toggle visibility Search & Display Options

Select All    Deselect All
 |   | 
Details
   print
  Records Links
Author (up) url  doi
openurl 
  Title Recommendations from the EGAPP Working Group: can testing of tumor tissue for mutations in EGFR pathway downstream effector genes in patients with metastatic colorectal cancer improve health outcomes by guiding decisions regarding anti-EGFR therapy? Type Journal Article
  Year 2013 Publication Genetics in Medicine : Official Journal of the American College of Medical Genetics Abbreviated Journal Genet Med  
  Volume 15 Issue 7 Pages 517-527  
  Keywords  
  Abstract SUMMARY OF RECOMMENDATIONS: The Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group (EWG) found that, for patients with metastatic colorectal cancer (mCRC) who are being considered for treatment with cetuximab or panitumumab, there is convincing evidence to recommend clinical use of KRAS mutation analysis to determine which patients are KRAS mutation positive and therefore unlikely to benefit from these agents before initiation of therapy. The level of certainty of the evidence was deemed high, and the magnitude of net health benefit from avoiding potentially ineffective and harmful treatment, along with promoting more immediate access to what could be the next most effective treatment, is at least moderate.The EWG found insufficient evidence to recommend for or against BRAF V600E testing for the same clinical scenario. The level of certainty for BRAF V600E testing to guide antiepidermal growth factor receptor (EGFR) therapy was deemed low. The EWG encourages further studies of the potential value of testing in patients with mCRC who were found to have tumors that are wild type (mutation negative) for KRAS to predict responsiveness to therapy.The EWG found insufficient evidence to recommend for or against testing for mutations in NRAS, or PIK3CA, and/or loss of expression of PTEN or AKT proteins. The level of certainty for this evidence was low. In the absence of supporting evidence, and with consideration of other contextual issues, the EWG discourages the use of these tests in guiding decisions on initiating anti-EGFR therapy with cetuximab or panitumumab unless further evidence supports improved clinical outcomes. RATIONALE: It has been suggested that patients with mCRC whose tumors harbor certain mutations affecting EGFR pathway signaling are typically unresponsive to therapy with anti-EGFR antibodies (cetuximab and panitumumab). The EWG identified recent evidence reviews that have addressed this topic, and this recommendation statement is based on results of these reviews. In developing these recommendations the EWG considered evidence in the areas described below. ANALYTIC VALIDITY: Although no research syntheses that have formally evaluated analytic validity of these tests were found, the EWG was able to draw the following conclusions from assessments included in the evidence reviews under consideration. There is adequate evidence that KRAS mutation analysis reliably and accurately detects common mutations (codons 12 and 13), whereas evidence was inadequate for less frequent KRAS mutations (e.g., codon 61). There is also adequate evidence that testing for BRAF V600E accurately and reliably detects the mutation. For common mutations in NRAS, PIK3CA, and expression of PTEN AKT, there is adequate evidence of accurate and reliable detection. However, much less data exist in support. Furthermore, in the specific context of mCRC, no evidence was found on the analytic validity of immunohistochemistry (IHC) assays for PTEN or AKT expression. CLINICAL VALIDITY: For KRAS mutation analysis, the EWG found convincing evidence for association with treatment response to anti-EGFR therapy, independent of prognostic association. For BRAF V600E mutation testing, the EWG found insufficient evidence for association with treatment response to anti-EGFR therapy independent of prognostic association. The EWG found insufficient evidence for association of results of testing for mutations in NRAS or PIK3CA, and loss of expression of PTEN or ATK proteins, with treatment response to anti-EGFR therapy. CLINICAL UTILITY: For KRAS mutation analysis, the EWG found adequate evidence that improved health outcomes are achieved by avoiding ineffective chemotherapy and potential side effects and expediting access to the next most effective treatment. Inadequate evidence was found regarding association of BRAF V600E mutation testing or loss of PTEN expression with improved health outcomes among patients with mCRC undergoing anti-EGFR therapy as compared with patients with tumors bearing wild-type BRAF sequence and PTEN expression levels, respectively. No evidence was found to support improved health outcomes associated with testing results for NRAS or PIK3CA variants, or AKT protein expression levels in this clinical scenario. CONTEXTUAL ISSUES: CRC is an important and highly prevalent health problem. Improvements in mCRC outcomes associated with pharmacogenetic testing could have important clinical, and potentially public health, impacts. Adverse events related to cancer chemotherapy can be common and severe. Therefore, successfully optimizing treatment to maximize efficacy and minimize side effects is important for reducing mCRC-related morbidity and mortality.  
  Address  
  Corporate Author Evaluation of Genomic Applications in Practice and Prevention (EGAPP) Working Group Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1098-3600 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:23429431 Approved no  
  Call Number refbase @ admin @ Serial 35201  
Permanent link to this record
 

 
Author (up) url  doi
openurl 
  Title President Wilson rises to an emergency Type Journal Article
  Year 2013 Publication JAMA : the Journal of the American Medical Association Abbreviated Journal Jama  
  Volume 309 Issue 13 Pages 1325  
  Keywords Federal Government/*history; *Floods; Great Lakes Region; History, 20th Century; Humans; Public Health/*history; Relief Work/*history; Typhoid Fever/prevention & control; Typhoid-Paratyphoid Vaccines/administration & dosage  
  Abstract  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0098-7484 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:23549558 Approved no  
  Call Number refbase @ user @ Serial 24694  
Permanent link to this record
 

 
Author (up) url  openurl
  Title Voluntary medical male circumcision – southern and eastern Africa, 2010-2012 Type Journal Article
  Year 2013 Publication MMWR. Morbidity and Mortality Weekly Report Abbreviated Journal MMWR Morb Mortal Wkly Rep  
  Volume 62 Issue 47 Pages 953-957  
  Keywords Adolescent; Adult; Africa, Eastern; Africa, Southern; Centers for Disease Control and Prevention (U.S.); Circumcision, Male/*statistics & numerical data; HIV Infections/*prevention & control; Humans; International Cooperation; Male; Program Evaluation; United States; *Voluntary Programs/economics; Young Adult  
  Abstract Sub-Saharan Africa bears the greatest global burden of human immunodeficiency virus (HIV) infection; 70% (25.0 million) of all persons living with HIV reside in this region. Voluntary medical male circumcision (VMMC) has been shown to reduce the risk for heterosexually acquired HIV among men by approximately 60% in three randomized controlled trials. Further studies found that the protection from HIV acquisition conferred by VMMC was sustained for 6 years following surgery. In 2007, the World Health Organization (WHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended that 14 countries with generalized HIV epidemics (i.e., where >1% of the population is HIV-positive) and low male circumcision prevalence prioritize scale-up of VMMC for HIV prevention. On December 1, 2011 (World AIDS Day), funding through the President's Emergency Plan for AIDS Relief (PEPFAR) was announced to support >4.7 million VMMCs over the next 2 years. This report presents the results of VMMC scale-up in nine countries where national ministries of health and CDC are implementing VMMC services for HIV prevention: Botswana, Kenya, Malawi, Mozambique, Namibia, South Africa, Tanzania, Uganda, and Zambia. During October 2009-September 2012, a total of 1,924,792 VMMCs were performed in 14 countries using PEPFAR funding provided through U.S. government agencies; of this total, 1,020,424 were conducted at approximately 1,600 CDC-supported VMMC sites: 137,096 VMMCs in 2010, 347,724 in 2011, and 535,604 in 2012. Continued program monitoring and quality assurance activities are required to ensure that CDC-supported country programs meet World AIDS Day targets for VMMC.  
  Address  
  Corporate Author Centers for Disease Control and Prevention (CDC) Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0149-2195 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:24280914 Approved no  
  Call Number refbase @ user @ Serial 27367  
Permanent link to this record
 

 
Author (up) url  openurl
  Title CDC's Emergency Management Program activities – worldwide, 2003-2012 Type Journal Article
  Year 2013 Publication MMWR. Morbidity and Mortality Weekly Report Abbreviated Journal MMWR Morb Mortal Wkly Rep  
  Volume 62 Issue 35 Pages 709-713  
  Keywords *Centers for Disease Control and Prevention (U.S.); Emergency Medical Services/*organization & administration; Humans; *International Cooperation; United States  
  Abstract In 2003, recognizing the increasing frequency and complexity of disease outbreaks and disasters and a greater risk for terrorism, CDC established the Emergency Operations Center (EOC), bringing together CDC staff members who respond to public health emergencies to enhance communication and coordination. To complement the physical EOC environment, CDC implemented the Incident Management System (IMS), a staffing structure and set of standard operational protocols and services to support and monitor CDC program-led responses to complex public health emergencies. The EOC and IMS are key components of CDC's Emergency Management Program (EMP), which applies emergency management principles to public health practice. To enumerate activities conducted by the EMP during 2003-2012, CDC analyzed data from daily reports and activity logs. The results of this analysis determined that, during 2003-2012, the EMP fully activated the EOC and IMS on 55 occasions to support responses to infectious disease outbreaks, natural disasters, national security events (e.g., conventions, presidential addresses, and international summits), mass gatherings (e.g., large sports and social events), and man-made disasters. On 109 other occasions, the EMP was used to support emergency responses that did not require full EOC activation, and the EMP also conducted 30 exercises and drills. This report provides an overview of those 194 EMP activities.  
  Address  
  Corporate Author Centers for Disease Control and Prevention (CDC) Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0149-2195 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:24005225 Approved no  
  Call Number refbase @ user @ Serial 27376  
Permanent link to this record
 

 
Author (up) url  openurl
  Title Voluntary medical male circumcision – southern and eastern Africa, 2010-2012 Type Journal Article
  Year 2013 Publication MMWR. Morbidity and Mortality Weekly Report Abbreviated Journal MMWR Morb Mortal Wkly Rep  
  Volume 62 Issue 47 Pages 953-957  
  Keywords Adolescent; Adult; Africa, Eastern; Africa, Southern; Centers for Disease Control and Prevention (U.S.); Circumcision, Male/*statistics & numerical data; HIV Infections/*prevention & control; Humans; International Cooperation; Male; Program Evaluation; United States; *Voluntary Programs/economics; Young Adult  
  Abstract Sub-Saharan Africa bears the greatest global burden of human immunodeficiency virus (HIV) infection; 70% (25.0 million) of all persons living with HIV reside in this region. Voluntary medical male circumcision (VMMC) has been shown to reduce the risk for heterosexually acquired HIV among men by approximately 60% in three randomized controlled trials. Further studies found that the protection from HIV acquisition conferred by VMMC was sustained for 6 years following surgery. In 2007, the World Health Organization (WHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended that 14 countries with generalized HIV epidemics (i.e., where >1% of the population is HIV-positive) and low male circumcision prevalence prioritize scale-up of VMMC for HIV prevention. On December 1, 2011 (World AIDS Day), funding through the President's Emergency Plan for AIDS Relief (PEPFAR) was announced to support >4.7 million VMMCs over the next 2 years. This report presents the results of VMMC scale-up in nine countries where national ministries of health and CDC are implementing VMMC services for HIV prevention: Botswana, Kenya, Malawi, Mozambique, Namibia, South Africa, Tanzania, Uganda, and Zambia. During October 2009-September 2012, a total of 1,924,792 VMMCs were performed in 14 countries using PEPFAR funding provided through U.S. government agencies; of this total, 1,020,424 were conducted at approximately 1,600 CDC-supported VMMC sites: 137,096 VMMCs in 2010, 347,724 in 2011, and 535,604 in 2012. Continued program monitoring and quality assurance activities are required to ensure that CDC-supported country programs meet World AIDS Day targets for VMMC.  
  Address  
  Corporate Author Centers for Disease Control and Prevention (CDC) Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0149-2195 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:24280914 Approved no  
  Call Number refbase @ user @ Serial 27821  
Permanent link to this record
Select All    Deselect All
 |   | 
Details
   print

Save Citations:
Export Records: