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The strength of a clinicians recommendation for patient care is greatest in data generated through carefully conducted experimental studies. In many cases, this quality of data is generated from randomized clinical trials where a novel intervention is compared against some standard of care. When properly designed and conducted, positive or negative results will generally provide convincing evidence to support a change in that standard or refute one, particularly if the outcomes are independently confirmed.
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Cancer screening for older women remains an area of active investigation. One current recommendation is to perform screening for individuals with a life expectancy of 5 years or more, as early detection of tumor in these individuals is more likely to have an impact on survival. In this cross-sectional population based study from California, it is apparent that screening is currently applied to older women without consideration of health status. Thus, for many, mammography and Pap smears are being obtained with little hope of benefit.
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Gefitinibs single-agent activity in a group consisting of pretreated NSCLC patients is confirmed. Side-effects of gefitinib were mild. Prolonged survival was associated with good PS and less significantly with a never-smoking history, female gender and histology. Additional studies on mechanisms of tumor control and selection of target populations for this remarkable new drug are warranted.
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Breast Cancer and the Use of Statins; Warnings Issued for IBS Drugs; FDA Actions
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In a phase II trial, the combination of low-dose carboplatin and paclitaxel was shown to be well tolerated by elderly and, or frail (ECOG performance status 2) patients with advanced small cell lung cancer. Response rates and survival were comparable to those published for other combinations.
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The first part of this series reviews cervical spine immobilization, patient selection for imaging and clinical decision rules for cervical spine radiography. This two-part article is critical for any physician who manages patients with potential cervical spine trauma.
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