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Special Feature: Preterm Birth — A Synopsis of Current Methods of Prediction and Prevention

The latest figure for the rate of preterm birth (PTB) in the United States is 12.7%, which represents a rise of more than 20% since 1980, despite concerted efforts to address the problem.

Pharmacology Watch

Apixaban and rivaroxaban near approval for nonvalvular atrial fibrillation; fidaxomicin for C. difficile infections; guideline for intensive insulin therapy; and FDA Actions.

The optimal standard salvage therapy for relapsed or refractory AML remains undetermined. The authors retrospectively compared two regimens at a single institution: CLAG (cladribine, high-dose cytarabine, and G-CSF) with MEC (mitoxantrone, etoposide, and cytarabine). These observational data without adjustment suggest CLAG may be superior to MEC. Nevertheless, outcomes for relapsed or refractory AML remain poor and clinical trials should be entertained when available.

Detecting Lung Cancer by Screening Serology

Among three distinct cohorts of lung cancer patients and matched controls (without tumor), the authors present data on the capacity for an assay that detects antibody to tumor-associated antigens to discriminate those with lung cancer and those without. Using a panel of six antigens, they found their assay to have sensitivity/specificity of approximately 40%/90%. If confirmed in an independent prospective study, such screening may be a very effective adjunct to imaging studies in the early recognition of lung cancer.

Pancreatic Cancer and Suicide

Using the SEER database, data for patients with adenocarcinoma of the pancreas diagnosed in 1995-2005 were analyzed for the occurrence of suicide. As expected, the rates were higher than those reported for the general population, but among men, particularly those who were recovering from surgery, the mortality rate from suicide was 10 times greater than that of the general population. Care providers should be aware of this heightened risk and intervene as possible.

Clinical Briefs in Primary Care Supplement

Therapy Related-AML

Approximately 10% of patients with newly diagnosed acute myelogenous (AML) leukemia have a history of prior treatment with chemotherapy, radiation, or both (t-AML).

Metastatic Pancreatic Cancer

A 58-year-old auto salesman was referred for initial management of metastatic pancreatic cancer. He had been well until approximately 3 months prior when he began to experience epigastric and mid-back pain.