Benign Hysterectomy Operative Times and 30-Day Complications: A Cohort Study.

STUDY OBJECTIVE: To evaluate the 30-day complication rate among different hysterectomy routes and operative times. DESIGN: A retrospective cohort study. SETTING: American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2019. PATIENTS: A total of 216 621 total cases including total abdominal hysterectomies (TAHs), total vaginal hysterectomies, total laparoscopic-assisted vaginal hysterectomies, and total laparoscopic hysterectomies. INTERVENTIONS: Eligible cases included benign hysterectomies with operative times between 20 minutes and 500 minutes. We excluded cases involving disseminated cancer, emergency surgery, supracervical approaches, or concomitant procedures. MEASUREMENTS AND MAIN RESULTS: Multivariable logistic regression was used to evaluate the relationship between postoperative complications and operative time for each operative route. Multivariable logistic regression with a linear spline term was used to analyze differences in the association between postoperative complications and operative time below and above threshold operative times. Multivariable logistic regression demonstrated a significant association between operative time and overall complication rates for all hysterectomy routes. Spline logistic regression demonstrated a significant increase in adjusted odds of a complication occurring at or above the thresholds of 100 minutes for TAH. CONCLUSION: Patients undergoing a TAH for benign indications had a significantly increased odds of developing a complication within 30 days when operative time exceeded 100 minutes. Operative time may play a larger role in preoperative, intraoperative, and postoperative management than previously recognized for TAH in contrast to other hysterectomy routes.

A nuclear polymorphism at the 8q24 region is associated with improved survival time and chemo-response in high-grade serous ovarian cancer.

The 8q24 chromosomal region is strongly associated with an increased risk of ovarian cancer. One single nucleotide polymorphism that is associated with ovarian cancer in this region is rs6983267, located within the long non-coding RNA colon cancer associated transcript 2 (CCAT2). The aim of the present study was to assess the association between rs6983267 and clinical outcomes in patients with high-grade serous ovarian cancer (HGSOC). The present retrospective genetic association study utilized Sanger sequencing to determine the genotype at the rs6983267 locus (GG, GT, TT) in 98 patients with HGSOC. Survival time and chemotherapy responses between patients were compared with the TT genotype and patients with a genotype containing a G allele (GT, GG). Survival analyses were performed using Cox proportional hazard ratio analysis. Association with chemo-response was performed using a logistic regression. The results revealed that patients with HGSOC and the TT genotype at the rs6983267 locus had improved survival time compared with patients with genotypes containing a G allele [hazard ratio=0.59; 95% confidence interval (CI), 0.36-0.97; P=0.039] and were significantly associated with International Federation of Gynecology and Obstetrics stage [odds ratio (OR)=5.34; 95% CI, 1.50-22.62; P=0.014] and positive chemo-response (OR=4.51; 95% CI, 1.40-18.00; P=0.018). In summary, patients with HGSOC and the TT genotype at the rs6983267 locus had improved survival time compared with those with a G allele, despite being associated with more advanced disease; this was possibly due to an improved response to chemotherapy.

A flavin binding cryptochrome photoreceptor responds to both blue and red light in Chlamydomonas reinhardtii.

Cryptochromes are flavoproteins that act as sensory blue light receptors in insects, plants, fungi, and bacteria. We have investigated a cryptochrome from the green alga Chlamydomonas reinhardtii with sequence homology to animal cryptochromes and (6-4) photolyases. In response to blue and red light exposure, this animal-like cryptochrome (aCRY) alters the light-dependent expression of various genes encoding proteins involved in chlorophyll and carotenoid biosynthesis, light-harvesting complexes, nitrogen metabolism, cell cycle control, and the circadian clock. Additionally, exposure to yellow but not far-red light leads to comparable increases in the expression of specific genes; this expression is significantly reduced in an acry insertional mutant. These in vivo effects are congruent with in vitro data showing that blue, yellow, and red light, but not far-red light, are absorbed by the neutral radical state of flavin in aCRY. The aCRY neutral radical is formed following blue light absorption of the oxidized flavin. Red illumination leads to conversion to the fully reduced state. Our data suggest that aCRY is a functionally important blue and red light-activated flavoprotein. The broad spectral response implies that the neutral radical state functions as a dark form in aCRY and expands the paradigm of flavoproteins and cryptochromes as blue light sensors to include other light qualities.