Paclitaxel and concomitant radiotherapy in high-risk endometrial cancer patients: preliminary findings

BACKGROUND: There is still much debate about the best adjuvant therapy after surgery for endometrial cancer (EC) and there are no current guidelines. Radiotherapy (RT) alone does not seem to improve overall survival. We investigated whether concomitant Paclitaxel (P) and RT gave better clinical results. METHODS: Twenty-three patients with high-risk EC (stage IIB, IIIA, IIIC or IC G3 without lymphadenectomy or with aneuploid tumor) underwent primary surgery and were then referred for adjuvant therapy. P was given at a dose of 60 mg/m2 once weekly for five weeks during RT, which consisted of a total radiation dose of 50.4 Gy. Three further weekly cycles of P at a dose of 80 mg/m2 were given at the end of RT. Overall survival and disease-free survival were calculated from the time of surgery. Patterns of failure were recorded by the sites of failure. RESULTS: A total of 157 cycles of P were administered both during radiotherapy and consolidation chemotherapy. Relapses occurred in five patients (21.7%). Median time to recurrence was 18.6 months (range 3–28). Survival rate for all the patients was 78.2%. Overall survival for the patients who completed chemo-radiation was of 81%. In this group median time to recurrence was 19.2 months (range 3–28). All recurrences were outside the radiation field. Mortality rate was 14.2%. CONCLUSION: This small series demonstrates pelvic radiotherapy in combination with weakly P followed by three consolidation chemotherapy cycles as an effective combined approach in high risk endometrial carcinoma patients

On the need for rigorous welfare and methodological reporting for the live capture of large carnivores: A response to de Araujo et al. (2021)

1.De Araujo et al. (Methods in Ecology and Evolution, 2021, https://doi.org/10.1111/2041-210X.13516) described the development and application of a wire foot snare trap for the capture of jaguars Panthera onca and cougars Puma concolor. Snares are a commonly used and effective means of studying large carnivores. However, the article presented insufficient information to replicate the work and inadequate consideration and description of animal welfare considerations, thereby risking the perpetuation of poor standards of reporting. 2.Appropriate animal welfare assessments are essential in studies that collect data from animals, especially those that use invasive techniques, and are key in assisting researchers to choose the most appropriate capture method. It is critical that authors detail all possible associated harms and benefits to support thorough review, including equipment composition, intervention processes, general body assessments, injuries (i.e. cause, type, severity) and post-release behaviour. We offer a detailed discussion of these shortcomings. 3.We also discuss broader but highly relevant issues, including the capture of non-target animals and the omission of key methodological details. The level of detail provided by authors should allow the method to be properly assessed and replicated, including those that improve trap selectivity and minimize or eliminate the capture of non-target animals. 4.Finally, we discuss the central role that journals must play in ensuring that published research conforms to ethical, animal welfare and reporting standards. Scientific studies are subject to ever-increasing scrutiny by peers and the public, making it more important than ever that standards are upheld and reviewed. 5. We conclude that the proposal of a new or refined method must be supported by substantial contextual discussion, a robust rationale and analyses and comprehensive documentation

Characteristic trade-offs in designing large-scale biometric-based identity management systems

Biometric-based identity management systems are deemed to be the new solution to address the challenges of global security and citizenship. While such systems do prove effective, the nature of biometric technology, the costs involved, and increasing threats to theft and loss of data bring with it a variety of other considerations that cannot be ignored. We approach such systems from the perspective of large-scale high-volume public deployments. We find that various characteristics of such deployments present a trade-off, where emphasis on one undermines the other. Such characteristic trade-off spaces are described and explored in this paper. The ultimate contribution lies in the understanding of such trade-off spaces for the purposes of optimal design of such systems. We use our approach to analyse the recently launched Identity Card scheme in the United Kingdom

Assessment of the use of Pap test in a sample of pregnant women

Four hundred and ninety-nine women were interviewed who gave birth in the "L. Mangiagali" Obstetrics-Gynaecological Clinic between March and April 1989. 22% of these women had never had a Pap-test, 37% reported having had 1-2 cervical smears and 41% 3 or more. In the group of patients that contacted a private gynaecologist during pregnancy, the percentage of women who had never had a Pap-test was 18% versus 30% in the group of subjects followed in the public health service. Although pluriparas reported a greater number of Pap-test than primiparas, this difference was not statistically significant. Youth is significantly related to the probability of never having had a cervical smear. Social and economic factors were also clearly important. In particular, women with a low educational level represented the group with the highest risk for the lack of cervical screening. The role of the gynaecologist and preventive programmes aimed at the higher risk levels play an important role in terms of heightening awareness

Risk factors for varicose disease before and during pregnancy

Risk factors for varicose disease before and during pregnancy have been analyzed by use of data from a survey on venous disease in pregnancy conducted in 611 women (mean age thirty years, range fifteen to forty-seven) who consecutively delivered at the Obstetric-Gynecologic Clinic ''L. Mangiagalli'' of Milan between January and April, 1989. In total, 137 women (22%) reported varicose disease before the index pregnancy. The relative risk (RR) of varicose disease before the index pregnancy increased with age, being, as compared with women aged twenty-nine years or less, 1.6 in those aged thirty to thirty-four and 4.1 in those aged thirty-five years or more (chi2(1) trend 29.28, p < 0.001). Compared with nulliparae, women reporting a full-term pregnancy before the index pregnancy had an RR of venous disease of 1.2, and the risk increased to 3.8 in women reporting two or more births (chi2(1), trend 25.28, p < 0.001). A family history of varicose disease was associated with an RR of venous disease of 6.2 (95% confidence interval, CI, from 4.1 to 9.6). No relationship emerged between varicose disease and overweight. Of the 474 women who did not report venous disease before the index pregnancy, 132 (28%) developed venous disease during the index pregnancy. The risk of developing venous disease in pregnancy increased with age, being, as compared with women aged twenty-four years or less, 4.0 in those aged thirty-five years or more, and the trend in risk was statistically Significant (chi2(1) trend 16.25, p < 0.001). To be secondiparae or more was associated with an increased risk of developing venous disease in pregnancy. Compared with primiparae, the estimated RR was 2.0 (95% CI 1.3 to 2.9) in women reported to have given birth to one child or more. Women who developed venous disease in pregnancy reported more frequently a family history of varicose disease than those who did not; the RR estimate was 5.8, (95% CI from 3.8 to 8.9)

The smoking habit in pregnancy : results of a survey conducted in Milan

The prevalence of smoking in pregnancy has been analyzed in a surveillance of women delivering between February and March 1989 in a large maternity clinic in Milan, Northern Italy. Out of the 411 interviewed women, 133 (32%) were current smokers before and 71 quit smoking during pregnancy. The probability to quit smoking decreased with increasing age and was lower in less educated women; these findings were however not statistically significant. Considering persistent smokers only, the mean number of cigarettes per day decreased from 13 before pregnancy to 8 during gestation; this finding was generally consistent in various subgroups of age and education. These reduction, however, are probably overestimated, since they are based on women's report only. Thus, these findings indicate that there is still ample scope for intervention on smoking in pregnancy, particularly in older and less educated women

Prognostic Factors in Patients with Locally Advanced Cervical Cancer Treated with Radical Hysterectomy and Adjuvant Radiotherapy

The purpose of this study was to investigate the presence of risk factors for node metastases and to estimate survival in patients with cervical cancer, stages IB and IIA. In a retrospective study of 103 patients with cervical cancer stages IB and IIA, all treated with radical hysterectomy and adjuvant radiotherapy, we estimated survival curves according to different prognostic parameters. Mean follow-up time was 97 months. A significant difference between clinical pre-operative assessment and histological determination of real extent of the disease was evidenced. Pelvic lymph node metastases (P = 0.0005) significantly correlated with survival. This study shows that only lymph node involvement is an independent prognostic factor. Stage acts through nodal status in its impact on survival. A surgical-pathological staging in early stage cervical cancers is found to be more appropriate to correctly estimate patients' survival and prognosis