New Britain General Hospital

The first part to a container journey is selecting a container runtime, learning the ins and outs of it, and containerizing applications. The next level is being prepared to run the containers in production at an enterprise level. For running containers in production, you will want an orchestration platform.

To evaluate the efficacy and safety of second uterine curettage in lieu of chemotherapy for patients with low-risk, nonmetastatic gestational trophoblastic neoplasia (GTN) and to evaluate whether response to second curettage is independent of patient age, World Health Organization (WHO) risk score, registration human chorionic gonadotropin (hCG) level, lesion size, and depth of myometrial invasion measured on ultrasound examination. This was a cooperative group multicenter prospective phase II study. Prestudy testing included quantitative hCG level, pelvic ultrasonography, and chest radiography. Patients were categorized according to WHO risk scoring criteria (low risk with a score of 0-6). Sixty-four women with newly diagnosed low-risk, nonmetastatic GTN were enrolled. Four patients were excluded. Twenty-four patients (40%) (lower 95% confidence limit 27.6%) were cured after second curettage. An additional two patients (3%) achieved a complete response but did not complete follow-up. Overall, 26 of 60 patients were able to avoid chemotherapy. Surgical failure was observed in 34 women (59%) and was more common in women 19 years old or younger or 40 years old or older. One case of grade 1 uterine perforation was successfully managed by observation. Four grade 1 and one grade 3 uterine hemorrhages were reported. New metastatic disease (lung) was identified in one of these women after second curettage. In three patients (surgical failures), the second curettage pathology was placental site trophoblastic tumor, and it was placental nodule in one additional patient. Second uterine curettage as initial treatment for low-risk, nonmetastatic GTN cures 40% of patients without significant morbidity. ClinicalTrials.gov, https://clinicaltrials.gov/, NCT00521118.

Despite the imperative for change in a world of persistent inequality, racism, oppression and violence, difficulties arise once we try to bring about a transformation. As scholars, students and activists, we may want to change the world, but we are not separate, looking in, but rather part of the world ourselves. The book demonstrates that we are not in control: with all our academic rigour, we cannot know with certainty why the world is the way it is, or what impact our actions will have. It asks what we are to do, if this is the case, and engages with our desire to seek change. Chapters scrutinise the role of intellectuals, experts and activists in famine aid, the Iraq war, humanitarianism and intervention, traumatic memory, enforced disappearance, and the Grenfell Tower fire, and examine the fantasy of security, contemporary notions of time, space and materiality, and ideas of the human and sentience. Plays and films by Michael Frayn, Chris Marker and Patricio Guzmán are considered, and autobiographical narrative accounts probe the author's life and background. The book argues that although we might need to traverse the fantasy of certainty and security, we do not need to give up on hope.

Recently, the National Cancer Institute endorsed intraperitoneal (IP) therapy as the treatment of choice for optimally debulked epithelial ovarian cancer. However, there are no drug regimens that are clearly indicated, and the exact method of administration has not been established. Furthermore and most importantly, physicians are unaware of what toxicities should be expected with their use of IP therapy. We report a recent unanticipated toxicity from IP cisplatin therapy and review the literature. A 63-year-old female with optimally debulked stage IIIC papillary serous carcinoma of ovary was admitted on postoperative day 14 for her first cycle of IP cisplatin. She received a cisplatin infusion of 100 mg/m(2). Four days after the cycle, she suffered acute onset of bilateral tinnitus and hearing loss (ototoxicity grade 3). Thus, we conclude that high-frequency hearing loss remains a potentially serious and permanent adverse effect of cisplatin.

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