Seminars in thoracic and cardiovascular surgery
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Semin. Thorac. Cardiovasc. Surg. · Jan 2011
Chest physiotherapy in lung resection patients: state of the art.
The role of chest physiotherapy in limiting postoperative pulmonary complications and in the recovery of pulmonary function and exercise capacity after lung surgery is still unclear because of the lack of conclusive, well-designed clinical trials. In this article the available literature on these topics is reviewed, and the effects of respiratory physiotherapy, instituted preoperatively or administered after surgery to patients undergoing lung resection, are commented on. ⋯ Also physiotherapy administered during the immediate period after lung resection probably decreases frequency of pulmonary complications. Finally, further investigation is required for a better understanding of the effects of long-term chest physiotherapy after hospital discharge in lung resection patients.
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Semin. Thorac. Cardiovasc. Surg. · Jan 2011
ReviewThe SYNTAX score and SYNTAX-based clinical risk scores.
Risk stratification is an important and essential component in appropriately informing patients electing to undergo coronary artery bypass graft or percutaneous coronary intervention. This process is an integral part of the SYNTAX pioneered Heart Team approach in selecting the most appropriate revascularization modality in patients with complex coronary artery disease. The SYNTAX score was pioneered as an anatomical-based risk score that aided in this decision-making process. The purpose of this review is to examine the SYNTAX score and subsequent risk models that have been developed on the basis of this landmark anatomical-based risk score.
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Semin. Thorac. Cardiovasc. Surg. · Jan 2011
ReviewPersonalized therapy for non-small cell lung cancer: which drug for which patient?
The elucidation of the molecular alterations in non-small cell lung cancer (NSCLC) and the development of molecularly targeted agents have permanently shifted NSCLC therapy to a personalized approach. In the metastatic setting, the addition of the anti-vascular endothelial growth factor monoclonal antibody, bevacizumab, to chemotherapy improves overall survival. The oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors, gefitinib and erlotinib, prolong progression-free survival in patients selected for the presence of an EGFR activating mutation. ⋯ The realm of personalized lung cancer therapy also includes the study of chemotherapy selected on the basis of the pharmacogenetic profile of a patient's tumor. Several ongoing clinical trials in both the metastatic and adjuvant settings are studying the excision repair cross-complementing group 1 (ERCC1) protein, the ribonucleotide reductase subunit 1 (RRM1) protein, thymidylate synthase, and BRCA1 as predictors of chemotherapy response. This review will outline the current state of the art of personalized NSCLC therapy.
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Semin. Thorac. Cardiovasc. Surg. · Jan 2011
ReviewSex and gender differences in non-small cell lung cancer.
Historically, lung cancer has been viewed as a male disease, but during the past 50 years there has been a dramatic increase in the incidence of lung cancer in women. Lung cancer is currently the most common cause of cancer death in American women, accounting for more than one quarter of all cancer deaths. This has been attributed to a significant increase in tobacco consumption by women; however, approximately 1 in 5 women with lung cancer never smoked. As the incidence of lung cancer in women has increased, significant gender-based differences in epidemiology, biology, and treatment responses have become evident and warrant further investigation to advance the treatment of lung cancer in all patients.