Platinum-containing chemotherapy agents (cisplatin, carboplatin, oxaliplatin) have been approved in the first-line setting of numerous malignancies, such as ovarian, bladder, head and neck, colorectal, and lung cancer. Their extensive use over the last decade has led to a significant increase in the incidence of hypersensitivity reactions, which are defined as unforeseen reactions whose signs and symptoms cannot be explained by the known toxicity of these drugs. Skin rash, flushing, abdominal cramping, itchy palms, and back pain are common symptoms. Cardiovascular and respiratory complications can prove fatal. Multiple pathogenetic mechanisms have been suggested. Hypersensitivity usually appears after multiple infusions, suggesting type I allergic reactions; however, other types of hypersensitivity also seem to be implicated. Several management options are available to treating physicians: discontinuation of chemotherapy, premedication, prolonging of infusion duration, desensitization protocols, and replacement with a different platinum compound after performing skin tests that rule out cross-reactions among platinum agents.

There seems to be a modest survival advantage for patients who receive neoadjuvant chemotherapy followed by surgery, as compared with surgery alone. There is an apparent increase in treatment-related mortality, mainly for patients who receive neoadjuvant chemoradiotherapy.

No abstract

This study was designed to provide estimates of overweight (OW), obesity (OB), and abdominal OB (AO) in a representative sample of adolescents throughout the whole of Greece. A total of 14,456 adolescents aged 13-19 years (6,677 boys and 7,779 girls) had direct measurements (height, weight, waist circumference (WC)) taken at school during 2003. The overall prevalence of OW including OB in the population studied was 29.4% in boys and 16.7% in girls. OB prevalence was also higher in boys than in girls (6.1% vs. 2.7%), whereas prevalence of AO was higher in girls than in boys (21.7% vs. 13.5%). Rates of OW, OB, and AO were significantly more prevalent in the Greek than in the foreign male population (immigrants). OW% in adolescent girls was independently associated with smoking and alcohol consumption. The prevalence of OW and OB in Greek adolescents is high, particularly in boys, comparable with that reported for most Mediterranean European countries. AO, mainly in adolescent girls, also appears high. Preventive and treatment strategies are urgently needed to combat this OB epidemic in Greece.

Aim: To provide estimates of the prevalence of obesity, overweight and body fat distribution among the adult population of Greece. Design: Epidemiological, cross-sectional nationwide survey providing self-reported data. Subjects: A total of 17,341 men and women aged from 20 to 70 years and classified into five 10-year age groups participated. The selection was conducted by stratified sampling through household family members of Greek children attending school. Measurements: The participants reported data on weight, height, waist and hip circumference. BMI and waist-to-hip ratio were calculated. Abdominal obesity was defined as waist circumference ≧102 cm in men and ≧88 cm in women. Results: In the total population, the mean BMI was 26.5 kg/m², (27.3 in men, 25.7 in women). The overall prevalence of obesity was 22.5%, (26% in men, 18.2% in women) while that of overweight was 35.2% (41.1% in men, 29.9% in women). The percentages of obesity and overweight in men were similar in almost all age groups, while in women they progressively increased with age. Abdominal obesity was more frequent among women than men (35.8 vs. 26.6%, respectively), especially after the age of 50. Conclusions: Excess body weight is reaching epidemic proportions in Greece and obesity rates are among the highest, if not the highest, in Western society. The problem affects particularly men, and women after menopause. Interestingly, more women than men present with abdominal obesity. Preventive and treatment strategies are urgently needed to stop the obesity epidemic in this Mediterranean European country.

In patients undergoing PD, insertion of a GJT is safe. Moreover, insertion of a GJT improves average length of stay. At the time of resection of periampullary tumors, GJT insertion should be considered, especially given this is a patient population in which weight loss and cachexia are frequent.

Breast angiosarcomas that are not related to previous radiotherapy are very rare. Surgical resection is the primary treatment for these tumors, but there is no general agreement on the extent of surgery. The role of multimodality adjuvant treatment also remains controversial. The aim of this study was to summarize the available data from the largest published series of patients in terms of management and outcome. We also sought to identify prognostic factors influencing patient survival. We have included studies presenting detailed data on multimodality therapy and survival of patients with breast angiosarcoma. Ten studies presenting data on 280 patients were included in the review. Seventy-five percent of patients underwent a total mastectomy and 25% had breast-conserving treatment (BCT). In 42% of patients, an axillary node dissection was combined with mastectomy or BCT. Thirty-six percent of patients received chemotherapy and 35% were treated with radiotherapy in an adjuvant or neoadjuvant setting. Survival varied significantly according to tumor size and grade. Adjuvant multimodality therapy may improve the outcome in selected patients with breast angiosarcoma. Tumor size, grade, and margin status are the most important prognostic factors for survival.

HighlightsDifferential diagnosis of LPD from leiomyosarcoma or benign metastasizing leiomyoma remains difficult.Ample history of the patient, clinical evaluation, preoperative guided FNA and histopathologic analysis of the FNA tissue and of the tumor resection are essential for differential diagnosis.Prompt diagnosis of LPD is crucial because, although benign in nature, LPD may degenerate into malignancy.