1,558 research outputs found
Adversarial versus inquisitorial testimony
No full textAn arbiter can decide a case on the basis of his priors, or the two parties to the conflict may present further evidence. The parties may misrepresent evidence in their favor at a cost. At equilibrium the two parties never testify together. When the evidence is much in favor of one party, this party testifies. When the evidence is close to the prior mean, no party testifies. We compare this outcome under a purely adversarial procedure with the outcome under a purely inquisitorial procedure (Emons and Fluet 2009). We provide sufficient conditions on when one procedure is better than the other one
The Diagnosis and Treatment of Endometrial Cancer
No full textBackground: Endometrial carcinoma is the fourth most common type of cancer among women in Germany, with more than 11 000 newly diagnosed cases each year. The present lack of clarity about the optimal clinical management of these patients is due in part to inconsistencies in the scientific evidence and in part to recent modifications of the FIGO classification. In this article, the issues requiring clarification are presented and discussed. Methods: This article is based on a selective review of the pertinent literature, including evidence-based guidelines and recommendations. Results and conclusion: Current scientific evidence does not support the screening of asymptomatic women. On the other hand, women with postmenopausal and acyclic bleeding should undergo histopathological evaluation, particularly if they have risk factors for endometrial cancer. The current FIGO classification divides endometrial cancer into stages depending on the findings at surgery. On the basis of risk stratification (e. g., by tumor stage and histological differentiation grade), women who are judged to be at high risk (FIGO Stage IB and above, Grade 3) should undergo not just hysterectomy and adnexectomy, but also systematic pelvic and para-aortic lymphadenectomy. Risk stratification also determines whether adjuvant radiotherapy should be given. The additional or alternative administration of chemotherapy is a particular consideration for women at high risk, although the pertinent clinical trials to date have yielded conflicting evidence on this point. Cite this as: Denschlag D, Ulrich U, Emons G: The diagnosis and treatment of endometrial cancer-progress and controversies. Dtsch Arztebl Int 2011;108(34-35): 571-7. DOI: 10.3238/arztebl.2011.057
Hormone replacement after breast cancer. A consensus recommendation
No full textWomen with treated breast cancer who wish to undergo hormone replacement therapy (HRT), or in whom sequelae of estrogen deficiency can be expected, should be informed about the available alternative treatments. HRT should be considered only in the case of a severe lowering of the quality of life by climacteric symptoms that cannot be controlled by other means, including modification of lifestyle. Before the commencement of HRT every patient must be informed in full about her individual constellation of potential benefits and risks, and if appropriate the treating oncologist should be consulted. These steps must be documented. HRT in breast cancer patients should be conducted with the lowest possible dosage and discontinued at the earliest possible time
Gonadotropin-releasing hormone receptor-targeted gene therapy of gynecologic cancers
No full textThe majority of ovarian, endometrial, and breast cancers express gonadotropin-releasing hormone (GnRH) receptors. Apart from reproductive organs (ovaries, fallopian tubes, and uterus) that are normally removed during surgical therapy of ovarian or endometrial cancer, pituitary gonadotrophs also express GnRH receptors. The signal transduction pathway in tumor cells is basically different from the classic GnRH receptor signal transduction, which is known to operate in the pituitary gonadotrophs and can therefore be considered tumor specific. Other organs and hematopoetic stem cells do not express GnRH receptors. We have recently shown specific activation of nucleus factor kappaB in ovarian, endometrial, and breast cancers after treatment with GnRH agonists. Based on this tumor-specific signaling pathway and the distribution pattern of GnRH receptors, we have developed and successfully tested a gene therapy concept by using a GnRH analogue as an inducer for the transcription of a therapeutic gene in cell culture and in nude mice
Is chemotherapy a new standard in the adjuvant treatment of stage II and IV endometrial cancer?
No full textEffect of GnRH analogues on bone-directed metastasis of human breast cancer cells in vitro and in vivo
No full textSignificance of Lymph Node Dissection in Gynecological Oncology
No full textLymph node dissection has been an integral part of the surgical treatment of gynecological malignancies for over a century. The significance of lymph node dissection in gynecological oncology is reviewed in the light of our current knowledge of tumor biology. The original 'centrifugal theory' of metastasis formation leading to the concept of 'radical' surgery has its limitations. Lymph node dissection will still be necessary in gynecological oncology until molecular diagnostics have developed sufficiently and efficacious systemic therapies are available
Effect of GnRH analogues on bone-directed metastasis of human breast cancer cells in vitro and in vivo
No full textThe End of the Risk-Free Rate: Investing When Structural Forces Change Government Debt
No full textBen Emons explains why government debt is no longer "risk free"--and how you can seek alternatives in order to invest your money accordingly
A timely alert to the fundamental changes taking place in today\u27s global economic and financial systems. The book discusses why there is no longer a true risk free rate, how this will impact risk premiums, financial and real asset valuations, what could be the future alternatives to the risk free rate and what to look for when investing
Is lymphadenectomy still a relevant procedure in the treatment of endometrial cancer?
No full textThe role of pelvic and para-aortic lymphadenectomy (LNE) in endometrial cancer (EC) is currently a matter of debate. It has been recommended by the International Federation of Gynecology and Obstetrics (FIGO) for staging purposes to allow a risk-adjusted adjuvant (radio) therapy. Many experts are convinced that it has a therapeutic impact by removing tumor metastases. In low risk EC (type 1 histology, 90%) in the absence of LNE and radiotherapy. In type 2 or G3 EC and those of higher stages (a parts per thousand yenaEuro parts per thousand pT1b) lymph node metastases are more frequent. In patients with these tumors the results of total hysterectomy plus bilateral salpingo-oophorectomy plus external beam radiotherapy are unsatisfactory. In these patients systematic pelvic and para-aortic LNE is probably beneficial
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