The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

Harrison's Principles of Internal Medicine

CA : A Cancer Journal for Clinicians

Global Prevalence of and Risk Factors for Irritable Bowel Syndrome: A Meta-analysis

Background: The suboptimal compliance to vaccinations continues to be a major public health problem.

Factors associated with

American Cancer Society Guidelines for the Early Detection of Cancer

Colorectal cancer is a rapidly rising trend in Asia. The incidence in many Asian countries is on par with the West. Several studies have provided data regarding the survival of patients with colorectal cancer. In Asia, the overall cure rate of colorectal cancer has not improved dramatically in the last decade, 5-year survival remaining at approximately 60%. Colorectal cancer survival time has increased in recent years, but mortality rate remains high. Although studies have determined a number of factors that can predict survival of patients after diagnosis, life expectancy has not been increased dramatically. It seems that among the prognostic factors explored so far, the most important are those that relate to early diagnosis of cancer. Primary detection is feasible since efficient screening modalities are available. Colonoscopic surveillance is needed, especially in subjects at higher risk.

An overview of colorectal cancer survival rates and prognosis in Asia

Background Colorectal cancer (CRC) is one of the most common cancers worldwide. But information regarding CRC in Iran is limited; the aim of this study was to investigate the epidemiologic features of CRC in Iran, using 5-year data from cancer registry. Methods This survey is a descriptive-analytic study consists of 1138 colorectal cancer patients who registered in Cancer Registry Center of Research Center for Gastroenterology and Liver Disease, Tehran, Iran. These data gathered using interview and pathology reports that registered in cancer registry forms. Data analysis was performed with descriptive and univariate methods. Results Of 1138 patients, 696 cases were male and 442 female. There was no significant difference between males and females regarding age at diagnosis. 400 patients (35.1%) had a family history of cancer. The most common histology type of tumor was adenocarcinoma, NOS. In most cases (39.1%) tumor grading was well differentiated and there was no significant difference between males and females. Conclusion Colorectal cancer is a disease with nonspecific symptoms. Family history of cancer was evident in 35.1% of our cases and also 42.9% of patients were below the age of 50 years old, suggests that genetic factors may be play an important role in the development of this disease in our country.

Colorectal cancer in Iran: an epidemiological study.

The incidence of colorectal cancer is increased in Iran in recent years and colorectal cancer is the fourth most common cancer in both sexes. The aim of this study is to define the prognostic factors in Iranian colorectal cancer patients using univariate and multivariate methods. All patients with colorectal cancer diagnosis according to the pathology report that registered in our cancer registry center in the period between Jan 2002 until Jan 2007 were eligible for this study. These patients were followed up by telephone contact. The probability curves for survival were calculated according to the Kaplan–Meier method and compared by the Log-rank test. Multivariate analysis was carried out using the Cox proportional hazard model. Of 1,138 cases, a survival information was available on 1,127 patients, 690 males (61.2%) and 437 females (38.8%). Mean survival time was 105.1 (CI: 95.1–115.1) months. The Kaplan–Meier method indicated that the 1, 3, 5, 7, 10, and 15 years of survival rates are 91.1%, 73.1%, 61.0%, 54.9%, 47.9%, and 25.9%, respectively. According to the univariate analysis, the factors influencing overall survival rate were the following: type of first treatment, body mass index, marital status, tumor grade, extent of wall penetration, distant metastasis, regional lymph nodes metastasis, and pathologic stage of tumor. The following five variables were independent prognostic factors for survival as determined by multivariate analysis: tumor size, metastasis of tumor, body mass index, marital status, and grade of tumor. Our results showed that stage of tumor, distant metastasis, grade of tumor, and tumor size should be considered as the most important prognostic factors in colorectal cancer patients.

Prognostic factors in 1,138 Iranian colorectal cancer patients

Background/Aim: To study the prevalence and risk factors of functional bowel disorders (FBD) in Iranian community using Rome III criteria. Materials and Methods: This study was a cross-sectional household survey conducted from May 2006 to December 2007 in Tehran province, Iran, including 18,180 participants who were selected randomly and interviewed face-to-face by a validated questionnaire based on Rome III criteria. Results: In all, 1.1% met the Rome III criteria for irritable bowel syndrome (IBS), 2.4% for functional constipation (FC), and 10.9% of the participants had any type of FBD. Among participants with functional dyspepsia, 83.8% had FBD; the majority cases were unspecified functional bowel disorder (U-FBD). Of the subjects fulfilling the IBS criteria, IBS with constipation (52%) was the most frequent subtype. In the multivariate analysis, women had a higher risk of any FBDs than men, except for functional diarrhea (FD). The prevalence of FBD, FC and FD increased and IBS decreased with increasing age. Marital status was only associated with a decrease in the risk of FBD and FD, respectively. IBS subtypes compared with FC and FD. There was no significant difference between FC and IBS with constipation (IBS-C), except for self-reported constipation; while, IBS with diarrhea (IBS-D) had more symptoms than FD. Conclusion: This study revealed a low rate of FBDs among the urban population of Tehran province. The ROME III criteria itself, and the problems with interpretation of the data collection tool may have contributed in underestimating the prevalence of FBD. In addition the reliability of recall over 6 months in Rome III criteria is questionable for our population.

Functional bowel disorders in Iranian population using Rome III criteria.

Background: Today, the quality of life studies has an important role in health care especially in chronic diseases. Breast cancer has third order among women's malignancies. Now, survival rate for this cancer is long. However breast cancer has several complications that affected the patient's life. Aims : The aim of this study was to assess the quality of life in Breast cancer patients under chemotherapy. Setting and Design: A cross-sectional study conducted on 119 breast cancer patients that were admitted and treated in chemotherapy ward of Namazi hospital in Shiraz city, south of Iran, between Jan and Feb 2006. Materials and Methods: The QLQ-C30 questionnaire was used to assess quality of life in these patients. Statistical Analysis: We used univariate methods. A multiple regression analysis was performed to identify predictors of quality of life. Results: Mean age of patients was 48.27±11.42 with quality of life total score 64.92±24.28. All symptoms scales had reverse association with quality of life except appetite loss (P>0.05) and diarrhea (P=0.752). The results of the regression analyses showed that only grade of tumor, occupational status, menopausal status, financial difficulties and dyspnea were statistically significant in predicting patients' quality of life. Conclusion: In conclusion, this study demonstrates the strength of the relationship between clinical and sociodemographical factors and breast cancer patients' quality of life. Psychological and financial support for women experiencing breast cancer diagnosis may improve quality of life.

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Bijan Moghimi-Dehkordi

Papers

An overview of colorectal cancer survival rates and prognosis in Asia

Colorectal cancer in Iran: an epidemiological study.

Prognostic factors in 1,138 Iranian colorectal cancer patients

Functional bowel disorders in Iranian population using Rome III criteria.

Predictors of quality of life in breast cancer patients under chemotherapy.