March 19, 2012 (Hollywood, Florida) — The new guideline on lung cancer screening was presented to an audience for the first time here at the National Comprehensive Cancer Network (NCCN) 17th Annual Conference.

Screening is an attempt to diagnose lung cancer in the early stages when the disease is curable. During this stage the patient has no symptoms. He/she feels absolutely well. Often when the patient develops symptoms such as a chronic cough it is already too late to be cured. Everyone over the age of 50 who has smoked for more than 20 years or over 55 who has smoked for more than 10 years, is advised to be screened for early lung cancer. For the full article click here

Immediate Effects of Smoking include:

One cigarette immediately raises a person's blood pressure and heart rate and decreases the blood flow to body extremities

Brain activity and the nervous system are stimulated for a short while and then reduced

A smoker may experience dizziness, nausea, watery eyes and acid in the stomach while or after smoking

Appetite, and senses such as taste and smell are distorted

Lung cancer is the leading cause of death from cancer in both men and women, killing more people than cancers of the breast, colon, cervix and prostate combined. In 1991 a group of doctors from Cornell University met with a goal of early lung cancer detection. In 1992 ELCAP (Early Lung Cancer Action Program) was formed.

Among their findings:
·       Curability of Stage I lung cancers is 80-90%
·       Annual CT screening allows at least 80% of lung cancers to be diagnosed at Stage I
·       CT screening creates a counseling opportunity that results in greater smoking cessation
·       Costs of CT screening for lung cancer compare favorably with breast, cervical, and colon cancer screenings 

Pectus carinatum, an anterior protrusion of the sternum or chest wall, is much less frequent than pectus excavatum; 16.7% of all chest wall deformities in the Boston Children’s Hospital experience. The anterior protrusion occurs in a spectrum of configurations often divided into four categories ^] The most frequent form, termed chondrogladiolar by Brodkin, consists of anterior protrusion of the body of the sternum with protrusion of the lower costal cartilages. It is described as appearing as if a giant hand had pinched the chest from the front, forcing the sternum and medial portion of the costal cartilages forward and the lateral costal cartilages and ribs inward. Asymmetric deformities with anterior displacement of the costal cartilages on one side and normal cartilages on the contralateral side are less common . Mixed lesions have a carinate deformity on one side and a depression or excavatum deformity on the contralateral side, often with sternal rotation. Some authors classify these as a variant of the excavatum deformities. The least frequent deformity is the chondromanubrial or “pouter pigeon” deformity with protrusion of the upper chest involving the manubrium and second and third costal cartilages and relative depression of the body of the sternum.

The etiology is unknown. The deformity becomes more prominent with the growth spurt of puberty.
The classic repair is a modified Ravitch which involves resection of the costal cartilages and fracture of the sternum. A recent innovation is the Abramson repair which is a modified Nuss operation. This is a minimally invasive operation which is much more cosmetically acceptable.

Bronchiectasis is a chronic disease of the lungs in which there is irreversible dilatation of pulmonary bronchi with copious sputum production. For full article click here.

Barretts esophagus is a disease related to chronic esophageal reflux. For full First Consult article click here.