In the past decade, several studies have investigated the effect of laser therapy on haemorrhoids, anal fistulas and tumours but few have explored its use in acute anal fissure. Therefore, the present study aimed to evaluate the efficiency of laser therapy in treating acute anal fissure. This clinical trial was conducted on all the patients referred to Valiasr Hospital, Arak, Iran, with acute anal fissure. Patients who were unresponsive to medical treatment and in whom surgery was indicated were divided into two equal-sized groups. Age, medical treatment duration, healing time, pain relief, relapse and indication for reoperation were recorded in all patients. The mean age of the patients and the mean medical treatment duration were significantly different in the two groups. Although there were no significant differences in the mean healing time and response to pain in the first and third months after surgery and laser therapy, by month 6 the mean response to pain was significantly different in the two groups. Frequency of relapse and need for further surgery were not significantly different between the groups. Laser therapy of acute anal fissure is a simple, non-invasive and painless surgical procedure with a low rate of complications. It can be viewed as an effective treatment for patients with anal fissure. However, this procedure has some limitations.

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Warfarin is the most widely prescribed anticoagulant worldwide. However, warfarin doses vary up to 20-fold and side-effects (at high doses) or therapy failure (at lower doses) are major risks of treatment. The target enzyme of warfarin, vitamin K epoxide reductase complex 1 (VKORC1), is encoded by the highly polymorphic VKORC1 gene and gene polymorphisms contributes to approximately 30% of the variability in dose. In this study, we used polymerase chain reaction (PCR) and direct DNA sequencing to genotype the two most clinically important variants (rs9923231 and rs7294) of the VKORC1 gene among Emiratis. We genotyped 117 healthy Emirati nationals and found that the frequencies of the rs9923231 genotypes GG, GA and AA are 0.256, 0.496 and 0.248, respectively. The frequency of the G allele for this single nucleotide polymorphism (SNP) is 0.504 while the frequency of the A allele is 0.496. However, the frequencies of the rs7294 GG, GA and AA genotypes are 0.462, 0.393 and 0.145, respectively. The alleles frequencies for this SNP were 0.660 for the G allele and 0.340 for the A allele. Genotypes and allele frequencies of the two studied SNPs were found to be different between the Emirati population studied and Indian and Chinese populations; however, they were similar to the frequencies found in Caucasians and other regional populations, such as the Saudis, Turkish and Iranians. These findings are potentially important for determining the starting warfarin dose for Emirati patients requiring anticoagulant treatment.

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Standard chemotherapy regimes (platinum-based combinations) for advanced non-small-cell lung cancer have reached their therapeutic limits. In the last few years standard chemotherapy has been supplemented by targeted therapy. Targeted therapy consists of tyrosine kinase inhibitors (TKIs) against epidermal growth factor receptor (EGFR) mutation-positive tumours or ALK (anaplastic lymphoma kinase)-rearranged tumours as well as antiangiogenic TKIs and monoclonal antibodies directed against vascular endothelial growth factor, vascular endothelial growth factor receptor 2 or EGFR. Although targeted therapy has made remarkable progress, there is great hope for the use of immune checkpoint inhibitors, which specifically enhance the immune response directed against the tumour.

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Endometriosis is an oestrogen-dependent clinical condition that manifests with functional endometrial tissue at sites outside the uterus or elsewhere than in the normal endometrial lining. Endometriosis of the colon is not common and its presentation is non-specific. In view of this, its diagnosis may be difficult. The aim of this review is to gather information from the available literature on endometriosis. Various internet databases were searched, including PubMed, Un-bound MEDLINE, DeepDyve, Google, Google Scholar, Educus and Yahoo. Colonic endometriosis is not uncommon and has a myriad of presentations. It affects Caucasians and the sigmoid colon predominantly. The risk of perforations, malignancy and mucosal involvement increases with gravidity, post-menopausal status and rectosigmoid sites, respectively. Clinicians should maintain a high index of suspicion when managing women of child-bearing age who present with gastrointestinal symptoms or pelvic pain.

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Screening for early-stage lung cancer has the potential to significantly increase cure rate, lower case fatality rate and even reduce cancer-specific and overall mortality in the screened population. Lung cancer screening is not a single test, but a process. It begins with the selection of subjects at high risk and proceeds to baseline low-dose computerized tomography (LDCT), followed by regular additional rounds of LDCT accompanied by constant decision-making and risk re-evaluation, and continuing to eventual identification and timely adequate treatment of early-stage lung cancer, ultimately preventing death from lung cancer in a particular patient. There are conflicting interpretations of data from randomized trials and large cohort studies. This review attempts to summarize the basic principles of screening methodology and provide concise information on effectiveness of LDCT in detecting early lung cancer.

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This review considers exhaled breath analysis, a non-invasive, widely applicable and cost-effective technique that holds great potential for evolving into a future screening tool for lung cancer and other diseases. Exhaled human breath contains thousands of volatile and non-volatile chemical compounds, which are products of metabolic processes and subject to changes in composition and concentration as a result of carcinogenesis. In the last decade, the analysis of volatile organic compounds (VOCs) has gained increasing interest because of the development of new technologies that might allow for detection of certain VOC biomarkers or patterns indicative of lung cancer. We provide an overview of the chemical analytical and sensor array technologies currently available for VOC analysis, including statistical methods implemented for the analysis of complex VOC patterns, and discuss issues of exhaled breath sampling and storage. Furthermore, we summarize the literature on exhaled breath analysis in lung cancer and discuss the results, limitations and future perspectives. We also briefly review the literature on sniffer dogs trained to detect lung cancer from human breath samples. In conclusion, even though certain issues have yet to be addressed and large randomized blinded studies are still lacking, there is evidence that exhaled breath analysis may be a promising tool for lung cancer screening.

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There has been a paradigm shift in the understanding of the role played by the fallopian tube in the development of malignancies involving the female reproductive system. In particular, malignancies affecting the ovaries, such as high-grade serous ovarian carcinoma and serous peritoneal carcinoma, are presently thought to originate from malignant seedlings derived from the fallopian tube. However, the literature on adenocarcinoma of the fallopian tube is limited despite the strategic role this malignancy plays in the pathogenesis of malignancies of the female reproductive system. In this review we discuss current knowledge of adenocarcinoma of the fallopian tube, including management. The role of adenocarcinoma of the fallopian tube in the development of other female reproductive system malignancies is also described, with the aim of identifying aspects of the condition that will need further study. A search of PubMed, using the keywords ‘adenocarcinoma’, ‘fallopian tube’, ‘treatment’ and ‘salpingectomy’, yielded 179 articles over the past 15 years, of which 40 were relevant to the review. The role played by adenocarcinoma and malignant precursor lesions of the fallopian tube in malignancies affecting other parts of the female reproductive system needs to be further researched to provide more understanding and possibly better management of these conditions.

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The current treatment of lung cancer is characterized by a broader interpretation of the term ‘targeted therapy’, which actually refers to the selective manipulation of molecular targets by neoadjuvant and/or adjuvant chemotherapy. The concept of targeted therapy may, however, also be translated to thoracic surgery in the sense that – despite greatly reduced invasiveness – treatment options with increased effectiveness and selectivity can be offered. In this paper, the current surgical treatment of all stages of non-small-cell lung cancer will be reviewed. The presented literature will show that – thanks to constantly renewing technology – radical and oncologically correct surgical treatment of bronchial carcinoma of the highest quality is possible for almost all stages. Thus, even locally advanced tumours can no longer be considered as an obstacle to cure. On the other hand – in tune with the overall trend of reduced invasiveness and enhanced effectiveness – sublobar resection for T1a tumours is gaining increasing acceptance amongst thoracic surgeons worldwide. The oncological radicality of limited lung resection can be further increased by innovative minimally invasive approaches to mediastinal lymphadenectomy. In conclusion, the paramount importance of radical mediastinal lymphadenectomy for patients' survival is emphasized once more by the current literature.

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