CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Angiogenesis is a process critical to both tumour growth and metastasis. It is a dynamic integrated process involving basement membrane degradation, endothelial cell proliferation and migration, and capillary tubule formation. ⋯ There are markers of angiogenesis that potentially could provide prognostic information in addition to that gained from conventional clinicopathologic data, and antiangiogenic therapy for urologic cancers has potential advantages over current therapeutic strategies. Promising preclinical studies have led to the initiation of phase I studies of antiangiogenic therapy in combination with chemotherapy, which may lead to novel treatments for urologic malignant tumours and may identify new intermediate markers for the response to therapy.
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A previous review by the Canadian Task Force on the Periodic Health Examination (now the Canadian Task Force on Preventive Health Care) in 1994 indicated fair evidence to exclude mammographic breast cancer screening of women aged 40-49 from the periodic health examination. This current review considers the available new and updated evidence regarding the effect of screening mammography on breast cancer mortality among women in this age group at average risk of breast cancer. ⋯ The Canadian Task Force on Preventive Health Care is funded through a partnership between the Provincial and Territorial Ministries of Health and Health Canada.
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Adverse events and medical errors are not uncommon. In this article we review the literature on such events and discuss the ethical, legal and practical aspects of whether and how they should be disclosed to patients. ⋯ Candour about error may lessen, rather than increase, the medicolegal liability of the health care professionals and may help to alleviate the patient's concerns. Guidelines for disclosure to patients, and their families if necessary, are proposed.