Tuesday, June 22, 2010
Systems Designed to Fail, Fail :: Steven Lewis (author) Longwoods.com
"....governed by the duty to put patients first..."
Note: background on Steven Lewis:
Bio:
Steven Lewis is a health policy and research consultant based in Saskatoon, and Adjunct Professor of Health Policy at the University of Calgary and Simon Fraser University (where he was Visiting Scholar from January to April 2007). Prior to resuming a full-time consulting practice he headed a health research granting agency and spent 7 years as CEO of the Health Services Utilization and Research Commission in Saskatchewan. He has served on various boards and committees, including the Governing Council of the Canadian Institutes of Health Research, the Saskatchewan Health Quality Council, the Health Council of Canada, and the editorial boards of several journals, including the newly launched Open Medicine. His published work covers topics such as reforming and strengthening medicare, improving health care quality, primary health care, regionalization, and the management of wait times.
Platinum-based adjuvant chemotherapy for early-stage ovarian cancer (abstract)
Conclusions
Combination therapy is administered more often than carboplatin; especially in those with younger age, better PS and nonmucinous histology. Recurrence and death rates were similar with both treatments. Well-designed trials are needed to identify the optimum chemotherapy regimen in this group.
Postmenopausal Hormone Therapy: An Endocrine Society Scientific Statement -- Concensus Statement/Review
Conclusions:
The major conclusions related to the overall benefits and risks of MHT expressed as the number of women per 1000 taking MHT for 5 yr who would experience benefit or harm. Primary areas of benefit included relief of hot flashes and symptoms of urogenital atrophy and prevention of fractures and diabetes. Risks included venothrombotic episodes, stroke, and cholecystitis. In the subgroup of women starting MHT between ages 50 and 59 or less than 10 yr after onset of menopause, congruent trends suggested additional benefit including reduction of overall mortality and coronary artery disease. In this subgroup, estrogen plus some progestogens increased the risk of breast cancer, whereas estrogen alone did not. Beneficial effects on colorectal and endometrial cancer and harmful effects on ovarian cancer occurred but affected only a small number of women. Data from the various Women's Health Initiative studies, which involved women of average age 63, cannot be appropriately applied to calculate risks and benefits of MHT in women starting shortly after menopause.
At the present time, assessments of benefit and risk in these younger women are based on lower levels of evidence.
Angiogenesis Inhibitors: Current Strategies and Future Prospects
Abstract/Full free access (chapters):
Introduction
Inhibition of Angiogenesis for Anticancer Purposes
Process of Carcinogenesis and Subsequent Tumor Angiogenesis
Angiopoietins and TIE Receptors
Delta/Jagged-Notch Signaling
HIF
Antiangiogenesis Compounds
Inhibitors of Growth Factors, RTKs, and Signaling Pathways
Monoclonal Antibodies Directed at EGFRPI3K/AKT/mTOR Pathway Inhibitors
MAPK-Farnesyltransferase Rho and Ras InhibitorsHIF Pathways and Binding...
Known and Potential Side Effects From the Inhibition of AngiogenesisConclusions
References
Conclusions:
The complex molecular pathways that govern tumor angiogenesis are logical targets for pharmacological manipulation given the important role they play in the growth and development of cancers.
Quality in Cancer Diagnosis (diagnostic pathology)
Summary
The quality of oncologic pathology testing currently is focused on the evaluation of testing steps involved in the ordering, procuring, processing, interpreting, reporting, and decision making based on pathology test results. Most errors in cancer diagnosis are related to several factors and not simply a pathologist's interpretation. Clinical practitioners may improve the safety of oncologic pathology testing services by facilitating communication between clinical services and pathology laboratories at all levels of testing.
Abstract/free full text - Associations between tamoxifen, estrogens, and FSH serum levels during steady state tamoxifen treatment of postmenopausal women with breast cancer
"Conclusions
We have shown an association between tamoxifen and its metabolites and estrogen serum levels. An impact of CYP2C19 predicted activity on tamoxifen, as well as estrogen kinetics may partly explain the observed association between tamoxifen and its metabolites and estrogen serum levels. Since the role of estrogen levels during tamoxifen therapy is still a matter of debate further prospective studies to examine the effect of tamoxifen and estrogen kinetics on treatment outcome are warranted."
(U.S.) Society of Gynecologic Oncologists Releases Data on the State of the Specialty
"SGO Practice Survey Task Force Chairman James Orr, MD, said in a news release, “The information in this report is a useful tool not only to current, practicing gynecologic oncologists with regard to how their practice composition relates to their peers, but also has important implications for individuals considering a career in this subspecialty, medical schools interested in creating a specialty program, and hospitals and health systems investigating the addition of specialized cancer care to their women's health care programs.”"
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