Cronkhite-Canada Syndrome: an unusual finding of gastro-intestinal adenomatous polyps in a syndrome characterized by hamartomatous polyps.

Cronkhite-Canada syndrome is a rare, hamartomatous polyposis syndrome of unknown etiology. Hamartomatous gastro-intestinal polyps, alopecia, onychodystrophy, cutaneous hyperpigmentation, abdominal pain, diarrhea, and complications of weight loss are typical of the syndrome. In this report, we describe a pathological finding of colonic adenomatous polyposis as opposed to hamartomatous polyposis. We also describe our treatment, long-term therapeutic plan, and the need for further research.

Preliminary safety and efficacy results of laser immunotherapy for the treatment of metastatic breast cancer patients.

We report our preliminary results of a pilot clinical trial of late-stage breast cancer patients treated by laser immunotherapy (LIT), a local intervention using an 805 nm laser for non-invasive irradiation, indocyanine green for selective thermal effect, and immunoadjuvant (glycated chitosan) for immunological stimulation. Ten breast cancer patients were enrolled in this study; all patients were considered to be out of other available treatment options. Toxicity was individually evaluated through physical exams and laboratory tests. Adverse reactions only occurred in the area of treatment due to photothermal injury and local administration of immunoadjuvant. No grade 3 or 4 side effects were observed. Treatment efficacy of LIT was also evaluated by physical examination and tomography. In 8 patients available for evaluation, the objective response rate was 62.5% and the clinical beneficial response rate was 75%. While the study is still ongoing, the initial outcomes of this clinical trial show that LIT is well tolerated and is promising in the treatment of metastatic breast cancer.

The totally implantable vascular access for long term chemotherapy

Over a 14 month period 20 Porta-A-Caths were implanted in 20 adults patients with a spectrum of malignancies requiring long term cyclic chemotherapy. The devices were inserted into the superior vena cava via a cephalic vein cutdown under local anaesthesia. The catheters were in situ for a total of 3,109 patient days, averaging 164 days per patient. The longest a catheter has remained indwelling is 385 days. Complications were minimal; 1 catheter was removed for sepsis, one revised for occlusion and 1 was associated with perficial thrombosis. We were impressed by the safe, simple catheter insertion, ease of establishing venous access, minimal morbidity and high patient acceptability. Its use is recommended in all patients requiring long term chemotherapy. (AU)

Epidemiologic reconnaissance of hypertension in the Bahamas

Preliminary studies suggest that in the indigenous Bahamian population hypertensive cardiovascular disease is a prominent cause of morbidity and mortality; however, coronary heart disease is rarely diagnosed. On the basis of the high linoleic acid content in the adipose tissue of the Bahamian children and adults compared to Americans, the hypothesis is proposed that in Bahamians, dietary sources of linolic acid modify the effect of hypertension as a risk factor predisposing to coronary heart disease (AU)

Preliminary observations on cardiovascular disease in the Bahamas with special reference to the prevalence of hypertension coronary atherosclerosis and composition of depot fat

The aims of the study were to confirm the prevalence of hypertension in Bahamians, to determine at autopsy the degree of coronary atherosclerosis in documented cases of hypertensive disease in Bahamians and to analyse depot fat for fatty acids in Bahamians. Blood pressure was measured by a standard technique in 1488, subjects of ages 10-69 years. The records of 1450 consecutive autopsies were examined and the degree of coronary atherosclerosis graded. There were 130 autopsies of Bahamians with clinical evidence of hypertension. Fatty acids were determined on fat biopsies by gas chromatography. A high mortality rate from and prevalence of hypertensive disease exist in the Bahamas, by contrast to a low mortality rate for myocardial infarction and an apparent low prevalence of coronary heart disease. Depot fat composition of Bahamians shows a high level of linoleic acid (C18:2) (13.3 percent) and a poly-unsaturated/saturated fat ratio of 0.51. The p/s ratio is greater than 0.5 in all countries where the incidence of coronary heart disease is low. It is postulated that the traditional Bahamian diet which is relatively rich in poly-unsaturated fats, modifies the effect of hypertension as a risk factor in the evolution of coronary heart disease in this population (AU)