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1/5. A new approach in specific, active immunotherapy.

    A vaccinia virus-lysed autochthonous tumor cell vaccine (vaccinia oncolysate) is introduced as a new specific, active immunotherapeutic agent against human cancer. Mouse experiments showed the vaccine to be a safe and potent immune mechanism stimulator. human experimentation was undertaken in the knowledge of relative safety of the components of the vaccine, i.e. vaccinia vaccine and lysed, autochthonous tumor cells. Vaccine-treated patients had advanced metastatic cancer but reacted to one or more common recall antigen skin tests. None of the 13 patients had untoward responses; 7/13 patients had classic delayed hypersensitivity reactions at the vaccine injection sites; and 2/7 patients with injection site reactions had significant reduction in tumor burden. These results indicate that this vaccine is a specific, active immune mechanism stimulator, and may prove to be a useful therapeutic agent in the treatment of human cancer.
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2/5. Nutritional assessment in cancer cachexia.

    Cancer cachexia causes nutritional depletion due to the tumor burden and the patient's inability to eat. A nutritional assessment is valuable in assisting the medical team in nutritionally repleting malnourished patients. Using readily available information, the practitioner can determine nutritional assessment and plan interventions that help the child to successfully withstand cancer and its treatment.
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3/5. serum sialic acid is a biologic marker for malignant disease.

    Serial serum sialic acid (n-acetylneuraminic acid) was measured in 16 patients with advanced cancer of various histologic types. In the 15 evaluable patients serial changes in sialic acid correlated with the clinical course. Isolated sialic acid values were not predictive of clinical response. Serial determination of serum sialic acid appears to be a useful monitor of tumor burden.
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4/5. Medical-legal issues in radiology: prevention and control.

    Concerns about legal implications affect many decisions of the average radiologist, and physicians do not always appreciate the validity of these concerns. However, such concerns often influence radiologists' decisions more than is warranted. An improved understanding of the law and its ramifications may serve to prevent adverse legal effects found in the everyday practice of radiology. Legal issues influence radiology in many ways. Two important ways the law affects the practice of radiology relate to the business affairs of radiologists and to the radiologist's duty to perform to a standard of care. Legal issues relate to the business aspects of radiology through radiologists' relationship to their group practice and the radiology group's relation to the outside world. radiology groups use legal services for issues such as employment contracts, hospital privileges, group relations, and bylaws. They make decisions with major legal implications when they establish their standard business practices. These decisions range from business procedures that ensure a timely delivery of service to the choice and implementation of quality assurance systems to how to ensure that patients are informed of the results of a radiologic examination. Legal matters affect many business decisions radiology groups make. Antitrust law is concerned about issues such as cost sharing, price sharing, mergers, acquisitions, and practice patterns. Laws limit the right to practice radiology. Billing practices, conflicts of interest, self-referral, right to refuse care, employment practices--all have substantial legal implications. These issues are a concern of every practicing radiologist. Changes in our health care system may cause new legal obligations. An appreciation of the relationship radiologists must have with payors and patients is increasingly important in preventing medical-legal problems. These additional duties and responsibilities occur when many physicians and the public at large seem to feel they are already overburdened with legal duties and responsibilities. A lack of familiarity with the legitimate relationship of the law to everyday life may greatly affect radiologists' job satisfaction. Many acts physicians perform in the practice of radiology have legal implications not often recognized by the practicing radiologist. This monograph seeks to enhance radiologists' understanding of some common and important legal issues related to their practice of medicine. We hope that this monograph will help radiologists appreciate the legal implications of their behavior. The opinions expressed in this monograph are those of the authors and should not be inferred to represent the official views of any government agency.(ABSTRACT TRUNCATED AT 400 WORDS)
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5/5. Psychosocial consequences of inadequate health insurance for patients with cancer.

    The psychosocial aspects of health insurance in general, and inadequate coverage in particular, have received scant attention from psycho-oncology professionals. However, with the dehospitalization of cancer treatment, and the longer survival time for patients with cancer, the economic and social burden of cancer has shifted to the patient and family. This article explores several domains of the life of the patient with cancer that can be affected by insufficient health insurance. These include the physical, emotional, financial, social, and employment consequences of inadequate insurance coverage, which can be far-reaching. health insurance can influence the patient's decision making regarding treatment, choice of physician, and hospital. The unmet needs that arise from deficient insurance coverage can cause strain and distress for the family and the patient. These areas of concern are discussed, and recommendations are made for clinical, educational, and research activities.
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