EpidemiologyVulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders.HistologySquamous cell carcinoma (SCC) is the most common malignant tumor of the vulva (95%).Clinical featuresPruritus is the most common and long-lasting reported symptom of vulvar cancer, followed by vulvar bleeding, discharge, dysuria, and pain.TherapyThe gold standard for even a small invasive carcinoma of the vulva was historically radical vulvectomy with removal of the tumor with a wide margin followed by an en bloc resection of the inguinal and often the pelvic lymph nodes. Currently, a more individualized and less radical treatment is suggested: a radical wide local excision is possible in the case of localized lesions (T1). A sentinel lymph node (SLN) biopsy may be performed to reduce wound complications and lymphedema.PrognosisThe survival of patients with vulvar cancer is good when convenient therapy is arranged quickly after initial diagnosis. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival.
Increased age appears to be a strong risk factor for COVID-19 severe outcomes. However, studies do not sufficiently consider the age-dependency of other important factors influencing the course of disease. The aim of this review was to quantify the isolated effect of age on severe COVID-19 outcomes. We searched Pubmed to find relevant studies published in 2020. Two independent reviewers evaluated them using predefined inclusion and exclusion criteria. We extracted the results and assessed seven domains of bias for each study. After adjusting for important age-related risk factors, the isolated effect of age was estimated using meta-regression. Twelve studies met our inclusion criteria: four studies for COVID-19 disease severity, seven for mortality, and one for admission to ICU. The crude effect of age (5.2% and 13.4% higher risk of disease severity and death per age year, respectively) substantially decreased when adjusting for important age-dependent risk factors (diabetes, hypertension, coronary heart disease/cerebrovascular disease, compromised immunity, previous respiratory disease, renal disease). Adjusting for all six comorbidities indicates a 2.7% risk increase for disease severity (two studies), and no additional risk of death per year of age (five studies). The indication of a rather weak influence of age on COVID-19 disease severity after adjustment for important age-dependent risk factors should be taken in consideration when implementing age-related preventative measures (e.g., age-dependent work restrictions).
This study indicates that traffic noise exposure might lead to depression. As a potential explanation for the decreasing risks at high traffic noise levels, vulnerable people might actively cope with noise (e.g. insulate or move away).
The size of an individual's home range is an important feature, influencing reproduction and survival, but it can vary considerably among both populations and individuals. The factors accounting for such variation are still poorly understood, and comprehensive long-term field studies considering various environmental factors that influence home range size are rare. We investigated the effects of seasonality, availability of food, cover, number of direct neighbours and the relative individual body mass on home range sizes in 125 adult female striped mice, Rhabdomys pumilio, in South Africa from 2004 to 2008. We used radiotelemetry to estimate home range sizes, trapping to determine the number of direct neighbours, and plant surveys in every home range to determine availability of food and cover. Home ranges were smaller when food quantity was high, many territorial neighbours were present, females had a relatively small body mass and during the nonbreeding season. We conclude that the availability of food resources and intraspecific competition are the main factors influencing home range size in female striped mice. Females enlarged their home ranges when territorial neighbours were few, and there was a significant positive correlation between home range size and quantity of food plants. This indicates that home range size might not reflect the minimal trade-off between access to resources that allow for a female's survival and lowest cost for defending and foraging in that area. Instead, we propose a hypothesis for future research that female striped mice occupy areas several times larger than needed to improve their fitness by providing resources for future offspring.Female home range size is regulated by resource distribution and intraspecific competition: a long-term field study
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