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Permanent Oncology Job in Ronceverte West Virginia with Community Health Systems
Seeking an Oncologist for Greenbrier Valley Medical Center. Offering a one-year income guarantee, a sign-on bonus, and relocation expenses; to either join a private practice or a mult-practice opportunity.
Permanent Oncology Job in Oncologist - Enid, OK Oklahoma with Universal Health Services, Inc.
Oncology Private Practice - Outstanding Personal and Professional Growth Opportunity St. Marys Regional Medical Center is assisting in the recruitment of a new Oncologist to the community. This is
Permanent Oncology Job in Southeast Kansas with Rural Health Education & Services
Medical Oncologist to join busy multi-specialty group. The 190-bed admitting hospital provides full service general acute care including CT, ER, home health, hospice, ICU, MRI, nuclear medicine, ultrasound,

Annals of Oncology - current issue

in this issue
Fri, 21 Nov 2008 00:00:00 -0000

Prevalence of undertreatment in cancer pain. A review of published literature
Deandrea, S., Montanari, M., Moja, L., Apolone, G. Fri, 21 Nov 2008 00:00:00 -0000
Background: Pain is a major health care problem for patients with cancer: despite the existence of guidelines for cancer pain management, undertreatment is a widespread problem. Pain Management Indexes (PMIs) evaluate the congruence between the patient's reported level of pain and the intensity/strength of the analgesic therapy. Negative scores indicate inadequate prescriptions. Materials and methods: We conducted a Medline search using terms for ‘pain management’, ‘index’ or ‘measure’ to select studies which measured undertreatment in cancer settings. Univariate and multivariate logistic regression identified associations between independent predictors and high prevalence of undertreatment. Results: Among the 44 studies identified, 26 studies used the PMI as proposed by Cleeland. The range of negative PMI varied from 8% to 82% with a weighted mean value of 43%. In multivariate analyses, factors associated with negative PMI were date of publication before 2001, provenance from Europe or Asia and countries with a gross national income per capita <$40 000 per year and a care setting not specific for cancer. Age was not a significant predictor for undertreatment. Conclusion: Nearly one of two patients with cancer pain is undertreated. The percentage is high, but consists of a large variability of undertreatment across studies and settings.
Primary extranodal lymphomas of stomach: clinical presentation, diagnostic pitfalls and management
Psyrri, A., Papageorgiou, S., Economopoulos, T. Fri, 21 Nov 2008 00:00:00 -0000
Gastrointestinal lymphoma is the most common form of extranodal lymphoma, accounting for 30%–40% of cases. The most commonly involved site is the stomach (60%–75% of cases), followed by the small bowel, ileum, cecum, colon and rectum. The most common histological subtypes are diffuse large B-cell lymphoma (DLBCL) and marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT). Helicobacter pylori infection has been implicated in the pathogenesis of MALT gastric lymphoma, but its role in gastric diffuse large B-cell non-Hodgkin's lymphoma (NHL) is controversial. The therapeutic approach for patients with gastric NHL has been revised over the last 10 years. Conservative treatment with anthracycline-based chemotherapy alone or in combination with involved-field radiotherapy has replaced gastrectomy as standard therapy in cases with DLBCL. Additionally, MALT lymphomas are mainly treated with antibiotics alone, which can induce lasting remissions in those cases associated with H. pylori infection. Nevertheless, various therapeutic aspects for primary gastric lymphomas are still controversial and several questions remain unanswered. Among others, the role of rituximab, consolidation radiotherapy as well as H. pylori eradication in histological aggressive subtypes warrants better clarification.

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