Medical Center

MODEST AND REAL OFFERS FOR MESOTHELIOMA
Physicians presenting clinical information at the Malignant Mesothelioma Conference, taken by the University of Chicago, echoed one and other with a recurring theme–while the past has offered little in the way of advancements in surgical, radiotherapy, and chemotherapy, new active drugs and insights into the biology of mesothelioma are showing real progress, assisting place long-term nihilism that had been associated with the cure of this disease.
Antifolates types, such as premetrexed disodium (Alimta), offer new future for effective treatments, as illustrated by the results of a phase II single agent trial of alimta, in which a confirmed partial response was seen in 14.5PCT (9/62) of advance pleural mesothelioma patients. In this study, 62 chemonaive patients were enrolled with a 5.2:1 M/F ratio, median age of 67 years (range 40-80) stage III/IV disease (31PCT/54PCT), and subhistology of epidermal (74PCT), mixed (14PCT), or sarcamatoid (9PCT) involvement.

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Endometrial Cancer
Women with endometrial cancer of high-intermediate risk, who comprise about 30% of the patient population, can be safely treated with vaginal brachytherapy (VBT) after surgery instead of undergoing external beam radiation therapy (EBRT). Both approaches offer similar control of recurrences and have a similar impact on survival, but VBT is associated with “significantly better” quality of life and fewer gastrointestinal (GI) adverse effects.
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Reactive Airways Dysfunction Syndrome (RADS)
Exposure to a very high concentration of gas, smoke, fume, or vapor that had irritant qualities.
Symptoms consistent with asthma: cough, wheeze, dyspnea.
Onset of symptoms within 24 hours after the acute exposure and persistence of symptoms for at least 3 months.
Possibly airflow limitation on pulmonary function tests.
Airway hyperresponsiveness on methacholine challenge.
Documented absence of preceding respiratory complains
Other types of pulmonary disease excluded.
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PPROVED DOCTOR’S GUIDANCE 10
ASTHMA : Asthma is a chronic condition characterised by inflammation within the airways. Symptoms are usually episodic and include cough, wheezing, chest tightness and breathlessness. Episodes may last from a few minutes to several weeks and vary in severity from trivial to fatal. Episodes may be provoked by various factors that include exposure to allergens, respiratory irritants, infections, and exercise or may occur apparently spontaneously. An individual with asthma may be affected by one or more of these factors. Asthma can occur at any age but is most common in childhood. Many children with asthma grow out of their symptoms during their teen age years. Occupational asthma may also occur in a previously unaffected individual as a result of sensitisation to certain chemicals and organic materials which are encountered in the course of work, some of which are found at sea. Modern treatment of asthma is very effective and results in substantial improvement in symptoms in most patients.
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ALLERGY, ASTHMA, AND IMMUNOLOGY
The Primary Care Physician should:
1.Perform a history and PE on the potentially allergic patient. Make use of appropriate environmental control measures.
2.Differentiate various forms of rhinitis and rhinoconjunctivitis, including seasonal and perennial forms. Treat with appropriate environmental control measures, antihistamines, decongestants, nasal steroids, and nasal anticholinergics. Occasional short bursts of systemic steroids may be indicated in allergic rhinitis, eosinophilic rhinitis, and nasal polyposis.
a)Consider referral to allergist if:
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Elevated fractional exhaled nitric oxide (FeNO) levels can help assess asthma severity, daytime symptoms, airflow limitation, and β-agonist responsiveness in children and adolescents, according to a retrospective study presented here at the American Academy of Allergy, Asthma and Immunology 2010 Annual Meeting.  “It was very clear,” Summer Monforte, MD, pediatric resident at Children’s Hospital in Denver, Colorado, told meeting attendees. “Those not diagnosed with asthma had normal levels, whereas those that were diagnosed with asthma had high levels. This is simply 1 more useful tool that’s available to us now.”

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Screening for ovarian cancer in 2010- what should be done?

Ovarian cancer is a deadly disease. It is frequently diagnosed late when it has a high mortality rate. Early detection of this disease by screening is attractive as when the disease is diagnosed early, the prognosis is better.  Two very large trials of different approaches to screening for ovarian cancer have recently reported some interim results. Although deadly when it does occur, ovarian cancer is relatively uncommon in women, compared with cancers of the breast or bowel, so studies of screening for ovarian cancer need to be very large to enable the questions about screening to be answered. This means that studies take a long time and they are very difficult and expensive to do.
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