Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of la...Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of late detection, leading to diagnosis at an advanced stage and a reduced chance of survival. Objective: The aim of this study is to identify the factors associated with late detection of breast cancer in women in Sub-Saharan Africa from 2014 to 2020.Setting: This systematic review focuses on sub-Saharan Africa. Methods: We searched for articles in four databases (PubMed, Embase, Global-Health and CINAHL) between 2014 and 2020 and performed a narrative synthesis to organize and group the different factors associated with late breast cancer detection. Result: After reviewing 583 publications, 6 studies were selected, highlighting factors such as lack of awareness, knowledge gaps, difficulties in accessing health services and financial constraints associated with late breast cancer screening. The participants, who ranged in number from 20 to 1776, were mainly aged between 18 and 25, with a mean age of 25 years and 6 months. Conclusion: The analysis enabled us to identify various factors associated with late breast cancer screening. Collaboration between health professionals, community organizations and policy-makers is essential to foster an environment conducive to the prevention and early detection of breast cancer.展开更多
<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Phylloid sarcomas are rare. There is not enough data...<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Phylloid sarcomas are rare. There is not enough data to codify the management. </span><b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"> The objective was to study the clinical and therapeutic aspects and the fate of patients after a follow-up of at least 4 years. Thus contributing to the limited body of knowledge on these tumors. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> a retrospective analysis of the files from 2013 to 2017 was carried out and patients were followed up until 2021at Hassan II Hospital. Epidemiological, clinical and therapeutic aspects were studied. Survival was calculated using the Kaplan-Meier method. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We collected 12 charts of patients treated for phyllodeal sarcoma from 2013 to 2017. The median age was 43 years. The circumstance of discovery was marked by the presence of nodule in all patients. The coupled echo-mammography examination classified the nodules, ACR 4 in 7 patients and ACR 3 in 3 and ACR 5 in 2 patients. Histological examination revealed a phylloid sarcoma in 11 patients and a borderline phylloid tumor in 1 patient. All patients had radical surgery with positive margins in 2 patients, 16.66%. One patient had revision surgery. Histological examination of the surgical specimens showed phylloid sarcoma on all specimens. All patients had adjuvant radiotherapy with doses of 50 Gy in 25 fractions of 2 Gy and a boost of 10 Gy was done in one patient. The median spread of radiotherapy was 37 days. Grade 1 and 2 skin toxicities were noted in 5 and 3 patients respectively. The median time from surgery to radiotherapy was 2.95 months. 3 patients relapsed after 13.6 months of follow-up. The recurrence-free survival at 1 and 3 years was 83% and 75% respectively. Overall survival at 3 and 5 years was 83% and 75% respectively. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This is a rare entity which requires randomized trials to codify its manage</span><span style="font-family:Verdana;">ment. It would seem that the multidisciplinary approach, associating surgery</span><span style="font-family:Verdana;"> ± radiotherapy, is a good option.</span></span></span></span>展开更多
Pheochromocytomas are tumors arising from the chromaffin cell of the adrenal gland and paragangliomas as tumors from extra-adrenal sympathetic chromaffin cells.The combined yearly incidence of pheochromocytoma and par...Pheochromocytomas are tumors arising from the chromaffin cell of the adrenal gland and paragangliomas as tumors from extra-adrenal sympathetic chromaffin cells.The combined yearly incidence of pheochromocytoma and paraganglioma(PPGL)is approximately 0.8 per 100000 person/year.Malignant pheochromocytoma is defined only by the presence of metastasis,as there is no confirmatory histology or biomarkers.The most common metastatic sites of these chromaffin tumors are the lymph node,bone,lungs,and liver.This review focuses on relevant clinical and immunohistological factors that are predictive of malignant PPGL or metastasis and determinants of prognosis.Findings showed that the risk of malignant PPGL,along with disease survival,is closely associated with age,primary tumor size,gender,synchronous metastasis,and absence of surgical excision.Other essential biomarkers or immunohistology investigated were galectin-3,COX-2,nm-23,microRNA-210,ERBB-2 overexpression and succinate dehydrogenase subunit mutation,which were predictive of malignancy as well as disease prognosis.Curative resection is possible but most metastatic diseases are amenable to radiopharmaceuticals and chemotherapy due to late presentation.Other therapeutic options,like molecular-targeted therapy,are still undergoing clinical trials.展开更多
The novel 2019 corona virus disease also called severe acute respiratory syndrome coronavirus 2 has caused a global pandemic and more than 2.5 million people have been affected globally with over 100000 deaths.The dis...The novel 2019 corona virus disease also called severe acute respiratory syndrome coronavirus 2 has caused a global pandemic and more than 2.5 million people have been affected globally with over 100000 deaths.The disease has caused an escalation in hospitalization with growing need for hospital beds and intensive care unit for severe cases.Recent evidence has shown that a significant proportion of cancer patients affected by the corona virus present with severe respiratory pneumonia-like illness with need for subsequent intensive care unit ventilation and higher mortality risk.This susceptibility may be due to the immunosuppressive state of patients with malignancy confounded by chemotherapy,immunotherapy and targeted therapy.Many solid tumors(lung cancer,pancreatic cancer)as well as hematological malignancies(leukemias)may require prompt diagnosis and treatment based on the disease aggression and progression.Many centers lack clear guideline on the management of cancer during the pandemic.The objective of this review is to synthesize the available literature and provide recommendations on the management of various soft tissue and hematological malignancies.The review will also assess the management guidelines for hospitalized cancer patients;cancer patients in the outpatient setting as well as available modalities for follow-up.展开更多
文摘Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of late detection, leading to diagnosis at an advanced stage and a reduced chance of survival. Objective: The aim of this study is to identify the factors associated with late detection of breast cancer in women in Sub-Saharan Africa from 2014 to 2020.Setting: This systematic review focuses on sub-Saharan Africa. Methods: We searched for articles in four databases (PubMed, Embase, Global-Health and CINAHL) between 2014 and 2020 and performed a narrative synthesis to organize and group the different factors associated with late breast cancer detection. Result: After reviewing 583 publications, 6 studies were selected, highlighting factors such as lack of awareness, knowledge gaps, difficulties in accessing health services and financial constraints associated with late breast cancer screening. The participants, who ranged in number from 20 to 1776, were mainly aged between 18 and 25, with a mean age of 25 years and 6 months. Conclusion: The analysis enabled us to identify various factors associated with late breast cancer screening. Collaboration between health professionals, community organizations and policy-makers is essential to foster an environment conducive to the prevention and early detection of breast cancer.
文摘<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Phylloid sarcomas are rare. There is not enough data to codify the management. </span><b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"> The objective was to study the clinical and therapeutic aspects and the fate of patients after a follow-up of at least 4 years. Thus contributing to the limited body of knowledge on these tumors. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> a retrospective analysis of the files from 2013 to 2017 was carried out and patients were followed up until 2021at Hassan II Hospital. Epidemiological, clinical and therapeutic aspects were studied. Survival was calculated using the Kaplan-Meier method. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> We collected 12 charts of patients treated for phyllodeal sarcoma from 2013 to 2017. The median age was 43 years. The circumstance of discovery was marked by the presence of nodule in all patients. The coupled echo-mammography examination classified the nodules, ACR 4 in 7 patients and ACR 3 in 3 and ACR 5 in 2 patients. Histological examination revealed a phylloid sarcoma in 11 patients and a borderline phylloid tumor in 1 patient. All patients had radical surgery with positive margins in 2 patients, 16.66%. One patient had revision surgery. Histological examination of the surgical specimens showed phylloid sarcoma on all specimens. All patients had adjuvant radiotherapy with doses of 50 Gy in 25 fractions of 2 Gy and a boost of 10 Gy was done in one patient. The median spread of radiotherapy was 37 days. Grade 1 and 2 skin toxicities were noted in 5 and 3 patients respectively. The median time from surgery to radiotherapy was 2.95 months. 3 patients relapsed after 13.6 months of follow-up. The recurrence-free survival at 1 and 3 years was 83% and 75% respectively. Overall survival at 3 and 5 years was 83% and 75% respectively. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This is a rare entity which requires randomized trials to codify its manage</span><span style="font-family:Verdana;">ment. It would seem that the multidisciplinary approach, associating surgery</span><span style="font-family:Verdana;"> ± radiotherapy, is a good option.</span></span></span></span>
文摘Pheochromocytomas are tumors arising from the chromaffin cell of the adrenal gland and paragangliomas as tumors from extra-adrenal sympathetic chromaffin cells.The combined yearly incidence of pheochromocytoma and paraganglioma(PPGL)is approximately 0.8 per 100000 person/year.Malignant pheochromocytoma is defined only by the presence of metastasis,as there is no confirmatory histology or biomarkers.The most common metastatic sites of these chromaffin tumors are the lymph node,bone,lungs,and liver.This review focuses on relevant clinical and immunohistological factors that are predictive of malignant PPGL or metastasis and determinants of prognosis.Findings showed that the risk of malignant PPGL,along with disease survival,is closely associated with age,primary tumor size,gender,synchronous metastasis,and absence of surgical excision.Other essential biomarkers or immunohistology investigated were galectin-3,COX-2,nm-23,microRNA-210,ERBB-2 overexpression and succinate dehydrogenase subunit mutation,which were predictive of malignancy as well as disease prognosis.Curative resection is possible but most metastatic diseases are amenable to radiopharmaceuticals and chemotherapy due to late presentation.Other therapeutic options,like molecular-targeted therapy,are still undergoing clinical trials.
文摘The novel 2019 corona virus disease also called severe acute respiratory syndrome coronavirus 2 has caused a global pandemic and more than 2.5 million people have been affected globally with over 100000 deaths.The disease has caused an escalation in hospitalization with growing need for hospital beds and intensive care unit for severe cases.Recent evidence has shown that a significant proportion of cancer patients affected by the corona virus present with severe respiratory pneumonia-like illness with need for subsequent intensive care unit ventilation and higher mortality risk.This susceptibility may be due to the immunosuppressive state of patients with malignancy confounded by chemotherapy,immunotherapy and targeted therapy.Many solid tumors(lung cancer,pancreatic cancer)as well as hematological malignancies(leukemias)may require prompt diagnosis and treatment based on the disease aggression and progression.Many centers lack clear guideline on the management of cancer during the pandemic.The objective of this review is to synthesize the available literature and provide recommendations on the management of various soft tissue and hematological malignancies.The review will also assess the management guidelines for hospitalized cancer patients;cancer patients in the outpatient setting as well as available modalities for follow-up.
