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Extragenital Malignant Mixed Mesodermal Tumor: Case Report And Review Of The Literature, M. Ergeneli, B. Demirhan, Eyup Duran, M. Erdogan
Extragenital Malignant Mixed Mesodermal Tumor: Case Report And Review Of The Literature, M. Ergeneli, B. Demirhan, Eyup Duran, M. Erdogan
Eyup Hakan Duran
Malignant mixed mesodermal tumors rarely occur in extragenital sites. An 80-year-old patient presented with a malignant mixed mesodermal tumor, consisting of papillary serous adenocarcinoma and chondrosarcomatous components. The patient refused further treatment following surgery and died of disease 2.5 months later. Based on the present case and a review of the literature, primary extragenital malignant mixed mesodermal tumors prove to be rare but highly malignant neoplasms. Further data is yet to be gathered in order to determine the exact origin and behavior of these tumors.
Pelvic Floor Symptoms And Lifestyle Factors In Older Women, Catherine Bradley, Colleen Kennedy, I. Nygaard
Pelvic Floor Symptoms And Lifestyle Factors In Older Women, Catherine Bradley, Colleen Kennedy, I. Nygaard
Colleen Kennedy Stockdale
OBJECTIVES: To measure the prevalence of pelvic floor symptoms in noncare-seeking older women and the association between symptoms and lifestyle factors. METHODS: Women enrolled at one site of the Women's Health Initiative Hormone Therapy clinical trial completed a questionnaire, modified from the Pelvic Floor Distress Inventory, on bladder, bowel, and prolapse symptoms. Individual symptoms and symptom groups were examined in a cross-sectional analysis. RESULTS: In the 297 women who participated, mean age was 68.2 years, mean body mass index (BMI) was 30.2 kg/m(2), and median vaginal parity was 3. The median number of symptoms endorsed was 3 (range 0-18). The …
Bladder And Bowel Symptoms Among Women With Vulvar Disease: Are They Universal?, Colleen Kennedy, I. Nygaard, Catherine Bradley, R. Galask
Bladder And Bowel Symptoms Among Women With Vulvar Disease: Are They Universal?, Colleen Kennedy, I. Nygaard, Catherine Bradley, R. Galask
Colleen Kennedy Stockdale
OBJECTIVE: To compare the prevalence of painful bladder syndrome, recurrent urinary tract infections, urinary leakage and irritable bowel syndrome between women with specific vulvar disorders and controls. STUDY DESIGN: Women with a primary diagnosis of vulvar intraepithelial neoplasia (dysplasia), vulvar vestibulitis (vestibulitis), contact vulvitis, atrophic vulvovaginitis, lichen simplex, lichen sclerosus and lichen planus, were compared to women presenting for annual examinations. RESULTS: As compared to controls, painful bladder syndrome was more prevalent among subjects with dysplasia, vestibulitis and contact vulvitis; a history of recurrent urinary tract infection was more prevalent among subjects with contact vulvitis; and urinary incontinence was less …
Risk Factors For Painful Bladder Syndrome In Women Seeking Gynecologic Care, Colleen Kennedy, Catherine Bradley, R. Galask, I. Nygaard
Risk Factors For Painful Bladder Syndrome In Women Seeking Gynecologic Care, Colleen Kennedy, Catherine Bradley, R. Galask, I. Nygaard
Colleen Kennedy Stockdale
The aim of this cross-sectional study was to report risk factors for painful bladder syndrome in women. We surveyed 645 women presenting for care to general gynecology clinics and a vulvar specialty clinic using a standardized questionnaire and validated outcome measures. We used two definitions for painful bladder syndrome, based on the O'Leary-Sant interstitial cystitis symptom and problem indices. Of those women surveyed, 29.5% met broader criteria and 8.5% met more restrictive criteria for painful bladder syndrome. After adjusting for confounders, bladder pain was significantly associated with current smoking, irritable bowel syndrome, and a generalized pain disorder. Tobacco use, the …
A New Questionnaire For Urinary Incontinence Diagnosis In Women: Development And Testing, Catherine Bradley, E. Rovner, M. Morgan, M. Berlin, J. Novi, J. Shea, L. Arya
A New Questionnaire For Urinary Incontinence Diagnosis In Women: Development And Testing, Catherine Bradley, E. Rovner, M. Morgan, M. Berlin, J. Novi, J. Shea, L. Arya
Catherine S. Bradley
OBJECTIVE: The purpose of this study was to develop a questionnaire for urinary incontinence diagnosis in women and to test its reliability and validity, with incontinence specialists' clinical evaluations as the gold standard. STUDY DESIGN: One hundred seventeen urogynecology outpatients with urinary incontinence symptoms completed the Questionnaire for Urinary Incontinence Diagnosis at enrollment and 1 week and 9 months later. Baseline clinical diagnoses were compared with Questionnaire for Urinary Incontinence Diagnosis diagnoses (criterion validity). Nine-month Questionnaire for Urinary Incontinence Diagnosis change scores were compared across treatment groups (responsiveness). RESULTS: Clinical diagnoses included stress (n = 15), urge (n = 26), …
Effects Of Colpocleisis On Bowel Symptoms Among Women With Severe Pelvic Organ Prolapse, R. Gutman, Catherine Bradley, W. Ye, A. Markland, W. Whitehead, M. Fitzgerald
Effects Of Colpocleisis On Bowel Symptoms Among Women With Severe Pelvic Organ Prolapse, R. Gutman, Catherine Bradley, W. Ye, A. Markland, W. Whitehead, M. Fitzgerald
Catherine S. Bradley
INTRODUCTION AND HYPOTHESIS: Our objective was to evaluate bowel symptoms after colpocleisis. METHODS: This was a planned ancillary analysis of a prospective, colpocleisis cohort study of 152 women. Those with baseline and 1-year questionnaires (Colorectal-Anal Distress Inventory (CRADI) and the Colorectal-Anal Impact Questionnaire (CRAIQ)) were included. "Bothersome" CRADI symptoms (score>2("moderately", "quite a bit")) were identified. CRADI and CRAIQ scores were compared, and postoperative symptom resolution and new symptom development were measured. RESULTS: Of 121 (80%) subjects with complete data, mean age was 79.2 +/- 5.4 years and all had stage 3-4 prolapse. Procedures performed: partial colpocleisis (61%), total colpocleisis …
Vaginal Wall Descensus And Pelvic Floor Symptoms In Older Women, Catherine Bradley, I. Nygaard
Vaginal Wall Descensus And Pelvic Floor Symptoms In Older Women, Catherine Bradley, I. Nygaard
Catherine S. Bradley
OBJECTIVE: To understand the clinical significance of early pelvic organ prolapse in older women, we studied associations between vaginal descensus and pelvic floor symptoms. METHODS: In this cross-sectional study, 270 women enrolled at one site of the Women's Health Initiative clinical trial completed a questionnaire modified from the Pelvic Floor Distress Inventory on pelvic floor symptoms and underwent a Pelvic Organ Prolapse Quantification (POP-Q) examination. We tested associations between symptoms (individual and grouped) with anterior, posterior, uterine, and maximum vaginal descensus. RESULTS: Mean age was 68 years. Ninety-six percent had POP-Q stages I or II. Only obstructive urinary symptoms and …
Bladder And Bowel Symptoms Among Women With Vulvar Disease: Are They Universal?, Colleen Kennedy, I. Nygaard, Catherine Bradley, R. Galask
Bladder And Bowel Symptoms Among Women With Vulvar Disease: Are They Universal?, Colleen Kennedy, I. Nygaard, Catherine Bradley, R. Galask
Catherine S. Bradley
OBJECTIVE: To compare the prevalence of painful bladder syndrome, recurrent urinary tract infections, urinary leakage and irritable bowel syndrome between women with specific vulvar disorders and controls. STUDY DESIGN: Women with a primary diagnosis of vulvar intraepithelial neoplasia (dysplasia), vulvar vestibulitis (vestibulitis), contact vulvitis, atrophic vulvovaginitis, lichen simplex, lichen sclerosus and lichen planus, were compared to women presenting for annual examinations. RESULTS: As compared to controls, painful bladder syndrome was more prevalent among subjects with dysplasia, vestibulitis and contact vulvitis; a history of recurrent urinary tract infection was more prevalent among subjects with contact vulvitis; and urinary incontinence was less …
Predictors Of Success And Satisfaction Of Nonsurgical Therapy For Stress Urinary Incontinence, J. Schaffer, C. Nager, F. Xiang, D. Borello-France, Catherine Bradley, J. Wu, E. Mueller, P. Norton, M. Paraiso, H. Zyczynski, H. Richter
Predictors Of Success And Satisfaction Of Nonsurgical Therapy For Stress Urinary Incontinence, J. Schaffer, C. Nager, F. Xiang, D. Borello-France, Catherine Bradley, J. Wu, E. Mueller, P. Norton, M. Paraiso, H. Zyczynski, H. Richter
Catherine S. Bradley
OBJECTIVE: To identify factors that may predict success and satisfaction in women undergoing nonsurgical therapy for stress urinary incontinence. METHODS: Baseline demographic and clinical characteristics of women participating in a multicenter randomized trial of pessary, behavioral, or combined therapy for stress urinary incontinence were evaluated for potential predictors of success and satisfaction. Success and satisfaction outcomes were assessed at 3 months and included the Patient Global Impression of Improvement, stress incontinence subscale of the Pelvic Floor Distress Inventory, and Patient Satisfaction Questionnaire. Logistic regression was performed to identify predictors, adjusting for treatment and other important clinical covariates. Adjusted odds ratios …
Risk Factors For Painful Bladder Syndrome In Women Seeking Gynecologic Care, Colleen Kennedy, Catherine Bradley, R. Galask, I. Nygaard
Risk Factors For Painful Bladder Syndrome In Women Seeking Gynecologic Care, Colleen Kennedy, Catherine Bradley, R. Galask, I. Nygaard
Catherine S. Bradley
The aim of this cross-sectional study was to report risk factors for painful bladder syndrome in women. We surveyed 645 women presenting for care to general gynecology clinics and a vulvar specialty clinic using a standardized questionnaire and validated outcome measures. We used two definitions for painful bladder syndrome, based on the O'Leary-Sant interstitial cystitis symptom and problem indices. Of those women surveyed, 29.5% met broader criteria and 8.5% met more restrictive criteria for painful bladder syndrome. After adjusting for confounders, bladder pain was significantly associated with current smoking, irritable bowel syndrome, and a generalized pain disorder. Tobacco use, the …
Serum Ca 125 Is An Independent Prognostic Factor In Cervical Adenocarcinoma, David Bender, J. Sorosky, R. Buller, A. Sood
Serum Ca 125 Is An Independent Prognostic Factor In Cervical Adenocarcinoma, David Bender, J. Sorosky, R. Buller, A. Sood
David P Bender
OBJECTIVE: The purpose of this study was to determine the prognostic significance of a pretreatment serum CA 125 value in patients who were diagnosed with adenocarcinoma of the cervix. STUDY DESIGN: All patients who were diagnosed with adenocarcinoma or adenosquamous carcinoma of the cervix and treated definitively between 1986 and 1998 were eligible. The relationship between pretreatment serum CA 125 values and various clinical factors was evaluated. RESULTS: Seventy-three patients had pretreatment CA 125 drawn, with values that ranged from 5 to 683 U/mL and all patients were included in this study. A CA 125 value of >or=30 U/mL was …
A Phase Ii Study Of Vorinostat In The Treatment Of Persistent Or Recurrent Epithelial Ovarian Or Primary Peritoneal Carcinoma: A Gynecologic Oncology Group Study, S. Modesitt, M. Sill, J. Hoffman, David Bender
A Phase Ii Study Of Vorinostat In The Treatment Of Persistent Or Recurrent Epithelial Ovarian Or Primary Peritoneal Carcinoma: A Gynecologic Oncology Group Study, S. Modesitt, M. Sill, J. Hoffman, David Bender
David P Bender
PURPOSE: This multi-institutional phase II trial assessed the activity and toxicity of a new histone deacetylase inhibitor, vorinostat (suberoylanilide hydroxamic acid--SAHA) in patients with recurrent or persistent epithelial ovarian or primary peritoneal carcinoma. PATIENTS AND METHODS: Women with recurrent or persistent epithelial ovarian or primary peritoneal carcinoma who were platinum-resistant/refractory (progression-free interval <12 months since platinum) were eligible for trial entry if they had measurable disease, a good performance status, and good overall organ function. Women were treated with a 400 mg daily oral dose of vorinostat and continued on treatment until disease progression or unacceptable toxicity. The primary endpoints …
Efficacy Of A Vitamin/Nutriceutical Formulation For Moderate To Late Alzheimer’S Disease: A Placebo-Controlled Pilot Study, Ruth Remington, A Chan, Thomas Shea
Efficacy Of A Vitamin/Nutriceutical Formulation For Moderate To Late Alzheimer’S Disease: A Placebo-Controlled Pilot Study, Ruth Remington, A Chan, Thomas Shea
Ruth Remington
Recent studies demonstrated efficacy of a vitamin/ nutriceutical formulation (folate, vitamin B12, alpha-tocopherol, S-adenosyl methionine, N-acetyl cysteine, and acetyl-L-carnitine) for mild to moderate Alzheimer's disease. Herein, we tested the efficacy of this formulation in a small cohort of 12 institutionalized patients diagnosed with moderate-stage to later-stage Alzheimer's disease. Participants were randomly separated into treatment of placebo groups. Participants receiving the formulation demonstrated a clinically significant delay in decline in the Dementia Rating Scale and clock-drawing test as compared to those receiving placebo. Institutional caregivers reported approximately 30% improvement in the Neuropyschiatric Inventory and maintenance of performance in the Alzheimer's Disease …
Interpreting Laboratory Values In The Rehabilitation Setting, Jane Flanagan, Karen Melillo, Lisa Abdallah, Ruth Remington
Interpreting Laboratory Values In The Rehabilitation Setting, Jane Flanagan, Karen Melillo, Lisa Abdallah, Ruth Remington
Ruth Remington
Treating patients in rehabilitation settings is becoming increasingly complex for a variety of reasons, such as the presence of several comorbid conditions, increased age, and earlier discharge from acute care facilities. As a result, careful monitoring and assessment by nurses is essential. Laboratory testing can improve the assessment when nurses are able to recognize when and what should be reported and what types of treatments may be needed. Understanding what laboratory findings should be monitored and what added assessment criteria are necessary can be daunting. Therefore, this article reviews critical laboratory and other assessment findings in light of common health …
Apple Juice Improved Non-Cognitive Symptoms In Moderate- To Late-Stage Alzheimer’S Disease In An Open-Label Pilot Study, Ruth Remington, A Chan, A Lepore, E Kotlya, Thomas Shea
Apple Juice Improved Non-Cognitive Symptoms In Moderate- To Late-Stage Alzheimer’S Disease In An Open-Label Pilot Study, Ruth Remington, A Chan, A Lepore, E Kotlya, Thomas Shea
Ruth Remington
Preclinical studies demonstrate that apple juice exerts multiple beneficial effects including reduction of central nervous system oxidative damage, suppression of Alzheimer's disease (AD) hallmarks, improved cognitive performance, and organized synaptic signaling. Herein, we initiated an open-label clinical trial in which 21 institutionalized individuals with moderate-to-severe AD consumed 2 4-oz glasses of apple juice daily for 1 month. Participants demonstrated no change in the Dementia Rating Scale, and institutional caregivers reported no change in Alzheimer's Disease Cooperative Study (ADCS)-Activities of Daily Living (ADL) in this brief study. However, caregivers reported an approximate 27% (P < .01) improvement in behavioral and psychotic symptoms associated with dementia as quantified by the Neuropsychiatric Inventory, with the largest changes in anxiety, agitation, and delusion. This pilot study suggests that apple juice may be a useful supplement, perhaps to augment pharmacological approaches, for attenuating the decline in mood that accompanies progression of AD, which may also reduce caregiver burden.
A Vitamin/Nutriceutical Formulation Improves Memory And Cognitive Performance In Community-Dwelling Adults Without Dementia, A Chan, Ruth Remington, E Kotlya, A Lepore, J Zemianek, Thomas Shea
A Vitamin/Nutriceutical Formulation Improves Memory And Cognitive Performance In Community-Dwelling Adults Without Dementia, A Chan, Ruth Remington, E Kotlya, A Lepore, J Zemianek, Thomas Shea
Ruth Remington
Adults of both genders without dementia consumed a nutriceutical formulation ("NF," consisting of folic acid, B12, Vitamin E, S-adenosylmethionine, N-acetyl cysteine and Acetyl-L-carnitine), previously shown to improve cognitive performance in Alzheimer's disease, or placebo. Participants receiving NF but not placebo improved statistically and clinically in the California Verbal Learning Test II and the Trail-Making Test. Both groups improved further during a 3-month open-label extension. Additional individuals displayed identical improvement during a separate 6-month open-label trial. Performance declined to baseline following withdrawal of NF, and statistically improved when participants resumed taking NF. Additional participants receiving NF but not placebo demonstrated improvement …
The Clock-Drawing Test: Time For A Change?, A Chan, Ruth Remington, J Paskavitz, Thomas Shea
The Clock-Drawing Test: Time For A Change?, A Chan, Ruth Remington, J Paskavitz, Thomas Shea
Ruth Remington
Clock-drawing tests are simple and rapid screening devices for dementia. It was observed that individuals (" . . .make the clock read 12:45") or an analog prompt (" . . .quarter to 1"), whereas individuals >70 years of age showed improved performance with an analog prompt. The digital prompt has routinely been used to force participants to recode the prompt via conceptualization. Differential scoring across a range of ages has likely derived from the advent and increase of digital clocks with the younger segment of the population. This implies the need for as-yet undetermined alteration in the nature of prompts …
Cadherins, Catenins And Cell Cycle Regulators: Impact On Survival In A Gynecologic Oncology Group Phase Ii Endometrial Cancer Trial, M. Singh, K. Darcy, W. Brady, R. Clubwala, Z. Weber, J. Rittenbach, A. Akalin, C. Whitney, R. Zaino, N. Ramirez, Kimberly Leslie
Cadherins, Catenins And Cell Cycle Regulators: Impact On Survival In A Gynecologic Oncology Group Phase Ii Endometrial Cancer Trial, M. Singh, K. Darcy, W. Brady, R. Clubwala, Z. Weber, J. Rittenbach, A. Akalin, C. Whitney, R. Zaino, N. Ramirez, Kimberly Leslie
Kimberly K. Leslie
OBJECTIVE: We evaluated the clinical relevance of catenins, cadherins and cell cycle regulators in stage IV or recurrent endometrial carcinoma in a multi-center phase II trial (GOG protocol #119). METHODS: Tissue microarrays of metastatic or recurrent (n=42) tumor were developed and immunohistochemistry was performed. Average expression (percent staining x intensity) was assessed in tumor epithelium ((E)) and stroma ((S)) and categorized into tertiles (T1, T2, T3) for E-cadherin(E), N-cadherin(E), alpha-catenin(E), beta-catenin(E), gamma-catenin(E), p120-catenin(E) and Ki-67(E); as negative, below median or above median for p16(E), p27(E) and CD44(S); or as negative or positive for p53(E), Ki-67(S) and APC(S) (adenomatous polyposis coli). …
A Phase Ii Evaluation Of Lapatinib In The Treatment Of Persistent Or Recurrent Epithelial Ovarian Or Primary Peritoneal Carcinoma: A Gynecologic Oncology Group Study, A. Garcia, M. Sill, H. Lankes, A. Godwin, R. Mannel, D. Armstrong, R. Carolla, M. Liepman, N. Spirtos, E. Fischer, Kimberly Leslie
A Phase Ii Evaluation Of Lapatinib In The Treatment Of Persistent Or Recurrent Epithelial Ovarian Or Primary Peritoneal Carcinoma: A Gynecologic Oncology Group Study, A. Garcia, M. Sill, H. Lankes, A. Godwin, R. Mannel, D. Armstrong, R. Carolla, M. Liepman, N. Spirtos, E. Fischer, Kimberly Leslie
Kimberly K. Leslie
OBJECTIVE: Activation and dimerization of the ERBB family play a role in the pathogenesis and progression of ovarian cancer. We conducted a phase II trial to evaluate the activity and tolerability of lapatinib in patients with recurrent or persistent epithelial ovarian cancer (EOC) and to explore the clinical value of expression levels of epidermal growth factor receptors (EGFR), phosphorylated EGFR, HER-2/neu, and Ki-67, and the presence of EGFR mutations. METHODS: Eligible patients had recurrent or persistent EOC or primary peritoneal carcinoma, measurable disease, and up to 2 prior chemotherapy regimens for recurrent disease. Patients were treated with lapatinib 1500 mg/day. …
Phase Ii Trial Of Bevacizumab In Recurrent Or Persistent Endometrial Cancer: A Gynecologic Oncology Group Study, C. Aghajanian, M. Sill, K. Darcy, B. Greer, D. Mcmeekin, P. Rose, J. Rotmensch, M. Barnes, P. Hanjani, Kimberly Leslie
Phase Ii Trial Of Bevacizumab In Recurrent Or Persistent Endometrial Cancer: A Gynecologic Oncology Group Study, C. Aghajanian, M. Sill, K. Darcy, B. Greer, D. Mcmeekin, P. Rose, J. Rotmensch, M. Barnes, P. Hanjani, Kimberly Leslie
Kimberly K. Leslie
PURPOSE: Bevacizumab, a recombinant humanized monoclonal antibody against vascular endothelial growth factor-A (VEGF-A), has clinical activity in multiple tumor types. We conducted a phase II trial to assess the activity and tolerability of single-agent bevacizumab in recurrent or persistent endometrial cancer (EMC). PATIENTS AND METHODS: Eligible patients had persistent or recurrent EMC after receiving one to two prior cytotoxic regimens, measurable disease, and Gynecologic Oncology Group performance status of