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To develop a survey evaluating women's experience of outpatient hysteroscopy (OPH) to generate data to benchmark OPH practice in the UK that can be used to optimise women's experience of OPH and improve services.

Quality improvement project and a population-based national survey.

77 hospitals with outpatient hysteroscopy (OPH) services across the UK collected data over two month-period (October-November 2019).

5151 women attending for outpatient hysteroscopy.

A new OPH-Patient Satisfaction Survey (OPH-PSS) was developed using a multi-disciplinary approach. Good practice guidance in hysteroscopy and existing survey's provided content for the survey. Pilot testing identified aspects of the women's OPH journey that contributed to a final survey. The final OPH-PSS was rolled out nationally to generate data for benchmarking OPH services.

The adequacy of OPH services reflected in women's experience of their OPH journey and the quality of care being delivered.

The majority (3193, 76 %) of hysteroscopicrent OPH units. Overall, the information provided to women and their subsequent experience of OPH is good, but pain is common.

This novel survey, evaluating women's experience of OPH (OPH-PSS), provides a useful tool for benchmarking performance across different OPH units. Overall, the information provided to women and their subsequent experience of OPH is good, but pain is common.In this review, we focus on the potential role of the γ-aminobutyric acidergic (GABAergic) system in age-related episodic memory impairments in humans, with a particular focus on Alzheimer's disease (AD). Well-established animal models have shown that GABA plays a central role in regulating and synchronizing neuronal signaling in the hippocampus, a brain area critical for episodic memory that undergoes early and significant morphologic and functional changes in the course of AD. Neuroimaging research in humans has documented hyperactivity in the hippocampus and losses of resting state functional connectivity in the Default Mode Network, a network that itself prominently includes the hippocampus-presaging episodic memory decline in individuals at-risk for AD. Apolipoprotein ε4, the highest genetic risk factor for AD, is associated with GABAergic dysfunction in animal models, and episodic memory impairments in humans. In combination, these findings suggest that GABA may be the linchpin in a complex system of factors that eventually leads to the principal clinical hallmark of AD episodic memory loss. Here, we will review the current state of literature supporting this hypothesis. First, we will focus on the molecular and cellular basis of the GABAergic system and its role in memory and cognition. Next, we report the evidence of GABA dysregulations in AD and normal aging, both in animal models and human studies. Finally, we outline a model of GABAergic dysfunction based on the results of functional neuroimaging studies in humans, which have shown hippocampal hyperactivity to episodic memory tasks concurrent with and even preceding AD diagnosis, along with factors that may modulate this association.

The influence of positive microscopic margin (R1) resection on the prognosis of gastrointestinal stromal tumors (GISTs) is controversial. Tumor rupture is significantly associated with the occurrence of R1 resection and may be a confounder of R1 resection in GISTs. The present meta-analysis evaluated the real influence of R1 resection on the prognosis of GISTs by excluding the confounding effect of tumor rupture.

The PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov databases were searched. Studies that compared R1 with negative microscopic margin (R0) resection in GIST patients and reported the time-to-event data of recurrence-free survival (RFS) or disease-free survival (DFS) were eligible for inclusion. The quality of the observational studies was assessed using the Newcastle-Ottawa scale.

Of the 4896 records screened, 23 retrospective studies with 6248 participants were selected. In the overall analysis, R1 resection resulted in a significantly shorter RFS/DFS than R0 resection for GISTs (HR=1.80, 95% CI=1.54-2.10, P<0.001, I

=14%). However, the inferior RFS/DFS vanished when tumor rupture cases were excluded (HR=1.34, 95% CI=0.98-1.83, P=0.07, I

=33%). Sensitivity analysis by high-quality studies brought about a more robust HR of 1.15 (95% CI=0.88-1.50, P=0.29), with low heterogeneity (I

=0%). The qualities of evidence for the outcomes were high.

This meta-analysis shows that R1 resection did not influence the survival outcome of GISTs. Reresection may not be necessary when positive microscopic margins exist. This analysis could provide high-quality evidence for the development of guidelines.

This meta-analysis shows that R1 resection did not influence the survival outcome of GISTs. Reresection may not be necessary when positive microscopic margins exist. This analysis could provide high-quality evidence for the development of guidelines.

The standard treatment for epithelial early stage ovarian cancer (eEOC) includes laparotomic surgical staging, according to ESGO-ESMO guidelines. In the last decade, many investigators have assessed the safety and feasibility of minimally invasive surgery (MIS) staging in properly selected patients. However, survival data related to different surgical approaches (open versus MIS) are extremely limited. The aim of this study is to analyze the long-term oncological outcomes in eEOC patients treated with MIS.

This is a multicenter observational retrospective study conducted in two tertiary oncological centers. We selected all consecutive women who underwent a laparoscopic or robotic staging for eEOC.

From January 2008 to December 2016, 254 eEOC patients underwent a MIS staging (188 laparoscopic staging and 66 robotic staging). Overall, 18.1% of patients were upstaged due to pathological findings. A total of 203 (79.9%) patients received platinum-based adjuvant chemotherapy. After a median follow-up of 61 months (range 13-118), 39 (15.3%) patients experienced recurrence. The 5-years progression free survival (PFS) and overall survival rates were 84.0% and 93.8%, respectively. In the univariate analysis, favorable variables influencing PFS were young age (≤45 years), non-serous histotype, tumor grade 1-2, and FIGO stage IA/IB. In the multivariate analysis, only grade 3 was shown to keep its negative independent prognostic value (HR=3.47; p=0.004), whereas FIGO stage≥IC showed a trend toward significance (HR=1.75; p=0.099).

This retrospective study represents the longest follow-up of eEOC patients managed by MIS. The MIS is a valuable therapeutic option in appropriately selected patients, although a randomized controlled trial is needed.

This retrospective study represents the longest follow-up of eEOC patients managed by MIS. Tubacin The MIS is a valuable therapeutic option in appropriately selected patients, although a randomized controlled trial is needed.