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Villoglandular adenocarcinoma of the cervix is a rare histologic entity that typically develops in young women, characterized by an association with oral contraceptives and excellent prognosis, though this point is controversial. These tumors have not been studied in the context of the International Endocervical Adenocarcinoma Criteria and Classification (IECC) or Silva Pattern Classification. We analyzed 31 cases that met strict diagnostic criteria, including being completely excised with negative margins. These were categorized according to IECC and Silva Pattern Classification and the association with various pathologic parameters analyzed. Most patients were young with a mean age of 41.1 (range 25-79). There were 14 (45.2%) pattern A, 11 (35.5%) pattern B, and 6 (19.3%) pattern C cases. Only 1 of 22 patients (4.5%) presented with lymph node metastasis at the time of diagnosis (pattern C, stage IB1) and 3 (9.7%) had lymphovascular invasion (2 pattern C, 1 pattern B). Overall survival was 100%, while recurrence-free survival was 96.2% for the entire cohort with only 1 case (3.2%) recurring 25 mo after surgery (IB2, pattern B). Kaplan Meier analysis (log rank test) revealed no significant correlation for recurrence-free survival at 5 and 10 yr associated with depth of invasion, tumor size, Silva pattern, FIGO stage, lymphovascular invasion, or lymph node metastasis. Cox univariate analysis demonstrated no independent prognostic factors predicting recurrence-free survival. These results indicate that completely excised villoglandular adenocarcinoma generally has an excellent prognosis and when Silva Pattern Classification is applied, those tumors that potentially have a higher chance for adverse outcomes can be identified.

Silva invasion pattern can help predict lymph node metastasis risk in endocervical adenocarcinoma. We analysed Silva pattern of invasion and lymphovascular invasion to determine associations with clinical outcomes in stage IA and IB1 endocervical adenocarcinomas. International Federation of Gynecology and Obstetrics (FIGO; 2019 classification) stage IA-IB1 endocervical adenocarcinomas from 15 international institutions were examined for Silva pattern, presence of lymphovascular invasion, and other prognostic parameters. Lymph node metastasis status, local/distant recurrences, and survival data were compared using appropriate statistical tests. Of 399 tumours, 152 (38.1%) were stage IA [IA1, 77 (19.3%); IA2, 75 (18.8%)] and 247 (61.9%) were stage IB1. On multivariate analysis, lymphovascular invasion (p=0.008) and Silva pattern (p0.001) were significant factors when comparing stage IA versus IB1 endocervical adenocarcinomas. Overall survival was significantly associated with lymph node metastasis (p=0.028); recurrence-free survival was significantly associated with lymphovascular invasion (p=0.002) and stage (1B1 versus 1A) (p=0.002). Five and 10 year overall survival and recurrence-free survival rates were similar among Silva pattern A cases and Silva pattern B cases without lymphovascular invasion (p=0.165 and p=0.171, respectively). Silva pattern and lymphovascular invasion are important prognostic factors in stage IA1-IB1 endocervical adenocarcinomas and can supplement 2019 International Federation of Gynecology and Obstetrics staging. Our binary Silva classification system groups patients into low risk (patterns A and B without lymphovascular invasion) and high risk (pattern B with lymphovascular invasion and pattern C) categories.

Funding Information: The authors thank ESGO, ESTRO, and ESP for their support. The authors also thank the 155 international reviewers (physicians and patient representatives, see Appendix 2 in Online Supplemental File 2) for their valuable comments and suggestions. The authors thank the ESGO office, especially Kamila Macku, Tereza Cicakova, and Kateřina Šibravová, provided invaluable logistical and administrative support throughout the process. The development group (including all authors) is collectively responsible for the decision to submit for publication. DC (chair), JL (chair), MRR (chair) and FP (methodologist) wrote the first draft of the manuscript. All other contributors have actively given personal input, reviewed the manuscript, and have given final approval before submission. DC is responsible for the overall content as the guarantor. Initiated through the ESGO the decision to develop multidisciplinary guidelines was made jointly by the ESGO, ESTRO, and ESP. The ESGO provided administrative support. The ESGO, ESTRO and ESP are nonprofit knowledgeable societies. *These guidelines were developed by ESGO, ESTRO and ESP and are published in the Int J Gynecol Cancer, Radiother Oncol and Virchows Archiv. CCh has reported advisory boards for GSK, MSD and EISAI; SFL has reported advisory boards for MSD, GSK, AstraZeneca and Novartis; DL has reported consultant honoria from AstraZeneca, Clovis Oncology, GSK, MSD, Immunogen, Genmab, Amgen, Seagen and PharmaMar, advisory boards for AstraZeneca, Merck Serono, Seagen, Immunogen, Genmab, Oncoinvest, Corcept and Sutro, research institutional funding from Clovis Oncology, GSK, MSD and PharmaMar, research sponsored by AstraZeneca, Clovis Oncology, Genmab, GSK, Immunogen, Incyte, MSD, Roche, Seagen and Novartis, and speakers’ bureau activities for AstraZeneca, Clovis Oncology, GSK, MSD and PharmaMar; UM has reported advisory boards for AstraZeneca (Steering committee member for CALLA Study); RN has reported research grants from Elekta, Varian, Accuray, Dutch Research Council, and Dutch Cancer Society; AO has reported personal fees for advisory board membersip from Agenus, AstraZeneca, Clovis Oncology, Corcept Therapeutics, Deciphera Pharmaceuticals, Eisai, EMD Serono, F. Hoffmann-La Roche, Genmab/Seagen, GSK, ImmunoGen, Itheos, Merck Sharp & Dohme de Espana, SA, Mersana Thereapeutics, Novocure, PharmaMar, piIME Oncology, Roche, Sattucklabs, Sutro Biopharma and Tesaro, and personal fees for travel/accomodation from AstraZeneca, PharmaMar and Roche; DQ has reported advisory boards for Mimark inc; MPS has reported research grants and personal fees for workshops from Elekta AB; DC, MRR, FP, CC, AF, DF, DJK, FJ, CK, PM, RN, FPec, JP, SR, AS, VS, KT, IZ and JCL have reported no conflicts of interest. Not commissioned; internally peer reviewed. Not applicable. Not applicable. David Cibula, Maria Rosaria Raspollini, François Planchamp, Carlos Centeno, Cyrus Chargari, Ana Felix, Daniela Fischerova, Daniela Jahn-Kuch, Florence Joly, Christhardt Kohler, Sigurd F. Lax, Domenica Lorusso, Umesh Mahantshetty, Patrice Mathevet, Raj Naik, Remi Nout, Ana Oaknin, Fedro Peccatori, Jan Persson, Denis Querleu, Sandra Rubio, Maximilian Paul Schmid, Artem Stepanyan, Valentyn Svintsitskyi, Karl Tamussino, Ignacio Zapardiel, Jacob Christian Lindegaard. All data relevant to the study are included in the article or uploaded as supplementary information. Funding Information: CCh has reported advisory boards for GSK, MSD and EISAI; SFL has reported advisory boards for MSD, GSK, AstraZeneca and Novartis; DL has reported consultant honoria from AstraZeneca, Clovis Oncology, GSK, MSD, Immunogen, Genmab, Amgen, Seagen and PharmaMar, advisory boards for AstraZeneca, Merck Serono, Seagen, Immunogen, Genmab, Oncoinvest, Corcept and Sutro, research institutional funding from Clovis Oncology, GSK, MSD and PharmaMar, research sponsored by AstraZeneca, Clovis Oncology, Genmab, GSK, Immunogen, Incyte, MSD, Roche, Seagen and Novartis, and speakers’ bureau activities for AstraZeneca, Clovis Oncology, GSK, MSD and PharmaMar; UM has reported advisory boards for AstraZeneca (Steering committee member for CALLA Study); RN has reported research grants from Elekta, Varian, Accuray, Dutch Research Council, and Dutch Cancer Society; AO has reported personal fees for advisory board membersip from Agenus, AstraZeneca, Clovis Oncology, Corcept Therapeutics, Deciphera Pharmaceuticals, Eisai, EMD Serono, F. Hoffmann-La Roche, Genmab/Seagen, GSK, ImmunoGen, Itheos, Merck Sharp & Dohme de Espana, SA, Mersana Thereapeutics, Novocure, PharmaMar, piIME Oncology, Roche, Sattucklabs, Sutro Biopharma and Tesaro, and personal fees for travel/accomodation from AstraZeneca, PharmaMar and Roche; DQ has reported advisory boards for Mimark inc; MPS has reported research grants and personal fees for workshops from Elekta AB; DC, MRR, FP, CC, AF, DF, DJK, FJ, CK, PM, RN, FPec, JP, SR, AS, VS, KT, IZ and JCL have reported no conflicts of interest. Publisher Copyright: © 2023 ESGO, ESTRO, ESP In 2018, the European Society of Gynecological Oncology (ESGO) jointly with the European Society for Radiotherapy and Oncology (ESTRO) and the European Society of Pathology (ESP) published evidence-based guidelines for the management of patients with cervical cancer. Given the large body of new evidence addressing the management of cervical cancer, the three sister societies jointly decided to update these evidence-based guidelines. The update includes new topics to provide comprehensive guidelines on all relevant issues of diagnosis and treatment in cervical cancer. To serve on the expert panel (27 experts across Europe) ESGO/ESTRO/ESP nominated practicing clinicians who are involved in managing patients with cervical cancer and have demonstrated leadership through their expertise in clinical care and research, national and international engagement, profile, and dedication to the topics addressed. To ensure the statements were evidence based, new data identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the international development group. Before publication, the guidelines were reviewed by 155 independent international practitioners in cancer care delivery and patient representatives. These updated guidelines are comprehensive and cover staging, management, follow-up, long-term survivorship, quality of life and palliative care. Management includes fertility sparing treatment, early and locally advanced cervical cancer, invasive cervical cancer diagnosed on a simple hysterectomy specimen, cervical cancer in pregnancy, rare tumors, recurrent and metastatic diseases. The management algorithms and the principles of radiotherapy and pathological evaluation are also defined. publishersversion published

Funding Information: Open access publishing supported by the National Technical Library in Prague. Funding Information: The authors thank ESGO, ESTRO, and ESP for their support. The authors also thank the 155 international reviewers (physicians and patient representatives, see Appendix 2 ) for their valuable comments and suggestions. The authors thank the ESGO office, especially Kamila Macku, Tereza Cicakova, and Kateřina Šibravová, provided invaluable logistical and administrative support throughout the process. Publisher Copyright: © 2023, ESGO, ESTRO, ESP. In 2018, the European Society of Gynecological Oncology (ESGO) jointly with the European Society for Radiotherapy and Oncology (ESTRO) and the European Society of Pathology (ESP) published evidence-based guidelines for the management of patients with cervical cancer. Given the large body of new evidence addressing the management of cervical cancer, the three sister societies jointly decided to update these evidence-based guidelines. The update includes new topics to provide comprehensive guidelines on all relevant issues of diagnosis and treatment in cervical cancer. To serve on the expert panel (27 experts across Europe) ESGO/ESTRO/ESP nominated practicing clinicians who are involved in managing patients with cervical cancer and have demonstrated leadership through their expertise in clinical care and research, national and international engagement, profile, and dedication to the topics addressed. To ensure the statements were evidence based, new data identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the international development group. Before publication, the guidelines were reviewed by 155 independent international practitioners in cancer care delivery and patient representatives. These updated guidelines are comprehensive and cover staging, management, follow-up, long-term survivorship, quality of life and palliative care. Management includes fertility sparing treatment, early and locally advanced cervical cancer, invasive cervical cancer diagnosed on a simple hysterectomy specimen, cervical cancer in pregnancy, rare tumors, recurrent and metastatic diseases. The management algorithms and the principles of radiotherapy and pathological evaluation are also defined. publishersversion published

Cervical clear cell carcinoma (CCC) is a rare human papillomavirus-independent adenocarcinoma. While recent studies have focused on gastric-type endocervical adenocarcinoma (GTA), little is known about CCC. A total of 58 (CCCs) were collected from 14 international institutions and retrospectively analyzed using univariable and multivariable methods and compared with 36 gastric-type adenocarcinomas and 173 human papillomavirus-associated (HPVA) endocervical adenocarcinoma (ECA) regarding overall survival (OS) and recurrence-free survival (RFS). Most cases were FIGO stage I (72.4%), with Silva C pattern of invasion (77.6%), and the majority were treated with radical surgery (84.5%) and adjuvant therapy (55.2%). Lymphovascular invasion was present in 31%, while lymph node metastasis was seen in 24.1%; 10.3% were associated with abdominopelvic metastases at the time of diagnosis; 32.8% had recurrences, and 19% died of disease. We did not find statistically significant differences in OS and RFS between CCC and GTA at 5 and 10 years (P=0.313 and 0.508, respectively), but there were significant differences in both OS and RFS between CCC and HPVA ECA (P=0.003 and 0.032, respectively). Also, OS and RFS in stage I clear cell and GTA were similar (P=0.632 and 0.692, respectively). Multivariate analysis showed that OS is influenced by the presence of recurrence (P=0.009), while RFS is influenced by the FIGO stage (P=0.025). Cervical CCC has poorer outcomes than HPVA ECA and similar outcomes to human papillomavirus-independent GTA. Oncologic treatment significantly influences RFS in univariate analysis but is not an independent prognostic factor in multivariate analysis suggesting that alternative therapies should be investigated.

This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics. The study of ()-induced carcinogenesis uses multiple in vivo mouse models, one of which relies on the cytokeratin 14 gene promoter to drive the expression of all HPV early oncogenes. This study aimed to determine the HPV16 variant and sublineage present in the K14HPV16 mouse model. This information can be considered of great importance to further enhance this K14HPV16 model as an essential research tool and optimize its use for basic and translational studies. Our study evaluated HPV DNA from 17 samples isolated from 4 animals, both wild-type (n = 2) and HPV16-transgenic mice (n = 2). Total DNA was extracted from tissues and the detection of HPV16 was performed using a qPCR multiplex. HPV16-positive samples were subsequently whole-genome sequenced by next-generation sequencing techniques. The phylogenetic positioning clearly shows K14HPV16 samples clustering together in the sub-lineage A1 (NC001526.4). A comparative genome analysis of K14HPV16 samples revealed three mutations to the human papillomaviruses type 16 sublineage A1 representative strain. Knowledge of the HPV 16 variant is fundamental, and these findings will allow the rational use of this animal model to explore the role of the A1 sublineage in HPV-driven cancer. This work is a result of Fundação para a Ciência e a Tecnologia (FCT); and also funded by Fundação para a Ciência e Tecnologia/Ministério da Ciência, Tecnologia e Ensino Superior (FCT/MCTES, Portugal) through national funds to iNOVA4Health (UIDB/04462/2020 and UIDP/04462/2020); from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020—Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Por tugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT). This work was also supported by Fundos FEDER through the Programa Operacional Factores de Competitividade—COMPETE and by Fundos Nacionais through the Fundação para a Ciência e a Tec nologia within the scope of the project UID/BIM/00009/2019 (Centre for Toxicogenomics and Human Health-ToxOmics); and from LA/P/0045/2020 (ALiCE), UIDB/00511/2020 and UIDP/00511/2020 (LEPABE), funded by national funds through FCT/MCTES (PIDDAC); 2SMART (NORTE-01-0145- FEDER-000054), supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF). info:eu-repo/semantics/publishedVersion

PIK3CA mutations are believed to contribute to the pathogenesis of human papillomavirus (HPV)-associated head and neck squamous cell carcinomas (HNSCC). This study aims to establish the frequency of PIK3CA mutations in a Portuguese HNSCC cohort and to determine their association with the HPV status and patient survival. A meta-analysis of scientific literature also revealed widely different mutation rates in cohorts from different world regions and a trend towards improved prognosis among patients with PIK3CA mutations. DNA samples were available from 95 patients diagnosed with HNSCC at the Portuguese Institute of Oncology in Lisbon between 2010 and 2019. HPV status was established based on viral DNA detected using real-time PCR. The evaluation of PIK3CA gene mutations was performed by real-time PCR for four mutations (H1047L; E542K, E545K, and E545D). Thirty-seven cases were found to harbour PIK3CA mutations (39%), with the E545D mutation (73%) more frequently detected. There were no significant associations between the mutational status and HPV status (74% WT and 68% MUT were HPV (+); p = 0.489) or overall survival (OS) (3-year OS: WT 54% and MUT 65%; p = 0.090). HPV status was the only factor significantly associated with both OS and disease-free survival (DFS), with HPV (+) patients having consistently better outcomes (3-year OS: HPV (+) 65% and HPV (−) 36%; p = 0.007; DFS HPV (+) 83% and HPV (−) 43%; p = 0.001). There was a statistically significant interaction effect between HPV status and PIK3CA mutation regarding DFS (Interaction test: p = 0.026). In HPV (+) patients, PIK3CA wild-type is associated with a significant 4.64 times increase in the hazard of recurrence or death (HR = 4.64; 95% CI 1.02–20.99; p = 0.047). Overall, PIK3CA gene mutations are present in a large number of patients and may help define patient subsets who can benefit from therapies targeting the PI3K pathway. The systematic assessment of PIK3CA gene mutations in HNSCC patients will require further methodological standardisation.

A seguinte resenha procura apresentar as discussões do Simpósio Temático “Jóvenes Indígenas en la Educación Superior en la América Latina”, sucedido no terceiro Congresso Internacional Povos Indígenas da América Latina (3o. CIPIAL) entre os dias 3 e 5 de julho de 2019 na Universidade de Brasília (UnB). O evento congregou ativistas, lideranças, estudantes, docentes e pesquisadores, indígenas e não indígenas, de diferentes países e áreas do conhecimento. Procura-se enfatizar os debates surgidos, restituindo a relevância do intercâmbio, comparação e contraste de experiências situadas em distintos contextos nacionais e regionais de ensino, pesquisa e extensão (como Argentina, Brasil e México). Ressalta-se a consolidação deste espaço de interlocução, em que inúmeras iniciativas, propostas e análises envolvendo os sentidos da escolarização superior de jovens indígenas, seus dilemas, limites e possibilidades vêm sendo apreendidos e aprimorados.

Epithelioid trophoblastic tumours are rare neoplasms showing differentiation towards the chorion leave-type intermediate cytotrophoblast, with only a handful of cases being reported in the literature. These tumours are slow-growing and are typically confined to the uterus for extended periods of time. While the pathogenesis is unclear, they are thought to arise from a remnant intermediate trophoblast originating from prior normal pregnancies or, less frequently, gestational trophoblastic tumours. A protracted time period between the gestational event and tumour development is typical. This case describes a 49-year-old previously healthy female who presented with a completely asymptomatic uterine mass, discovered incidentally during a routine gynaecological assessment. The pathological analysis of the hysterectomy specimen confirmed an epithelioid trophoblastic tumour, involving the uterus and cervix. This is a rare gynaecological tumour. A comparative short tandem repeat analysis revealed genetic similarities to a previous healthy gestation seventeen years prior. She was successful treated with adjuvant pembrolizumab, with no evidence of disease recurrence to date., peer-reviewed

Gynecological cancers (GCs) are currently among the major threats to female health. Moreover, there are different histologic subtypes of these cancers, which are defined as ‘rare’ due to an annual incidence of

Este artículo surge a partir del Taller “Abordajes Epistemológicos y Metodológicos de investigación sobre las experiencias formativas de jóvenes indígenas”1 del que participamos entre junio y noviembre de 2020. Luego de compartir reflexiones sobre diversas temáticas vinculadas a las experiencias formativas de jóvenes indígenas, nos centraremos aquí en aquellas vinculadas a la organización de colectivos indígenas (1), las relaciones con los medios digitales (2) y las trayectorias escolares de las mujeres indígenas jóvenes (3). Nos interesa explorar las vivencias y las prácticas de apropiación que las y los jóvenes indígenas realizan de los espacios universitarios y citadinos, en tanto se posicionan como agentes que movilizan -o pugnan por movilizar- distintos tipos de recursos simbólicos, estrategias y acciones al interior de la educación superior, como así también en ámbitos mayores en los que se disputan las relaciones interculturales. Nos referiremos principalmente a los debates que suceden en Argentina, Brasil y México, lo cual nos permite establecer puntos de contraste entre realidades diferentes. Fil: Sant’ Ana Felix dos Santos, Ricardo. Universidade Federal Fluminense; Brasil Fil: Di Pietro, Noelia Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Investigaciones en Ciencias Sociales y Humanidades. Universidad Nacional de Salta. Facultad de Humanidades. Instituto de Investigaciones en Ciencias Sociales y Humanidades; Argentina Fil: Mira Tapia, Alejandro. No especifíca; Fil: Rodríguez, Nuria Macarena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Investigaciones en Ciencias Sociales y Humanidades. Universidad Nacional de Salta. Facultad de Humanidades. Instituto de Investigaciones en Ciencias Sociales y Humanidades; Argentina Fil: Ossola, María Macarena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Investigaciones en Ciencias Sociales y Humanidades. Universidad Nacional de Salta. Facultad de Humanidades. Instituto de Investigaciones en Ciencias Sociales y Humanidades; Argentina

Dissertação de Mestrado em Sociologia das Organizações e do Trabalho O aumento da esperança de vida, as grandes e inerentes dependências ao nível da saúde do idoso e as alterações recentes na estrutura familiar, leva a que as famílias procurem respostas de apoio para acolher e cuidar dos seus idosos, o que leva à necessidade, cada vez maior, de profissionais com uma formação pessoal e profissional que garanta maior rigor e competência no trabalho executado. O presente trabalho centra-se no papel das ajudantes de ação direta em contexto de Estruturas Residenciais para Pessoas Idosas. A tarefa das ajudantes de ação direta, que se denomina de cuidadores formais, exige um esforço físico e mental e, como tal, acarreta dificuldades. A falta de capacitação, de conhecimentos e de experiência profissional, podem muitas vezes levar à insegurança, desorganização, atitudes inadequadas face aos idosos, e provocar algum desgaste ao cuidador. Torna-se muito importante que as ajudantes de ação direta, para além de competências humanas, detenham competências técnicas. Neste estudo optou-se por uma investigação qualitativa através da realização de entrevistas semi-dirigidas a quinze Ajudantes de Ação Direta que prestam serviço na Estrutura Residencial para Pessoas Idosas (ERPI) da Santa Casa da Misericórdia da Amadora. Os dados recolhidos, revelam que se trata de um grupo com baixos níveis de escolaridade e fracas qualificações profissionais. Contudo, valorizam os conhecimentos e competências adquiridas no local de trabalho, e consideram traduzir-se numa mais-valia no seu dia-a-dia, apostando em ter mais formação não só ao nível de competências técnicas, mas também adquirir conhecimento teórico sobre os vários tipos de demência, para saber melhor lidar com o idoso. O desconhecimento acerca das várias demências provoca sentimentos negativos ao nível do stresse e frustração. No que se refere aos aspetos positivos os entrevistados manifestaram gosto que têm por desempenharem as funções inerente ao ato de cuidar dos idosos. Manifestando que esta profissão confere uma realização ao nível pessoal e até mesmo identitária. The increase in life expectancy, inherent to the current level of health in the old age, along with the new changes in family structures, leads the families to seek support answers in order to welcome and care for their elderly. This is a reality that leads to the need bet on professionals with a specific personal and professional training, associated with a greater rigor and competence in the work performed. This paper focuses on the role of direct action helpers in the context of Residential Structures for Elderly. The task of direct action helpers, the so called formal caregivers, requires a physical and mental effort and, as such, entails difficulties. The lack of training, knowledge and experience, can often lead to insecurity, disorganization, inadequate attitudes to the elderly and cause wear and tear to the caregiver. It is very important that the direct action helpers maximize their technical skills, as well as their human skills. It was chosen a qualitative research by conducting semi-structured interviews with 15 Direct Action Helpers who serve in Santa Casa da Misericórdia da Amadora ERPI (Residential Structure for Older People). The data collected show that it is a group with low levels of education and low professional qualifications. However, value the knowledge and skills acquired in the workplace and consider translate into added value in their day-to-day, betting on having more training not only in terms of technical skills, but also acquire theoretical knowledge about the various types of dementia, to know better deal with the elderly. The lack of knowledge about the various dementias causes negative feelings to the level of stress and frustration. With regard to the positive aspects of the respondents expressed like that have to carry out the duties inherent in the act of caring for the elderly. Stating that this profession gives it an achievement on a personal level and even identity. N/A

Early aggressive rehabilitation therapies maximize functional recovery. We examined patient-reported preferences for their initial rehabilitation therapy setting during their acute stroke hospitalization and whether there was an association between their preferences and their actual discharge destination.Eligible stroke patients were surveyed during their acute hospital stay at either a primary stroke center or a rural community hospital in North Carolina. Patients were questioned about their knowledge of inpatient rehabilitation, preferences for the initial rehabilitation therapy setting and intensity, and how far from home they were willing to travel to receive therapies. The primary outcome was their actual discharge destination. The exposure variable was their preference for initial rehabilitation therapy setting. Logistic regression models assessed the relationship between the outcome and exposure while controlling for other variables of interest.Among 53 patients surveyed in the study, 85% preferred to be discharged home. After controlling for other factors, discharge to the actual destination of home was associated with a preference for an initial rehabilitation therapy setting of home (OR, 7.19; 95% CI, 1.10-46.89).Patient preference for the initial rehabilitation therapy setting is home. Providers should inquire about patient preference and provide information about treatment options to help inform decision making.

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Background and Purpose— The prognostic value early diffusion-weighted magnetic resonance imaging (DWMRI) adds in the setting of transient ischemic attack (TIA), after risk stratification by a clinical score, is unclear. The purpose of this study is to evaluate, after ABCD 2 score risk categorization in admitted TIA patients, whether negative DWMRI performed within 24 hours of symptom onset improves on the identification of patients at low risk for experiencing a disabling stroke within 90 days. Methods— At 15 North Carolina hospitals, we enrolled a prospective nonconsecutive sample of admitted TIA patients. We excluded patients not undergoing a DWMRI within 24 hours of admission and patients for whom a dichotomized (≤ or >3) ABCD 2 score could not be calculated. We conducted a medical record review to determine disabling ischemic stroke outcomes within 90 days. Results— Over 35 months, 944 TIA patients met inclusion criteria, of whom 4% (n=41) had a disabling ischemic stroke within 90 days. In analyses stratified by low versus moderate/high ABCD 2 score, the combination of a low risk ABCD 2 score and a negative early DWMRI had excellent sensitivity (100%, 95% CI 34 to 100) for identifying low-risk patients. In patients classified as moderate to high risk, a negative early DWMRI predicted a low risk of disabling ischemic stroke within 90 days (sensitivity 92%, 95% CI 80 to 97; NLR 0.11, 95% CI 0.04 to 0.32). Conclusions— After risk stratification by the ABCD 2 score, early DWMRI enhances the prediction of a low risk for disabling ischemic stroke within 90 days. Further study is warranted in a large, consecutive TIA population of early DWMRI as a sensitive negative predictor for disabling stroke within 90 days.

Submitted by Teresa Margarida Cunha (tmargarida@gmail.com) on 2016-07-23T14:20:53Z No. of bitstreams: 1 2000-Sarcomatoid squamous cell carcinoma of the uterine cervix.pdf: 1886963 bytes, checksum: 8a12ab3237854ef88b07958d29c0ed60 (MD5) Approved for entry into archive by Raquel Truta (comum@rcaap.pt) on 2016-11-15T17:01:24Z (GMT) No. of bitstreams: 2 1008624248408986.zip: 1786760 bytes, checksum: cf24a184dab8ee963bf0587f8b20abab (MD5) 2000-Sarcomatoid squamous cell carcinoma of the uterine cervix.pdf: 1886963 bytes, checksum: 8a12ab3237854ef88b07958d29c0ed60 (MD5) Made available in DSpace on 2016-11-15T17:01:24Z (GMT). No. of bitstreams: 2 1008624248408986.zip: 1786760 bytes, checksum: cf24a184dab8ee963bf0587f8b20abab (MD5) 2000-Sarcomatoid squamous cell carcinoma of the uterine cervix.pdf: 1886963 bytes, checksum: 8a12ab3237854ef88b07958d29c0ed60 (MD5) Previous issue date: 2000

Study objective We evaluate, in admitted patients with transient ischemic attack, the accuracy of the ABCD 2 (age [A], blood pressure [B], clinical features [weakness/speech disturbance] [C], transient ischemic attack duration [D], and diabetes history [D]) score in predicting ischemic stroke within 7 days. Methods At 16 North Carolina hospitals, we enrolled a prospective, nonconsecutive sample of admitted patients with transient ischemic attack and with no stroke history, presenting within 24 hours of transient ischemic attack symptom onset. We conducted a medical record review to determine ischemic stroke outcomes within 7 days. According to a modified Rankin Scale Score, strokes were classified as disabling (>2) or nondisabling (≤2). Results During a 35-month period, we enrolled 1,667 patients, of whom 373 (23%) received a diagnosis of an ischemic stroke within 7 days. Eighteen percent (69/373) of all strokes were disabling. We were unable to calculate an ABCD 2 score in 613 patients (37%); however, our imputed analysis indicated this did not significantly alter results. The discriminatory power of the ABCD 2 score was modest for ischemic stroke in 7 days ( c statistic 0.59), and fair for disabling ischemic stroke within 7 days ( c statistic 0.71). Patients characterized as low risk according to ABCD 2 score (≤3) were at low risk for experiencing a disabling stroke within 7 days, with a negative likelihood ratio of 0.16 (95% confidence interval [CI] 0.04 to 0.64) with missing values excluded and 0.34 (95% CI 0.15 to 0.76) when missing values were imputed. Conclusion Our analysis suggests the best application of the ABCD 2 score may be to identify patients at low risk for an early disabling ischemic stroke. Further study of the ability to determine an ABCD 2 score in all patients is needed, along with validation in a large, consecutive population of patients with transient ischemic attack.

O Instituto Português de Oncologia de Francisco Gentil – Centro Regional Oncológico de Lisboa S.A acolhe anualmente cerca de mulheres portadoras de Cancro Ginecológico. O Serviço de Ginecologia tem, desde a sua criação, fomentado a existência de um Grupo Multidisciplinar dos Tumores Ginecológicos que engloba não só os Ginecologistas como Oncologistas Médicos, Radioterapeutas Oncológicos, Anátomo-Patologistas, Imagiologistas e outros Especialistas com competência em Oncologia Ginecológica. A Comissão de Protocolos de Diagnóstico e de Terapêutica é a emanação prática desta filosofia. Assim, a revisão e actualização dos Protocolos elaborados por esta Comissão e agora publicados traduzem a metodologia usada no Serviço e baseiam-se nos protocolos de Instituições Oncológicas Internacionais de referência e na experiência acumulada na nossa Instituição, considerando a capacidade técnica e meios materiais existentes. Pretendem, tanto quanto possível, uniformizar procedimentos e agilizar a colaboração com todas as Instituições que nos referenciam as suas doentes, tendo como fim último o tratamento correcto do Cancro Ginecológico, com um aproveitamento racional dos recursos humanos e técnicos.

Submitted by Teresa Margarida Cunha (tmargarida@gmail.com) on 2016-07-23T13:32:16Z No. of bitstreams: 1 10870-Sclerosing stromal tumor of the ovary.pdf: 1084467 bytes, checksum: d1919dae4367247d1449bdd351c8b216 (MD5) Approved for entry into archive by Raquel Truta (comum@rcaap.pt) on 2016-10-06T15:47:30Z (GMT) No. of bitstreams: 2 1008624248408986.zip: 1083467 bytes, checksum: d73a9d65305a652e355cc41100fa179f (MD5) 10870-Sclerosing stromal tumor of the ovary.pdf: 1084467 bytes, checksum: d1919dae4367247d1449bdd351c8b216 (MD5) Made available in DSpace on 2016-10-06T15:47:30Z (GMT). No. of bitstreams: 2 1008624248408986.zip: 1083467 bytes, checksum: d73a9d65305a652e355cc41100fa179f (MD5) 10870-Sclerosing stromal tumor of the ovary.pdf: 1084467 bytes, checksum: d1919dae4367247d1449bdd351c8b216 (MD5) Previous issue date: 2013