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Trastuzumab has been shown to be an effective therapy for women with breast cancer that overexpresses the human epidermal growth factor receptor 2 (HER2) protein. In the pivotal metastatic breast cancer trials, cardiac dysfunction was observed in women treated with trastuzumab and chemotherapy. The incidence and severity of cardiac dysfunction was greatest among patients who received trastuzumab in combination with anthracycline-based therapy. Those findings influenced the design of subsequent trastuzumab trials to include prospective evaluations of cardiac effects and protocols for cardiac monitoring and management. The risk of cardiotoxicity has also driven efforts to develop non-anthracycline-based regimens for women with HER2-positive breast cancers.With the increasing use of trastuzumab, particularly in the curative adjuvant setting, the need for a rational approach to the treatment and cardiac management of the relevant patient population is clear. The mandate of the Canadian Trastuzumab Working Group was to formulate recommendations, based on available data, for the assessment and management of cardiac complications during adjuvant trastuzumab therapy. The panel formulated recommendations in four areas:• Risk factors for cardiotoxicity • Effects of various regimens • Monitoring • ManagementThe recommendations published here are expected to evolve as more data become available and experience with trastuzumab in the adjuvant setting grows.

A cube tiling of eight-dimensional space in which no pair of cubes share a complete common seven-dimensional face is constructed. Together with a result of Perron, this shows that the first dimension in which such a tiling can exist is seven or eight.

Objective To assess the results of holmium-laser resec-Results There was a large and sustained improvement in symptom scores and urinary flow rates, with no tion of the prostate (HOLRP) in the treatment of benign prostatic hyperplasia. mortality and low morbidity. Conclusion We recommend this technique as an alterna-Patients and methods Between 1994 and 1997, 967 patients underwent HOLRP in Tauranga, New tive to transurethral resection in the surgical treatment of bladder outlet obstruction due to benign Zealand, and in Derby, United Kingdom. The patients were followed at 1, 3 and 6 months after treatment prostatic hypertrophy. Keywords Benign prostatic hyperplasia, holmium laser using measurements of symptom score and urinary flow rate.resection of the prostate Peri-operatively, the duration of the operation, laser

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