After almost 50 years of data analysis, screening for colorectal cancer has proven to be an effective tool in reducing colorectal cancer mortality. However, implementing the optimal strategy represents a challenge for many healthcare facilities around the world. There is much discussion regarding how screening should be done, the optimal tools that should be used, and the proper timing for screening procedures. Another essential step is to maintain the adherence of patients to screening programs. Also, the recommendation for lowering the age to initiate screening is in progress, as there is an increase in colorectal incidence in people born after 1970.
Objectives: Gout is the most common inflammatory arthritis of the 21 century, but is still frequently misdiagnosed. This review aims to provide guidance for gout management in clinical practice, which includes the diagnosis, treatment of acute episodes, but also long-term therapy to reduce serum urate, as well as lifestyle changes and prevention of recurrent episodes.Design: Systematic review without meta-analysis.Methods: We have systematically searched Google Scholar, PubMed, and all relevant worldwide guidelines to identify and select clinical guidelines for gout. We have included eligible gout articles according to predefined inclusion and exclusion criteria after selecting titles, abstracts and full texts. The characteristics of the recommendations reported in the guidelines included were extracted and analyzed.Results: We selected 27 eligible papers and tried to facilitate the identification of recommendations for the treatment of gout in the acute phase, but also in the chronic phase. The recommendations were detailed and explained during this extensive review.Conclusions: Despite the availability of effective serum urate reduction therapies, overall gout management is poor. Achieving therapeutic goals is often low both at the initiation of therapy and in long-term treatment. Optimal strategies for managing gout are necessary in both acute and chronic gout flames in patients who are prone to the development of this pathology.
Soft tissue sarcoma (STS) is a biologically heterogeneous malignancy with over 50 subtypes. This solid tumor is one of the most challenging diseases to treat for the medical oncologist. STS often forms in the body’s muscles, joints, fat, nerves, deep skin tissues, and blood vessels. The natural history of high-grade STS is characterized by a strong tendency toward local recurrence and metastatic spreading, despite optimal initial strategies. The lung is the most common site of metastases, with poor prognosis. We present the current international guidelines for the adjuvant treatment and systemic treatment for advanced STS and the new discoveries. Many new molecular targeting drugs have been tried in the last ten years, and some were approved for soft tissue sarcoma. The first approved was Imatinib, as a treatment for gastrointestinal stromal tumors (GISTs). Following Imatinib, other tyrosine kinase inhibitors (TKIs) received the approval for GISTs such as Sunitinib and Regorafenib, and Pazopanib for non-GIST soft tissue sarcomas. In 2016, FDA approved the first monoclonal antibody that targets platelet-derived growth factor receptor (PDGFR)-α, Olaratumab. The new treatment demonstrates an overall survival advantage. In this review, we aimed to summarize the results from the most recent studies on adjuvant treatment for high-grade STS and systemic strategies for advanced STS.
Background. The treatment of stage II colon cancer has been a subject of debate for a long time. In the last years, a few risk factors have been proposed in order to guide any treatment decision more accurately. One of these risk factors is the number of resected lymph nodes, and according to the latest guidelines, it is recommended that at least 12 lymph nodes should be resected for optimal staging. The aim of this study is to evaluate the role of lymph node resection, in stage II colon cancer and the implication of suboptimal lymph node resection on disease free survival and overall survival. Patients and methods. This was a prospective study that included 130 patients with stage II colon cancer who were monitored between October 2014 and October 2016. The relation between patients’ tumour characteristics that include number of lymph node resection and the use of adjuvant chemotherapy using Chi test and multiple logistic regression was analyzed. The disease-free survival and overall survival were estimated with the Kaplan-Meier method and compared with the log-rank test. Results. 130 patients with stage II colon cancer were recruited. 56 patients were treated with surgery alone and 74 patients received fluorouracil- based chemotherapy after surgery. Patients' age varied from 37 years to 81 years. According to the number of resected lymph nodes, patients were divided into two groups - with less than 12 lymph nodes resected and at least 12 lymph nodes resected. The number of resected lymph nodes varied from 2 to 32 lymph nodes. Median follow up was 36 months. Suboptimal resections of lymph nodes confirmed to be a negative prognostic factor for survival without disease recurrence. Conclusion. Data results confirmed the importance of lymph node resection as a prognostic factor for stage II colon cancer and the role of chemotherapy for patients with suboptimal lymph node resection.
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