Showing papers by "Renee A. Desmond published in 2005"
TL;DR: EUS-FNA is a safe, accurate, and minimally invasive technique that improves the staging of patients with NSCLC and was more accurate and had a higher positive predictive value than the PET or CT scan in confirming cancer in the posterior mediastinal lymph nodes.
201 citations
TL;DR: The data support the sexual transmission of BV, and sex with a new partner since the prior visit was the only behavior found to be significantly associated with incident BV.
Abstract: Objective and Goal:Bacterial vaginosis (BV) is extremely common and is associated with adverse obstetrical and gynecological outcomes. The etiology of the microbiologic changes is unknown. The objective of this study was to determine risk factors associated with incident BV.Study:96 women without BV
109 citations
TL;DR: The use of Ad5/3-Δ24, a serotype 3 receptor targeted Rb/p16 pathway selective CRAd, in combination with gemcitabine against human ovarian adenocarcinoma showed synergistic cell killing in vitro compared to single treatments, but the effect was dependent on dose and sequencing.
Abstract: Combination of gemcitabine and Ad5/3-Δ24, a tropism modified conditionally replicating adenovirus, for the treatment of ovarian cancer
90 citations
TL;DR: A retargeted CRAd featuring a secreted marker protein, soluble human carcinoembryogenic antigen (hCEA), and using in vivo bioluminescence imaging, was able to detect effective tumor cell killing by the virus, which led to enhanced therapeutic efficacy.
Abstract: In clinical trials with cancer patients, the safety of conditionally replicating adenoviruses (CRAds) has been good. However, marginal data are available on the persistence or antitumor efficacy of these agents. The oncolytic potency of CRAds is determined by their capacity for entering target cells. Consequently, we constructed a retargeted CRAd featuring a secreted marker protein, soluble human carcinoembryogenic antigen (hCEA), which can be measured in growth medium or plasma. We found that virus replication closely correlated with hCEA secretion both in vitro and in vivo. Further, antitumor efficacy and the persistence of the virus could be deduced from plasma hCEA levels. Finally, using in vivo bioluminescence imaging, we were able to detect effective tumor cell killing by the virus, which led to enhanced therapeutic efficacy.
63 citations
TL;DR: SLN status was the most significant factor for melanoma recurrence and death, and other important predictors include tumor thickness, ulceration, lymphatic invasion, and mitotic index.
Abstract: Selective sentinel lymphadenectomy (SSL) following preoperative lymphoscintigraphy is the most significant recent advance in the management of patients with primary melanoma. This study evaluates the prognostic value of sentinel lymph node (SLN) status and other risk factors in predicting survival and recurrence in patients with primary cutaneous melanoma. From October 1993 to July 1998 a series of 412 patients with primary invasive melanoma underwent SSL at the UCSF/ Mt. Zion Melanoma Center. The outcome of 363 evaluable patients is summarized in this study. The factors related to survival and disease recurrence were analyzed by Cox proportional hazard regression models. The overall incidence of patients with positive SLNs was 18%. Over a median follow-up of 4.8 years, the overall mortality rate in patients with primary cutaneous melanoma was 18.7%, and 74 recurrences occurred (20.4%). Mortality was significantly related to SLN status [HR = 2.06; 95% Confidence interval (CI) 1.18, 3.58], angiolymphatic invasion (HR = 2.21; 95% CI 1.08, 4.55), ulceration (HR = 1.79; 95% CI 1.02, 3.15), mitotic index (HR =1.38; 95% CI 1.01, 1.90), and tumor thickness (HR = 2.20, 95% CI 1.21, 3.99). Factors significantly related to disease-free survival included SLN status (HR = 2.09; 95% CI 1.31, 3.34), tumor thickness (HR = 1.89; 95%. CI 1.20,2.98), and age (HR= 1.26 95% CI 1.08, 1.47). SLN status was the most significant factor for melanoma recurrence and death. Other important predictors include tumor thickness, ulceration, lymphatic invasion, and mitotic index.
42 citations
TL;DR: Stage-matched interventions can reduce douching among adolescent and young adult women, and the difference between the intervention and comparison group was statistically significant at 12 months.
Abstract: The objective of this study was to evaluate an intervention to reduce vaginal douching among adolescent and young women who report douching. This study consisted of a randomized controlled trial of 275 primarily black adolescent and young adults aged 14 to 23 years. All women participated in 3 15-minute individualized counseling sessions. The experimental group received interventions based on their stage of readiness for ceasing vaginal douching. The comparison condition emphasized healthy eating and nutrition. The primary outcome measure was douching cessation (i.e. no douching in the preceding 3 months) at the 6-and 12-month assessment; a secondary outcome was progression through the stages of change toward douching cessation. Based on an intention-to-treat model participants assigned to the douching intervention group were significantly more likely to report having stopped douching at 6 months (relative risk [RR] 1.34; 95% confidence interval [CI] 1.03–1.73) and at 12 months (RR 1.60; 95% CI 1.28–2.00). At baseline 89.9% of all women reported no intention to stop douching. Also based on an intention-to-treat model there were no differences in stage across the 2 groups at 6 months (P = 0.29); however at 12 months the difference between the intervention and comparison group was statistically significant (P = 0.008). Stage-matched interventions can reduce douching among adolescent and young adult women. (authors)
39 citations
TL;DR: HIV primary care clinics provide access to patients in need of HIV prevention intervention and are appropriate sites for these activities.
Abstract: Objective: HIV primary care clinics offer an environment in which to deliver prevention messages and to conduct sexually transmitted disease (STD) screening. Determination of the prevalence and factors associated with risk-taking behaviors among HIV clinic attendees is needed. Goal: The goal of this study was to describe risk behaviors and STD prevalence in males receiving HIV primary care. Study: Participants underwent an interviewer-administered survey and STD testing during this cross-sectional study. Results: Over two thirds of study participants reported sexual activity within the prior 6 months of which 6% were infected with gonorrhea or chlamydia. Men performing insertive rectal sex were 5 times less likely to use condoms when the partner was HIV-positive (odds ratio [OR], 5.14; 95% confidence interval [CI], 1.90-13.91), whereas patients with higher CD4 counts were more likely to engage in unprotected receptive rectal sex (OR, 1.20; 95% CI, 1.02-1.42). Conclusion: HIV primary care clinics provide access to patients in need of HIV prevention intervention and are appropriate sites for these activities.
35 citations
TL;DR: The findings suggest that mathematic interpretation of plethysmograph waveform data may estimate the severity of airway obstruction and be of clinical utility in objective assessment of patients with obstructive airway diseases.
Abstract: Validated measures to assess the severity of airway obstruction in patients with obstructive airway disease are limited. Changes in the pulse oximeter plethysmograph waveform represent fluctuations in arterial flow. Analysis of these fluctuations might be useful clinically if they represent physiologic perturbations resulting from airway obstruction. We tested the hypothesis that the severity of airway obstruction could be estimated using plethysmograph waveform data. Using a closed airway circuit with adjustable inspiratory and expiratory pressure relief valves, airway obstruction was induced in a prospective convenience sample of 31 healthy adult subjects. Maximal change in airway pressure at the mouthpiece was used as a surrogate measure of the degree of obstruction applied. Plethysmograph waveform data and mouthpiece airway pressure were acquired for 60 seconds at increasing levels of inspiratory and expiratory obstruction. At each level of applied obstruction, mean values for maximal change in waveform area under the curve and height as well as maximal change in mouth pressure were calculated for sequential 7.5 second intervals. Correlations of these waveform variables with mouth pressure values were then performed to determine if the magnitude of changes in these variables indicates the severity of airway obstruction. There were significant relationships between maximal change in area under the curve (P < .0001) or height (P < 0.0001) and mouth pressure. The findings suggest that mathematic interpretation of plethysmograph waveform data may estimate the severity of airway obstruction and be of clinical utility in objective assessment of patients with obstructive airway diseases.
29 citations
TL;DR: Investigation of the relationship between race, socioeconomic characteristics, physician density, and colon cancer incidence in Alabama found a higher incidence of distant disease is related to black race and increased poverty, which is positively related to aggregate SES factors, including education and physician density.
Abstract: OBJECTIVES: The objective of this population-based study was to examine the relationship between race, socioeconomic characteristics (socioeconomic status, SES), physician density, and colon cancer incidence in Alabama METHODS: Data for 5,788 colon cancer cases from 1996 to 1999 provided by the Alabama Statewide Cancer Registry are linked to county-level measures of SES, including median household income, percentage of high school graduates, percentage of families below poverty level, and occupational and health care factors Poisson regression is used to model the predictors adjusting for age, gender, and race RESULTS: Blacks had higher incidences of colon cancer compared with whites and presented with later stages (204% versus 148% for distant disease (P = 00089) After controlling for race, gender, and age at diagnosis, significant associations were detected between colon cancer incidence and higher education (RR = 110; 95% CI, 103-117), and increased number of physicians per 1,000 (RR = 114; 95% CI, 106-122) The county percentage of families below poverty is associated inversely with localized disease and positively with distant stage CONCLUSIONS: Colon cancer incidence varies geographically across Alabama and is positively related to aggregate SES factors, including education and physician density A higher incidence of distant disease is related to black race and increased poverty Health disparities in colon cancer across Alabama warrant further investigation
23 citations
23 citations
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