The factor most strongly related to the physicians’ use of geneti

The factor most strongly related to the physicians’ use of genetic testing was patients requests for breast (odds ratio = 12.65; 95% confidence interval 7.77-20.59) or colorectal cancer tests (odds ratio = 7.02; 95% confidence interval 3.61-13.64). A high level of

interest for specific training was reported by almost all physicians surveyed.\n\nConclusions. Targeted educational programs are needed to improve the expertise of physicians, and, ultimately, to enhance the appropriate use of genetic tests in clinical practice. (C) 2013 The Authors. Published by Elsevier Inc. All rights reserved.”
“Background: click here In 1996, all colorectal surgery in the county of Vastmanland, Sweden, was centralized to the central District Hospital in Vasteras. A Colorectal Unit was established and modern surgical procedures were introduced. The aim of this study was to analyze the outcome for patients treated surgically for distal sigmoid colonic cancer before and after the centralization. Methods: Hospital records of all patients with distal sigmoid colonic cancer, treated between 19911995, group 1 (n

= 64), and 1996-2000, group 2 (n = 82), were studied retrospectively. Results: In find protocol group 2, there were fewer reoperations (n = 0) than in group 1 (n = 6; p = 0.005) and the postoperative mortality was lower; one in group 2 compared with five in group 1 (p = 0.047). The amount of lymph nodes examined were

higher and the length of distal surgical margin longer in group 2. Curatively treated patients in group 2 had better overall survival compared to group 1 (RR 0.56; 95% CI 0.34-0.93). Conclusion: Centralization of colorectal surgery resulted in an improvement of pathologic specimens and a decrease in postoperative reoperations and mortality in patients treated surgically for distal sigmoid colonic cancer. Moreover, the overall survival of curatively treated patients was improved. Copyright (C) 2009 S. Karger AG, Basel”
“Breast reconstruction after mastectomy positively affects psychosocial well-being; however, the influence of reconstruction on cancer outcomes is unknown. The objective of our study was to compare survival in reconstructed versus nonreconstructed patients after mastectomy. All consecutive female patients diagnosed with invasive breast cancer and treated with mastectomy between 2002 and 2011 were identified from our single-institution database. All cancer operations were performed by two surgeons. Survival was calculated using the Kaplan-Meier method and compared using the log-rank test. To identify the effect of reconstruction on survival, a multivariate Cox regression analysis was performed. Of 474 patients treated, 340 (71.7%) underwent breast reconstruction. At a mean follow-up 3.3 years, reconstructed patients had a longer 5-year survival (91 vs 74%, P smaller than 0.001).

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