Diagnostic performance of intraoperative assessment in grade 2 endometrioid endometrial carcinoma

Background Endometrial carcinoma is the most common gynecologic malignancy in developed countries. Grade 2 carcinoma is associated with pelvic lymph-node metastasis, depending on selected risk factors. Intraoperative assessment (IOA) can identify patients at risk for lymph node metastasis who should undergo staging surgery. Our objective was to establish the diagnostic precision of IOA in determining the need for surgical staging in grade 2 endometrioid endometrial carcinoma. Methods Two hundred twenty-two patients underwent IOA. Results were compared to the final pathology report. The accuracy of the IOA parameters was calculated. Variables were evaluated in patients with positive versus negative IOA. Overall and disease-free survivals were calculated according to IOA, lymphadenectomy, and nodal metastasis. Results IOA was positive in 80 patients. It showed an accuracy of 76.13% when compared with the postoperative assessment. The best individual parameter was myometrial invasion. Nodal metastasis was observed in 16 patients in the positive IOA group and 7 patients in the negative group. Patients with lymph node metastasis had a 5-year overall survival rate of 80.9%, whereas patients without metastasis had a 5-year overall survival rate of 97.9%. Conclusions IOA is an adequate tool to identify high-risk patients in grade 2 endometrial carcinoma. Myometrial invasion is the individual parameter that yields the highest diagnostic precision

Evidence‐based treatment for gynoid lipodystrophy: A review of the recent literature

Resumen La lipodistrofia ginoide (LDG) es una alteracion estructural, inflamatoria y bioquımica del tejido subcutaneo que causa modificaciones topograficas en la piel. Conocida comunmente como “celulitis”, la LDG afecta hasta a 90% de las mujeres, practicamente en todas las etapas de la vida, iniciando en la pubertad. Se trata de una condicion que afecta considerablemente la calidad de vida de quien la padece. Es motivo frecuente de consulta aunque las pacientes recurren a tratamientos empıricos, improvisados, sin bases ni evidencia cientıfica, los cuales desmotivan y producen frustracion no solo por su falta de resultados, sino por complicaciones derivadas de dichos tratamientos. Un grupo de expertos de diversas especialidades involucradas en el manejo de este problema presenta en este artıculo el resultado de una busqueda bibliografica sistematica y de la discusion consensuada de la evidencia obtenida de diversos tratamientos disponibles actualmente. El analisis se dividio en tratamientos topicos, tratamientos sistemicos, tratamientos no invasivos y tratamientos mınimamente invasivos

Extramural Perineural Invasion in pT3 and pT4 Gastric Carcinomas

Background Perineural invasion (PNI) is widely studied in malignant tumors, and its prognostic significance is well demonstrated. Most studies have focused on evaluating the mural PNI (mPNI); however, extramural PNI (ePNI) may influence the prognosis in gastric cancer. We evaluated the prognostic value of ePNI compared with mPNI in gastric cancer in this observational comparative cross-sectional study. Methods Seventy-three pT3 and pT4 gastric carcinomas with PNI were evaluated. Forty-eight (65.7%) were in the mPNI group and the remaining in the ePNI group. Results Clinicopathologic characteristics between the two groups were similar, except for the outcomes. The 5-year disease-specific survival (DSS) rate was 64% for the mPNI group and 50% for the ePNI group (p=.039), a difference that did not remain significant in multivariate analysis. The only independent adverse prognostic factor in multivariate analysis was the presence of lymph node metastasis (hazard ratio, 1.757; 95% confidence interval, 1.082 to 2.854; p=.023). Conclusions We demonstrated the prognostic effect of ePNI for DSS in surgically resected pT3–pT4 gastric cancer patients. ePNI could be considered in the staging and prognostic systems of gastric cancer to stratify patients with a high risk of recurrence

Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability

Introduction: Colorectal medullary carcinoma (MC) is a rare subtype of poorly differentiated adenocarcinoma (PDA) with unclear prognostic significance. Microsatellite instable (MSI) colorectal carcinomas have demonstrated better prognosis in clinical stage II. Aim: To analyze the survival and clinicopathological characteristics of MCs versus PDAs with MSI in clinical stage III. Material and methods: We studied 22 cases of PDAs with MSI versus 10 MCs. Results : Of the 10 MCs, 7 patients were men; the mean age was 57.8 ±5.6 years. The mean tumor size was 9.6 ±4.1 cm, and the primary site was the right colon in 9; 7 patients showed lymph node metastases (LNM) and lymphovascular invasion (LVI). Of the 22 PDA cases, 12 (54.5%) were women with a mean age of 75 ±16.1 years. The mean tumor size was 6.4 ±3.2 cm. Twelve (54.5%) presented in the right colon, 21 (95.5%) showed LNM and 7 (31.8%) LVI. Follow-up was 32 ±8 months, with a 5-year overall survival of 42.9% for MCs and 76.6% for PDAs (p = 0.048). Univariate analysis found local recurrence (p = 0.001) and medullary subtype (p = 0.043) associated with lower survival. Conclusions : Medullary carcinomas were of greater tumor size and associated with more LVI and worse survival versus PDAs with MSI in stage III

Habitabilidad y política de vivienda

En esta obra, en la que participan destacados investigadores y profesores, dedicados al estudio de la problemática habitacional se presentan diferentes análisis que permiten conocer cuales son las condiciones de habitabilidad y las características de la actual política de vivienda de México. En sus capítulos se abordan los principales desafíos que enfrentan las familias mexicanas para acceder a una vivienda digna y decorosa y cuales son los retos económicos, políticos, territoriales, arquitectónicos, ambientales, financieros y culturales de las formas de producción habitacional en México y en otros países, en el marco de una sociedad global

Miradas a la Venezuela del siglo XXI : temáticas, enfoques y evidencias. Tomo I

Miradas a la Venezuela del XXI. Temáticas, enfoques y evidencias. Es el resultado de las X jornadas de investigación, realizadas por el Instituto de Investigaciones Económicas y Sociales "Dr. Rodolfo Quintero", de la Facultad de Ciencias Económicas y Sociales, FaCES, de la Universidad Central de Venezuela, UCV. Los documentos aquí presentados, constituyen un aporte a la discusión, a la indagación crítica y el análisis sistemático de la realidad política, económica, social, humanística y tecnológica de Venezuela. Esos estudios han sido elaborados por profesores e investigadores de la Universidad Central de Venezuela y de otras instituciones académicas. Estos documentos representan las líneas de trabajo que actualmente integran la investigación y tributan un panorama de las principales preocupaciones de las Ciencias Sociales, las Humanidades, las Políticas, Económicas e incluso, lo relacionado con la informática y la web 2.0