Pembrolizumab Improves Survival After Resection of Intracardiac Metastatic Cervical Carcinoma.

Intracardiac metastasis of cervical squamous cell carcinoma (C-SCC) is rare, with historically poor long-term survival. We report the case of a 55-year-old woman with prior metastatic C-SCC who was found to have a right ventricular mass causing functional pulmonic stenosis and multiple pulmonary emboli 19 months after her initial diagnosis. She underwent surgical resection to prevent further embolization and heart failure. Pathology confirmed metastatic C-SCC and she was maintained on adjuvant pembrolizumab. She remained well 32 months later without further disease progression. Surgical resection of intracardiac metastasis of C-SCC combined with pembrolizumab therapy may result in improved postoperative life expectancy.

Minimizing exposure to passive smoke in the enclosed environment of U.S. submarines.

OBJECTIVE: This study was designed to determine which designated smoking area on a submarine, forward or aft, minimizes nonsmokers' exposure to environmental tobacco smoke. METHODS: A survey was administered and urine tested by an enzyme-linked immunoassay for urinary cotinine before and during a 10 d underway. There were four groups tested; submariners on boats with forward or aft designated smoking areas, with each of these groups further divided into submariners whose watch is primarily forward or aft. RESULTS: There were no significant differences in urine cotinine levels between submariners whose watches are primarily in the forward section as compared with those who work primarily aft. This was true for predeployment as compared with deployment levels and whether the designated smoking area was located forward or aft. CONCLUSION: Using cotinine as a marker, passive smoke exposure appears to be minimum. The location of the designated smoking area aboard U. S. Navy submarines does not appear to have any effect on urinary cotinine levels.