Archive for the ‘Cancer’ Category

Bilateral Paramediastinal Post- Traumatic Lung Cysts: DISCUSSION

Lung Cysts

To our knowledge, this case is the first report of bilateral post-traumatic paramediastinal lung cysts. Furthermore, it illustrates several characteristic features of this condition. All patients have a history of blunt chest trauma, which may be minor. Over 80 percent are 30 years of age or less, with no previous pulmonary complaints. Many patients present with hemoptysis, chest pain, cough, and dyspnea. There may be a low-grade fever with mild leukocytosis.

A number of factors have been implicated as important mechanisms of injury. Initially, a blunt force applied to the chest wall results in compression and high pressures within the underlying pulmonary parenchyma. This may lead to the rupture of small bronchi, causing the surrounding alveoli to burst. Air can then enter between the layers of the pulmonary ligament. Rupture of capillaries around the lacerated alveoli then leads to accumulation of blood within the newly formed air space. A closed glottis may play a role in producing high intrathoracic pressure from chest com­pression. The bursting process may involve any area of either lung, although the apices are usually spared. An alternative theory proposes that a blow to the chest wall creates a concussive wave, leading to shearing stresses which exceed the elasticity of the pulmonary tissue. Still another proposal notes that increased intrathoracic pressure may be followed by negative pressure due to elastic recoil after compression. This might produce bursting followed by shearing forces, leading to parenchymal lacerations, and escape of air and fluid into the lung.

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Bilateral Paramediastinal Post- Traumatic Lung Cysts: Case Report

Case Report

The patient was a 25-year-old white man with a history of intravenous drug abuse, bisexual behavior, HIV antibody-positive status, a perirectal abscess, hepatitis B, and recurrent lower- extremity staphylococcal infections, who presented to University Medical Center after a motorcycle accident. An emergency-room, portable chest roentgenogram was initially interpreted as revealing no gross abnormality (Fig 1). The patient was treated for chin lacerations and discharged the next day. Four days later, he was readmitted with cough, hemoptysis, pleuritic chest pain, and low- grade fever. Read the rest of this entry »

Bilateral Paramediastinal Post- Traumatic Lung Cysts

Unilateral post-traumatic and paramediastinal lung cysts are uncommon and usually do not require treatment. Nevertheless, recognition of a traumatic lung cyst is impor­tant, since misdiagnosis may lead to unnecessary surgery. This report describes a patient whose bilateral post-trau­matic paramediastinal lung cysts were mistaken for hemi- diaphragmatic hernias. Read the rest of this entry »

American Society of Clinical Oncology: Standard Therapy plus Oxaliplatin for the Treatment of Colorectal Cancer

Clinical cancerSpeaker: Norman Wolmark, MD, Chairman and Professor, Department of Human Oncology, Drexel University College of Medicine and Allegheny Cancer Center, and Chairman of the National Surgical Adjuvant Breast and Bowel Project.

The addition of oxaliplatin (Eloxatin®, Sanofi-Aventis) to standard fluorouracil (5-FU) (Efudex®, Roche)/leucovorin (LV) (Wellcovorin®, Immunex) therapy (FULV) significantly improved three-year disease-free survival in patients with early-stage, markedly reducing the risk of disease recurrence by 21%.

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American Society of Clinical Oncology: Oblimersen Sodium for Advanced Malignant Melanoma

Speaker: John Kirkwood, Professor of Medicine and Director, the Melanoma Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania.

Long-term follow-up results for a minimum of 24 months demonstrated that adding oblimersen sodium (Genasense®, Genta), also called Bcl-2 antisense, to dacarbazine (DTIC-Dome®, Bayer)—the only chemotherapy agent approved for the treatment of advanced melanoma—achieved a significant increase in “durable” responses (lasting longer than six months) and a near-significant trend toward increased survival, when compared with dacarbazine alone in patients with this cancer.

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American Society of Clinical Oncology: Zolendronic Acid and Bone Mass in Women with Breast Cancer

Speaker: Adam Brufsky, MD, PhD, Co-Director, Magee Women’s Hospital/University of Pittsburgh Cancer Institute, Comprehensive Center, and Assistant Professor of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.

“Up-front” zolendronic acid (Zometa®, Novartis), an intravenous (IV) bisphosphonate, when given with adjuvant letrozole (Novartis) therapy, was able to inhibit bone loss in postmenopausal women with early breast cancer. At 12 months, bone mineral density (BMD) was significantly increased in patients receiving this regimen, compared with patients who received the aromatase inhibitor letrozole canadian and delayed zolendronic acid.

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American Society of Clinical Oncology

Clinical OncologyAnastrozole in Localized Breast Cancer

Speaker: David Cella, PhD, Director of Center on Outcomes, Research and Education (CORE), Evanston Northwestern Healthcare, and Professor, Northwestern University Medical School, Evanston, Illinois.

A five-year quality-of-life (QOL) follow-up study of adjuvant endocrine therapy for postmenopausal women with early breast cancer in the Arimidex or Tamoxifen Alone or in Combination (ATAC) trial demonstrated the superiority of anastrozole (Arimidex drug, AstraZeneca) over tamoxifen (AstraZeneca) without a detrimental impact on overall QOL. Findings were reported in the ATAC Completed Treatment Analysis (CTA).

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So Many Advances in Medicine, So Many Yet to Come