Highlights • Increased expression of ABC transporters is one cause of chemoresistance. • This review summarises the roles of all 48 ABC transporters in ovarian cancer. • Current list of chemotherapy ...drugs transported by ABC transporters. • Summary of ABC transporter inhibitors and studies/trials assessing therapeutic benefit. • A better understanding of their function will lead to more effective therapies.
Modern multimodality cancer treatment has led to a rise in cancer survivors, and by 2030 the survival rate is estimated to increase by 31.4%. This is an impressive survival statistic on which ...clinicians and services continue to build. One of the less well-acknowledged consequences of survivorship among health professionals and patients alike is female sexual dysfunction, despite it occurring in more than 60% of women diagnosed with cancer. The systematic assessment and management of late effects from cancer lack integration within current models of oncology follow-up. Although highly prevalent, issues linked to sexual health are often not addressed among survivors. This overview aims to focus on the sexual impact of gynaecological cancer treatment. Clinicians should raise the topic of the sexual consequences of cancer treatment as a legitimate aspect of survivorship and service provision. Increased focus on the sexual consequences of treatment and cancer survivorship may in time lead to greater clinical recognition, service development and, most importantly, increase research focused on the effective management of what remains a neglected aspect of cancer care.
Although endometrial cancer (EC) is associated with relatively good survival rates overall, women diagnosed with high-risk subtypes have poor outcomes. We examined the relationship between lifestyle ...factors and subsequent all-cause, cancer-specific and non-cancer related survival.
In a cohort of 1359 Australian women diagnosed with incident EC between 2005 and 2007 pre-diagnostic information was collected by interview at recruitment. Clinical and survival information was abstracted from women's medical records, supplemented by linkage to the Australian National Death Index. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific survival (EC death vs. non-EC death) associated with each exposure, overall and by risk group (low-grade endometrioid vs. high-grade endometrioid and non-endometrioid).
After a median follow-up of 7.1 years, 179 (13%) women had died, with 123 (69%) deaths from EC. As expected, elevated body mass index (BMI), diabetes and the presence of other co-morbidities were associated with a significantly increased risk of all-cause and non-cancer related death. Women with diabetes had higher cancer-specific mortality rates (HR 2.09, 95% CI 1.31–3.35), particularly those who had were not obese (HR 4.13, 95% CI 2.20–7.76). The presence of ≥2 other co-morbidities (excluding diabetes) was also associated with increased risk of cancer-specific mortality (HR 3.09, 95% CI 1.21–7.89). The patterns were generally similar for women with low-grade and high-grade endometrioid/non-endometrioid EC.
Our findings demonstrate the importance of diabetes, other co-morbidities and obesity as negative predictors of mortality among women with EC but that the risks differ for cancer-specific and non-cancer related mortality.
•Diabetes and co-morbidity were associated with higher EC-specific mortality.•Diabetes and obesity have a negative impact on non-cancer related mortality.•Understanding the impact of these factors can help inform women and clinicians.
Abstract Aim Obesity is an established risk factor for endometrial cancer. Associations tend to be stronger for the endometrioid subtype. The role of adult weight change and weight cycling is ...uncertain. Our study aimed to determine whether there is an association between different adult weight trajectories, weight cycling and risk of endometrial cancer overall, and by subtype. Methods We analysed data from the Australian National Endometrial Cancer study, a population-based case–control study that collected self-reported information on height, weight at three time points (age 20, maximum and 1 year prior to diagnosis recent), intentional weight loss/regain (weight cycling) from 1398 women with endometrial cancer and 1538 controls. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression analysis. Results Relative to women who maintained a stable weight during adulthood, greater weight gain after the age of 20 was associated with increased risk of endometrial cancer (OR for gain 40+kg all subtypes 5.3, 95% CI 3.9–7.3; endometrioid 6.5, 95% CI 4.7–9.0). The strongest associations were observed among women who were continually overweight from the age of 20 (all subtypes OR 3.6, 95% CI 2.6–5.0). Weight cycling was associated with increased risk, particularly among women who had ever been obese (OR 2.9 95% CI 1.8–4.7), with ∼3-fold risks seen for both endometrioid and non-endometrioid tumour subtypes. Women who had intentionally lost weight and maintained that weight loss were not at increased risk. Conclusion These results suggest that higher adult weight gain, and perhaps weight cycling, independently increase the risk of endometrial cancer, however women who lost weight and kept that weight off were not at increased risk.
Cytoreductive surgery and chemotherapy continue to be the mainstay of ovarian cancer treatment. However, as mortality from advanced ovarian cancer remains very high, novel therapies are required to ...be integrated into existing treatment regimens. Immunotherapy represents an alternative and rational therapeutic approach for ovarian cancer based on a body of evidence supporting a protective role of the immune system against these cancers, and on the clinical success of immunotherapy in other malignancies. Whether or not immunotherapy will have a role in the future management of ovarian cancer is too early to tell, but research in this field is active. This review will discuss recent clinical developments of selected immunotherapies for ovarian cancer which fulfil the following criteria: (i) they are antibody-based, (ii) target a distinct immunological pathway, and (iii) have reached the clinical trial stage. Specifically, the focus is on Catumaxomab (anti-EpCAM × anti-CD3), Abagovomab, Oregovomab (anti-CA125), Daclizumab (anti-CD25), Ipilimumab (anti-CTLA-4), and MXD-1105 (anti-PD-L1). Catumaxomab has reached phase III clinical trials and exhibits promise with reports, showing that it can cause a significant and sustained reduction in ascites. Phase I–III clinical trials continue to be conducted on the other antibodies, some of which have had encouraging reports. We will also provide our perspective on the future of immunotherapy for ovarian cancer, and how it may be best employed in treatment regimens.
Wear phenomena in worm gears are dependent on the size of the gears. Whereas larger gears are mainly affected by fatigue wear, abrasive wear is predominant in smaller gears. In this context ...a simulation model for abrasive wear of worm gears was developed, which is based on an energetic wear equation. This approach associates wear with solid friction energy occurring in the tooth contact. The physically-based wear simulation model includes a tooth contact analysis and tribological calculation to determine the local solid tooth friction and wear. The calculation is iterated with the modified tooth flank geometry of the worn worm wheel, in order to consider the influence of wear on the tooth contact. Experimental results on worm gears are used to determine the wear model parameter and to validate the model. A simulative study for a wide range of worm gear geometries was conducted to investigate the influence of geometry and operating conditions on abrasive wear.
•Often asymptomatic, hidden location and present late.•Radiation is a well-recognised cause ofany angiosarcoma irrespective of the anatomic site.•Management can only be generalised from reported ...angiosarcomas of the uterus, cervix, and ovary.•Treatment includes external radiation and intracavitary brachytherapy after surgical excision.•Follow-up is required to assess efficacy as the prognosis remains poor even with early intervention.
We describe an extremely rare case of a 66-year-old woman with a vaginal epithelioid angiosarcoma. She presented with constitutional symptoms, pelvic pain, vaginal bleeding, and a violaceous vaginal lesion. A thorough gynaecological examination, tissue biopsy and imaging were crucial to establish an accurate diagnosis. With only 3 other cases reported in the literature, epithelioid angiosarcoma of the vagina seem to present late due to their nonspecific presentation and secluded location. Once diagnosed, optimal treatment is difficult to determine and together with the overly aggressive behaviour of these tumours, they are associated with a poor prognosis. To our knowledge, our case study and systematic literature review is the first to compare the management outcomes of epithelioid subtype angiosarcomas of the vagina. The rarity of this pathology contributes to diagnostic difficulties and lack of consensus regarding treatment of angiosarcomas of the vagina.
Capacitive sensors can be employed for measuring the electrocardiogram of a human heart without electric contact with the skin. This configuration avoids contact problems experienced by conventional ...electrocardiography. In our studies, we integrated these capacitive electrocardiogram electrodes in a 15-sensor array and combined this array with a tablet personal computer. By placing the system on the patient's body, we can measure a 15-channel electrocardiogram even through clothes and without any preparation. The goal of this development is to provide a new diagnostic tool that offers the user a reproducible, easy access to a fast and spatially resolved diagnostic 'heart view'.
Menorrhagia: an update Oehler, M. K.; Rees, M. C. P.
Acta obstetricia et gynecologica Scandinavica,
20/May , Letnik:
82, Številka:
5
Journal Article
Recenzirano
Menorrhagia is defined as a ‘complaint of heavy cyclical menstrual bleeding occurring over several consecutive cycles’. Objectively it is a total menstrual blood loss equal to or greater than 80 ml ...per menstruation. It is estimated that approximately 30% of women complain of menorrhagia. Excessive bleeding is the main presenting complaint in women referred to gynecologists and it accounts for two‐thirds of all hysterectomies, and most of endoscopic endometrial destructive surgery. Thus, menorrhagia is an important healthcare problem. Its etiology, investigation, medical and surgical management are described. In approximately 50% of cases of menorrhagia no pathology is found at hysterectomy. Abnormal levels of prostaglandins or the fibrinolytic system in the endometrium have been implicated. Effective medical treatments suitable for long‐term use include intrauterine progestogens, antifibrinolytic agents (tranexamic acid) and nonsteroidal anti‐inflammatory agents (mefenamic acid). Over the past decade there has been increasing use of endometrial destructive techniques as an alternative to hysterectomy. Their further refinement and the advent of fibroid embolization has increased the options available to women.
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