Gynecologic malignancies

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  • Harrison's Internal Medicine Chapter 93. Gynecologic Malignancies Ovarian Cancer Incidence and Epidemiology Ovarian cancer can develop from three distinctive cell types (germ cells, stromal cells, and epithelial cells), and each of these presents with distinctive features and outcomes and requires widely different management approaches. Epithelial ovarian cancer is the most common of the three and the leading cause of death from gynecologic cancer in the United States. In 2007, 22,430 new cases were diagnosed, and 15,280 women died from ovarian cancer.

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  • Table 93-1 Staging and Survival in Gynecologic Malignancies St age Ovarian -Year 5 trial Endome 5 -Year x Surviv al, % Cervi -Year 5 Surviv al, % Surviv al, % 0 — — Carcin oma in situ 00 1 I Confined 9 Confine 8 Confin 8 to ovary 0 d tocorpus 9 ed to uterus 5 II Confined to pelvis 0 7 corpus cervix Involves and 0 8 s Invade beyond 5 6 uterus but not to pelvic wall III Intraabdo minal spread 5–20 1 Extends outside the 0 3 Exten 3 ds to pelvic 5 wall and/or uterus but not outside the true pelvis lower third of vagina, or hydronephros is ...

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  • Malignant germ cell tumors are usually large (median—16 cm). Bilateral disease is rare except in dysgerminoma (10–15% bilaterality). Abdominal or pelvic pain in young women is the usual presenting symptom. Serum human chorionic gonadotropin (β-hCG) and α fetoprotein levels are useful in the diagnosis and management of these patients. Before the advent of chemotherapy, extensive surgery was routine, but it has now been replaced by careful evaluation of extent of spread, followed by resection of bulky disease and preservation of one ovary, the uterus, and the cervix, if feasible.

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  • Uterine Cancer Incidence and Epidemiology Carcinoma of the endometrium is the most common female pelvic malignancy. Approximately 39,080 new cases are diagnosed yearly, although in most (75%), tumor is confined to the uterine corpus at diagnosis, and therefore most can be cured. The 7400 deaths yearly make uterine cancer only the eighth leading cause of cancer death in females.

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  • Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học đề tài : CGB and GNRH1 expression analysis as a method of tumor cells metastatic spread detection in patients with gynecological malignances

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  • Clinical Presentation Molar pregnancies are generally associated with first-trimester bleeding and excessive uterine size. About 45% of patients have ovarian theca-lutein cysts present on ultrasound. The β-hCG levels are generally markedly elevated. Fetal parts and heart sounds are not present. The diagnosis is generally made by the passage of grapelike clusters from the uterus, but ultrasound demonstration of the hydropic mole can be diagnostic. Patients suspected of a molar pregnancy require a chest film, careful pelvic examinations, and weekly serial monitoring of β-hCG levels.

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  • Screening In contrast to patients who present with advanced disease, patients with early ovarian cancers (stages I and II) are commonly curable with conventional therapy. Thus, effective screening procedures would improve the cure rate in this disease. Although pelvic examination and CA-125 can occasionally detect early disease, these are relatively insensitive screening procedures. Transvaginal sonography is often used, but significant false-positive results are noted, particularly in premenopausal women.

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Effects of pegylated G-CSF on immune cell number and function in patients with gynecological malignancies

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  • Patients with stage I disease, no residual tumor, and well or moderately differentiated tumors need no adjuvant therapy after definitive surgery, and 5-year survival exceeds 95%. For all other patients with early disease and those stage I patients with poor prognosis histologic grade, adjuvant platinum-based therapy is warranted. Large prospective randomized trials have demonstrated that adjuvant therapy improves disease-free and overall survival by 8% (82% vs. 74%, p = .008).

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  • Patients with stage IV disease (outside the abdomen or invading the bladder or rectum) are treated palliatively with irradiation, surgery, and platinum-based chemotherapy. Progestational agents produce responses in ~10–20% of patients. Well-differentiated tumors respond most frequently, and response can be correlated with the level of progesterone receptor expression in the tumor.

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  • Clinical Presentation and Staging Patients with cervix cancer generally are asymptomatic, and the disease is detected on routine pelvic examination. Others present with abnormal bleeding or postcoital spotting that may increase to intermenstrual or prominent menstrual bleeding. Yellowish vaginal discharge, lumbosacral back pain, lower-extremity edema, and urinary symptoms may be present. The staging of cervical carcinoma is clinical and generally completed with a pelvic examination under anesthesia with cystoscopy and proctoscopy.

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: CGB and GNRH1 expression analysis as a method of tumor cells metastatic spread detection in patients with gynecological malignances

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  • Cancers of the endometrium, ovary and cervix share certain characteristics. However, etio-pathogenesis of all the gynecological malignancies is yet to be explored. Even though the etiologic factors are generally environmental, the exact cause of each gynecological cancer is not known (Senate Community Affairs References Committee, Commonwealth of Australia, 2006). Worldwide, cancer incidence rates vary widely between different geographic regions and ethnic groups.

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  • Ovarian cancer can develop from three distinctive cell types (germ cells, stromal cells, and epithelial cells), and each of these presents with distinctive features and outcomes and requires widely different management approaches. Epithelial ovarian cancer is the most common of the three and the leading cause of death from gynecologic cancer in the United States. In 2007, 22,430 new cases were diagnosed, and 15,280 women died from ovarian cancer.

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  • he 2004-05 Tanzania Demographic and Health Survey is the most recent in a series of national surveys conducted in Tanzania to meas- - ure levels, patterns, and trends in fertility, family planning, and health indicators. he previous surveys were carried out in 1991-92, 1994, 1996, and 1999. he 2004-05 TDHS was conducted by the National Bureau of Statistics (NBS). he 2004-05 survey included a nationally representative sample of 10,329 women and 2,635 men from approximately 9,700 households.

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  • The all-too-common conditions this woman and her children face illustrate how health programs and weak systems in many developing countries are not meeting needs. Although health services may be available, too often they are of poor quality and are provided in an uncoordinated or ad hoc manner. Often, they are organized around funding sources or diseases, rather than in a way that addresses the broader needs of the populations they seek to serve.

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  • Other peculiarities of the sites are that the systems are updated frequently, that advertising is not a source for funding and that the webmasters’ work is unsalaried. Privacy policy is implemented through different guarantees. Publication of personal information is dependent from a personal written agreement, for example, for the member list of AIG. The principles of the Health-On-the-Net-Foundation (HON) are implemented by both websites.

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  • The new toolkit focuses on relapse prevention, risks of secondhand smoke exposure and the health benefits of quitting smoking for mother and infant. It also emphasizes the potential and underlying issues related to relapse including postpartum depression, stress and miscarriage. An appendix for counselors to use as a reference tool during counseling sessions is also included in the toolkit.

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  • Endometrial, cervical, and ovarian cancers are the three most common malignancies of the female reproductive tract. In the United States alone, roughly 12,000 women are diagnosed with uterine cervical cancer annually, and 4,000 will die from the disease [1]. The relatively low incidence of cervical cancer in the US is largely attributable to the effectiveness of Papanicolaou’s cytological cervical screening test (the Pap test).

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  • In response to Texas’s affiliate rule, the federal Centers for Medicare and Medicaid Services (CMS) announced that it would no longer provide federal matching funds for the program because the rule denies beneficiaries the freedom to choose providers, as assured under federal policy and stated that the waiver and federal funding would terminate after six months. 4 Two lawsuits are now in progress as a result of these decisions.

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