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Aspirin and cancer prevention; rivaroxaban for pulmonary embolism; new rhinosinusitis practice guidelines; and FDA actions.
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A 61-year-old small business owner was seen in consultation for advice regarding management of a newly discovered pulmonary mass. Seven years previously, he had a 3.5 cm moderately differentiated adenocarcinoma of the sigmoid colon resected along with four regional nodes, all of which were negative for metastatic involvement.
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This randomized Phase 3 clinical trial found that adding cetuximab to standard mFOLFOX6 adjuvant chemotherapy did not improve either overall survival or disease-free survival in patients with resected stage III colon cancer, including those with wild-type KRAS tumors.
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In a meta-analysis of current observational (both case-control and prospective cohort) studies evaluating the potential association between type 2 diabetes mellitus and the incidence of hematological malignancy, an increased risk for non-Hodgkin lymphoma and leukemia was demonstrated as well as a trend toward an increased risk for myeloma. Confounding factors such as age, obesity, smoking, and alcohol (risks for both diabetes and malignancy) could not be completely accounted for in such an analysis.
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Azithromycin and cardiac risk; warfarin and heart failure; aspirin and VTE; effectiveness of long-acting contraceptives; and FDA actions.
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This randomized, placebo-controlled, Phase 3 clinical trial showed that the majority of patients treated with pegfilgrastim experience bone pain, and that taking 500 mg of naproxen twice a day decreases its incidence and severity.
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A 64-year-old commercial airline pilot was seen by his primary physician because of a bothersome, non-productive cough. He has a history of asthma but requires no medications other than occasional albuterol inhalation. Physical examination was unremarkable, as were the complete blood count and chest x-ray.
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By a systematic review of observational (case-control and cohort) studies, data regarding aspirin use and cancer risk were compared to data obtained from randomized clinical trials. In general, there was very good correlation regarding reduced risk for several types of cancer and the development of metastatic disease. The analysis provides confidence that observational studies can be of value in addressing the many outstanding questions regarding aspirin and cancer prevention.