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This study was designed to assess the value of whole-body positron emission tomography (PET) using 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) for the diagnosis of recurrent ovarian cancer. Twenty-five patients who had previous...
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This study was designed to assess the value of whole-body positron emission tomography (PET) using 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) for the diagnosis of recurrent ovarian cancer. Twenty-five patients who had previously undergone surgery for ovarian cancer were imaged using whole-body FDG-PET. During the 4 weeks preceding the PET study, conventional imaging, comprising computed tomography (CT) and magnetic resonance (MR) imaging of the abdomen and/or pelvis, was performed and serum CA125 levels were measured. PET imaging was commenced at 60 min after the intravenous administration of FDG in all patients. PET results were compared with the results of conventional imaging and CA125 levels, and related to pathological findings and clinical follow-up for more than 6 months. FDG-PET showed a sensitivity of 80% (16/20), a specificity of 100% (5/5) and an accuracy of 84% accuracy (21/25) for the diagnosis of recurrent ovarian cancer. The sensitivity, specificity and accuracy of conventional imaging were 55% (11/20), 100% (5/5) and 64% (16/25), respectively. PET could detect recurrent lesions in seven of nine patients in whom conventional imaging was falsely normal, while conventional imaging was true positive in two of four patients with false-negative PET results. The CA125 results showed a sensitivity of 75% (15/20), a specificity of 100% (5/5) and an accuracy of 80% accuracy (20/25). Among the 15 patients with true-positive CA125 results, PET correctly detected abnormal foci of recurrence in 13 patients (86.7%) whereas conventional imaging showed recurrent lesions in only eight patients (53.3%). In conclusion, our preliminary study demonstrates that FDG-PET may be accurate and useful for the detection of tumour recurrence when conventional imaging is inconclusive or negative, especially in patients with abnormal CA125 levels.
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Most breast cancer patients in sub-Saharan Africa are diagnosed at advanced stages after prolonged symptomatic periods. In the multicountry African Breast Cancer-Disparities in Outcomes cohort, we dissected the diagnostic journey ...
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Most breast cancer patients in sub-Saharan Africa are diagnosed at advanced stages after prolonged symptomatic periods. In the multicountry African Breast Cancer-Disparities in Outcomes cohort, we dissected the diagnostic journey to inform downstaging interventions. At hospital presentation for breast cancer, women recalled their diagnostic journey, including dates of first noticing symptoms and healthcare provider (HCP) visits. Negative binomial regression models were used to identify correlates of the length of the diagnostic journey. Among 1429 women, the median (interquartile range) length (months) of the diagnostic journey ranged from 11.3 (5.7-21.2) in Ugandan, 8.2 (3.4-16.4) in Zambian, 6.5 (2.4-15.7) in Namibian-black to 5.6 (2.3-13.1) in Nigerian and 2.4 (0.6-5.5) in Namibian-non-black women. Time from first HCP contact to diagnosis represented, on average, 58% to 79% of the diagnostic journey in each setting except Nigeria where most women presented directly to the diagnostic hospital with advanced disease. The median number of HCPs visited was 1 to 4 per woman, but time intervals between visits were long. Women who attributed their initial symptoms to cancer had a 4.1 months (absolute) reduced diagnostic journey than those who did not, while less-educated (none/primary) women had a 3.6 months longer journey than more educated women. In most settings the long journey to breast cancer diagnosis was not primarily due to late first presentation but to prolonged delays after first presentation to diagnosis. Promotion of breast cancer awareness and implementation of accelerated referral pathways for women with suspicious symptoms are vital to downstaging the disease in the region.
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Purpose The incidence of new CT-based torso cancer diagnoses and the most commonly diagnosed cancer types in the emergency department (ED) setting are unknown. The purpose of our study was to determine the incidence and types ofne...
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Purpose The incidence of new CT-based torso cancer diagnoses and the most commonly diagnosed cancer types in the emergency department (ED) setting are unknown. The purpose of our study was to determine the incidence and types ofnew CT-based torso cancer diagnoses in the ED. Methods A total of 19,496 CT reports including all or parts of the torso from 2017 were searched for the keywords: "mass", "tumor", "neoplasm", "malignancy", or "cancer". Each report and corresponding medical record was evaluated for presence of a new cancer. Cases were scored as no cancer, subcentimeter lung nodule, known cancer, new cancer, or suspicious, but unconfirmed for new cancer. Each mass was characterized as symptom-related or incidental. Results At least one keyword was found in 2086 reports. Of these 706, 126 and 905 were known cancer cases, subcentimeter lung nodules, and non-cancerous cases, respectively. There were 251 confirmed new cancers and 98 suspicious cases which lacked adequate diagnostic workup. Depending on whether only definite or definite and suspicious cases were included together, the number ofnew cancer cases per 100 torso CT exams was 1.3 or 1.8, respectively. Gastrointestinal, lung, pancreaticobiliary, urinary, and gynecologic cancers were most common. Only 58 of the confirmed cases (23%) were deemed as incidental findings. Conclusion CT-diagnosis ofnew torso cancers was uncommon in our setting. Still, while extensive knowledge of cancer staging may not be necessary for ED radiologists, knowledge of the most common types of cancer including gastrointestinal, lung, pancreaticobiliary, urinary, and gynecologic cancers may improve sensitivity for these diagnoses and may expedite appropriate referrals for the newly diagnosed patients.
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Behind breast, colorectal, and lung cancers, cervical cancer is the fourth most common cancer affecting females. Despite, it is a preventable form of cancer both the incidence and mortality figures reflect it as a major reproducti...
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Behind breast, colorectal, and lung cancers, cervical cancer is the fourth most common cancer affecting females. Despite, it is a preventable form of cancer both the incidence and mortality figures reflect it as a major reproductive health problem. Late-stage cervical cancer diagnosis is associated with complicated clinical presentation which can result in short survival time and increased mortality. Several factors contribute to the late-stage presentation of cervical cancer patients. In Ethiopia nationally summarized evidence on the level and the factors contributing to late-stage cervical cancer diagnosis is scarce. Therefore, this systematic review and meta-analysis aimed to assess the pooled prevalence of late-stage cervical cancer diagnosis and its determinants in Ethiopia.A systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in PubMed, Embase, Google Scholar, and African Online Journal to retrieve eligible articles. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I2 statistics were computed to assess heterogeneity among studies. Funnel plot and Egger’s regression test were done to assess publication bias.Overall, 726 articles were retrieved and finally 10 articles were included in this review. The pooled prevalence of late-stage cervical cancer diagnosis in Ethiopia was 60.45% (95%CI; 53.04%-67.85%). Poor awareness about cervical cancer and its treatment (AOR = 1.55, 95% CI: (1.03 – 2.33, longer delay to seek care (AOR = 1.02, 95% CI: (1.01 – 1.03)) and rural residence (AOR = 2.07, 95% CI:( 1.56 – 2.75)) were significantly associated to late-stage diagnosis.In Ethiopia, six in every ten cervical cancer cases are diagnosed at the late stage of the disease. Poor awareness about cervical cancer and its treatment, long patient delay to seek care, and rural residence were positively associated with late–stage diagnosis. Therefore intervention efforts should be made to improve public awareness about cervical cancer, minimize patient delay to seek care, and expand screening services specifically in the rural residing segment of the population to detect the disease early and improve survival.
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Modest gains have been made in the prevention and early detection of cancer in the past decade. Pharmacologic agents, lifestyle modifications, and diet and physical activity changes have been linked to preventing cancer. Breast ca...
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Modest gains have been made in the prevention and early detection of cancer in the past decade. Pharmacologic agents, lifestyle modifications, and diet and physical activity changes have been linked to preventing cancer. Breast cancer detection now includes digital mammography, computer-assisted diagnosis, and, most recently, breast magnetic resonance imaging. Research of cancer prevention and early detection will no doubt continue to result in improved strategies and outcomes. The premise of cancer prevention and early detection is that cancer will either be prevented or detected when cancer therapy is most likely to be effective, cost efficient, and associated with decreased morbidity and mortality. Clearly, nurses need to be engaged in cancer prevention and early detection and explore creative ways to implement both into the daily practice of all individuals, regardless of cancer diagnosis.
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摘要 :
Modest gains have been made in the prevention and early detection of cancer in the past decade. Pharmacologic agents, lifestyle modifications, and diet and physical activity changes have been linked to preventing cancer. Breast ca...
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Modest gains have been made in the prevention and early detection of cancer in the past decade. Pharmacologic agents, lifestyle modifications, and diet and physical activity changes have been linked to preventing cancer. Breast cancer detection now includes digital mammography, computer-assisted diagnosis, and, most recently, breast magnetic resonance imaging. Research of cancer prevention and early detection will no doubt continue to result in improved strategies and outcomes. The premise of cancer prevention and early detection is that cancer will either be prevented or detected when cancer therapy is most likely to be effective, cost efficient, and associated with decreased morbidity and mortality. Clearly, nurses need to be engaged in cancer prevention and early detection and explore creative ways to implement both into the daily practice of all individuals, regardless of cancer diagnosis.
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In this issue of Clinical Chemistry, Mary Lopez and colleagues (1) describe novel methods for isolation of protein-bound peptides from serum and their characterization by mass spectrometry. Lopez et al. used selected peptide combi...
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In this issue of Clinical Chemistry, Mary Lopez and colleagues (1) describe novel methods for isolation of protein-bound peptides from serum and their characterization by mass spectrometry. Lopez et al. used selected peptide combinations to develop a new profiling method for ovarian cancer diagnosis. To put this advance into perspective, I will briefly summarize relevant previous literature on diagnostic applications of serum proteomic and peptidomic profiling by mass spectrometry. Approximately 5 years ago, a new approach for diagnosing ovarian cancer, by use of SELDI-TOF mass spectrometry, was proposed by the coauthors of the article under discussion (2 ). It was then hypothesized that proteins or protein fragments released by tumor cells or their microenvironment may enter the general circulation. By the use of a SELDI chip, proteins or peptides could be extracted from crude serum and used for diagnostic purposes with the aid of mass spectrometry and a mathematical algorithm. Similar methods have subsequently been used to diagnose numerous other malignancies, such as breast, prostate, bladder, pancreatic, head and neck, lung, liver, and nasopharyngeal cancers, as well as glio-mas and melanomas, with impressive diagnostic sensitivities and specificities. This method has enjoyed ample coverage in scientific journals, the media, and international conferences (3).
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Sixty-nine cases of metastatic tumors involving the stomach were reported. The primary sites, in decreasing order of frequency, were esophagus, breast, pancreas and lung. Thirty-nine cases (57%) mimicked primary gastric carcinoma ...
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Sixty-nine cases of metastatic tumors involving the stomach were reported. The primary sites, in decreasing order of frequency, were esophagus, breast, pancreas and lung. Thirty-nine cases (57%) mimicked primary gastric carcinoma without showing submucosal appearances. More than half of the cases from breast and pancreas showed scirrhous carcinoma (type 4). Metastatic lesions from esophagus were solitary and located near the gastric cardia.
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There are many. You don’t need to get your hair cut, for example. Or colored. Because you have none. How quickly and guiltlessly you will delete the appointment reminder email from the hairdresser. You’ll notice how people have ...
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There are many. You don’t need to get your hair cut, for example. Or colored. Because you have none. How quickly and guiltlessly you will delete the appointment reminder email from the hairdresser. You’ll notice how people have all kinds of ideas of what you need. Some of the ideas are brilliant. Friends will buy you a wig before you thought you needed one. They will come with you to pick it out. You will look at yourself wearing the wig and joke about looking like a Muppet or Elvira. Your friends will assure you that you do not look like either one. You are not sure. But you love them, and you know they are saying it out of love. You will make a joke about getting a pink wig. Your friends may not laugh.
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