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[PMID]: 29480826 [Au] Autor: Zhou J; Chen Y; Xu X; Yan D; Lou H [Ad] Endereço: Key Laboratory of Radiation Oncology of Zhejiang Province. [Ti] Título: Postoperative clinicopathological factors affecting cervical adenocarcinoma: Stages I-IIB. [So] Source: Medicine (Baltimore);97(2):e9323, 2018 Jan. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Currently, cervical adenocarcinoma (ADC) receives the same standard treatment as squamous cell carcinoma, but this treatment regimen is not wholly suited for ADC. The present study was conducted to assess the prognostic role of postoperative clinicopathological factors in patients with stage I-IIB cervical ADC.The study examined 312 patients with stage I-IIB cervical ADC who underwent radical hysterectomy, including pelvic lymphadenectomy, at our institutions between October 2006 and September 2014. Overall survival (OS) and relapse-free survival (RFS) was analyzed by the Kaplan-Meier method. Sites of recurrence were classified as local and distant locations.The 5-year OS and RFS rates were 88.2% and 83.8%, respectively. The 5-year OS rates for patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA, IB, IIA, and IIB were 100.0%, 90.7%, 82.8%, and 55.6%, respectively. The Cox model identified number of positive pelvic nodes and age at surgery as independent prognostic factors for survival, and number of positive pelvic nodes and postoperative tumor diameter (≥4 cm) as independent prognostic factors for relapse. Cancer recurrence developed in 35 women. The top three recurrence sites were pelvis, vaginal stump, and lung.A more aggressive therapeutic strategy different from current practice in cervical cancer is urgently required for cervical ADC. As a new prognostic factor, postoperative tumor diameter should receive special attention in ADC treatment. [Mh] Termos MeSH primário: Adenocarcinoma/patologia Adenocarcinoma/cirurgia Neoplasias do Colo do Útero/patologia Neoplasias do Colo do Útero/cirurgia [Mh] Termos MeSH secundário: Adenocarcinoma/diagnóstico Adulto Fatores Etários Idoso Intervalo Livre de Doença Feminino Seguimentos Seres Humanos Histerectomia Estimativa de Kaplan-Meier Excisão de Linfonodo Meia-Idade Estadiamento de Neoplasias Prognóstico Modelos de Riscos Proporcionais Resultado do Tratamento Carga Tumoral Neoplasias do Colo do Útero/diagnóstico Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180302 [Lr] Data última revisão: 180302 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180227 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009323

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[PMID]: 29424975 [Au] Autor: López-Vera EA; Reynosa-Oviedo Y; Treviño-Báez JD; Martínez-Salazar GJ; González-Díaz OA; Cortés-Flores R [Ti] Título: [Subsequent reoperation obstetric hysterectomy and selective ligation of hypogastric arteries]. [Ti] Título: Reintervención posterior a histerectomía obstétrica y ligadura selectiva de arterias hipogástricas.. [So] Source: Ginecol Obstet Mex;84(9):562-6, 2016 Sep. [Is] ISSN: 0300-9041 [Cp] País de publicação: Mexico [La] Idioma: spa [Ab] Resumo: Background: Bleeding in pregnancy, childbirth or postpartum period is an emergency. Selective internal iliac (hypogastric) arteries ligation is a surgical therapy in selected cases of obstetric massive hemorrhage. It had proven to be safe. Objetive: To evaluate the risk for re-intervention for post-operatory bleeding in patients with obstetric hysterectomy and selective hypogastric arteries ligation. Material and method: Cross-sectional study including women diagnosed with obstetric hysterectomy with and without selective arterial ligation as a factor to assess the risk of re-intervention, from December 2013 to December 2014, at High Specialty Medical Unit 23 of Gynaecology and Obstetrics, in Monterrey, which is a tertiary care medical center. Those patients with 28 weeks of gestation or more were selected. The postoperative blood loss was quantified by open drainage system (Penrose). Results: We performed 88 hysterectomies in the study period. We included 45 women according to selection criteria. The average was 31.9 ± 5.48 years old. Performing a selective hypogastric arteries ligation may be a protective factor (p<0.05) for re-intervention as a consequence of postoperative bleeding. Conclusion: Selective arterial ligation is a factor that could help to prevent a re-intervention. A continuous training of physicians and residents of Gynecology and Obstetrics is essential to ensure the reduction in morbidity and maternal mortality. [Mh] Termos MeSH primário: Histerectomia/métodos Artéria Ilíaca/cirurgia Hemorragia Pós-Parto/cirurgia [Mh] Termos MeSH secundário: Adulto Perda Sanguínea Cirúrgica Estudos Transversais Feminino Seres Humanos Ligadura Gravidez Reoperação [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180301 [Lr] Data última revisão: 180301 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180210 [St] Status: MEDLINE

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[PMID]: 29424510 [Au] Autor: Solórzano-Vázquez JF; Hernández-Higareda S; Segura-Zavala JM; OsegueraTorres LF; De la Rosa-Hernández SS [Ti] Título: [Blood loss and use of blood products in cases of cesarean hysterectomy for placenta accrete]. [Ti] Título: Pérdida sanguínea e indicación de hemoderivados en pacientes con cesárea-histerectomía por acretismo placentario.. [So] Source: Ginecol Obstet Mex;84(8):491-7, 2016 08. [Is] ISSN: 0300-9041 [Cp] País de publicação: Mexico [La] Idioma: spa [Ab] Resumo: Background: Placenta accreta (abnormal insertion of the placenta or part of the myometrium ) endangers the lives of pregnant women. It is a public health problem because it can be complicated by obstetric hemorrhage , the latter being the main cause of maternal death worldwide. Objetive: To estimate the blood loss and the use of blood products in patients who underwent cesarean ­ hysterectomy for placenta accreta. Material and methods: A descriptive study was conducted in HGO UMAE CMNO IMSS in patients who underwent cesarean ­ hysterectomy for placenta accreta in a period of 4 years. Results: 106 cases of placenta accreta were studied, 23% had a massive bleeding of > 3000 cc. Packed red blood cells were transfused in 68% of events, fresh frozen plasma in platelet concentrates 29% and 6%. The history of uterine curettage was observed in 64 % and cesarean section 1 or 2 occasions in 76 % of cases. Conclusion: An early detection of placenta accreta in patients with risk factors to avoid emergency surgery is desired. Being prepared with blood products and appropriate use is a cornerstone in the management of this condition. The average blood loss was determined in cases of accreta in cesarean hysterectomy was 2523 milliliters. [Mh] Termos MeSH primário: Perda Sanguínea Cirúrgica Cesárea/métodos Histerectomia/métodos Placenta Acreta/cirurgia [Mh] Termos MeSH secundário: Adulto Transfusão de Sangue/métodos Feminino Seres Humanos México Gravidez Estudos Retrospectivos Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180301 [Lr] Data última revisão: 180301 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180210 [St] Status: MEDLINE

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[PMID]: 29293635 [Au] Autor: Knight S; Aggarwal R; Agostini A; Loundou A; Berdah S; Crochet P [Ad] Endereço: Department of Obstetrics and Gynecology, Assistance Publique-Hôpitaux de Marseille, La Conception Hospital, Marseille, Aix Marseille Université, France. [Ti] Título: Development of an objective assessment tool for total laparoscopic hysterectomy: A Delphi method among experts and evaluation on a virtual reality simulator. [So] Source: PLoS One;13(1):e0190580, 2018. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: INTRODUCTION: Total Laparoscopic hysterectomy (LH) requires an advanced level of operative skills and training. The aim of this study was to develop an objective scale specific for the assessment of technical skills for LH (H-OSATS) and to demonstrate feasibility of use and validity in a virtual reality setting. MATERIAL AND METHODS: The scale was developed using a hierarchical task analysis and a panel of international experts. A Delphi method obtained consensus among experts on relevant steps that should be included into the H-OSATS scale for assessment of operative performances. Feasibility of use and validity of the scale were evaluated by reviewing video recordings of LH performed on a virtual reality laparoscopic simulator. Three groups of operators of different levels of experience were assessed in a Marseille teaching hospital (10 novices, 8 intermediates and 8 experienced surgeons). Correlations with scores obtained using a recognised generic global rating tool (OSATS) were calculated. RESULTS: A total of 76 discrete steps were identified by the hierarchical task analysis. 14 experts completed the two rounds of the Delphi questionnaire. 64 steps reached consensus and were integrated in the scale. During the validation process, median time to rate each video recording was 25 minutes. There was a significant difference between the novice, intermediate and experienced group for total H-OSATS scores (133, 155.9 and 178.25 respectively; p = 0.002). H-OSATS scale demonstrated high inter-rater reliability (intraclass correlation coefficient [ICC] = 0.930; p<0.001) and test retest reliability (ICC = 0.877; p<0.001). High correlations were found between total H-OSATS scores and OSATS scores (rho = 0.928; p<0.001). CONCLUSION: The H-OSATS scale displayed evidence of validity for assessment of technical performances for LH performed on a virtual reality simulator. The implementation of this scale is expected to facilitate deliberate practice. Next steps should focus on evaluating the validity of the scale in the operating room. [Mh] Termos MeSH primário: Histerectomia/métodos Laparoscopia/métodos Realidade Virtual [Mh] Termos MeSH secundário: Competência Clínica Técnica Delfos Estudos de Viabilidade Feminino Seres Humanos Reprodutibilidade dos Testes [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180221 [Lr] Data última revisão: 180221 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180103 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0190580

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[PMID]: 27779566 [Au] Autor: Lai JC; Chen HH; Chu KH; Wang KL; Huang N; Hu HY; Chou YJ [Ad] Endereço: 1Institute of Public Health and Department of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan 2Department of Nursing, Ching Kuo Institute of Management and Health, Keelung, Taiwan 3Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan 4Department of Obstetrics and Gynecology, Taitung Mackay Memorial Hospital, Taitung, Taiwan 5Department of Obstetrics and Gynecology, Mackay Memorial Hospital and Mackay Medical College, Taipei, Taiwan 6Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan 7Department of Education and Research, Taipei City Hospital, Taipei, Taiwan. [Ti] Título: In-hospital complications of bilateral salpingo-oophorectomy at benign hysterectomy: a population-based cohort study. [So] Source: Menopause;24(2):187-195, 2017 Feb. [Is] ISSN: 1530-0374 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: The study compared the in-hospital complications and related outcomes between women who underwent bilateral salpingo-oophorectomy at hysterectomy for benign diseases and those who had hysterectomy only. METHODS: We conducted a population-based, retrospective cohort study using data from Taiwan's National Health Insurance program. Women who underwent concurrent bilateral salpingo-oophorectomy at hysterectomy for benign indications (n = 34,509) were compared with those who had hysterectomy only (n = 176,305). Separate models were estimated to account for the effect of baseline comorbid condition, age, and hysterectomy approach on the relationship between bilateral salpingo-oophorectomy and study outcomes. A secondary analysis was also performed to evaluate the association of inpatient readmission within 30 days and complications among women who underwent bilateral salpingo-oophorectomy. RESULTS: The addition of a bilateral salpingo-oophorectomy to hysterectomy was associated with a lower risk of surgical complications, a longer length of hospital stay, and an increased risk of inpatient readmission within 30 days. Among women who underwent bilateral salpingo-oophorectomy, women with complications were also more likely to require inpatient readmission within 30 days than those without complications. Our data also suggested that bilateral salpingo-oophorectomy was not associated with an overall risk of medical complications, with the exception of urethral obstruction. The relationships remained even after adjustments by age, surgical indications, hysterectomy approach, and health-related risk factors, such as baseline comorbid condition and status of any prior catastrophic illness. CONCLUSIONS: Bilateral salpingo-oophorectomy at hysterectomy for benign conditions is not associated with an increased risk of in-hospital complications. [Mh] Termos MeSH primário: Doenças dos Genitais Femininos/cirurgia Hospitalização/estatística & dados numéricos Histerectomia/efeitos adversos Complicações Pós-Operatórias/epidemiologia Salpingo-Ooforectomía/efeitos adversos [Mh] Termos MeSH secundário: Adulto Idoso Terapia Combinada Feminino Seres Humanos Histerectomia/métodos Meia-Idade Complicações Pós-Operatórias/etiologia Estudos Retrospectivos Fatores de Risco Salpingo-Ooforectomía/métodos Taiwan/epidemiologia Adulto Jovem [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180215 [Lr] Data última revisão: 180215 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161026 [St] Status: MEDLINE [do] DOI: 10.1097/GME.0000000000000746

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[PMID]: 29390473 [Au] Autor: Zhao H; Yao Y; Yang H; Ma D; Chen A [Ad] Endereço: Department of Gynecology, The Affiliated Hospital of Qingdao University, Qingdao, PR China. [Ti] Título: Hormone therapy as a management strategy for lung metastasis after 5 years of endometrial cancer: A case report and literature review. [So] Source: Medicine (Baltimore);96(51):e9223, 2017 Dec. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: Endometrial cancer patients with lung metastases are rare, and more rarely with long-term management of progesterone after recurrence. PATIENT CONCERNS: Informed consent of the patients and their families. DIAGNOSES: Endometrial cancer (IVB) (Refer to 2009 FIGO stag of endometrial cancer). INTERVENTIONS: the patient was treated with Megestrol Acetate Dispersible Tablets (trade name Yilizhi), 160 mg, orally, once daily, without interruption. OUTCOMES: The patient has been treated with progesterone therapy for stable conditions and her survival time is already roughly a decade (December 2006-October 2016). LESSONS: Hormone therapy may as a long-term management for hormone receptor-positive patients with recurrent endometrial cancer. [Mh] Termos MeSH primário: Adenocarcinoma/cirurgia Neoplasias do Endométrio/cirurgia Neoplasias Pulmonares/tratamento farmacológico Neoplasias Pulmonares/secundário Megestrol/uso terapêutico [Mh] Termos MeSH secundário: Adenocarcinoma/secundário Administração Oral Antineoplásicos Hormonais/uso terapêutico Biópsia por Agulha Neoplasias do Endométrio/diagnóstico Feminino Seguimentos Seres Humanos Histerectomia/métodos Imuno-Histoquímica Neoplasias Pulmonares/diagnóstico por imagem Meia-Idade Invasividade Neoplásica/patologia Recidiva Local de Neoplasia/tratamento farmacológico Recidiva Local de Neoplasia/patologia Estadiamento de Neoplasias Medição de Risco Fatores de Tempo Tomografia Computadorizada por Raios X/métodos Resultado do Tratamento Hemorragia Uterina/diagnóstico Hemorragia Uterina/etiologia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Antineoplastic Agents, Hormonal); EA6LD1M70M (Megestrol) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180214 [Lr] Data última revisão: 180214 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180203 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009223

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[PMID]: 28463949 [Au] Autor: Peters A; Sadecky AM; Winger DG; Guido RS; Lee TTM; Mansuria SM; Donnellan NM [Ad] Endereço: *Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital of UPMC, Pittsburgh, PA; †Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR; and ‡Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA. [Ti] Título: Characterization and Preoperative Risk Analysis of Leiomyosarcomas at a High-Volume Tertiary Care Center. [So] Source: Int J Gynecol Cancer;27(6):1183-1190, 2017 Jul. [Is] ISSN: 1525-1438 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: INTRODUCTION: Uterine morcellation in minimally invasive surgery has recently come under scrutiny because of inadvertent dissemination of malignant tissue, including leiomyosarcomas commonly mistaken for fibroids. Identification of preoperative risk factors is crucial to ensure that oncologic care is delivered when suspicion for malignancy is high, while offering minimally invasive hysterectomies to the remaining patients. OBJECTIVES: The aim of this study was to characterize risk factors for uterine leiomyosarcomas by reviewing preoperative, intraoperative, and postoperative data with an emphasis on the presence of concurrent fibroids. METHODS: A retrospective case-control study of women undergoing hysterectomy with pathologic diagnosis of uterine leiomyosarcoma at a tertiary care center between January 2005 and April 2014. RESULTS: Thirty-one women were identified with leiomyosarcoma and matched to 124 controls. Cases with leiomyosarcoma were more likely to have undergone menopause and to present with larger uteri (19- vs 9-week sized), with the most common presenting complaint being a pelvic mass (35.5% vs 8.9%). Controls were ten times more likely to have undergone a tubal ligation (30.6% vs 3.2%). Endometrial sampling detected malignancy preoperatively in only 50% of cases. Leiomyosarcomas were more commonly present when pelvic masses were identified in addition to fibroids on preoperative imaging. Most leiomyosarcoma cases (77.4%) were performed by oncologists via an abdominal approach (83.9%), with only 2 of 31 leiomyosarcomas being morcellated. Comparative analysis of preoperative imaging and postoperative pathology showed that in patients with leiomyosarcoma, fibroids were misdiagnosed 58.1% of the time, and leiomyosarcomas arose directly from fibroids in only 6.5% of cases. CONCLUSIONS: Leiomyosarcoma risk factors include older age/postmenopausal status, enlarged uteri of greater than 10 weeks, and lack of previous tubal ligation. Preoperative testing failed to definitively identify leiomyosarcomas, although the presence of synchronous pelvic masses in fibroid uteri should raise clinical suspicion. Given the difficulty of preoperative identification, future efforts should focus on the development of safer minimally invasive techniques for uterine morcellation. [Mh] Termos MeSH primário: Leiomiossarcoma/patologia Leiomiossarcoma/cirurgia Neoplasias Uterinas/patologia Neoplasias Uterinas/cirurgia [Mh] Termos MeSH secundário: Estudos de Casos e Controles Feminino Seres Humanos Histerectomia/efeitos adversos Histerectomia/métodos Leiomioma/patologia Leiomioma/cirurgia Meia-Idade Inoculação de Neoplasia Cuidados Pós-Operatórios Cuidados Pré-Operatórios Estudos Retrospectivos Medição de Risco Centros de Atenção Terciária [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180206 [Lr] Data última revisão: 180206 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170503 [St] Status: MEDLINE [do] DOI: 10.1097/IGC.0000000000000940

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[PMID]: 29233120 [Au] Autor: Obrzut B; Kusy M; Semczuk A; Obrzut M; Kluska J [Ad] Endereço: Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Rzeszow, Lwowska 60, Rzeszow, 35-301, Poland. [Ti] Título: Prediction of 5-year overall survival in cervical cancer patients treated with radical hysterectomy using computational intelligence methods. [So] Source: BMC Cancer;17(1):840, 2017 12 12. [Is] ISSN: 1471-2407 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Computational intelligence methods, including non-linear classification algorithms, can be used in medical research and practice as a decision making tool. This study aimed to evaluate the usefulness of artificial intelligence models for 5-year overall survival prediction in patients with cervical cancer treated by radical hysterectomy. METHODS: The data set was collected from 102 patients with cervical cancer FIGO stage IA2-IIB, that underwent primary surgical treatment. Twenty-three demographic, tumor-related parameters and selected perioperative data of each patient were collected. The simulations involved six computational intelligence methods: the probabilistic neural network (PNN), multilayer perceptron network, gene expression programming classifier, support vector machines algorithm, radial basis function neural network and k-Means algorithm. The prediction ability of the models was determined based on the accuracy, sensitivity, specificity, as well as the area under the receiver operating characteristic curve. The results of the computational intelligence methods were compared with the results of linear regression analysis as a reference model. RESULTS: The best results were obtained by the PNN model. This neural network provided very high prediction ability with an accuracy of 0.892 and sensitivity of 0.975. The area under the receiver operating characteristics curve of PNN was also high, 0.818. The outcomes obtained by other classifiers were markedly worse. CONCLUSIONS: The PNN model is an effective tool for predicting 5-year overall survival in cervical cancer patients treated with radical hysterectomy. [Mh] Termos MeSH primário: Histerectomia/estatística & dados numéricos Redes Neurais (Computação) Neoplasias do Colo do Útero/mortalidade Neoplasias do Colo do Útero/cirurgia [Mh] Termos MeSH secundário: Adulto Idoso Feminino Seguimentos Seres Humanos Meia-Idade Complicações Pós-Operatórias Curva ROC Máquina de Vetores de Suporte Análise de Sobrevida Neoplasias do Colo do Útero/epidemiologia [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180202 [Lr] Data última revisão: 180202 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171214 [St] Status: MEDLINE [do] DOI: 10.1186/s12885-017-3806-3

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[PMID]: 28454573 [Au] Autor: Kim SW; Chun M; Ryu HS; Chang SJ; Kong TW; Oh YT; Kang SH [Ad] Endereço: Department of Radiation Oncology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea. [Ti] Título: Long-term results of early adjuvant concurrent chemoradiotherapy for high-risk, early stage uterine cervical cancer patients after radical hysterectomy. [So] Source: BMC Cancer;17(1):297, 2017 04 28. [Is] ISSN: 1471-2407 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: The aim of the present study was to investigate the long-term survival outcomes and toxicities associated with our experienced early administration of adjuvant concurrent chemoradiotherapy (CCRT). METHODS: Ninety-eight patients with pelvic lymph node metastasis, positive resection margin, and/or parametrial invasion who received adjuvant CCRT between 1995 and 2011 were analyzed retrospectively. The first cycle of platinum-based adjuvant chemotherapy was initiated within 2-3 weeks after surgery (median, 12 days) and continued every 4 weeks for a total of 4 cycles. Adjuvant radiotherapy was performed during the second and third cycles of chemotherapy. RESULTS: After a median follow-up period of 119 months for survivors, 13 patients (13.3%) experienced recurrence and 11 patients died of cancer during the follow-up period. The 5-year recurrence-free survival and cancer specific survival rates were 87.6% and 90.6%, respectively. Ninety-four patients (95.9%) received ≥3 cycles of chemotherapy. Total radiation dose of ≥45 Gy was delivered in 91 patients (92.9%). Grade 3-4 hematologic and gastrointestinal toxicities developed in 37 (37.8%) and 14 (14.3%) patients during CCRT, respectively. CONCLUSION: The present study confirmed the long-term safety and encouraging survival outcomes of early administration of adjuvant CCRT, suggesting the benefits of early time to initiation of adjuvant treatments. [Mh] Termos MeSH primário: Histerectomia/métodos Avaliação de Resultados (Cuidados de Saúde)/métodos Neoplasias do Colo do Útero/cirurgia Neoplasias do Colo do Útero/terapia [Mh] Termos MeSH secundário: Adulto Idoso Quimiorradioterapia Adjuvante/efeitos adversos Quimiorradioterapia Adjuvante/métodos Diarreia/etiologia Feminino Seres Humanos Histerectomia/efeitos adversos Estimativa de Kaplan-Meier Leucopenia/etiologia Metástase Linfática Meia-Idade Análise Multivariada Estadiamento de Neoplasias Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos Fatores de Tempo Neoplasias do Colo do Útero/patologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180202 [Lr] Data última revisão: 180202 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170430 [St] Status: MEDLINE [do] DOI: 10.1186/s12885-017-3299-0

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[PMID]: 28461392 [Au] Autor: Yang C; Whitmire WM; Sturdevant GL; Bock K; Moore I; Caldwell HD [Ad] Endereço: Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA. [Ti] Título: Infection of Hysterectomized Mice with Chlamydia muridarum and Chlamydia trachomatis. [So] Source: Infect Immun;85(7), 2017 07. [Is] ISSN: 1098-5522 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: We studied infection and immunity of hysterectomized mice infected with and to determine if there were differences between these species in their ability to infect vaginal squamous epithelial cells independently of proximal upper genital tract tissues. We found that readily colonized and infected vaginal squamous epithelial cells, whereas did not. Primary infection of the vaginal epithelium with produced infections of a duration longer than that reported for normal mice. Infection resulted in an inflammatory response in the vagina characterized by neutrophils and infiltrating submucosal plasma cells consisting primarily of T cells. Despite the delayed clearance, rechallenged -infected mice were highly immune. Mice vaginally infected with produced serum and vaginal wash antibodies and an antigen-specific gamma interferon-dominated Th1-biased T cell response. By comparison, mice vaginally infected with exhibited transient low-burden infections, produced no detectable tissue inflammatory response, and failed to seroconvert. We discuss how these marked differences in the biology of vaginal infection between these otherwise genetically similar species are possibly linked to pathogen-specific virulence genes and how they may influence pathology and immunity in the upper genital tract. [Mh] Termos MeSH primário: Infecções por Chlamydia/microbiologia Infecções por Chlamydia/patologia Chlamydia muridarum/crescimento & desenvolvimento Chlamydia muridarum/imunologia Chlamydia trachomatis/crescimento & desenvolvimento Histerectomia Vagina/microbiologia [Mh] Termos MeSH secundário: Animais Anticorpos Antibacterianos/análise Anticorpos Antibacterianos/sangue Infecções por Chlamydia/imunologia Feminino Interferon gama/secreção Camundongos Endogâmicos C57BL Linfócitos T/imunologia [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., INTRAMURAL [Nm] Nome de substância: 0 (Antibodies, Bacterial); 82115-62-6 (Interferon-gamma) [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 180131 [Lr] Data última revisão: 180131 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170503 [St] Status: MEDLINE

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1			PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
2	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
3	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2

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