Endometrioid endometrial adenocarcinoma: an increase of G3 cancers?

PURPOSE: Endometrial cancer can be divided into two types: endometrioid Type 1 (G1, G2) has a hormonal driven etiology, while Type 2 is more aggressive (G3 endometrioid, clear cell and serous cancer type) and estrogen independent. We noticed an increase of more aggressive G3 endometrioid endometrial adenocarcinomas. This observation is of relevance for daily clinical practice because therapy depends on the histopathological grading and myometrial invasion. G3 cancers or myometrial invasion of more than 50% should be hysterectomized including bilateral adnexectomy with pelvine and paraaortal lymphadenectomy. In G1/G2 and lower infiltration levels, hysterectomy with adnexectomy without lymphadenectomy is sufficient. METHODS: Data of the ASF Statistic were used to analyze the changes in the incidences of patients with endometrioid cancer, grading groups and their first diagnosed stages between 2006 and 2014. RESULTS: 2611 patients, with 243-341 women per year, were analyzed. The number of diagnosed G1 tumors increased from 25 to 37% and the G3 tumors from 18 to 32%, whereas the G2 cancers decreased from 58 to 31%. Despite the rise of G3 tumors, an increase in age at diagnosis was not observed. The proportions of initial diagnosed stages (FIGO I-IV) in each grading remained constant over time. CONCLUSION: Potential consequences in treatment recommendations and prognosis urge attention to the detected increase of G3 endometrioid cancers.

The effects of dietary non-starch polysaccharides on Ascaridia galli infection in grower layers.

This study examined whether Ascaridia galli infection can be controlled by dietary non-starch polysaccharides (NSP) in chickens. One-day-old chicks were fed either a basal diet (CON) or CON plus insoluble NSP (I-NSP), or CON plus soluble NSP (S-NSP) for 11 weeks. Three weeks later, birds from half of each feeding group were inoculated with 250 embryonated eggs of A. galli, and slaughtered 8 weeks post-infection to determine worm counts. Both NSP diets, particularly S-NSP, increased prevalence of infection (P<0·05) and worm burden (roughly +50%) of the birds (P<0·001). A. galli infection caused a less efficient (P=0·013) feed utilization for body weight gain (BWG) resulting in lower body weights (P<0·001) irrespective of type of diet consumed. NSP-fed birds, particularly those on I-NSP, consumed more (+8%) feed per unit BWG and showed retarded (P<0·001) BW development compared to CON-fed birds. Intracaecal pH was lowered by S-NSP (P<0·05). Both NSP diets increased the volatile fatty acids pool size in caeca (P<0·001) with S-NSP exerting a greater effect (+46%) than I-NSP (+24%). It is concluded that both NSPs supplemented diets alter gastrointestinal environment in favour of the nematode establishment, and thus have no potential for controlling A. galli infection in chickens.

Surgical reduction of ileal impactions in the horse: 28 cases.

OBJECTIVE: To evaluate the seasonal influence, signalment, type of hay consumed, clinical examination findings, and outcome after surgery for horses with ileal impaction. STUDY DESIGN: A retrospective study. RESULTS: Between 1988 and 1993, 28 horses had surgical correction of ileal impaction. There was a significantly higher rate of ileal impaction during the Fall (September-November, P = .0041 ). Mean duration of clinical signs of abdominal pain before referral was 15 hours. Transrectal palpation was used to localize the impaction in 11 horses. The ileal impaction was reduced by extraluminal massage aided by admixing of intestinal fluid oral to the impaction or injection of fluids intraluminally and then movement of the ingesta into the cecum alone in 24 horses. A total of 26 horses recovered from surgery; 24 horses were discharged from the hospital and eventually returned to previous use. Two horses had fatal postoperative complications: jejunocecostomy dehiscence and development of extensive small intestine adhesions after manual reduction of the impaction. One horse initially treated by manual reduction required jejunocecostomy twice for management of recurrent ileal impaction. Follow-up information was obtained for 21 horses, of which 20 were alive 1 year or longer after surgery. A total of 27 of 28 horses were fed Coastal Bermudagrass hay as the primary type of hay consumed. A total of 9 horses continued to be fed Coastal Bermudagrass hay as the only roughage source, whereas 6 horses were fed Coastal Bermudagrass with at least 50% other hay, and in 6 horses, Coastal Bermudagrass hay was entirely eliminated from the diet. CONCLUSION AND CLINICAL RELEVANCE: Ileal impactions can be successfully reduced by celiotomy and extraluminal massage and injection techniques to soften the ingesta for passage into the cecum without enterotomy or bypass techniques in most horses. Changes in weather and feeding practices in the Fall may account for an increased risk of ileal impaction in horses in the southeastern United States at that time of year.

Medical treatment of horses with ileal impactions: 10 cases (1990-1994).

OBJECTIVE: To evaluate clinical and laboratory findings for horses treated medically for ileal impactions. DESIGN: Retrospective case series. ANIMALS: 10 horses with primary ileal impaction that were treated successfully with medical treatment alone. PROCEDURE: Medical records were reviewed for all horses with naturally developing ileal impaction seen at our hospital between 1990 and 1994. RESULTS: Transrectal palpation revealed an impaction in the midabdominal area in all horses. Generalized distention of the small intestine was evident in 6 horses, whereas 4 horses were examined early in the course of the condition and did not have intestinal distention. Treatment consisted of intravenous administration of a balanced electrolyte solution, nasogastric intubation and siphonage, and administration of analgesics. Mineral oil was administered after gastric reflux had ceased. Mean time for resolution of ileal impaction was 11.7 hours. CLINICAL IMPLICATIONS: Medical treatment may be a viable alternative for horses that cannot have surgery, provided persistent signs of severe pain or progressive gaseous distention of the small intestine are not features of the condition. Improvement of cardiovascular status, reduction in signs of abdominal pain, decrease in distention of loops of small intestine during repeated transrectal examination, softening of the impaction, and decreases in amounts of gastric reflux were indicative of a response to medical treatment.

Traumatic tarsal luxation repaired without internal fixation in three horses and three ponies.

Three horses and three ponies were treated for traumatic luxation of the proximal intertarsal or tarsometatarsal joint. In each case, there were fractures of one or more tarsal bones. Three of the animals had disruption of one of the collateral ligaments. Five animals were treated by closed reduction and external coaptation. One pony was treated by open curettage, a cancellous bone graft, and cast immobilization. No internal fixation was used in any of these animals. From this series of cases, it would appear that closed reduction and external coaption alone is adequate treatment for most cases of tarsal luxation.

Noniatrogenic rectal tears in three horses.

Rectal tears were detected in three horses treated for colic. Based on historical, clinical, and postmortem findings, the tears could not be attributed to the attending veterinarian and were therefore not iatrogenic (physician induced). One tear was attributable to an infarction that presumably resulted from thromboembolism; 1 tear occurred without any evidence of external cause and resulted in such severe peritonitis that the cause and resulted in such severe peritonitis that the cause could not be determined, and 1 tear occurred during rectal palpation by the owner, before he called the veterinarian. Postmortem examination of the last horse revealed lesions suggestive of thromboembolism. It was concluded that thromboembolism may have caused or predisposed to two of the rectal tears and could not be ruled out in the third.

Effect of exercise, phenylbutazone, and furosemide on the plasma renin activity and angiotensin I in horses.

Circulating concentrations of angiotensin I and plasma renin activity (PRA) were determined in 45 Thoroughbreds before prerace medication (at rest), 1 to 1 1/2 hours before racing but after prerace medication (prerace), within 15 minutes after racing (immediately postrace), and between 1 to 2 hours after racing. Angiotensin I was measured by radioimmunoassay, and PRA was determined by the rate of generation of angiotensin I in plasma incubated at 37 C. Irrespective of prerace medication, there was a marked increase in angiotensin I (0.478 +/- 0.034 to 0.848 +/- 0.051 ng/ml) and PRA (0.191 +/- 0.018 to 0.522 +/- 0.061 ng/hour/ml) from the at-rest samples to the immediate-postrace samples, with the exception of anhidrotic horses in which increases in angiotensin I (0.7131 +/- 0.0794 to 0.8081 +/- 0.0608 ng/ml) and PRA (0.1635 +/- 0.0379 to 0.2176 +/- 0.0437 ng/hour/ml) were not as marked as they were in other horses. Administration of 1 mg of furosemide/kg 2 hours before racing caused an increase in PRA from 0.2438 +/- 0.0324 to 0.3706 +/- 0.1110 ng/hour/ml, whereas horses under the influence of 4 mg of phenylbutazone/kg had a decrease in PRA from 0.2090 +/- 0.0440 to 0.0669 +/- 0.0206 ng/hour/ml. Marked increases in angiotensin I and in PRA did not occur when horses were administered furosemide and phenylbutazone as prerace medication.