WASHINGTON—The Department of Health and Human Service (HHS) has created a unified advisory committee on HIV and sexually transmitted diseases (STD) by merging two existing groups. The new committee brings together the Advisory Committee for HIV Prevention at the Centers for Disease Control and Prevention (CDC) and the AIDS Advisory Committee at the Health Resources and Services Administration (HRSA). The two groups have met jointly on several occasions during the last 2 years, and all current... More »
Since the implementation of highly active antiretroviral therapy (HAART) in the United States in 1996, the number of persons diagnosed with acquired immunodeficiency syndrome (AIDS) and the number of deaths among persons with AIDS have More »
WASHINGTON—The National Institute of Allergy and Infectious Diseases (NIAID) has awarded a 5-year, $14.8 million grant to bolster China’s HIV/AID research effort. Health and Human Services Secretary Tommy G. Thompson and Chinese Health Minister Zhang Wenkang signed a Memorandum of Understanding and announced the grant in a ceremony here. More »
Rubinstein and colleagues provide an excellent review of mathematical models for estimating breast cancer risk, including the risk of carrying inherited mutations of BRCA1 and BRCA2. Since we and others reviewed early models to predict the likelihood of inherited susceptibility to breast cancer,[1] newer quantitative tools, most notably by Parmigiani and colleagues,[2] have been developed. These models have been made available on CD-ROM, over the Internet, and in other electronic versions that... More »
As active participants in the care of patients with acquired immunodeficiency syndrome (AIDS), oncologists need to be aware of the many facets of pain management in this population. This two-part article, which began in the More »
BETHESDA, Maryland—Wyeth Vaccines, a unit of Wyeth Pharmaceuticals, has won a 5-year, $22.8 million contract from the National Institute of Allergy and Infectious Diseases (NIAID). The contract was awarded by NIAID’s HIV Vaccine Design and Development Teams (HVDDT) program, a public-private effort that seeks to accelerate the development of HIV vaccines. More »
SEATTLE—A response to highly active antiretroviral therapy (HAART) independently predicts the outcome of AIDS-related lymphoma, underscoring the importance of giving HIV-positive patients this therapy whenever possible, Christian More »
The article by Dr. William Breitbart and Lucia DiBiase offers an excellent in-depth review of our current knowledge of the epidemiology, pharmacologic, and nonpharmacologic interventions in the field of pain management in patients with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). More »
MOUNTAIN VIEW, California—Pegylated liposomal doxorubicin (Doxil, Caelyx) offered a sustained clinical benefit to 37% of patients with AIDS-related Kaposi’s sarcoma vs 16% of patients treated with liposomal daunorubicin (DaunoXome) in a randomized trial comparing the two drugs (ASCO abstract 1640). More »
Concern about prescribing controlled substances underlies, in part, the undertreatment of pain, even in palliative care settings. That the same is true for human immunodeficiency virus (HIV) patients is therefore not surprising, particularly given injection drug use as a risk factor. More »
The purposes of this study were to determine the clinical importance and relative value of reinterpretation of brain CT studies by subspecialty experts by assessing the accuracy of interpretation by general radiologists at primary stroke centers and to assess interpretive quality outcomes as a function of change in the treatment of patients with stroke diagnoses or acute presentations of suspected stroke.|Computerized medical records for the years 2009-2010 at four major community hospitals were queried for primary interpretation of brain CT studies of stroke patients with an acute presentation of either stroke or suspected stroke as diagnosed by board-certified general radiologists (nonneuroradiologists). A central database was queried that allowed one to query by clinical history or symptoms. Secondary interpretation of images of the identified patient sample was then performed by three experienced neuroradiologists. Each case was initially interpreted as an emergency or urgent
Survivin is overexpressed in major types of cancer and is considered an ideal "universal" tumor-associated antigen that can be targeted by immunotherapeutic vaccines. However, its anti-apoptosis function raises certain safety concerns. Here, a new truncated human survivin, devoid of the anti-apoptosis function, was generated as a candidate tumor vaccine. Interleukin 2 (IL-2) has been widely used as an adjuvant for vaccination against various diseases. Meanwhile, the DNA prime and recombinant adenovirus (rAd) boost heterologous immunization strategy has been proven to be highly effective in enhancing immune responses. Therefore, the efficacy of a new cancer vaccine based on a truncated form of survivin, combined with IL-2, DNA prime, and rAd boost, was tested. As prophylaxis, immunization with the DNA vaccine alone resulted in a weak immune response and modest anti-tumor effect, whereas the tumor inhibition ratio with the DNA vaccine administered with IL-2 increased to 89% and was
Hodgkin lymphoma (HL) is one of the most common types of non-AIDS-defining tumors in the HIV-infected. Its incidence however seems to have increased under highly active anti-retroviral therapy (HAART). HIV-HL is a different entity from HL in HIV-negative subjects with a poorer prognosis that is associated with tumor-subtype, EBV-infection, and "B" symptoms. Despite the aggressive nature of the disease, clinical outcome has improved with combination therapies including appropriately timed antiretroviral strategies and the quality of supportive care-notably the use of hematopoietic growth factors. More intensive chemotherapy regimens with or without autologous stem cell transplantation appear to improve survival. Functional imaging such as positron emission tomography and computed tomography (FDG-PET) may help guide treatment strategy and minimize long-term toxicity.
To evaluate the effect of hexaminolevulinate (HAL)-induced fluorescence during resection of noninvasive bladder cancer on tumor recurrence compared with resection under white light.|Between 2008 and 2010, 102 consecutive patients with suspected bladder cancer were randomized to undergo transurethral resection with either conventional white light or combination of white light and HAL-induced fluorescence. Difference in tumor recurrence rate and recurrence-free survival between the 2 groups was evaluated. Subgroup analysis on recurrence-free survival was performed for different tumor parameters.|Cystoscopy at 3 months revealed tumor recurrence in 6 of 45 (13.3%) patients of the white light group compared with only 1 of 41 patients of the HAL group (2.4%) (P < .001). The recurrence-free rates in white light patients at 12 and 18 months were 56.3% and 50.6%, respectively, compared with 91% and 82.5% in HAL patients (P = .0006). In subgroup analyses, recurrence-free survival was similar
Ewing sarcoma is a high-grade round cell sarcoma that affects bones and soft tissues in children and young adults. Its diagnosis can be challenging, and the differential diagnoses include a wide variety of small round cell tumors. CD99 and FLI-1 are the currently accepted immunohistochemical markers for Ewing sarcoma, but their accuracy has been controversial. NKX2.2 is a homeodomain-containing transcription factor that plays a critical role in neuroendocrine/glial differentiation. The NKX2.2 gene was recently identified as a target of EWS-FLI-1, the fusion protein specific to Ewing sarcoma, and was shown to be differentially upregulated in Ewing sarcoma on the basis of array-based gene expression analysis. However, the immunohistochemical diagnostic potential of this marker has not been tested. We immunostained representative sections of 30 genetically confirmed Ewing sarcomas and 130 non-Ewing small round cell tumors by using an antibody to NKX2.2. Nuclear staining in at least 5% of
Primary Care Can't Thrive Without Nurse Practitioners Courtney H. Lyder, ND, May 17, 2013 With a projected shortfall of primary-care physicians, it's time for alternate solutions to patient care. Nurse practitioners are one logical remedy.
