In his article, Dr. Mitsuyasu concisely reviews a large body of data concerning the etiology, pathogenesis, epidemiology, and treatment of Kaposi’s sarcoma (KS) in the setting of the human immunodeficiency virus (HIV) infection. As he correctly points out, effective highly active antiretroviral therapy (HAART), with its consequent improvements in immune function and decrease in production of viral and cytokine cofactors that promote KS growth, has been partly responsible for the decline of KS... More »
SAN DIEGO—AIDS experts have long worried that human immunodeficiency virus (HIV) infection might increase a woman’s risk of cervical cancer, particularly in the presence of concurrent human papillomavirus (HPV) infection. More »
WASHINGTON—President Clinton will ask Congress to appropriate an additional $100 million to battle AIDS outside the United States in his budget request for fiscal year 2001. This would raise to $325 million the amount of funding pledged by the United States that year to help foreign nations prevent and treat the disease. More »
BETHESDA, Md—The Adult AIDS Clinical Trials Group (AACTG) will continue its research activities for another 5 years under a new grant from the National Institute of Allergy and Infectious Diseases. NIAID will provide the group $80 million in the first year of renewed funding. More »
CHICAGO—A new ultrasound technology that amasses as much as nine times more information than conventional ultrasound provides greater detail in characterizing breast lesions and also allows real-time tracking of the entire path of the breast biopsy needle, Jacques Souquet, PhD, senior vice president and chief technology officer at ATL Ultrasound (Bothell, Washington), said in an interview with ONI. More »
Cervical cancer has a high incidence and is a rapidly progressive illness among human immunodeficiency virus (HIV)-infected women. This cancer has received increasing attention since 1993 following its addition to the list of AIDS-defining illnesses monitored by the Centers for Disease Control and Prevention (CDC). With increased heterosexual transmission of HIV and frequent co-infection with the human papillomavirus (HPV), invasive cervical cancers will appear more often among... More »
ATLANTA—AIDS deaths fell by 20% between 1997 and 1998, but this was a significantly smaller decline than the 42% fall in mortality that occurred between 1996 and 1997, according to data released by the Centers for Disease Control and Prevention (CDC). More »
ROCKVILLE, Md—Doxil (doxorubicin HCl liposome injection, ALZA Corporation) has won accelerated FDA approval of its supplemental New Drug Application for the treatment of metastatic ovarian cancer refractory to both paclitaxel (Taxol)- and platinum-based chemotherapy regimens. Accelerated approval requires the company to conduct additional research to demonstrate that the drug is associated with clinical benefit. Doxil, a liposomal formulation of doxorubicin, is currently approved for use in... More »
ASCO—In a phase II trial, more than one-third of patients with AIDS-related Kaposi’s sarcoma responded to self-administration of a nasal solution containing the small antiangiogenic peptide IM862, Parkash Gill, MD, of the University of Southern California, reported at the ASCO annual meeting. 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
Five Steps to Improving Patient Access Judy Capko, May 21, 2013 Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.