The treatment of early stage cervical cancer: an assessment of pre-operative factors

OBJECTIVE: To assess the pre-operative clinical factors of a group of early stage cervical cancer patients and correlate them to the risk for adjuvant radiotherapy using GOG 92 and 109 criteria. METHOD: A retrospective chart review of cervical cancer patients treated at the Saint Louis University Division of Gynecologic Oncology between the years 1989 and 2004 was performed. The results were compared with chi-squared testing and multivariable regression analysis. A p-value of 0.05 was considered significant. RESULTS: One hundred and thirty-one cervical cancer patients underwent exploration for radical hysterectomy during the study time period. Five patients had stage IA1 disease, 6 patients had stage IA2 disease, 98 patients had stage IB1 disease, 20 patients had stage IB2 disease and one patient had stage IIA disease. No patient with stage IA1 or IA2 disease met criteria for adjuvant radiotherapy. The patients with stage IB1 tumors who were 45 years of age or younger and had tumors up to 2 cm in diameter had a low (14%) likelihood for treatment with adjuvant radiotherapy. The patients with stage IB1 tumors who were older than 45 years of age with tumors larger than 2 cm in diameter and the patients with stage IB2 tumors both had a high likelihood for adjuvant radiotherapy (77% and 90% respectively). CONCLUSION: In our study group, the stage of cervical cancer and a combination of tumor diameter and patient age was found to stratify early stage cervical cancer patients by likelihood for adjuvant radiotherapy.     

Results of the national survey of borderline ovarian tumors in Spain

MATERIAL AND METHODS: Retrospective multi-center analysis of women diagnosed with borderline ovarian tumor and treated between January 1990 and December 1997. A national survey was conducted, in which 457 patients from 27 centers corresponding to ten of Spain's autonomous communities were analyzed. RESULTS: Four hundred fifty-seven women with borderline ovarian tumor were analyzed. The mean age of patients was 45.5+/-16.9 years. Of these, 390 patients (85.3%) were at stage I, 8 (1.8%) were at stage II and 36 (7.9%) at stage III. A bilateral tumor was observed in 63 women (13.8%). The mean tumor size was 14.2 cm and in 88 cases (19.3%) the tumor was on the surface of the ovary. Microinvasion was observed in 25 (5.5%) cases, and 29 women (6.3%) showed a micropapillary pattern. Study of the factors related to the appearance of peritoneal implants revealed positive tumor markers (OR 15.02: 1.9-32.9) and a tumor on the ovarian surface (OR 8.0: 1.8-127) to be independent risk factors. With respect to recurrence, the presence of peritoneal implants at the time of initial surgery (OR 3.4: 1.1-10.4) and signs of microinvasion in the anatomicopathological study (OR 5.5: 1.5-17.8) were found to be independent risk factors. The overall survival rate in our series was 97% with a mean follow-up of 88.3 months. The survival rate by stage was 97% for stage I, 100% for stage II and 97% for stage III. CONCLUSIONS: Although borderline ovarian tumors have an excellent prognosis, they are not exempt from a risk of recurrence. Characterization of patients with borderline ovarian tumor is essential in order to prevent their evolution. Likewise, the taking on board of risk factors will enable more selective treatments to be offered in each case.     

Inspecting the Ribozyme Region of Hepatitis Delta Virus Genotype 1: Conservation and Variability

The hepatitis delta virus (HDV) genome has an autocatalytic region called the ribozyme, which is essential for viral replication. The aim of this study was to use next-generation sequencing (NGS) to analyze the ribozyme quasispecies (QS) in order to study its evolution and identify highly conserved regions potentially suitable for a gene-silencing strategy. HDV RNA was extracted from 2 longitudinal samples of chronic HDV patients and the ribozyme (nucleotide, nt 688–771) was analyzed using NGS. QS conservation, variability and genetic distance were analyzed. Mutations were identified by aligning sequences with their specific genotype consensus. The main relevant mutations were tested in vitro. The ribozyme was conserved overall, with a hyper-conserved region between nt 715–745. No difference in QS was observed over time. The most variable region was between nt 739–769. Thirteen mutations were observed, with three showing a higher frequency: T23C, T69C and C64 deletion. This last strongly reduced HDV replication by more than 1 log in vitro. HDV Ribozyme QS was generally highly conserved and was maintained during follow-up. The most conserved portion may be a valuable target for a gene-silencing strategy. The presence of the C64 deletion may strongly impair viral replication, as it is a potential mechanism of viral persistence.     

Face Mask Wastes as Cementitious Materials: A Possible Solution to a Big Concern

After more than two years wearing surgical masks due to the COVID-19 pandemic, used masks have become a significant risk for ecosystems, as they are producing wastes in huge amounts. They are a potential source of disturbance by themselves and as microplastic contamination in the water system. As 5500 tons of face masks are estimated to be used each year, there is an urgent need to manage them according to the circular economy principles and avoid their inadequate disposal. In this paper, surgical wear masks (WM), without any further pretreatment, have been introduced as addition to mortars up to 5% in the weight of cement. Mechanical and microstructural characterization have been carried out. The results indicate that adding MW to the cement supposes a decrease in the properties of the material, concerning both strength and durability behavior. However, even adding a 5% of WM in weight of cement, the aspect of the mortars is quite good, the flexural strength is not significantly affected, and the strength and durability parameters are maintained at levels that—even lower than the reference—are quite reasonable for use. Provided that the worldwide production of cement is around 4.1 Bt/year, the introduction of a 5% of WM in less than 1% of the cement produced, would make it possible to get rid of the mask waste being produced.     

Increase in Hepatitis A Cases Linked to Imported Strains to Rio de Janeiro,Brazil: A Cross-Sectional Study

This study aims to evaluate the epidemiological and molecular features associated with HAV transmission in adults in Rio de Janeiro during a period of increased registered cases of HAV (2017–2018). Socio-epidemiological data and serum samples from anti-HAV IgM+ individuals were obtained. HAV RNA was RT-PCR amplified and sequenced for further phylogenetic and phylogeographic analyses. From fifty-two HAV IgM+ individuals, most were men (78.85%; p = 0.024), aged 20–30 years old (84.61%; p < 0.001), resided in the Rio de Janeiro north zone (31/52; 59.62%; p = 0.001), and are men who have sex with men (MSM) (57.69%; p = 0.002). Sexual practices were more frequent (96%) than others risk factors (food-borne (44%), water-borne (42.31%), and parenteral (34.62%)). Individuals who traveled to endemic regions had a 7.19-fold (1.93–36.04; p < 0.01) increased risk of HAV. Phylogenetic analysis revealed four distinct clades of subgenotype IA, three of them comprised sequences from European/Asian MSM outbreaks and one from Brazilian endemic strains. Bayesian Inference showed that the imported strains were introduced to Brazil during large mass sportive events. Sexual orientation and sexual practices may play a role in acquiring HAV infection. Public policies targeting key populations must be implemented to prevent further dissemination of HAV and other STIs.     

Effect of atropine sulfate in pulmonary hypertrophic osteoarthropathy

A 49-year-old patient with pulmonary hypertrophic osteoarthropathy was treated with 0.4 mg of atropine sulfate every 4 hours for 14 days. A good clinical response was obtained as measured by handgrip strength, range of motion, and quantitative thermography. Chemical vagotomy supports the hypothesis of the vagal reflex as the pathophysiological mechanism in pulmonary hypertrophic osteoarthropathy.