AimTo determine whether statin use is associated with improved epithelial ovarian cancer (OvCa) survival.MethodsThis is a single-institution retrospective cohort review of patients treated for OvCa between 1992 and 2013. Inclusion criteria were International Federation of Gynecology and Obstetrics (FIGO) stage I–IV OvCa. The primary exposures analyzed were hyperlipidemia and statin use. The primary outcomes were progression-free survival (PFS) and disease-specific survival (DSS).Results442 patients met inclusion criteria. The cohort was divided into three groups: patients with hyperlipidemia who used statins (n = 68), patients with hyperlipidemia who did not use statins (n = 28), and patients without hyperlipidemia (n = 346). OvCa outcomes were evaluated. When we analyzed the entire cohort, we found no significant differences in PFS or DSS among the groups. The median PFS for hyperlipidemics using statins, hyperlipidemics not using statins, and non-hyperlipidemics was 21.7, 13.6, and 14.7 months, respectively (p = 0.69). Median DSS for hyperlipidemics using statins, hyperlipidemics not using statins, and non-hyperlipidemics was 44.2, 75.7, and 41.5 months, respectively (p = 0.43). These findings did not change after controlling for confounders. However, a secondary analysis revealed that, among patients with non-serous-papillary subtypes of OvCa, statin use was associated with a decrease in hazards of both disease recurrence (adjusted HR = 0.23, p = 0.02) and disease-specific death (adjusted HR = 0.23, p = 0.04). To augment the findings in the retrospective cohort, the histology-specific effects of statins were also evaluated in vitro using proliferation assays. Here, statin treatment of cell lines resulted in a variable level of cytotoxicity.ConclusionStatin use among patients with non-serous-papillary OvCa was associated with improvement in both PFS and DSS.

Bacteria belonging to the genus Listeria have been isolated from food products of animal, plant, and fish origin, and are associated with infections in immunocompromised hosts, pregnant women, and infants. The species Listeria grayi has rarely been reported as a human pathogen. It has a unique antibiotic sensitivity profile. We describe a case of L. grayi bacteremia in a heart transplant recipient. The organism demonstrated a reduced sensitivity to ampicillin. The patient was successfully treated with a combination of vancomycin and ciprofloxacin.

Enhanced recovery after surgery is a standardized, multidisciplinary approach for caring patients with a goal of decreasing length of hospital stay and care without negatively affecting patient outcomes. Aim: to investigate the impact of enhanced recovery pathway application outcomes on nurses and women undergoing cesarean section. Design: A quasi experimental (pre-posttest for maternity nurses and study/control groups for women undergoing cesarean section) design was utilized in this study. Settings: This study was conducted at the obstetrics departments affiliated to University Hospital and Shebin El-Kom teaching hospital, Menoufia Governorate, Egypt. Sample: A convenient sample of 50 maternity nurses worked in the previous settings and a purposive sample of 250 cesarean delivery women were recruited in this study. Instruments: for collecting data; a structured interviewing questionnaire, knowledge assessment & an observational checklist for the nurses, knowledge assessment instrument, an observational checklist and numeric pain intensity scale for the mothers were used. Results: There was an increase in total knowledge and practice scores of the maternity nurses regarding the enhanced recovery pathway application. Also, its application following CS had an effect on relieving the women's postoperative problems especially pain than those who received the routine hospitals nursing care only.Conclusion: application of enhanced recovery pathway significantly reduces the postoperative complications especially pain, length of hospital stay, and improves the maternity nurses' knowledge and practice scores post caesarean . Recommendation: Enhanced recovery pathway should be applied during cesarean section operations to improve the patients' outcomes and reduce the postoperative complications.

Background: Hemoptysis is a clinical condition encountered in the emergency department (ED) and must be managed and investigated urgently to maintain the patient's hemostasis. The management of hemoptysis depends on treating the underlying cause. Tranexamic acid (TXA) is an anti-fibrinolytic drug used to systemically control bleeding. There are a few studies available that investigate the use of nebulized tranexamic acid for hemoptysis with contradictory results. Our paper demonstrates three cases where patients presented with significant hemoptysis and had significant improvement in symptoms following the administration of nebulized tranexamic acid. The overall need for blood transfusion was reduced. Results: Three patients presented to the emergency room for evaluation of hemoptysis. All three patients had different underlying pathologies resulting in their hemoptysis and were monitored in the ICU. Initial conventional medical therapies including the correction of coagulopathy and discontinuing offending agents were utilized for treatment. After persistent symptoms, nebulized TXA at a dose of 500 mg three times a day was administered. The patients were all discharged from the hospital with improvement in their symptoms. Conclusion: Tranexamic acid may be considered in the treatment of hemoptysis regardless of the underlying cause. This may be utilized pending further workup and investigation into the underlying source of the bleeding.