Efficacy and safety of gefitinib in chemonaive patients with advanced non-small cell lung cancer treated in an Expanded Access Program.

Chemotherapy (CT) is recommended in numerous clinical guidelines for advanced non-small cell lung cancer (NSCLC) and offers improved survival over best supportive care. However, many patients with advanced NSCLC never receive CT because of advanced age, poor performance status, comorbidities, or patient refusal. The epidermal growth factor receptor tyrosine kinase inhibitor gefitinib has shown antitumor activity and a favorable toxicity profile in pretreated patients with recurrent advanced NSCLC and was made available in a worldwide Expanded Access Program (EAP) to >37,000 patients who did not respond to standard treatment or were ineligible for or refused CT.

Colonic perforation following intraoperative temporary pacemaker implantation.

This report describes the case of a 73-year-old man who was referred for consultation for increasing abdominal free air 1 week after he underwent surgery for aortic valve replacement and coronary artery bypass grafting with intraoperative pacemaker implantation. Laparoscopic exploration revealed that the pacemaker wires had passed through the left transverse colon. Although no previous reports of colonic perforation due to pacemaker lead placement was found, this experience suggests that physicians should suspect this complication in patients with increasing free intraabdominal air and peritoneal signs who have recently undergone placement of a temporary cardiac pacing system.

Necessity of axillary dissection in elderly women with early breast cancer.

The need for axillary dissection for staging and treating early breast cancer has been questioned recently. Can a patient forego axillary dissection, with its associated costs, risks, and morbidity, if it does not affect survival? The study attempted to find a subset of patients with early breast cancer in whom disease-free survival was independent of axillary lymph node status. If survival does not depend on lymph node status, axillary dissection could be omitted in the care of these patients.

Comparative environmental threat analysis: Three case studies.

In comparative threat analysis, threats imposed by different environmental problems are measured and compared. This type of analysis can be used to assess the overall threat to the environment, and to identify the most serious threat ('key problem') and areas which are particularly threatened ('problem areas'). Fundamental to comparative threat analysis is a common yardstick by which stresses imposed by different environmental problems can be compared.