Advantages and challenges of publishing in medical school

Once accepted into medical school, students find themselves facing numerous expectations: coping with tremendous study burden, completing internships and participating in the race for publishing are only to name a few. It becomes hard for the medical student to focus on research; it is often easier to postpone publication and involvement in research to a later stage in their career. In fact, there are many advantages to publishing in the current publication system but there are many disadvantages as well. With the widespread of social media and open access systems, new challenges have arisen. We will discuss the advantages and disadvantages of publishing in the current system while highlighting the new challenges that the students might need to overcome.Our aim is to provide medical students with information to enhance their understanding of the current publication system and thus most importantly, probe their desire to publish

two-front war: targeting synchronous metastatic pancreatic and renal cell carcinomas with the combination of gemcitabine and sunitinib

The occurrence of multiple synchronous primary tumors is extremely rare. The management plan of synchronous cancers has long been debatable and difficult mainly in tumors with different molecular characteristics. In this report, we present the second case in literature of a concomitant diagnosis of a metastatic pancreatic adenocarcinoma and a locally advanced renal cell carcinoma. We also elaborate on our management combining chemo-therapy and targeted therapy through an extensive review of literature

Early increase of CA 19-9 in advanced pancreatic cancer receiving FOLFIRINOX: Is it a sign of efficacy?

Advanced pancreatic cancer [APC], one of the most aggressive tumors, was considered to be resistant to chemotherapy for decades. FOLFIRINOX [5-FU, leucovorin, irinotecan and oxaliplatin] regimen showed an improvement of quality of life and overall survival in APC patients with good performance status [ECOG < 2]

Material and methods: Seven patients diagnosed with APC, during a six-month period, received FOLFIRINOX as first line treatment. Tumor measurement was assessed every two months and CA 19-9, the specific tumor marker of pancreatic cancer, was assessed every two weeks at every cycle

Results: Three patients out of seven receiving FOLFIRINOX experienced an early and transitory increase of CA 19-9 after the first two cycles resulting in a considerable response with a median survival of 15 months and suggesting a model of tumor release syndrome

Conclusion: This phenomenon of early and transitory increase of CA 19-9 in APC could reflect the high efficacy of FOLFIRINOX and could predict better outcome in these patients

[Chimo-radiotherapie dans les lymphomes de hodgin-stades precoces]

To evaluate the response to and toxicities of chemo-radiotherapy [CT-RT] in patients with early stage Hodgkin lymphoma treated in our institution. Retrospective study of 42 patients with early stage Hodgkin lymphoma treated between 2002 and 2007. The age of patients ranges from 11 to 57 with a mean of 30.7 years ; the sex-ratio is 0.8 [19 males and 23 females]. There are 33 cases of nodular-sclerosing Hodgkin lymphoma, 6 of mixed cellularity, one lymphocyte-rich, one interfollicular and one granulomatous. As for the stages, 31 Hodgkin lymphomas are stage IIA, 6 stage IA, 3 bulky and 2 stage IAe. The ABVD protocol was given to 38 patients, the VBVP to 3 patients and the ABV to one patient. IFRT was used with dose ranging from 19.8 to 39.6 Gy. The acute toxicity of chemotherapy was hematologic only, grade 1 anemia accounting for 11.1% and grade 2 anemia for 14.8%, grade 1 leukopenia for 51.8%, grade 2 leukopenia for 33.3% and grade 3 leukopenia for 14.8%. Dysphagia, radiodermitis and radiomucositis were seen after radiotherapy, accounting for 16.5%, 4.6% and 9.1% respectively. No long-term toxicity of the combined therapy was found. During the follow-up period, one relapse occurred and no death was reported. The overall survival [OS], the disease free survival [DFS] and the toxicities of the combined therapy CT-RT of the patients with early stage Hodgkin lymphoma stage IA and IIA treated in our institution were similar to those seen in the literature

Inflammatory breast cancer with refractory diarrhea a case report

Excessive amounts of vasoactive intestinal polypeptide [VIP] cause a special clinical syndrome characterized by secretory diarrhea, hypokalemia and dehydration. A careful clinical workup of a 62-year-old female admitted for refractory diarrhea revealed a neglected inflammatory right breast ductal carcinoma with VIP hypersecretion without any localized abdominal tumor. Immunohistochemistry of the breast biopsy showed neuroendocrine characteristics with positive staining for VIP, and Octreotide scan showed hyperfixation to the right breast and axilla. Primary therapy of breast cancer with hormones and chemotherapy achieved transitory regression of diarrhea, VIP level decrease, and tumor border reduction. Bilateral modified radical mastectomy and irradiation of the tumor failed to prevent liver and bone dissemination of the disease. Once more, partial response was obtained by octreotide and salvage chemotherapy ; however, the patient died from progressive disease 23 months after initial diagnosis. To our best knowledge, this unusual presentation of a breast carcinoma with related VIPoma syndrome is the first reported case in the literature

Spontaneous pneumothorax following chemotherapy for metastatic germ cell tumor. A case report

We report on a 30-year-old man with metastatic non seminomatous germ cell tumor of the left testicle to the abdomen and the lungs, who suddenly developed a bilateral spontaneous pneumothorax after the first course of salvage chemotherapy. Rapid destruction and lysis of lung nodules by chemotherapy seem to be the main mechanism of pneumothorax development. According to our case report and to the literature, the onset of acute dyspnea after chemotherapy for lung metastatic germ cell tumor should alert to the possibility of spontaneous pneumothorax

Outcome of cancer patients admitted to the intensive cave unit [ICU].

This is a retrospective study aiming to determine the cause, the survival and the factors influencing survival in cancer patients admitted to an ICU. Between January 1998 and June1999, 181cancer patients were admitted to the ICU of HDF hospital [a general academic hospital of 300 beds]. One hundred fifteen patients were admitted after surgery and 66 for medical reasons. Among the non-surgical group, 37 had solid tumors and 29 had hematological malignancies. Most of non-surgical patients were admitted for respiratory or infectious complications due to their disease or treatment-related [59 patients]. Among the non-surgical group of patients, 44 required mechanical ventilation [MV]. The mortality rate was 41% during ICU recovery, 62% during the hospitalization period, 73% at 2 months from discharge and 83% at last follow-up. The duration of stay in the ICU was the only factor affecting mortality. Age, disease type and MV did not influence the mortality rate in this population

Mesotheliome - asbeste au Liban: un probleme a retenir

To estimate the incidence of pleural mesothelioma and its relationship with the occupational and environmental exposure to asbestos in Chekka region. Between 1991 and 2000, 22 cases of malignant mesothelioma were diagnosed at Hotel-Dieu de France Hospital. Eighteen cases were epidemiologically investigated. Fifteen among these 18 patients [83%] had a positive exposure history exposure was occupational in 11 cases and environmental in 4 cases.The tumor was attributable to Eternit Company in 12 cases among the exposed 15 [80%]. These 12 cases were secondary to occupational exposures in 8 and to environmental exposure in 4 cases. Mean latency period between exposition and diagnosis was 29 years. Fifteen patients died from the progression of their disease after a median survival of 8 months. The relationship between pleural mesothelioma and Eternit Company with the related occupational and environmental risk in Chekka region is obvious.The assessment of the incidence needs a national cancer registry.Despite the protective measures taken by the government since-1996, an increase in the incidence is suspected in the coming ten years because of the long latency period of the disease

Case reports-second colon cancer following Hodgkin's Disease

We report the case of a 36-year-old male patient who was treated with combined radiotherapy and chemotherapy for Hodgkin's disease in 1972, and developed a colon cancer 18 years later. Development of second malignancy in Hodgkin's disease patients and its relationship with treatment modality are discussed