Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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Rev Med Chir Soc Med Nat Iasi · Apr 2004
Review[Imaging in screening and diagnosis of lung cancer].
While the lung cancer is detected, the majority of the patients could not be surgical cured. Thus appears the great necessity of prevention, of a more efficient treatment and the developing of new methods for early detection. ⋯ None of the studies had no prove in decreasing of mortality by screening for lung cancer. The lack of sensitivity of thoracic radiographs and sputum cytology was leading the investigators to use the monoclonal antibodies in detecting the neoplastic changes in sputum, the spiral computerized tomography with low dose of radiations, the autofluorescence bronchoscopy and more recent the positron emission tomography, offering the possibility of reducing mortality by early detection in lung cancer.
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Rev Med Chir Soc Med Nat Iasi · Oct 2003
Review[Systemic treatment of colorectal cancers--factual standards and perspectives].
Adjuvant therapy has been shown to reduce recurrence and improve survival in patients with stage III colo-rectal cancer (CRC). However, the use of adjuvant therapy is still much debated in stage II disease. Fluorouracil (5-FU) and folinic acid (FA) are currently the standard adjuvant drug combination. ⋯ The oral fluoropyrimidines capecitabine and UFT/FA seem to have a comparable activity to intravenous bolus 5-FU/FA in the first line treatment of metastatic CRC. New agents acting on novel targets are under development. Epidermal growth factors inhibitors, vascular endothelial growth inhibitors, and cyclo-oxygenase 2 inhibitors might play a role in the future in the treatment of CRC.
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It is a disease of obscure cause that is characterized by the accumulation of a granular material that contains abundant lipid within the alveoli of lung. Pulmonary alveolar proteinosis (PAP) has been divided into a congenital and an adult form. The acquired form has been subdivided into a idiopathic form and a secondary form associated with a know disorder or exposure as silica, aluminium, titanium. ⋯ Mice genetically deficient in granulocyte macrophagecolony stimulating factor (GM-CSF) show an alveolar proteinosis. A neutralizing antibody against GM-CSF was found in bronchoalveolar lavage fluid and serum of patients with idiopathic PAP. Currently, no specific therapy exists for pulmonary alveolar proteinosis, and sequential whole lung lavage is standard treatment.
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Peripartum cardiomyopathy (CMP) represents an intriguing and incompletely characterised cause of heart failure arising in women without previously known heart disease during last trimester of pregnancy or first 20 weeks after birth. Fundamental clinical and basic research is lacking regarding this rare but potentially devastating disorder. ⋯ It describes identified risk factors for CMP, clinical symptoms and signs, diagnostic assessment and treatment. Prognosis, follow up criteria and education for patients with previous CMP concerning subsequent pregnancies are also described.
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Patients with unknown primary site cancer represents 5% to 10% of all neoplasia patients. Liver is a favourite site for gastrointestinal tumors, but not only. ⋯ However, liver biopsy could be essential for histological diagnosis and important to identify the tumors who may benefit from specific and effective therapy (breast cancer, prostate cancer, ovarian cancer and small-cell carcinoma of the lung). Systemic chemotherapy represents the most frequently treatment, but only patients with good performance status and without co-morbidities may benefit. "Best supporting care" may be the optimal treatment for most patients, majority with poor performance status at the time of diagnosis.