Conservative management of endometrial cancer: a survey amongst European clinicians.

OBJECTIVE: To investigate differences and similarities in the clinical approach of young clinicians managing women with endometrial cancer (EC) conservatively. METHODS: A web-based survey was carried out. A platform of the European Network of Young Gynaecological Oncologists (ENYGO) database was used. A 38-item multiple-choice questionnaire was used to evaluate current practice in fertility-sparing management of EC. The survey covered investigations, treatment options, follow-up and management of recurrence and future family planning. Descriptive statistics were used. RESULTS: Overall, 116 out of 650 (17.84%) ENYGO members responded to the survey. In 92 (79.3%) centres, the caseload of early stage EC treated conservatively was less than 10 per year. One hundred and seven responders (93.8%) believe that treatment with progestins could be offered in grade 1 EC without myometrial invasion, but a minority would recommend it even for grade 2 tumours with no myometrial invasion or grade 1 with superficial invasion. The diagnostic tool for establishing grade of tumour was hysteroscopy with dilatation and curettage in 64 (55%) centres. Medroxyprogesterone acetate represents the most commonly prescribed progestogen (55, 47.4%). In 78 (67.2%) centres, a repeat endometrial biopsy was offered after 3 months of treatment commencement. Recurrences are treated mostly with hysterectomy (81, 69.9%) with only a small number of responders recommending to repeat progestin treatment. Lynch syndrome is a contraindication for conservative management in half of the responders (57, 49.1%). Most clinicians agree that patients should be referred promptly for assisted reproductive techniques once complete response has been achieved (68, 58.6%). CONCLUSIONS: Our study shows that conservative management is increasingly offered to women affected by early stage EC wishing to preserve their fertility. Further studies and joint registries are required to evaluate safety and effectiveness of this approach in this probably growing number of patients.

Independent psychometric validation of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Endometrial Cancer Module (EORTC QLQ-EN24).

The endometrial cancer (EC)-specific Quality of Life module of the European Organization for Research and Treatment of Cancer (EORTC QLQ-EN24), was developed and validated in one study. We independently validated and assessed the psychometric properties of the instrument. Two hundred and eight women with EC before surgery, during adjuvant treatment and follow-up; in three different cancer centres completed the EORTC QLQ-C30 and the EN24. The questionnaire's completion rate was 100%, except sexuality items, that were answered by 35% of patients. All item-scale correlations for the multi-item scales exceeded the .4 criterion and correlated well with their own scale, while correlations with the other scales were low. The internal consistency of all multi-item scales were satisfactory (Cronbach's alpha coefficients ranging from .77 to .97). Discriminance for single-item scales was low. The QLQ-EN24 module discriminated well between clinically different patients, and there were no differences in quality of life questionnaire scales between patients with body mass index ≤30 when compared to those with >30. This validation study supports the reliability, as well as convergent and divergent validity of the EORTC QLQ-EN24. The module is a useful instrument for the assessment of QOL in patients with EC. However, data concerning sexuality should be interpreted with caution.

Influence of body weight changes on survival in patients undergoing chemotherapy for epithelial ovarian cancer.

OBJECTIVE: Epithelial ovarian cancer is a highly fatal gynecologic malignancy with a poor prognosis. Therefore, identification of new modifiable prognostic factors is important. Due to the fact that the effect of body weight changes during chemotherapy for EOC is still not very well known we aimed to describe, considering evidence, role of body weight changes in relation to survival. MATERIALS AND METHODS: Between October 2014 and August 2015 we systematically searched the following databases: Medline, Scopus, Web of Science and EMBASE to identify the studies describing the influence of body weight changes on survival in patients undergoing chemotherapy for EOC. RESULTS: We identified 601 potentially relevant publications, however finally only one article was included for data extraction and analysis. The overall survival in the selected paper was significantly associated with body weight changes during the first-line chemotherapy. Nevertheless, no influence on progression free survival was found. CONCLUSIONS: The analyzed data provides initial evidence, showing poorer overall survival  associated with body weight loss and improved overall survival associated with body weight gain during primary chemotherapy for epithelial ovarian cancer. Prospective and retrospective trials are an urgent calling to confirm this conclusion.

The investigation of correlation among selected biochemical parameters and vital signs in dairy herd to design the bio-cybernetic dairy cow model.

The paper presents investigations of the relationship between the biochemical parameters and vital signs in dairy cows. We analyzed the welfare and functioning of a dairy herd using biochemical parameters and vital signs. Life and biochemical parameters were examined. In the model indicators useful for monitoring the herd are: the age of the cows, the number of cows' lactating, daily amount of received milk, length of lactation period for cows in the herd, the length of inter-calving period for cows, the number of days to effective insemination, the amount of protein in the feed, the level of ß-oxidation in leucocytes, glucose transport through red blood cells and plasma insulin. Based on the results the mathematical model was designed allowing the presentation of a cybernetic model of cow's organism. There was constructed a multi-equation model which determined the relationships between the selected variables describing the state of dairy cows in the herd and variables that characterize their welfare with its statistical verification.

Perfluorinated compounds in some terrestrial and aquatic wildlife species from Poland.

Perfluorooctanesulfonate (PFOS) at 1.6-39 ng/g ww and 4.8-200 pg/mL, respectively, perfluorooctanoate (PFOA) at 0.06-0.28 ng/g ww and<0.05-1.8 pg/mL, and perfluorodecanoate (PFDA) at 0.13-0.57 ng/g ww and 0.05-1.8 pg/mL, were detected in all specimens of European Beaver's (Castor fiber) liver as well as in whole blood of Cod (Gadus morhua), Velvet Scoter (Melanitta fusca), Eider Duck (Sommateria mollisima), Long-tailed Duck (Clangula hyemalis), Razorbill (Alca torda), Red-throated Diver (Gavia stellata) sampled in Poland. At smaller concentrations and at less frequency was perfluorononanoate (PFNA) at 0.05-1.4 ng/g ww and<0.2-2 pg/mL, perfluorohexanoate (PFHxA) at 0.03-0.23 ng/g ww and<0.05-0.69 pg/mL, while perfluorohexanesulfonate (PFHxS) at 0.05-4.3 pg/mL and perfluorooctanesulfonamidoacetate (PFOSA) at 0.1-13 pg/mL were also found in Cod as well as in molluscivorous diving-ducks and fish-eating birds but not in Beaver, while perfluoroheptanoate (PFHpA) at<0.05-0.74 pg/mL was found only in Cod.

Concentrations of heavy metals in the tissues of red deer (Cervus elaphus) from the region of Warmia and Mazury, Poland.

Cadmium, lead, copper and zinc were quantified using a validated ICP/MS method in the tissues and organs of 82 specimens of red deer of different sexes and ages, which had been hunted at the Great Lakes Land region in the north-eastern of Poland in 2000-01. Copper and zinc occurred in liver, kidney and muscle tissue of red deer at concentrations of 6.4-29, 3.3-7.2 and 1.9-6.4, and of 19-43, 17-41 and 19-64 mg kg(-1), respectively, which are considered typical for the species, age and gender compared with values noted for some other wild and domestic ruminant species elsewhere. For cadmium and lead, the concentrations decreased in the order kidney > liver > muscle tissue, with overall means of 2.2, 0.19, and 0.10, 0.31, and 0.26, 0.22 mg kg(-1) wet weight, respectively. The cadmium content of the kidney of a proportion of red deer sampled exceeded the legal tolerance limits set in Poland. The means (but not individual animal data) obtained for cadmium in kidney and liver correlated (0.99) with the age of red deer. Also, the lead content of the muscle meat of red deer for many carcasses exceeded the legal limit, which was probably due to contamination from the fine dust particle remains from the lead bullets used.

Morphological analysis of yeast cells using an automated image processing system.

In order to control the growth of the yeast Saccharomyces cerevisiae during cultivations, a fully-automated sampling and analysing system has been developed. Based on the microscopic appearance of cells, a detailed characterization of yeast suspensions from the bioreactor is available, presenting data of current cell concentrations, distributions of process-dependent cell structures and parts of cells containing vacuoles. This measuring system combines quantitative and qualitative analysis methods in a digital image processing technique, which offers the possibility of on-line estimation of cell development that approximates real-time. Perturbations within the process are detectable in time and regulative actions can be done without any delay.