While robotic surgery has seen much success in the treatment of gynecologic malignancies, the technical aspects of this approach raise concern for spreading tumor cells within the peritoneal cavity ...and to trocar sites. To date, robotic trocar site metastases have been identified following surgery for both endometrial and cervical cancer.
The research described by Lydia Tien, Vicki Roth, and Jack Kampmeier (J. Res. Sci. Teach. 2002, 39, 606-632) clearly suggests that peer-led team learning workshops in the organic chemistry course ...studied both increased the level of student achievement and increased the retention of students in the course. The benefit appears to apply to all groups, regardless of gender or ethnicity.
Rhabdomyosarcomas (RMSs) are malignant soft-tissue tumors arising from skeletal muscle progenitor cells. They are most commonly diagnosed in children and adolescents and are rare in adults. These ...tumors arise from a variety of anatomical sites, including the head and neck, urogenital tract, and extremities. Classification of RMSs depends on histopathologic and immunohistochemical features. Embryonal and alveolar subtypes are more common in children and adolescents, whereas the pleomorphic subtype is seen almost exclusively in adults. Adult RMS is associated with poor outcomes and high recurrence rate. Because of the low incidence of adult RMS, most published reports of RMS in adults are either case series or retrospective analyses, and most treatment protocols are extrapolated from clinical trials performed in children. The present report describes a 61-year-old woman with RMS whose presentation included atypical symptoms.
Abstract Objective While primary cisplatin-based intraperitoneal chemotherapy has been shown to favorably impact survival in small-volume residual advanced ovarian cancer, there is a need to develop ...strategies that improve the effectiveness of this approach. Methods A multi-center phase 2 trial was conducted that added intravenous pegylated liposomal doxorubicin (day 8; 30–40 mg/m2 ) to a regimen of intraperitoneal cisplatin (day 2; 75 mg/m2 ) and intravenous (day 1; 135 mg/m2 ) plus intraperitoneal (day 8; 60 mg/m2 ) paclitaxel. Treatment was initially delivered on an every 3-week schedule, but was modified to an every 4-week program due to excessive toxicity. Patients were to receive 6 cycles of this regimen. Results Of 68 patients entering this trial, 63 patients were eligible and evaluable, of whom 39 (62%) completed 6 cycles. Overall, 32 (51%) experienced at least 1 grade 4 or worse toxicity (most commonly hematologic) including 5 treatment-related deaths. Median progression-free survival (PFS) was 25 months (2-year PFS: 52%) and median overall survival 51 months, an outcome similar to previous reports of cisplatin-based intraperitoneal chemotherapy in comparable patient populations. Seventeen patients (27% of all eligible patients) were without evidence of disease recurrence > 4 years following entry into the trial. Conclusion Both the overall trial outcome, and specifically the excessively severe systemic toxicity of this regimen would prevent its future development in this exact form. The provocative PFS in a subset of individuals should encourage the development of alternative strategies designed to optimize the delivery of regional therapy in ovarian cancer management.
The aim of this retrospective study was to evaluate differences in treatment of embryonal rhabdomyosarcoma (RMS) of the uterus in 2 premenopausal women. We discuss adjuvant chemotherapy and use of ...ChemoFx Assay (Precision Therapeutics, Pittsburgh, PA) to guide choice of active chemotherapeutic agents. Two premenopausal patients were identified with a pathologic diagnosis of embryonal RMS of the uterus. Both met inclusion criteria for the study. A 21-year-old woman underwent a staging abdominal hysterectomy for a variant of embryonal RMS. Vincristine, actinomycin D, and cyclophosphamide were given adjunctively for a complete response. A 20-year-old woman underwent a diagnostic dilation and curettage revealing embryonal RMS. Initial treatment included an abdominal hysterectomy and nodal sampling. Presentation to a subsequent gynecologic oncologist 7 months later revealed recurrence. Carboplatin, doxorubicin, and paclitaxel provided a partial response. After a second surgical resection, ChemoFx Assay identified ifosfamide and mitomycin C as active agents and resulted in a complete response. Recommended treatment includes surgery and chemotherapy with possible radiation therapy if deemed necessary. The benefit of adding neoadjuvant or adjuvant chemotherapy and radiation therapy allows for a conservative surgical approach and improved survival. Choosing active chemotherapy agents can be aided by ChemoFx Assay. The chemotherapy most commonly used for treatment of embryonal RMS is a combination of vincristine, actinomycin D, and cyclophosphamide.
This paper discusses an article* that explores the scientific method based on interviews with 52 science faculty members in nine science departments at a large midwestern research university. These ...interviews led to a description of how scientists go about research, a description that differs from the scientific method as described in most science textbooks.*Harwood, W.; Reiff, R; Phillipson, T. Proceedings of the 2002 Annual International Conference of the Association for the Education of Teachers in Science , 1022-1052; (accessed Feb 2004).
How should we design multimedia instructional messages in order to promote deep understanding in learners? This is the leading question from the research program described in Richard Mayer's article ..."Cognitive Theory and the Design of Multimedia Instruction: An Example of the Two-Way Street Between Cognition and Instruction" (Mayer, R. E.; New Directions for Teaching and Learning 2002, 89 Spring 55-71). Eight principles for the design of effective multimedia have been derived from that program and are described in the article.
INTRODUCTION:
In the United States, cancer screening rates declined in spring 2020 due to the COVID-19 pandemic. Stay-at-home orders and social distancing mandates created a new barrier to health ...care while further exposing the pre-pandemic health care disparities.
METHODS:
Using fully de-identified electronic health record data from the University of Mississippi Medical Center’s (UMMC) Patient Cohort Explorer, we assessed changes in cervical cancer screening before and during the COVID-19 pandemic. The number of women screened with cervical cytology and human papillomavirus (HPV) testing in the pre-COVID months of September 2019 and January 2020 were compared with the same months of the following year during the pandemic (September 2020; January 2021).
RESULTS:
Data showed a pre-pandemic baseline of 319 and 340 women screened via cervical cytology during September 2019 and January 2020, respectively. Compared to pre-pandemic baseline, cervical cytology screening remained consistent throughout the pandemic with 302 and 311 women screened in September 2020 and January 2021, respectively. Similarly, HPV testing in the pre-COVID months resulted in 229 and 226 women screened as compared to 211 and 170 women screened during the pandemic.
CONCLUSION:
Cervical cancer screening did not significantly decline during the COVID-19 pandemic in Mississippi as compared to the 80% decline in cervical screening noted in California. The lack of change could be attributed to the low number of women screened both before and during the pandemic. Low cancer screening in women demonstrates various health care disparities affecting the UMMC patient population and the need to increase patient awareness and education regarding the importance of routine cancer screening.
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