Surgery in recurrent ovarian cancer

Ovarian cancer is one of the most challenging diseases in gynecologic oncology. The presentation of frequent recurrences requires the establishment and further development of therapy standards for this patient group. Surgery is crucial in the therapy of patients with primary ovarian cancer, and the postoperative residual tumor mass is the most relevant clinical prognostic factor. The surgical management of recurrent disease is still subject to an emotional international discussion. Only a few prospective clinical trials focused on the effects of surgery in relapsed ovarian cancer have been published. The available data show improvements in the prognosis due to complete cytoreduction in the setting of recurrence. However, the selection of eligible patients is the essential issue. Therefore, the establishment of reliable predictive factors for complete tumor resection as well as a definition of the group of patients who might profit from this approach remains a field for research. Further randomized trials designed to develop and incorporate operative standards for recurrent ovarian cancer should follow

American palm ethnomedicine: A meta-analysis

<p>Abstract</p> <p>Background</p> <p>Many recent papers have documented the phytochemical and pharmacological bases for the use of palms (<it>Arecaceae</it>) in ethnomedicine. Early publications were based almost entirely on interviews that solicited local knowledge. More recently, ethnobotanically guided searches for new medicinal plants have proven more successful than random sampling for identifying plants that contain biodynamic ingredients. However, limited laboratory time and the high cost of clinical trials make it difficult to test all potential medicinal plants in the search for new drug candidates. The purpose of this study was to summarize and analyze previous studies on the medicinal uses of American palms in order to narrow down the search for new palm-derived medicines.</p> <p>Methods</p> <p>Relevant literature was surveyed and data was extracted and organized into medicinal use categories. We focused on more recent literature than that considered in a review published 25 years ago. We included phytochemical and pharmacological research that explored the importance of American palms in ethnomedicine.</p> <p>Results</p> <p>Of 730 species of American palms, we found evidence that 106 species had known medicinal uses, ranging from treatments for diabetes and leishmaniasis to prostatic hyperplasia. Thus, the number of American palm species with known uses had increased from 48 to 106 over the last quarter of a century. Furthermore, the pharmacological bases for many of the effects are now understood.</p> <p>Conclusions</p> <p>Palms are important in American ethnomedicine. Some, like <it>Serenoa repens </it>and <it>Roystonea regia</it>, are the sources of drugs that have been approved for medicinal uses. In contrast, recent ethnopharmacological studies suggested that many of the reported uses of several other palms do not appear to have a strong physiological basis. This study has provided a useful assessment of the ethnobotanical and pharmacological data available on palms.</p

Understanding curriculum making by teachers: implications for policy as text and as practice

Recent debates in curriculum studies have focused on the role of teachers as active curriculum makers. In this chapter, we argue for a more systematic approach to curriculum making as social practice. Our particular focus is on micro and nano curriculum making by teachers, that is curriculum making in schools and classrooms respectively, as curricular programmes are developed and enacted into practice. In making sense of these complex practices, we draw upon a theoretical typology for understanding and analysing curriculum making across different sites within education systems, and an ecological understanding of teacher agency. We apply these theoretical insights to the analysis of various influences on micro/nano curriculum, emerging from a range of recent empirical studies in five European education systems. In undertaking this analysis, we challenge prevalent notions of curriculum making as a linear process of delivery or implementation, instead seeking to understand it as interpretation and enactment across sites by multiple social actors, and tracing the multiple and dynamic connections that operate across sites and which shape micro and nano curriculum making in schools.</p

Behind the scene: Paracetamol hypersensitivity in children.

Background Paracetamol, a non-steroidal anti-inflammatory drug, is commonly being used for fever and pain relief worldwide. The aim of this study was to evaluate children with a suspected history of paracetamol hypersensitivity. Methods Sixty patients who were referred to our clinic in between January 2015 and December 2018 with a suspected history of paracetamol hypersensitivity were included. Reactions were classified according to the European Network for Drug Allergy (ENDA)/Global Allergy and Asthma European Network classification and European Academy of Allergy and Clinical Immunology (EAACI)/ENDA Position Paper. Diagnoses were confirmed by skin tests and oral challenge tests (OCTs). In those with verified paracetamol hypersensitivity, an OCT with a strong COX-1 inhibitor was performed to classify the type of the reaction to refer as either selective or cross-intolerance hypersensitivity. A subsequent OCT with a selective COX-2 inhibitor was performed in those cross-intolerant patients to find out a safe alternative drug. Results Sixty OCTs with paracetamol were performed to patients with a median age of 8.5 years, and hypersensitivity to paracetamol was verified in 8 patients. Four children were classified as selective responders, and 3 were classified as cross-intolerant after OCT with a COX-1 inhibitor. Overall, skin test positivity for paracetamol was detected in only one patient, in whom OCT with paracetamol was negative. In all 3 cross-intolerant patients, a safe alternative non-steroidal anti-inflammatory drug was identified after an OCT with a selective COX-2 inhibitor. Conclusion OCT stands as the gold-standard procedure in verifying the diagnosis of patients with paracetamol-induced drug hypersensitivity, as well as, in defining the type of reactions and finding out safe alternative drugs

Deletion analysis and clinical correlations in patients with Xp21 linked muscular dystrophy

PubMed ID: 15641267We carried out molecular deletion analysis on 142 patients with Duchenne/Becker muscular dystrophy which covered 25 exons of the dystrophin gene. We also evaluated the results by comparing with the clinical findings and examples in the literature. A deletion ratio of 63.7% was achieved. Exon 46 was the most frequently affected region. Interestingly we also observed four cases with muscle promoter (Mp) region deletions which have been rarely reported in the literature

Applicability of the Magnetic Barkhausen Noise Method for Nondestructive Measurement of Residual Stresses in the Carburized and Tempered 19CrNi5H Steels

There exist no materials and/or structures of technical importance without residual stresses. The residual stress management concept has gained importance in industrial applications aiming to improve service performance and useful life of the product. Thus, the industry requests rapid, reliable, and nondestructive methods to determine residual stress state. The aim of this article is to investigate the applicability of the Magnetic Barkhausen Noise (MBN) method to measurement of surface residual stresses in the carburized steels. To comprehend the differences in the surface residual stress state, 19CrNi5H steel samples were carburized at 900 degrees C for 8 and 13 hours, and then, tempered in the range of 180 degrees C and 600 degrees C. The MBN measurement results were correlated with those obtained by the X-ray diffraction (XRD) measurements. Microstructural investigations and hardness measurements were also conducted. For this particular study, it was concluded that both techniques give similar qualitative results for monitoring of the residual stress variations in the carburized and tempered steels. Since the MBN method is much faster than the XRD method, from the industrial point of view it is a very strong candidate for qualitative monitoring of residual stress variations. With an appropriate pre-calibration by considering the effect of microstructure, the MBN method may give reliable quantitative results for residual stress

Deletion analysis and clinical correlations in patients with Xp21 linked muscular dystrophy

We carried out molecular deletion analysis on 142 patients with Duchenne/Becker muscular dystrophy which covered 25 exons of the dystrophin gene. We also evaluated the results by comparing with the clinical findings and examples in the literature. A deletion ratio of 63.7% was achieved. Exon 46 was the most frequently affected region. Interestingly we also observed four cases with muscle promoter (Mp) region deletions which have been rarely reported in the literature