Retrospective assesment of the levonorgestrel intrauterine device to treat complex atypical hyperplasia and early endometrioid endometrial cancer

Objective: The primary objective of this project was to describe the efficacy of the Levonorgestrel Intrauterine Device (LIUD) for treatment of Complex Endometrial Cancer (CAH) and Grade 1 Endometrial Cancer (G1EEC) in terms of rate of Complete Response (CR) and Partial Response (PR) after 6 months of therapy. Finally, we assessed if any clinical or pathologic features were associated with response to the LIUD. ^ Methods: This study was a retrospective case series designed to report the response rate of patients with CAH or G1EEC treated with LIUD therapy. In addition, this study has a laboratory component to assess molecular predictors of response to LIUD therapy. Retrospective data already collected from patients diagnosed with CAH or EEC grade 1 and treated with LIUD therapy at MD Anderson Cancer Center (MDACC) were used for this study. Patients from all ethnic and race groups were included. A Complete Response (CR) was defined in patients diagnosed with CAH if pathologic report at 6 months demonstrated either no evidence of hyperplasia or no atypia in the setting of simple or complex hyperplasia. Partial Response (PR) was recorded if disease downgraded to only CAH from G1EEC. No Response (NR) was recorded if pathologic report demonstrates no change (Stable Disease, SD) or progression to cancer (Progressive Disease, PD). We calculated the proportion of patients with complete response to LIUD therapy with 95% confidence interval. We compared the response rates (CR/PR vs NR) by obesity status (Obese if BMI > 40 kg/m2 vs non-obese if BMI <= 40 kg/m2) as well as other clinical and pathologic factors, such as age, uterine size (median size), and presence of exogenous progesterone effect. ^ Results: There were 39 patients diagnosed with either CAH or G1EEC treated with the LIUD. Of 39 patients, 12 did not have pathological results of biopsy at 6months time period. Of 27 evaluable patients, 17 were diagnosed with CAH and 10 with G1EEC. Overall response rate (RR) was 78% (95% CI = 62-94%) at 6 months, 18 patients had CR (4 in G1EEC; 14 in CAH), 3 patients had PR (3 in G1EEC), 3 had SD (1 in CAH; 2 in G1EEC), 3 had PD (2 in CAH; 1 in G1EEC). After histology stratification, RR at 6 months was 82.35% (14/17; 95%CI = 67.4-97.3%) in CAH and 70% (7/10; 95% CI = 41-98.4%) in G1EEC. ^ There was no difference in response (R) and no response (NR) based on BMI (p=0.56). He observed a trend showing association between age with response (p=0.1). There was no association between uterine size and response to therapy (p=0.17). We recorded strong association between exogenous progesterone effect and response. ^ Conclusion: LIUD therapy for the treatment of CAH and G1EEC may be effective and safe. Presence of exogenous progesterone effect may predict the response to LIUD therapy at earlier time points. There is need of further studies with larger sample size to explore the relationship of response with other clinical and pathologic factors^

Health care providers' opinions on abortion: a study for the implementation of the legal abortion public policy in the Province of Santa Fe, Argentina

Background: In Argentina, abortion has been decriminalized under certain circumstances since the enactment of the Penal Code in 1922. Nevertheless, access to abortion under this regulatory framework has been extremely limited in spite of some recent changes. This article reports the findings of the first phase of an operations research study conducted in the Province of Santa Fe, Argentina, regarding the implementation of the local legal and safe abortion access policy. Methods: The project combined research and training to generate a virtuous circle of knowledge production, decision-making, and the fostering of an informed healthcare policy. The project used a pre-post design of three phases: baseline, intervention, and evaluation. It was conducted in two public hospitals. An anonymous self-administered questionnaire (n = 157) and semi-structured interviews (n = 27) were applied to gather information about tacit knowledge about the regulatory framework; personal opinions regarding abortion and its decriminalization; opinions on the requirements needed to carry out legal abortions; and service’s responses to women in need of an abortion. Results: Firstly, a fairly high percentage of health care providers lack accurate information on current legal framework. This deficit goes side by side with a restrictive understanding of both health and rape indications. Secondly, while a great majority of health care providers support abortion under the circumstances consider in the Penal Code, most of them are reluctant towards unrestricted access to abortion. Thirdly, health care providers’ willingness to perform abortions is noticeably low given that only half of them are ready to perform an abortion when a woman’s life is at risk. Willingness is even lower for each of the other current legal indications. Conclusions: Findings suggest that there are important challenges for the implementation of a legal abortion policy. Results of the study call for specific strategies targeting health care providers in order to better inform about current legal abortion regulations and to sensitize them about abortion social determinants. The interpretation of the current legal framework needs to be broadened in order to reflect a comprehensive view of the health indication, and stereotypes regarding women’s sexuality and abortion decisions need to be dismantled.

Equity and Guidance : The challenge of following up young graduates

In this paper we present a support strategy of guidance for the young people from vulnerable population, both urban and rural, who have completed high school and are involved in an extension program so called Equity and guidance: the challenge of a proposal in state educational institutions from the La Plata, Berisso and Ensenada districts. This program gives them a reflection space to analyze their personal, social and community situation as a self-managed process towards a project of life. For some time we have supported young people with the purpose of helping them to make a life project. When doing so, we've always noticed the need of finding strategies to provide reasons to carry on the project of completing high school, to search new knowledge, request scholarships, to think of alternatives according to their circumstances, etc. In this sense, the Project: ?Equity and Guidance: the challenge of following up young graduates? is a revealing experience since it shows the urgent need to provide real means to enable communities we work with to make the most of opportunities. For the young people who belong to a vulnerable community, a project of life doesn't mean just thinking of the choice of careers, trainings or jobs. It also means to find how to make it possible in their daily life. Everything we make, think and manage in this project has the same purpose: help them so they can make a life project according to their subjectivity

Exilio y autotraducción en la narrativa testimonial concentracionaria argentina : El caso de The Little School. Tales of Disappearance and Survival in Argentina, de Alicia Partnoy (1986)

Algunos escritores exiliados a partir de la última dictadura militar argentina (1976-1983) tradujeron ellos mismos sus textos para publicarlos en el país de exilio. Un ejemplo es el de Alicia Partnoy, autora de The Little School. Tales of Disappearance & Survival in Argentina, quien habiendo escrito un testimonio en español sobre su paso por el campo de concentración La Escuelita, ubicado en Bahía Blanca, se dedicó a traducirlo al inglés para su publicación en Estados Unidos en 1986. Sus numerosas ediciones, primero en el extranjero y más tarde en Argentina, lo ubican entre una de las obras más importantes de la narrativa testimonial concentracionaria argentina. Una forma de abordarlo reside en el análisis sobre el proceso y el resultado de la autotraducción, lo cual permite aportar elementos de reflexión acerca de la necesidad de los supervivientes exiliados de dar a conocer su experiencia en el exilio, algo que sobrepasa, incluso, las barreras lingüísticas

Equity and Guidance : The challenge of following up young graduates

In this paper we present a support strategy of guidance for the young people from vulnerable population, both urban and rural, who have completed high school and are involved in an extension program so called Equity and guidance: the challenge of a proposal in state educational institutions from the La Plata, Berisso and Ensenada districts. This program gives them a reflection space to analyze their personal, social and community situation as a self-managed process towards a project of life. For some time we have supported young people with the purpose of helping them to make a life project. When doing so, we've always noticed the need of finding strategies to provide reasons to carry on the project of completing high school, to search new knowledge, request scholarships, to think of alternatives according to their circumstances, etc. In this sense, the Project: ?Equity and Guidance: the challenge of following up young graduates? is a revealing experience since it shows the urgent need to provide real means to enable communities we work with to make the most of opportunities. For the young people who belong to a vulnerable community, a project of life doesn't mean just thinking of the choice of careers, trainings or jobs. It also means to find how to make it possible in their daily life. Everything we make, think and manage in this project has the same purpose: help them so they can make a life project according to their subjectivity

Exilio y autotraducción en la narrativa testimonial concentracionaria argentina : El caso de The Little School. Tales of Disappearance and Survival in Argentina, de Alicia Partnoy (1986)

Algunos escritores exiliados a partir de la última dictadura militar argentina (1976-1983) tradujeron ellos mismos sus textos para publicarlos en el país de exilio. Un ejemplo es el de Alicia Partnoy, autora de The Little School. Tales of Disappearance & Survival in Argentina, quien habiendo escrito un testimonio en español sobre su paso por el campo de concentración La Escuelita, ubicado en Bahía Blanca, se dedicó a traducirlo al inglés para su publicación en Estados Unidos en 1986. Sus numerosas ediciones, primero en el extranjero y más tarde en Argentina, lo ubican entre una de las obras más importantes de la narrativa testimonial concentracionaria argentina. Una forma de abordarlo reside en el análisis sobre el proceso y el resultado de la autotraducción, lo cual permite aportar elementos de reflexión acerca de la necesidad de los supervivientes exiliados de dar a conocer su experiencia en el exilio, algo que sobrepasa, incluso, las barreras lingüísticas

Equity and Guidance : The challenge of following up young graduates

In this paper we present a support strategy of guidance for the young people from vulnerable population, both urban and rural, who have completed high school and are involved in an extension program so called Equity and guidance: the challenge of a proposal in state educational institutions from the La Plata, Berisso and Ensenada districts. This program gives them a reflection space to analyze their personal, social and community situation as a self-managed process towards a project of life. For some time we have supported young people with the purpose of helping them to make a life project. When doing so, we've always noticed the need of finding strategies to provide reasons to carry on the project of completing high school, to search new knowledge, request scholarships, to think of alternatives according to their circumstances, etc. In this sense, the Project: ?Equity and Guidance: the challenge of following up young graduates? is a revealing experience since it shows the urgent need to provide real means to enable communities we work with to make the most of opportunities. For the young people who belong to a vulnerable community, a project of life doesn't mean just thinking of the choice of careers, trainings or jobs. It also means to find how to make it possible in their daily life. Everything we make, think and manage in this project has the same purpose: help them so they can make a life project according to their subjectivity

Exilio y autotraducción en la narrativa testimonial concentracionaria argentina : El caso de The Little School. Tales of Disappearance and Survival in Argentina, de Alicia Partnoy (1986)

Algunos escritores exiliados a partir de la última dictadura militar argentina (1976-1983) tradujeron ellos mismos sus textos para publicarlos en el país de exilio. Un ejemplo es el de Alicia Partnoy, autora de The Little School. Tales of Disappearance & Survival in Argentina, quien habiendo escrito un testimonio en español sobre su paso por el campo de concentración La Escuelita, ubicado en Bahía Blanca, se dedicó a traducirlo al inglés para su publicación en Estados Unidos en 1986. Sus numerosas ediciones, primero en el extranjero y más tarde en Argentina, lo ubican entre una de las obras más importantes de la narrativa testimonial concentracionaria argentina. Una forma de abordarlo reside en el análisis sobre el proceso y el resultado de la autotraducción, lo cual permite aportar elementos de reflexión acerca de la necesidad de los supervivientes exiliados de dar a conocer su experiencia en el exilio, algo que sobrepasa, incluso, las barreras lingüísticas

Evidence of cryptic and pseudocryptic speciation in the Paracalanus parvus species complex (Crustacea, Copepoda, Calanoida), supplementary material

Introduction Many marine planktonic crustaceans such as copepods have been considered as widespread organisms. However, the growing evidence for cryptic and pseudo-cryptic speciation has emphasized the need of re-evaluating the status of copepod species complexes in molecular and morphological studies to get a clearer picture about pelagic marine species as evolutionary units and their distributions. This study analyses the molecular diversity of the ecologically important Paracalanus parvus species complex. Its seven currently recognized species are abundant and also often dominant in marine coastal regions worldwide from temperate to tropical oceans. Results COI and Cytochrome b sequences of 160 specimens of the Paracalanus parvus complex from all oceans were obtained. Furthermore, 42 COI sequences from GenBank were added for the genetic analyses. Thirteen distinct molecular operational taxonomic units (MOTU) and two single sequences were revealed with cladistic analyses (Maximum Likelihood, Bayesian Inference), of which seven were identical with results from species delimitation methods (barcode gaps, ABDG, GMYC, Rosenberg's P(AB)). In total, 10 to 12 putative species were detected and could be placed in three categories: (1) temperate geographically isolated, (2) warm-temperate to tropical wider spread and (3) circumglobal warm-water species. Conclusions The present study provides evidence of cryptic or pseudocryptic speciation in the Paracalanus parvus complex. One major insight is that the species Paracalanus parvus s.s. is not panmictic, but may be restricted in its distribution to the northeastern Atlantic.