Current Issue : July-September Volume : 2025 Issue Number : 3 Articles : 5 Articles
Background: High-grade advanced ovarian, fallopian tube, and primary peritoneal (HGAOC) cancers require both surgical and systemic treatment. The introduction of polyADP-ribose polymerase inhibitors (PARPis) has significantly improved outcomes. This study presents an analysis of HGAOC patients treated at a single center, following updated guidelines. Methods: We observed 437 women newly diagnosed with HGAOC at the Department of Gynecological Oncology between January 2018 and December 2023. Results: Since November 2022, first-line treatment has included bevacizumab and PARPi, regardless of residual disease post-cytoreductive surgery. In both BRCA1/2-mutated and nonmutated groups, PARPi-based regimens increased significantly after May 2021 (p < 0.01). Recurrence number emerged as a strong prognostic factor for survival (p < 0.001), with each recurrence raising mortality risk by 80%. Median survival was 21 months for paclitaxel + platinum derivatives (PC), 27 months for PC + bevacizumab (BEV), and 30 months for PC + BEV + PARPi. Conclusions: The rapid adoption of modern therapies at our center has aligned treatment strategies with HRD status and global standards. However, variations in financial regulations and drug accessibility persist across countries. Despite these challenges, physicians should prioritize the most effective therapies available....
Colorectal cancer (CRC) is one of the most common malignancies worldwide, with high morbidity and mortality rates. Conventional treatments, including surgery, radiotherapy, and chemotherapy, have limited effects on advanced and metastatic CRC (mCRC). Fruquintinib, a novel and highly selective vascular endothelial growth factor receptor (VEGFR) inhibitor, has shown significant efficacy and tolerance in treating mCRC. The FRESCO and FRESCO-2 trials demonstrated that fruquintinib significantly prolongs progression-free survival and the overall survival of refractory mCRC patients, establishing it as the standard third-line treatment strategy for mCRC. In addition, the combination of fruquintinib with other anticancer drugs and immune checkpoint inhibitors demonstrated potential for enhanced efficacy, which warrants further exploration. In this review, we aimed to systematically summarize the current knowledge about the pharmacological mechanisms, pharmacokinetic characteristics, adverse events, and corresponding treatment options of fruquintinib and provide an update on the clinical trials related to fruquintinib in CRC by conducting a comprehensive literature search of PubMed and consulting the relevant clinical trials via ClinicalTrials.gov and the ChiCTR website, aiming to offer new insights into the role of fruquintinib in the comprehensive treatment of CRC....
Background/Objectives: Knowledge about the safety and effectiveness of early post-stroke mobilization and its correlation with various factors is necessary to select an appropriate rehabilitation program and reduce the time of convalescence. Understanding the above processes will help to effectively lower the economic burden. Thus, we conducted a review to assess the safety and effectiveness of early post-stroke rehabilitation and the impact of various factors on the course of therapy. Methods: The analysis included publications meeting the inclusion criteria published in the years 2015–2024 in Web of Science, Scopus, Embase, and PubMed. Finally, 12 studies were qualified for the review. The study group ranged from 37 to 2325 people. Results: The results of studies on early stroke mobilization indicate possible benefits, including reduced time of hospitalization and faster achievement of higher functional scores. It has been shown that the important factors correlating with the effectiveness of therapy include: rehabilitation intensity, age, functional status before the stroke, depression, social support, lesion location, lower extremity deep vein thrombosis, cognitive disorder, dysphagia, and lower limb spasticity. Conclusions: There is a strong need for research into post-stroke rehabilitation to speed up recovery times and reduce the economic burden on the country. Current research findings on the efficacy and safety of early rehabilitation are inconsistent. There is a strong need for international guidelines....
Background/objectives: The implementation of appropriate hemodialysis treatment in the transition from end-stage kidney disease to reduced frequency schedules represents a major challenge. The aim of our work is to report only treatment protocols that used once-weekly hemodialysis. Methods: The benefits and risks of 1WHD were explored in this systematic review. A search of MEDLINE, Scopus, and the Cochrane Central Register was conducted to identify publications relating to once-weekly hemodialysis trials performed between June 1981 and December 2024 and assess clinical impact, duration, safety, and mortality. Items, including age, causes of chronic kidney disease (CKD), creatinine levels, Blood Urea Nitrogen and GFR values, diuresis, nutritional supplementation, drop-out, survival, clinical benefit or drawbacks, and data from eventual control groups relating to higher frequency weekly HD sessions were included. Outcome at the end of a 1WHD regimen was represented by death or transition to twice/thrice-weekly HD rhythms. Results: A total of 1238 articles focused on IHD were included in the review, and 1226 trials were excluded as they referred either to twice-weekly hemodialysis (2WHD) schedules or failed to meet eligibility criteria, whilst another two were excluded based on incomplete outcome or patient recruitment issues. A total of eight articles comprising 254 patients undergoing 1WHD schedules were ultimately identified and evaluated. Only three studies focused on a comparison with a 1WHD schedule, whilst 107 referred to thrice-weekly HD (3WHD) and 15 2WHD). This choice demonstrated the possibility of slowing down the progression of CKD in the patients studied. Daily amino acid supplementation also proved to be beneficial. However, the milestone on which the 1WHD protocol is based is a low-protein diet. Conclusions: 1WHD has been shown to be safe and may result in improved clinical outcomes, particularly in appropriately selected patients. Large-scale randomized controlled trials should be carried out to confirm these potential advantages. However, the standard recruitment techniques applied tended to prevent suitably selected patients from transitioning into less frequent and potentially long-lasting 1WHD schedules....
Background/Objectives: There exist several interconnected issues that hinder the development of family medicine in Commonwealth realms such as the United Kingdom, Canada, New Zealand, and Australia. These issues affect both the medical and nursing professions. Family physicians, in most countries including the United Kingdom, are not considered “specialists” and are called “general practitioners” instead. The term GP is an outdated and potentially demeaning term relegated to the early 20th century when they did not receive any more than a few rotations as staff grades before being allowed to run their own community clinic. Registered nurses often cover a minor and subaltern role when working as practice nurses in the UK. They are often replaced by cost-effective, licensed practical nurses in most other English-speaking countries. Nurse practitioners in the UK, though being de facto entirely equal to family physicians in countries like Canada, Australia, New Zealand, and most US states, do not hold a special registration status. Their training is not defined in specific legislation, and they do not function as alternatives to general practitioners in the sense that patient may register with them alone which is often the case in Canada or the USA. Family medicine is, therefore, generally left lacking leadership with members of the medical and nursing professions often struggling for “power” in a way that undermines the foundation of family medicine which is to serve the health needs of a large population ranging from children to seniors. Methods: The purpose of this paper is to describe a solution to management in a Family Medicine Clinic in Calgary, Alberta, Canada. Results: In this model, the physician-nurse team developed a highly trained role of Clinical Nurse Specialist which serves as an overall clinic manager. Conclusions: The implementation of the Clinical Nurse Specialist-led model in family medicine has improved clinic efficiency, patient access, and provider satisfaction. This approach demonstrates a viable framework for enhancing primary care management across Commonwealth realms....
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