Accuracy of preoperative cross-sectional imaging in cervical cancer patients undergoing primary radical surgery.

OBJECTIVE: We aim to describe the false negative (FN) and false positive (FP) rates of preoperative cross-sectional imaging (PCI) prior to radical surgery for cervical cancer. METHODS: A retrospective cohort study of patients who underwent radical hysterectomy for early-stage cervical cancer from January 2010 until December 2017 at a single tertiary care center was performed. Patients were included if they underwent preoperative PCI and radical surgery. Patient demographics and clinicopathologic information were recorded from medical record review. Descriptive statistics were used. RESULTS: Overall, 106 patients met inclusion criteria. Eighty-four percent (89/106) of patients had no suspicion for metastatic disease on PCI, while 16% (17/106) had suspicion for metastatic disease. Of the 89 without suspicion for metastatic disease on PCI, 16% (14/89) had a false negative study with metastatic disease identified on final surgical pathology. False negative rates by modality were 16% (11/70) for PET/CT and 6% (2/33) for diagnostic CT. Of the 17 cases with suspicion for metastatic disease on imaging, 53% (9/17) were false positive studies with no metastatic disease identified histologically. False positive rates by modality were 7% (5/70) for PET/CT and 12% (4/33) for diagnostic CT. CONCLUSION: PCI is a tool to help identify patients who are optimal candidates for radical surgery. In this sample, the false negative rate was 16%, and false positive rate was 53% for PCI among women who underwent primary radical surgery. Further study is needed to explore preoperative testing that may more accurately identify optimal surgical candidates.

Aedes aegypti (L.) and Anopheles stephensi Liston (Diptera: Culicidae) Susceptibility and Response to Different Experimental Formulations of a Sodium Ascorbate Toxic Sugar Bait.

Attractive toxic sugar baits (ATSBs) require target insects to locate, orient toward, and feed on an insecticidal sugar solution to control populations. Formulating these baits with different attractants and phagostimulants can increase their efficacy by causing insects to choose the ATSB over competing natural sugar sources, and to ingest more of the bait solution. We tested formulations of a 20% sodium ascorbate (SA) ATSB solution using different sugars, adenosine triphosphate (ATP), gallic acid, and six plant volatile compounds to determine their effect on adult Aedes aegypti (L.) and Anopheles stephensi Liston mortality. Baits formulated with fructose or sucrose had no effect on either species, neither did the addition of ATP. Gallic acid increased the survival of Ae. aegypti. Four of the six volatile compounds increased mortality in at least one species. We also examined An. stephensi response to baits formulated with each of the six volatile compounds. Anisaldehyde significantly increased the number of mosquitoes responding toward the SA-ATSB, but increasing the amount had no effect. Addition of anisaldehyde also significantly increased An. stephensi feeding rates on the SA-ATSB, though mosquitoes will avoid the toxic bait if a nontoxic sugar source is available. Formulation of SA-ATSBs with synthetic blends of attractive compounds can increase bait efficacy and consistency, though further research is needed to assess their performance in the field in the presence of natural sugar sources.

The Role of Obesity in the Development and Management of Gynecologic Cancer.

IMPORTANCE: Endometrial cancer is the most common gynecologic malignancy, with an estimated 54,000 new cases and 10,000 deaths in the United States in 2015. The obesity epidemic directly contributes to the escalating prevalence of chronic diseases, including obesity-related cancers. Patient body weight and nutritional status markedly impact perioperative oncologic care, chemotherapy administration, recurrence risk, and survivorship goals. OBJECTIVES: The objective of this review is to explore the association between obesity and the development, treatment, and survival outcomes of gynecologic cancers. EVIDENCE ACQUISITION: A systematic literature review was performed utilizing PubMed and ClinicalTrials.gov. CONCLUSIONS AND RELEVANCE: Caring for obese women with gynecologic cancers presents unique challenges. A coordinated multidisciplinary and system effort is required to address the prevention and treatment of obesity, as the sequela of this disease is a clear risk factor for the development of gynecologic malignancy and other comorbidities. Health care providers must be ready to address this worldwide health problem.