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To investigate the attitudes and practices of health care providers toward intrauterine device (IUD) use in nulliparous women, the authors performed a national survey of both office-based physicians and Title X health care providers from December 2009 to March 2010.
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In this issue: Drug shortages; metformin and cancer prevention; migraine prevention guidelines; and FDA actions.
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Endoscopic hysterectomy and staging has proved to be equivalent to open laparotomy in reference to survival for selected women with endometrial cancer. Increasingly, endoscopic procedures are being performed with robotic assistance under the claim of improved safety and efficacy.
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A 78-year-old female had been generally well with no known chronic medical conditions and was taking no medications when she presented to her primary care physician with lower abdominal pain and urinary frequency of one month's duration. Physical examination at the time revealed a well-appearing woman with normal vital signs and no abnormal physical findings except a palpably enlarged uterus by bimanual pelvic examination. CT scan confirmed the presence of a uterine mass suspicious for malignancy. She was referred to a gynecologic oncologist and had a total abdominal hysterectomy and salpingo-oophorectomy with partial infracolic omentectomy and pelvic debulking of what appeared to be a large (15 cm) tumor mass. Final pathology was high-grade leiomyosarcoma with microscopic invasion of the colon and bladder.
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In this case-control study, dietary lignan intake was inversely associated with risk of breast cancer in both premenopausal and postmenopausal women. Also noted were more favorable prognostic characteristics associated with lignan intake, especially in premenopausal women.
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Four large data sets were analyzed to evaluate the effect of adjuvant treatment on survival in patients with stage III colon cancer diagnosed after age 75. While adjuvant chemotherapy was associated with a survival benefit, oxaliplatin-based regimens offered no more than a small incremental benefit over non-oxaliplatin-containing regimens.
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Side effects of finasteride; new ruling on pharmaceutical companies paying generic manufacturers; and FDA actions.
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A multi-institutional study examined the addition of a purine analog, either cladribine or fludarabine, to the standard induction regimen ("7 & 3") in adult patients 60 years of age and younger with acute myelogenous leukemia, and found improved outcomes for those receiving cladribine. The added benefit from cladribine appears to be the result of a reduction in the incidence of resistant disease. The study arm containing cladribine, daunorubicin, and cytaribine yielded an overall survival at 3 years of 45% while conventional "7 & 3" therapy was only 33% at 3 years. Cladribine added to daunorubicin and cytarabine during remission induction improves leukemia control and patient survival for those 60 years of age and younger.
