Ann Acad Med Singap
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Ovarian cancer is predominantly a disease of postmenopausal women which presents at a late stage and has an overall 5-year survival of less than 30%. If detected at stage I, survival is dramatically increased and this would suggest that screening for ovarian cancer may reduce mortality. However, the inaccessibility of the ovaries and the absence of a confirmed premalignant condition make screening for preclinical disease difficult. ⋯ Multimodal screening using tumour markers and ultrasound in combination gives high sensitivity and specificity and is also the most cost-effective potential screening strategy. The sensitivity and specificity of these techniques are sufficient to warrant large-scale clinical trials of ovarian cancer screening. Three such trials are currently underway and, in due course, will establish whether any screening strategy will ultimately reduce mortality from ovarian cancer.
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Despite advances in antimicrobial therapy and medical support, septic shock remains a leading cause of death. Emerging adjunctive therapy for septic shock can be divided into those directed against bacterial components, those directed against host-derived inflammatory-mediators and those designed to limit tissue damage. ⋯ Therapies against endotoxin, tumour necrosis factor, interleukin-1 and platelet activating factor did not reduce mortality. Future effective therapies will probably use combination of agents depending upon the nature of the infection and the type of patient.
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The Polarprobe is a portable non invasive electronic device designed for the detection of cervical precancer and cancer. It measures both electrical and optical properties of cervical tissue to allow a real time comparison with a databank of previously determined cervical tissue types. ⋯ Indeed it has been shown to be associated with less pain and anxiety than the smear and has the capability of encouraging women to attend for screening. Some of the preliminary clinical trials on the Polarprobe are reported as well as the ongoing developments and modifications to the device.