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In examining the National Comprehensive Cancer Network Colorectal Database, reasons for not completing the recommended postsurgical chemotherapy were examined. Although only 17% of patients for whom adjuvant therapy was recommended failed to receive treatment, the decision to not proceed was based on a number of factors, most notably the existence of comorbidities. In comparison to this cohort of patients treated at academic centers, the percent of patients not treated with adjuvant chemotherapy is likely to be greater in the community setting.
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The experience from Harbin, China, in the treatment of de novo acute promyelocytic leukemia (APL) in patients 60 years and older demonstrates the efficacy and safety of single agent arsenic trioxide. This agent with or without all trans retinoic acid may ultimately prove optimal for induction and maintenance APL treatment in older adults.
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Ten years of adjuvant tamoxifen is significantly better than the standard 5 years of treatment. Continuing adjuvant tamoxifen for 10 years substantially reduces rates of both recurrence and breast cancer-specific mortality in women with estrogen receptor-positive breast cancer.
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Relative to the general population, the risk of anal cancer in HIV-infected patients remains very high. Unlike other malignancies associated with AIDS, effective antiretroviral treatment appears to have no preventive effect on anal cancer, particularly among men who have sex with men.
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There comes a time in infection control when there are enough epidemiological indicators and sufficient risk of patient harm that one must take decisive action, a la public health pioneer John Snow removing the Broad Street water pump handle to end a legendary cholera outbreak in 19th century London.
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Threat of untreatable infections could prompt regulatory action
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A proposed guideline by the Centers for Disease Control and Prevention on hospital antimicrobial stewardship programs includes the following key aspects, as outlined recently in Atlanta at a meeting of the CDC Healthcare Infection Control Practices Advisory Committee.
