Eran Pras, MD, Elon Pras, MD, Tengiz Bakhan, PhD, Etgar Levy-Nisenbaum, BSc, Hadas Lahat, MSc, Ehud I. Assia, MD, Hana J. Garzozi, Daniel L. Kastner, MD, PhD, Boleslaw Goldman, MD and Moshe Frydman, MD
Ilan Leibovitch, MD, Ronan Lev, MD, Yoram Mor, MD, Jacob Golomb, MD, Zohar A. Dotan and Jacob Ramon, MD
Background: Extensive necrosis is rare in primary renal cell carcinoma. This finding may reflect the biological characteristics of the carcinoma and therefore could be of prognostic and clinical value.
Objectives: To assess the incidence of necrosis in renal cell carcinoma and its potential prognostic value.
Methods: We conducted a consecutive retrospective study of 173 patients after radical nephrectomy for renal cell carcinoma. Clinical and pathological data were collected from hospital medical records and compiled into a computerized database.
Results: Extensive necrosis was found in 31 tumor specimens (17.9%). Univariate analysis showed that the specimens with extensive necrosis were significantly larger and manifested more perirenal and venous extension than the tumors without necrosis. The size of the renal tumor was the only parameter that remained significant in multivariate analysis (P=0.0001). Overall disease-free survival did not differ significantly between patients with necrotic tumors and those without (68% and 66% respectively).
Conclusions: The finding of extensive necrosis in renal cell carcinoma specimens does not seem to be related to tumor biology but rather may reflect the relation between size and vascularity of the tumor.
Liat Lubish, MD, Shragit Greenberg, MD, Michael Friger and Pesach Shvartzman, MD
Background: Breast cancer is one of the most prevalent malignancies in women, yet one of the most treatable. Early detection is essential to obtain the desired remission and longevity. Numerous studies have shown that periodic screening for breast cancer can reduce mortality by 20-30%.
Objective: To assess the rates, compliance, characteristics as well as barriers in women regarding mammography screening.
Methods: The study group comprised a random sample of 702 women aged 50 or older from 5914 eligible women in two teaching clinics in southern Israel. Phone interviews using structured questionnaires were conducted.
Results: The mean age of the study population was 61 years. The vast majority of the women were not born in Israel. Sixty-three percent of the women had undergone a mammography screening, 48% in the past 2 years. Monthly self-breast examinations were performed by 12% of the women in the last 2 years. Significant factors associated with undergoing mammography were: more than 7 years since immigration, married, a higher education level, adequate knowledge about breast cancer and mammography, presence of past or current cancer, and cancer in relatives. The main reasons for not being screened was no referral (54%) and a lack of knowledge about breast cancer and mammography (19%) - conditions easily remedied by physician counseling.
Conclusion: The study suggests that promotional efforts should be concentrated on new immigrants and on less educated and unmarried women.
Tami Soffer, Yan Press, MD, Aya Peleg, PhD, Michael Friger, PhD, Uri Ganel, MD and Roni Peleg, MD
Background: Complementary medicine incorporates several methods of treatment, all of which aim to promote the health and quality of life of the patient. Public interest and demand for complementary medicine services have increased in recent years in Israel, as they have throughout the western world.
Objective: To characterize patients attending the Complementary Medicine Clinic in southern Israel at the completion of its first 2 years of operation.
Methods: Data for 398 patients selected at random from 4,400 patients treated in the clinic were collected retroactively from the patientsq' charts.
Results: Of those who visited the clinic, 68% were women with an average age of 49 years. Patients attending the clinic had higher rates of hypertension (20%), diabetes (6%) and heart disease (7%) than the general population of patients insured at the Clalit Health Services in the southern region. In addition to musculoskeletal problems (47%), the other most common complaint was emotional problems (13%) such as tension and anxiety. Acupuncture and Shiatsu were the most commonly used types of treatment (61%). Homeopathy was used by 7%. Among patients with musculoskeletal problems, there were significantly more men than women (P= 0.02). The mean age was higher (P= 0.07). And more of them were referred by friends or family (P= 0.06) than those with other problems.
Conclusions: Characterizing patients attending a complementary medicine clinic is imporant for the planning of marketing and resource management, and can assist primary care physicians in decisions regarding the referral of patients to this type of healthcare.
Paull Radu, MD and Jacob Atsmon, MD
Yehuda Shoenfeld, Dror Harats and Georg Wick