Lymphovascular space invasion is an overall poor prognostic factor in T1N0 endometrial cancer. After adjusting for other factors, LVSI remains an independent risk factor for worse overall survival. Therefore, estimation of overall survival in patients with early-stage, node-negative endometrial cancer should take into account LVSI status.

CLINICIAN'S CAPSULE What is known about the topic? Little is known about the outcomes of older patients who are classified as "low acuity" at triage. What did this study ask? What are the differences in outcome of ED patients ages 65 years and older who received a CTAS score of 4 or 5, compared with patients 40 to 55 years old. What did this study find? Older patients were significantly more likely to be admitted; patients aged 85 years and older were particularly at risk. Why does this study matter to clinicians? Consideration should be given to triage modifiers for age, given the higher admission and re-presentation rates in older patients.

An effective taper in training load is essential for increased performance outcomes at competition, however optimal taper individualization remains elusive. Monitoring psychological and physical adaptations that occur during the taper may help guide the optimization of training during a taper resulting in improvements in performance. We monitored physical and psychological variables as well as competition performance of 10 elite swimmers before and during a 21-day taper in preparation for the Canadian National Championships or World Championships. Mood and recovery were assessed using the Brunel Mood Scale and the Recovery-Stress Questionnaire. Resting muscle tension, skin conductance, and respiration rate were measured using biofeedback technology. Speed and heart rate were assessed with a 2 Â 200 m submaximal swim test. Resting HR was measured using the Rusko test. We hypothesized that psychological and physiological measurements would change during the taper phase and that these changes would be associated with improved competition performance. Results showed that the Brunel Mood Scale, Recovery-Stress Questionnaire, 2 Â 200 m submaximal test, and the Rusko test changed significantly throughout the taper period. Variables from the Brunel Mood Scale and the Recovery-Stress Questionnaire showed a significant relationship with improved performance, indicating that these questionnaires show good utility for assessing progress during a taper in the future.

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While working in the emergency department you see a 65-year-old patient who presents as hypotensive and tachycardic with a decreased level of consciousness. The patient is unable to give a history. The blood work from a venous sample reveals the following: pH 7.00, CO 2 25 mmol/L, HCO 3 6 mmol/L, anion gap 25, potassium 6.0 mmol/L, and creatinine 300 µmol/L. Despite resuscitation the patient deteriorates and has a cardiac arrest. With the information available, at any point in the care of this patient would you give sodium bicarbonate?