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Biomedical subjects

J S Kaur

Publications and source records attributed to J S Kaur.

At least 19 recordsLinked to original sources
PubMed2006

Phase II trial of oral vinorelbine for the treatment of metastatic breast cancer in patients > or = 65 years of age: an NCCTG study.

BACKGROUND: A one-stage phase II trial was conducted to assess the tumor response rate and toxicity profile of single agent oral vinorelbine as first or second-line chemotherapy for women at least 65 years of age with metastatic breast cancer. PATIENTS AND METHODS: Twenty-five patients with metastatic breast cancer aged > or = 65 years of age were enrolled to receive oral vinorelbine on a weekly basis. The oral vinorelbine was given at 60 mg/m2 weekly for the first four doses and was increased to 70 mg/m2 for the subsequent administrations if there was no grade 4 neutropenia or no more than one episode of grade 3 neutropenia. Therapy was continued until progression or intolerable toxicity. RESULTS: Twenty-five patients were included and evaluable for analysis. One patient (4%) achieved a partial response (PR) that lasted for more than 13 months. Two additional patients remained stable for at least 6 months for a clinical benefit rate (PR + stable disease) of 12%. The 1-year survival rate was estimated to be 48% (95% CI 30% to 74.5%). Median time to progression was estimated to be 4.7 months (95% CI 2.0-5.5 months) and the 9-month disease progression-free rate was estimated to be 8% (95% CI 30.9% to 74.5%). The treatment was fairly well tolerated with grade 3 neutropenia in 12.5%, fatigue in 12.5% of the patients, and grade 2 neuromotor and neurosensory toxicities in 12.5% and 8.3%, respectively. CONCLUSION: Oral vinorelbine as a single agent at these dose and schedule in this population of women > or = 65 years is well tolerated but has a low level of objective efficacy for the treatment of metastatic breast cancer.

Administration, Oral↗
PubMed2005

Cancer-related disparities: weathering the perfect storm through comprehensive cancer control approaches.

During the last two decades extraordinary progress in developing and using effective cancer prevention strategies, early detection interventions, and cancer treatments has been made. This progress has resulted in an overall decline in mortality rates for all cancers combined. Nonetheless, cancer is the second most common cause of death in the United States. Although cancer is a diagnosis that many survive, cancer experiences across populations may vary considerably. These differences in cancer experiences have created an unequal disease burden that presents distinct professional and moral challenges to our nation. Many cancer control plans suggest specific strategies that prioritize eliminating cancer-related disparities. This article describes certain cancer-related disparities in the United States and gives several examples of how communities and disenfranchised populations are using comprehensive cancer control (CCC) approaches to eliminate these disparities. One or two interventions are highlighted in each example.

Delivery of Health Care↗
PubMed2003

Learning and memory in the mosquito Aedes aegypti shown by conditioning against oviposition deterrence.

Oviposition site choice by female mosquitoes, Aedes aegypti (L) (Diptera: Culicidae), was affected by rearing them in water treated with 0.016% of the repellent Mozaway trade mark containing citronella and neem. Given a choice between a bowl of repellent-treated and a bowl of untreated water, Ae. aegypti reared in untreated water strongly preferred to oviposit on the clean water (93-98%) instead of repellent-treated water. This demonstrates effective deterrence of oviposition by dilute Mozaway trade mark. Those reared in repellent-treated water were less deterred: 38-46% of their eggs were laid on the repellent-treated water and 54-62% on the clean water. Evidently the female mosquitoes reared in repellent-treated water were conditioned against oviposition site deterrence, as shown when choice tests were conducted 6 days post-emergence from the treated water. This demonstrates learning and memory in the mosquito Ae. aegypti, with implications for dengue vector surveillance and control.

Aedes↗
PubMed2001

Calciphylaxis associated with cholangiocarcinoma treated with low-molecular-weight heparin and vitamin K.

Calciphylaxis is a rare disorder of small-vessel calcification and cutaneous infarction associated with chronic renal failure. Rare cases of calciphylaxis not associated with chronic renal failure have been reported with breast cancer, hyperparathyroidism, and alcoholic cirrhosis. To our knowledge, we report the first case of calciphylaxis without chronic renal failure associated with cholangiocarcinoma and the first attempt to treat calciphylaxis with vitamin K. A 56-year-old woman presented with necrotic leg ulceration. She was treated initially with low-molecular-weight heparin, with no effect. A coagulation work-up showed vitamin K deficiency. During vitamin K therapy, the patient had fulminant progression of the calciphylaxis. She died, and an autopsy showed metastatic cholangiocarcinoma. Thrombosis and protein C deficiency have been implicated in the pathophysiology of calciphylaxis. Functional protein C deficiency may be one of several factors contributing to the development of calciphylaxis. Vitamin K therapy was ineffective in our patient and may have been detrimental.

Adenocarcinoma↗
PubMed2000

Migration patterns and breast carcinoma.

BACKGROUND: Many American Indian and Alaska Native women have lower incidence rates of breast carcinoma than other racial/ethnic groups in the United States. The rates in most areas, however, have increased in recent years. The author reviews the migration patterns and effects that might contribute to this change. METHODS: A review of the literature on migration and breast carcinoma incidence was conducted. RESULTS: Migration significantly impacts on breast carcinoma incidence in all groups of women studied. CONCLUSIONS: Research must be designed that will explore the components of host, life-styles, and environment on breast carcinoma rates in American Indian and Alaska Native women to elucidate mechanisms of breast carcinoma etiology.

Alaska↗
PubMed2000

Palliative care and hospice programs.

Palliative care and hospice programs are points on the continuum of comprehensive patient care. Unfortunately, provision of care for terminally ill patients is suboptimal. There are many new approaches to improving the skills of all physicians to fulfill the needs of patients, including better education for house staff, "train-the-trainers" programs for physicians in practice, research into methods of symptom control, and better access to established hospice programs. This review covers the history, current status, and practical suggestions for improving palliative care and hospice programs in primary care settings.

Advance Directives↗
PubMed2000

Phase II study of paclitaxel and cisplatin for advanced urothelial cancer.

PURPOSE: We examined the role of paclitaxel and cisplatin as first line therapy for metastatic urothelial cancer. MATERIALS AND METHODS: A total of 34 patients were enrolled in this study, and all were eligible for treatment and assessable for response. Patients received 135 mg./m.2 paclitaxel intravenously for 3 hours followed by 70 mg./m.2 cisplatin for 2 hours every 3 weeks to a maximum of 6 cycles. RESULTS: Of the patients 70% experienced a major response to treatment, which was partial/regression in 38% and complete in 32%. Toxicity was manageable with no episodes of grade 4 leukopenia or thrombocytopenia. Nonhematological toxicities included primarily nausea, anorexia and neuropathy, which rarely were severe. CONCLUSIONS: This regimen of paclitaxel and cisplatin is effective, safe and convenient to administer in an outpatient setting for advanced urothelial cancer.

Aged↗
PubMed1999

The ability of trained nurses to detect lumps in a test set of silicone breast models.

BACKGROUND: Screening for breast carcinoma is a Healthy People 2000 objective and physical examination is an important component of the screening process. However, many women do not have access to a high quality breast examination. To help address this problem for Native American women, the authors developed the Nurses Providing Annual Cancer Screening (NPACS) training program, a week-long training session conducted at the nurses' clinical site. The goal of the current study was to demonstrate that, after receiving training, the nurses can detect masses in breast models at acceptably high rates. METHODS: Thirty-four nurses who had completed the NPACS training program performed examinations of a test set of six silicone breast models. True-positive and false-positive rates of lump detection were calculated. RESULTS: The nurses were able to detect more lumps in the simulated breasts than both untrained and trained physicians tested in previous trials using the same methodology. On the average, nurses found 76% of the 18 lumps in the 6 breast models. However, their rate of false-positive detections also was somewhat higher. Although the modal number of false-positive detections for both physicians and nurses was 0, the median number of false-positive detections was 0 for the physicians and 1.0 for the nurses. CONCLUSIONS: In the current study, trained nurses were able to detect masses in breast models at high rates. This observation suggests that widespread training of nurses to perform screening breast examinations might be considered as a response to the breast carcinoma screening needs of adult women.

Breast Neoplasms↗
PubMed1997

Phase III randomized double-blind study to evaluate the efficacy of a polycarbophil-based vaginal moisturizer in women with breast cancer.

PURPOSE: Vaginal dryness and dyspareunia are significant estrogen-depletion symptoms that affect many breast cancer survivors. The present trial was developed to evaluate the nonhormonal vaginal lubricating preparation, Replens, for alleviating these symptoms. MATERIALS AND METHODS: A double-blind, crossover, randomized clinical trial was developed. Patients received 4 weeks of Replens (Columbia Research Laboratories, Rockville Centre, NY) followed by a 1-week washout period followed by 4 weeks of a placebo lubricating product, or vice versa. Weekly patient-completed diaries were used for measuring efficacies and toxicities of therapy. RESULTS: The 45 assessable patients provided well-balanced treatment groups. During the first 4 weeks, average vaginal dryness decreased by 62% and 64% in the placebo and Replens groups, respectively (P = .3). Average dyspareunia scores also improved by 41% and 60%, respectively (P = .05). Crossover analysis indicated that the bulk of the beneficial effects appeared within the first 2 weeks of the first treatment and remained constant thereafter. Both treatments were relatively well tolerated. CONCLUSION: Both Replens and the placebo appear to substantially ameliorate vaginal dryness and dyspareunia in breast cancer survivors.

Adult↗
PubMed1996

The potential impact of cancer survivors on Native American cancer prevention and treatment.

Cancer has recently become a major health problem for American Indians and Alaska Natives. Surveillance, Epidemiology, and End Results data showed that Native American survival rates at 1, 3, and 5 years from cancer diagnosis are the poorest of any minority population studied. The causes for this finding are multifactorial and include a lack of awareness of cancer risks and symptoms, fatalism, and lack of access to screening services. Cancer survivors in native communities can be invaluable resources to educate others, raise cancer awareness, and most importantly prove that cancer is not always fatal.

Adaptation, Psychological↗
PubMed1993

Comparative morphine pharmacokinetics following sublingual, intramuscular, and oral administration in patients with cancer.

Previous literature reports have suggested that sublingually administered morphine sulfate results in an improved bioavailability of the drug when compared to orally administered morphine. To investigate this possibility further, we studied six cancer patients all of whom received 10 mg doses of morphine sulfate by intramuscular, oral and sublingual routes. Pharmacokinetic analyses failed to suggest an advantage of sublingual administration when compared with oral dosing. Bioavailability of morphine following intramuscular administration appeared superior to both oral and sublingual routes.

Administration, Oral↗
PubMed1991

Isolation and characterization of a cryptic plasmid from mesophilic aeromonads: potential as a cloning vector.

A 2.6 kb covalently closed circular plasmid has been isolated from clinical and environmental isolates of Aeromonas sobria and A. hydrophila. The possibility that the plasmid carries genetic determinants that mediate resistance to a variety of anti-microbial agents has been eliminated. The plasmid is stable at approximately 20-25 copies per chromosome equivalent which, together with its relatively small size and the presence of unique restriction sites, makes it a good candidate for development as a cloning vector.

Aeromonas↗
PubMed1988

Malignant melanoma--profile of an epidemic.

Cutaneous malignant melanoma is occurring in epidemic proportions in the United States. To provide a profile of persons at risk and the epidemiologic features of malignant melanoma, we reviewed the records of 325 patients with cutaneous malignant melanoma seen at the University of Colorado Health Sciences Center between 1973 and 1983. Most patients had fair skin, brown or blonde hair, blue or green eyes, and had difficulty in suntanning. The majority of melanomas (72%) developed in preexisting nevi. In women, melanomas were most common on the extremities, and in men they occurred most frequently on the trunk, head or neck. The most frequently noted depth of invasion was Clark's level IV. At diagnosis, most of the patients (77%) were at stage I. We conclude that malignant melanoma constitutes a major disease problem in the western United States that is largely preventable with appropriate physician and patient education.

Adolescent↗
PubMed1983

Antinuclear, antinucleolar, and anticytoplasmic antibodies in patients with malignant melanoma.

Immunofluorescence was used to examine antibodies to cellular antigens in the sera of patients with malignant melanoma. Sera from 60 melanoma patients and from 33 control individuals (13 normal subjects and 20 disease controls) were studied. Ninety % of the melanoma sera were found to have antinuclear antibodies when epithelial cell lines or melanoma lines were used as substrates for their detection, compared to 18% in the control group. Antinucleolar antibodies and anticytoplasmic antibodies were present in 32 and 17%, respectively, in malignant melanoma but none in the controls. Antinuclear and antinucleolar antibodies could be classified into different types according to different patterns of staining and susceptibility of antigens to digestion with DNase, RNase, and trypsin. Certain types of antibodies, such as those showing granular nuclear staining, appeared to be associated with less advanced stages of malignant melanoma, whereas those showing nucleolar and large speckled nuclear staining were associated with more advanced stages of the disease.

Antibodies, Antinuclear↗
PubMed1982

Acute renal failure following arteriography in a patient with polyarteritis nodosa.

The use of radioiodinated contrast material has become an important diagnostic aid. However, certain categories of patients appear to be at risk for development of oliguric acute renal failure after receiving radiocontrast media. In the article, a patient with polyarteritis nodosa is presented who had development of oliguric azotemia after angiography; the loss in renal function was largely irreversible. The course of this patient suggests that active vasculitis, even in the presence of an inactive urine sediment, may be an additional risk factor for development of acute renal failure when considering the use of radioiodinated contrast material.

Acute Kidney Injury↗
PubMedDate not supplied

Native women and cancer.

Literature regarding cancer patterns in American Indians and Alaska Native women is reviewed and attention is paid to promising research initiatives to improve cancer prevention and control as well as approaches to enhance exchange of knowledge through a new national resource center. Lung, breast, and colorectal cancer are the leading cause of cancer deaths in American Indians and Alaska Native women. There continues to be a disproportionate death rate from cervical cancer. Enhanced availability for breast and cervical cancer screening in conjunction with community education is showing promising trends toward reversing the patterns of late diagnosis. Communities can benefit from sharing their collective resources in a new national resource center called "Native C.I.R.C.L.E." housed in the Mayo Cancer Center.

Attitude to Health↗
PubMedDate not supplied

Low national breast and cervical cancer-screening rates in American Indian and Alaska Native women with diabetes.

BACKGROUND: The cervical cancer mortality rate for American Indian and Alaska Native women is twice that of all races in the United States. To date the only published national breast and cervical cancer-screening rates for American Indian and Alaska Native women are based on self-reported data. When the Indian Health Service (IHS) conducts an annual audit on patients with diabetes, it includes cancer screening. This observational study presents national breast and cervical cancer-screening rates for American Indian and Alaska Native women with diabetes. METHODS: Cancer-screening rates were extracted from the 1995 diabetic audit for the 12 IHS areas. These rates were compared with rates for women without diabetes of the same age, 50 to 69 years, by chart review, at four IHS hospitals in the Aberdeen IHS area. RESULTS: Screening rates for women with diabetes in the 12 areas varied: mammogram (ever) 35% to 78%; clinical breast examination (last year) 28% to 70%, and Papanicolaou smear (last year) 26% to 69%. The Aberdeen IHS area women with diabetes had 51% more clinic visits per year than women without diabetes, but the groups had similar screening rates. CONCLUSION: Cancer-screening rates for American Indian and Alaska Native women vary by region. In the Aberdeen IHS area, women with diabetes had more visits (missed opportunities) but similar screening rates as women without diabetes. The diabetic audit could be used to monitor national IHS cancer-screening trends for women with diabetes and in the Aberdeen IHS area for all women aged 50 to 69 years.

Aged↗