Taxanes and epothilones are chemotherapeutic agents that ultimately lead to cell death through inhibition of normal microtubular function. This review summarizes the literature demonstrating their current use and potential promise as therapeutic agents in the treatment of epithelial ovarian cancer (EOC), as well as putative mechanisms of resistance. Historically, taxanes have become the standard of care in the front-line and recurrent treatment of epithelial ovarian cancer. In the past few years, epothilones (i.e., ixabepilone) have become of interest as they may retain activity in taxane-treated patients since they harbor several features that may overcome mechanisms of taxane resistance. Clinical data now support the use of ixabepilone in the treatment of platinum-resistant or refractory ovarian cancer. Clinical data strongly support the use of microtubule-interfering drugs alone or in combination in the treatment of epithelial ovarian cancer. Ongoing clinical trials will shed further light into the potential of making these drugs part of current standard practice.
The aim of this study was to describe genital hair thread tourniquet syndrome (HTTS) and its treatment by pediatric and adolescent health care providers through a systematic literature review. Methods:We performed a systematic literature review on pediatric male and female genital HTTS. Studies were included if they involved genital HTTS in males or females 21 years and younger and were published in English. The main outcomes were body parts involved, symptoms, treatment, anesthetic type, providers involved in diagnosis and management, and implications of delayed or missed diagnosis.Results: There were 38 female cases from 33 publications and 147 male cases from 47 publications . The average age among females and males was 9.1 and 5.1 years, respectively. Among cases involving female patients, 93% of them were premenarchal; patients were circumcised in 90% of reviewed cases of male HTTS. The most commonly involved body parts were clitoris and labia minora in females, and penis and urethra in males. Males most commonly presented with edema and urinary symptoms, whereas females most commonly presented with edema and pain. General anesthesia was used for tourniquet excision in most cases. Male and female genital HTTS were mostly managed by urologists and emergency medicine physicians, respectively. Conclusion:This systematic literature review of more than 150 cases of male and female genital HTTS describes evaluation and management of genital HTTS spanning 7 decades. The main treatment of genital HTTS remains prompt diagnosis and removal of the tourniquet, as well as education on prevention strategies. Delayed diagnosis due to lack of recognition of the HTTS can lead to serious sequelae. Development of national guidelines regarding best practices in management of genital HTTS disseminated to all providers taking care of pediatric and adolescent patients will lead to improved patient care.
INTRODUCTION: Little is known about OB-GYN residents’ habits or preferences with regard to self-education. We investigated current resident learning behaviors and preferences, as well as attitudes towards podcasting as an educational tool. METHODS: A 28 question survey was generated to query resident self-education generally and genetics education specifically. An invitation to complete the online survey was sent to all ACGME Program Directors, asking them to forward the survey to their residents. Data was collected and analyzed using Qualtrics Software. RESULTS: 195 residents from 51/292 (17.5%) programs participated in the study. Average age was 28.9 years (SD 2.3 years), 85% were female, 13% were male. Half of residents (51%) reported spending between three and five hours a week on self-directed learning activities, excluding lectures, with 31% spending even less time, between zero and two hours. Residents reported they most commonly used UptoDate (129, 66%), Google (121, 62%), and Guidelines/Practice Bulletins (100, 43%) for learning. Guidelines and Practice Bulletins were considered very helpful for learning by 86% (167/195) followed by UpToDate (151, 77%). Only 35% (70) found textbooks helpful. A majority of residents reported they would be very likely to complete residency curriculum podcasts lasting 10 minutes (78%) or 20 minutes (63%). Residents would listen to podcasts while commuting to work (142, 78%), doing household chores (104, 53%), or exercising (50%). CONCLUSION: Residents spend five hours or less on self-education per week, and prefer concise, easily accessible learning modalities. Podcasts may be a useful educational tool for the modern OB-GYN resident.
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