The significance of Erb-b2 immunostaining in cervical cancer

OBJECTIVE

The aim of this study was to assess the relationship between survival and erb-b2 immunohistochemical staining in patients with early stage cervical carcinoma.

METHODS

Archival specimens for 126 patients with stage IB/IIA cervical carcinoma treated with radical hysterectomy and bilateral pelvic node dissection (RH-BPND) were retrieved and submitted to immunohistochemistry for ERBB2 expression. The association between positive results and poor survival was assessed in a multivariate analysis.

RESULTS

Erb-b2 immunostaining was significantly associated with poor survival (P = 0.0284) but less so than parametrial extension (P = 0.0014) and nodal disease (P = 0.0106). Tumor type (squamous/adenosquamous/adenocarcinoma) and the status of surgical margins were not significantly associated with survival.

CONCLUSIONS

These results supported further investigations of ERBB2 expression as a marker of high-risk disease in patients treated with RH-BPND.

Wound infection surveillance

This paper describes a prospective study of all surgical wounds of patients at the Foothills Hospital (Calgary, Alberta, Canada) during a period of 10 years to determine the rate of infection of surgical wounds and to assess the factors that influenced this rate. My colleagues and I found that the overall infection rate was 4.7% but that the rate of infection of clean wounds was 1.5%; this latter rate proved to be far more useful than the former as an indicator of control of infections of surgical wounds. Endogenous contamination at the time of operation is more important as a cause of infection than is exogenous contamination. Having the patient shower with an antiseptic agent before the operation and not shaving the operative site reduced the clean wound infection rate. Use of adhesive plastic drapes did not reduce the infection rate. Glove punctures did not prove hazardous. Advanced age of the patient, prolonged preoperative hospitalization, and long operations were associated with an increase in the rate of infection of surgical wounds.

Florence Nightingale

This is a brief review of the accomplishments of Florence Nightingale. She is known to all as the Lady with the Lamp and the Founder of Modern Nursing. It is less well-known that in her lifetime she played a major role in the reform of the medical services of the British Army and the initiation of the British Army Medical School; she was a statistician and one of the founders of epidemiology; she was a world authority on hospital design; and additionally she was a linguist and a Greek scholar. She achieved all this, not through being a ministering angel, but because of her iron will, hard work, leadership, and political skill.

Dietary cholesterol is co-carcinogenic for human colon cancer

Colorectal carcinoma is becoming the most common form of visceral cancer in Western populations. A fat-related dietary factor is implicated in its pathogenesis, and evidence in man suggests that this factor may be cholesterol. Dietary cholesterol is co-carcinogenic in animals with colon cancer, and there is indirect evidence for a similar role in man. It is proposed that prolonged exposure to dietary cholesterol is co-carcinogenic for human colon cancer in that it facilitates the development, growth, and spread of this disease.

Establishing demand feeding in hospital

In the summer of 1975 demand feeding was introduced for all babies born at the John Radcliffe Hospital, where previously babies were fed according to a rigid schedule to fit in with ward routine--clock feeding. Over a 10-day period before demand feeding was introduced details were collected about infant feeds concerning 42 normal babies whose mothers had decided to breast feed. 2 weeks after the introduction of demand feeding similar details were collected about 43 normal breast-fed babies. At the time of the observations 65% of all babies born in this hospital were being breast fed. Comparing breast feeding patterns, there was a wider scatter of interfeed time intervals in the demand-fed group than in the clock-fed group, over the first 2 days after birth. By the end of the first week these differences were no longer present. The introduction of demand feeding presented no problems in ward management and is now the established routine in this maternity hospital.

Infection surveillance: identifying the problems and the high-risk patient

A prospective wound surveillance program (47,917 wounds studied) proved valuable in determining the factors responsible for infection, the operations at risk, and the influence of variables. Because the rate of infection in clean wounds is the most sensitive indicator of surgical technic, it is a useful method of quality control.