Friday, April 06, 2012
Cancer's epicentre - The Economist
Cancer's epicentre - The Economist:
Cancer's epicentre
The Economist THE biggest conceptual breakthrough in the war on cancer was the realisation by the 1980s that it is always a genetic disease. Sometimes the genetic flaw is inherited. Sometimes it is the result of exposure to an outside agent such as tobacco smoke or radioactivity. Sometimes it is plain bad luck; a miscopying of a piece of DNA during the normal process of cell division. Turning that breakthrough into medicine, though, is hard. No one has worked out how to repair DNA directly. It is, rather, a question of discovering the biochemical consequences of the genetic damage and trying to deal with those instead. But recently, another pattern has emerged. It is too early to call it a breakthrough as significant as the cancer-is-caused-by-broken-genes finding, but it might be....... |
abstract: Incontinence after colonoscopy - an unrecognized and preventable problem. A cross-sectional study from the Gastronet quality assurance program
Abstract
"Female patients had a higher risk of incontinence than men."
Background:
Colonoscopy requires insufflation of gas for visualization of the bowel wall. Worldwide, this is usually done using air. The aim of the present study was to assess the risk of post colonoscopy incontinence, and to investigate whether insufflation of CO2 instead of air may reduce this risk, since it is easily absorbed through the bowel mucosa.
Conclusion:
About every 20th patient undergoing colonoscopy using standard air insufflation experiences post examination incontinence. This proportion can be reduced by 60 % by converting from air insufflation to insufflation with the absorbable CO2.
abstract: The effect of hysterectomy on survival of patients with borderline ovarian tumors (repost)
The effect of hysterectomy on survival of patients with borderline ovarian tumor
Objective
The classically recommended surgical treatment of borderline ovarian tumors (BOTs) includes hysterectomy in addition to bilateral adnexectomy. Possible reasons for hysterectomy might be a high frequency of uterine involvement and its favorable effect on survival. The purpose of the present study was to assess the frequency of uterine involvement in patients with BOTs and the effect of hysterectomy on survival.
Methods
All incident cases of histological confirmed BOTs diagnosed in Israeli Jewish women between March 1 1994 and June 30 1999, were identified. Clinical and pathological characteristics were abstracted from medical records. Patients with tumors grossly confined to the ovaries (apparently stage I) were considered to have had surgical staging when at least hysterectomy, bilateral salpingooophorectomy, omentectomy and pelvic lymph node sampling were done.
Results
The study group comprised 225 patients. Hysterectomy was performed in 147 (65.31%) patients and uterine involvement was present in only 3 (2.0%) of them. The 13 year survival of the total group of patients was 85.8% and of those in apparent stage I, 88.5%. Among patients with tumors apparently confined to the ovaries, no significant survival difference was observed between unstaged and surgically staged patients. There was also no survival difference between the overall staged and unstaged patients and between patients in stages II–III who did and did not undergo hysterectomy.
Conclusions
Our data indicate that the rate of uterine involvement in BOT is low and that hysterectomy does not favorably affect survival. The necessity of hysterectomy in BOT patients is questioned.
abstract: A phase II evaluation of belinostat and carboplatin in the treatment of recurrent or persistent platinum-resistant ovarian, fallopian tube, or primary peritoneal carcinoma: A gynecologic oncology group study
A phase II evaluation of belinostat and carboplatin in the treatment of recurrent or persistent platinum-resistant ovarian, fallopian tube, or primary peritoneal carcinoma: A gynecologic oncology group study:
Background
Patients with recurrent ovarian cancer have limited options, especially in the context of relapse less than six months from primary platinum-based therapy. This Gynecologic Oncology Group (GOG) study was conducted to evaluate the impact of the histone deacetylase inhibitor, belinostat, in combination with carboplatin in women with platinum-resistant ovarian cancer.
Methods
Eligible patients had measurable, recurrent disease within six months of their last dose of a platinum-based combination. Belinostat was dosed at 1000mg/m2 daily for five days with carboplatin AUC 5 on day three of 21-day cycles. The primary endpoint was overall response rate (ORR), using a two-stage design.
Results
Twenty-nine women enrolled on study and 27 were evaluable. The median number of cycles given was two (range 1–10). One patient had a complete response and one had a partial response, for an ORR of 7.4% (95% CI, .9%–24.3%). Twelve patients had stable disease while eight had increasing disease. Response could not be assessed in five (18.5%). Grade 3 and 4 events occurring in more than 10% of treated patients were uncommon and limited to neutropenia (22.2%), thrombocytopenia (14.8%), and vomiting (11.1%). The median progression-free survival (PFS) was 3.3months and overall survival was 13.7months. PFS of at least six months was noted in 29.6% of patients. Due to the lack of drug activity, the study was closed after the first-stage.
Conclusions
The addition of belinostat to carboplatin had little activity in a population with platinum-resistant ovarian cancer.
abstract: Changes in serum CA-125 can predict optimal cytoreduction to no gross residual disease in patients with advanced stage ovarian cancer treated with neoadjuvant chemotherapy
Changes in serum CA-125 can predict optimal cytoreduction to no gross residual disease in patients with advanced stage ovarian cancer treated with neoadjuvant chemotherapy
Objective
To evaluate the predictive power of serum CA-125 changes in the management of patients undergoing neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) for a new diagnosis of epithelial ovarian carcinoma (EOC).
Conclusions
Patients who undergo NACT-IDS achieve a high rate of optimal cytoreduction. In our series, after treatment with taxane and platinum-based chemotherapy, patients with a preoperative CA-125 of ≤100U/mL were highly likely to be cytoreduced to no residual disease.
Witnessing, Experiencing Traumatic Events May Worsen Heart Disease - MedicineNet
Witnessing, Experiencing Traumatic Events May Worsen Heart Disease - MedicineNet
WEDNESDAY, April 4 (HealthDay News) -- Large amounts of lifetime exposure to traumatic stress -- even when it doesn't result in post-traumatic stress disorder -- boosts inflammation levels in heart disease patients, a new study suggests.......
no abstract: Obstetrics and Gynecology Clinics of North America | ScienceDirect.com
Blogger's Note: this journal is subscriber based, this article has no abstract
Obstetrics and Gynecology Clinics of North America (journal)
Trends in Gynecologic Cancer Care in North America
Review ArticleIn Press, Corrected Proof, Available online 5 April 2012
Clare Reade, Laurie Elit
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| Related articles | Related reference work articles Abstract | Figures/Tables | ReferencesNo abstract is available for this article.
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