et al.[27] retrospectively reviewed all cases of women who underwent appendectomy between the years 1995 and 2002.
CHOLECYSTECTOMY
Another meta-analysis published in 2012 by Wilasrusmee et al [28] evaluated eleven studies comparing laparoscopic and open appendectomy in pregnancy from January 1990 to July 2011. In a weighted and pooled analysis, fetal loss was significantly worse in of those who underwent laparoscopy compared with open appendectomy (pooled RR = 1.91).
COMMON SURGICAL PROCEDURES IN SURGERY
Studies comparing conservative and surgical treatment of biliary disease show that up to 50% of patients treated conservatively will have recurrent symptoms, compared with approximately 10% in the surgically treated group. Considering that up to 60% of cases of gallstone pancreatitis in pregnant patients result in fetal death, it is generally agreed that surgery should be performed.
ADNEXAL DISEASE
Reviewer: Shimi SM, Sonoda K, Tsikouras PPT, Zafrakas M, Zhang XQ
Women with persistent urinary incontinence usually complain of continuous urine leakage and recurrent fistulas require exclusion. Causes of persistent urinary incontinence after fistula closure include urodynamic stress incontinence, detrusor overactivity (DO), and voiding dysfunction.
Urinary incontinence following obstetric fistula repair
Basic advice: About a quarter of women suffer from residual urinary incontinence after surgical closure of genito-urinary fistula. Despite anatomical closure of the genito-urinary fistula, persistent urinary incontinence may persist.
OBSTETRIC FISTULA - DEMOGRAPHICS
COMPLICATIONS FOLLOWING OBSTETRIC FISTULA
URINARY INCONTINENCE FOLLOWING SUCCESSFUL CLOSURE OF OBSTETRIC
There is no association between the duration of the obstetric fistula before closure and the risk of urinary incontinence[12]. In 2002, Murray et al [13] published the first known article on urodynamic studies of obstetric fistulas in a low-income country.
MANAGEMENT OF POST-FISTULA URINARY INCONTINENCE
Predicting the risk of failure of obstetric fistula closure and residual urinary incontinence using a classification system. Krause et al[22] described the use of periurethral polyacrylamide hydrogel for a small group of women with post-fistula stress urinary incontinence.
Gynecologic oncologists involvement on ovarian cancer standard of care receipt and survival
Sun Hee Rim, Cheryll C Thomas, Trevor D Thompson, Sherri L Stewart, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States. Supported by the United States Federal Government, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Observational Study
Institutional Review Board Statement: The study was reviewed and approved by the Institutional Review Board of the Centers for Disease Control and Prevention through an expedited review process in accordance with standard procedures. Correspondence to: Sun Hee Rim, Epidemiologist, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, CDC 4770 Buford Hwy NE MS F-76, Atlanta, GA 30341, United States.
ORIGINAL ARTICLE
CONCLUSION: A survival benefit associated with receiving surgical SOC and overall treatment by a GO is supported. Key Tip: A significant survival benefit is associated with receiving surgical standard of care (SOC), but still some women had lower odds of receiving surgical SOC.
MATERIALS AND METHODS
Women who received surgery from a GO vs non-GO had 2.35 times the odds of receiving the surgical SOC and 1.25 times the odds of receiving chemotherapeutic SOC (P . < 0.01). Comparisons of the distribution of OC patients receiving the SOC by physician specialty were examined using the Pearson χ2 test.
RESULTS
The median survival time for women who received total SOC was 52 months compared with 38 months for women who did not receive total surgical and chemotherapy SOC (Figure 2). The median survival time was 14 months longer for women who received total SOC compared with women who did not receive total SOC.
ACKNOWLEDGMENTS
Our definition of chemotherapy SOC may have been too strict and potentially introduce selection or survival bias. The receipt of surgical standards was associated with better survival outcomes, even after adjustment for provider specialty.
COMMENTS
Differences in utilization of gynecologic oncologists for women with ovarian cancer in the United States. High-volume ovarian cancer care: impact on survival and disparities in access for advanced-stage disease.
Single incision slings: Are they ready for real life?
In the paper by Mostafa et al[9], this was assessed using the patient global impression of improvement (PGI-I) questionnaire. In the prospective study by Mostafa et al[13], the authors assessed post-operative urgency in a group of pure SUI and mixed incontinence patients, using the urgency perception scale (UPS).
