Ovarian cancer

Ovarian cancer is not a single disease and can be subdivided into at least five different histological subtypes that have different identifiable risk factors, cells of origin, molecular compositions, clinical features and treatments. Ovarian cancer is a global problem, is typically diagnosed at a late stage and has no effective screening strategy. Standard treatments for newly diagnosed cancer consist of cytoreductive surgery and platinum-based chemotherapy. In recurrent cancer, chemotherapy, anti-angiogenic agents and poly(ADP-ribose) polymerase inhibitors are used, and immunological therapies are currently being tested. High-grade serous carcinoma (HGSC) is the most commonly diagnosed form of ovarian cancer and at diagnosis is typically very responsive to platinum-based chemotherapy. However, in addition to the other histologies, HGSCs frequently relapse and become increasingly resistant to chemotherapy. Consequently, understanding the mechanisms underlying platinum resistance and finding ways to overcome them are active areas of study in ovarian cancer. Substantial progress has been made in identifying genes that are associated with a high risk of ovarian cancer (such as BRCA1 and BRCA2), as well as a precursor lesion of HGSC called serous tubal intraepithelial carcinoma, which holds promise for identifying individuals at high risk of developing the disease and for developing prevention strategies

Waiting time to radiotherapy as a prognostic factor for glioblastoma patients in a scenario of medical disparities

Objective To evaluate the effect of waiting time (WT) to radiotherapy (RT) on overall survival (OS) of glioblastoma (GBM) patients as a reliable prognostic variable in Brazil, a scenario of medical disparities. Method Retrospective study of 115 GBM patients from two different health-care institutions (one public and one private) in Brazil who underwent post-operative RT. Results Median WT to RT was 6 weeks (range, 1.3-17.6). The median OS for WT ≤ 6 weeks was 13.5 months (95%CI , 9.1-17.9) and for WT > 6 weeks was 14.2 months (95%CI, 11.2-17.2) (HR 1.165, 95%CI 0.770-1.762; p = 0.470). In the multivariate analysis, the variables associated with survival were KPS (p 6 semanas foi de 14,2 meses (IC95%, 11,2-17,2) (HR 1,165, 0,770-1,762; p = 0,470). Na análise multivariada, as variáveis associadas à sobrevida foram perfomance status (p < 0,001), extensão da ressecção (p = 0,009) e tratamento adjuvante (p = 0,001). Conclusão Não se observou impacto prognóstico para TE até a radioterapia na sobrevida. Diante de outros fatores prognósticos, é possível assegurar de que o espaço de tempo até a radioterapia não parece influenciar o controle da doença.Hospital Israelita Albert EinsteinUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaHospital do Coração Departamento de OncologiaUniversidade de São Paulo Faculdade de MedicinaUNIFESP, EPMSciEL

Suplementação com gordura protegida para vacas de corte desmamadas precocemente mantidas em pastagem natural

The objective of this work was to evaluate the productive and reproductive performance of beef cows, as well as the performance of their calves according to the following dietary treatments: PRE: supplemented with protected fat (PF) during 45 days prepartum; PREPOS: supplemented with PF during 45 days prepartum and 63 days postpartum; POS: supplemented with PF during 63 days postpartum; PN: without supplementation. The productive performance of cows was not influenced by feed management (P&gt;0.05), except for body condition score (BCS), which was lower for PRE and PREPOS cows at the end of mating season, with the latter cows having similar BCS POS and PN. The calving interval (CI) was shorter for cows supplemented in PREPOS - 376 days -, and did not differ in cows maintained in PN - 383 days. Supplemented PREPOS cows weaned 4.4% more pounds of calf per 100kg of cow at calving - 22.6kg - than the PRE and POS cows - 21.6kg and 21.6kg, respectively - and 8,4% more pounds of calf per 100 of cow at calving than the cows maintained in native pasture - 20.7kg. The fat protected supplementation during pre and/or postpartum periods did not affect the performance of cows and calves.Avaliaram-se os desempenhos produtivo e reprodutivo de vacas de corte, bem como o desempenho de seus bezerros, de acordo com os tratamentos alimentares: PRE: suplementação com gordura protegida (GP) 45 dias antes do parto; PREPOS: suplementação com GP 45 dias antes do parto e 63 dias pós-parto; POS: suplementação com GP 63 dias pós-parto; PN: sem suplementação. O desempenho produtivo das vacas não foi influenciado pelo manejo alimentar (P>0,05), exceto para o escore da condição corporal (ECC) no final do período de acasalamento, que foi mais baixo para as vacas do PRE e do PREPOS, sendo que esta última apresentou ECC semelhante ao das vacas do POS e do PN. O intervalo entre partos foi menor para as vacas do tratamento PREPOS - 376 dias -, não diferindo das vacas do PN - 383 dias. As vacas do PREPOS desmamaram 4,4% mais quilos de bezerro para cada 100kg de vaca ao parto - 22,6kg - do que as vacas do PRE e do POS - 21,6kg e 21,6kg, respectivamente - e 8,4% mais quilos de bezerro para cada 100kg de vaca ao parto do que as vacas mantidas em pastagem nativa - 20,7kg. A suplementação com gordura protegida durante os períodos pré e/ou pós-parto não afeta o desempenho de vacas e bezerros.Universidade Estadual Paulista, Departamento de Zootecnia, Faculdade de Ciências Agrárias e Veterinárias de Jaboticaba

Tongue forces and handgrip strength in normal individuals: association with swallowing

OBJECTIVES: To describe and correlate tongue force and grip strength measures and to verify the association of these measures with water swallowing in different age groups. METHOD: Tongue force was evaluated using the Iowa Oral Performance Instrument and grip strength using the Hand Grip in 90 normal individuals, who were divided into three groups: young (18-39 years old), adult (40-59 years old) and elderly (above 60 years old) individuals. The time and number of swallows required for the continuous ingestion of 200 ml of water were also measured. RESULTS: A reduction in tongue force and grip strength, as well as an increase in the time required to drink 200 ml of water, were observed with increasing participant age. There was no difference in the number of swallows among the three groups. A correlation was observed between reductions in tongue force and grip strength in the groups of young and elderly individuals. CONCLUSION: There were differences in the measures of tongue force in young, adult and elderly individuals. Greater variations within these differences were observed when repeated movements were performed; in addition, a decrease in strength was associated with an increase in age. The decrease in tongue force among the elderly was offset by the increase in time needed to swallow the liquid. There was an association between the measures of tongue force and grip strength in the different age groups. The results of this study can be applied clinically and may act as a basis for guidelines in healthy or vulnerable elderly populations

Small cell carcinoma of the ovary-hypercalcemic type (SCCOHT): A review of 47 cases*

Objective. Small cell carcinoma of the ovary-hypercalcemic type (SCCOHT) is a rare disease with a poor prognosis. SCCOHT has recently been shown to be associated with SMARCA4 gene mutations as well as molecular and genetic similarities to malignant rhabdoid tumors (MRT). The objective of our study is to describe the clinical characteristics, treatment modalities and outcomes of 47 patients with SCCOHT. Methods. We performed a retrospective analysis of 47 patients with SCCOHT evaluated at MD Anderson Cancer Center between 1990 and 2014. Medical records were reviewed for demographic information, pathologic findings, treatment regimens and outcomes. Results. Median age at diagnosis was 30 years (range 5-46). All patients underwent surgery with unilateral salpingo-oophorectomy (USO) performed in 26 patients (55%), and hysterectomy with bilateral salping000phorectomy (BSO) in 21 patients (45%). Sixteen patients (34.0%) had stage I disease, six (12.8%) stage II, 23 (48.9%) stage III, and two patients (4.3%) had stage IV disease. Information on adjuvant treatment was available for 43 patients: 83.3% received chemotherapy alone, 9.5% chemotherapy followed by radiotherapy, 2.4% chemoradiation, and 4.8% did not receive any adjuvant therapy. Median follow-up was 13.2 months (range, 0.1 to 210.7) with a median overall survival of 14.9 months. Multi-agent chemotherapy and radiotherapy were associated with a better prognosis. Conclusion. Our findings suggest that aggressive therapy including multi-agent chemotherapy and possibly radiotherapy may extend survival. Further study is needed to improve outcomes in these patients including the adoption of systemic therapies used in MRT as well as the development of novel agents targeting specific mutations. (c) 2015 Elsevier Inc. All rights reserved.National Institutes of Health through MD Anderson's Cancer Center Support Grant [CA016672]Hosp Israelita Albert Einstein, Dept Med Oncol, Sao Paulo, BrazilUniv Texas MD Anderson Canc Ctr, Dept Gynecol Oncol & Reprod Med, Houston, TX 77030 USAUniv Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX 77030 USAUniv Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USAUniv Texas MD Anderson Canc Ctr, Dept Pathol, Houston, TX 77030 USAUniv Fed Sao Paulo, Div Gynecol Oncol, Sao Paulo, BrazilDivision of Gynecologic Oncology, Universidade Federal de São Paulo, São Paulo, BrazilNational Institutes of Health through MD Anderson's Cancer Center Support Grant CA016672.Web of Scienc