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Rodino-Klapac L, Pozsgai E, Lewis S, Griffin D, Meadows A, Lehman K, Church K, Reash N, Iammarino M, Sabo B, Alfano L, Lowes L, Neuhaus S, Li X, Mendell J. P.170 Safety, β-sarcoglycan expression, and functional outcomes from systemic gene transfer of bidridistrogene xeboparvovec in limb-girdle muscular dystrophy type 2E/R4. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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2
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Rodino-Klapac L, Pozsgai E, Lewis S, Griffin D, Meadows A, Lehman K, Church K, Reash N, Iammarino M, Lowes L, Koenig E, Neuhaus S, Li X, Mendell J. LGMD. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ndashimye E, Avino M, Olabode AS, Poon AFY, Gibson RM, Li Y, Meadows A, Tan C, Reyes PS, Kityo CM, Kyeyune F, Nankya I, Quiñones-Mateu ME, Arts EJ. Accumulation of integrase strand transfer inhibitor resistance mutations confers high-level resistance to dolutegravir in non-B subtype HIV-1 strains from patients failing raltegravir in Uganda. J Antimicrob Chemother 2021; 75:3525-3533. [PMID: 32853364 DOI: 10.1093/jac/dkaa355] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/03/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Increasing first-line treatment failures in low- and middle-income countries (LMICs) have led to increased use of integrase strand transfer inhibitors (INSTIs) such as dolutegravir. However, HIV-1 susceptibility to INSTIs in LMICs, especially with previous raltegravir exposure, is poorly understood due to infrequent reporting of INSTI failures and testing for INSTI drug resistance mutations (DRMs). METHODS A total of 51 non-subtype B HIV-1 infected patients failing third-line (raltegravir-based) therapy in Uganda were initially selected for the study. DRMs were detected using Sanger and deep sequencing. HIV integrase genes of 13 patients were cloned and replication capacities (RCs) and phenotypic susceptibilities to dolutegravir, raltegravir and elvitegravir were determined with TZM-bl cells. Spearman's correlation coefficient was used to determine cross-resistance between INSTIs. RESULTS INSTI DRMs were detected in 47% of patients. HIV integrase-recombinant virus carrying one primary INSTI DRM (N155H or Y143R/S) was susceptible to dolutegravir but highly resistant to raltegravir and elvitegravir (>50-fold change). Two patients, one with E138A/G140A/Q148R/G163R and one with E138K/G140A/S147G/Q148K, displayed the highest reported resistance to raltegravir, elvitegravir and even dolutegravir. The former multi-DRM virus had WT RC whereas the latter had lower RCs than WT. CONCLUSIONS In HIV-1 subtype A- and D-infected patients failing raltegravir and harbouring INSTI DRMs, there is high-level resistance to elvitegravir and raltegravir. More routine monitoring of INSTI treatment may be advised in LMICs, considering that multiple INSTI DRMs may have accumulated during prolonged exposure to raltegravir during virological failure, leading to high-level INSTI resistance, including dolutegravir resistance.
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Affiliation(s)
- Emmanuel Ndashimye
- Department of Microbiology and Immunology, Western University, London, Canada.,Center for AIDS Research Uganda Laboratories, Joint Clinical Research Centre, Kampala, Uganda
| | - Mariano Avino
- Department of Pathology and Laboratory Medicine, Western University, London, Canada
| | - Abayomi S Olabode
- Department of Pathology and Laboratory Medicine, Western University, London, Canada
| | - Art F Y Poon
- Department of Microbiology and Immunology, Western University, London, Canada.,Department of Pathology and Laboratory Medicine, Western University, London, Canada.,Department of Applied Mathematics, Western University, London, Canada
| | - Richard M Gibson
- Department of Microbiology and Immunology, Western University, London, Canada
| | - Yue Li
- Department of Microbiology and Immunology, Western University, London, Canada
| | - Adam Meadows
- Department of Microbiology and Immunology, Western University, London, Canada
| | - Christine Tan
- Department of Microbiology and Immunology, Western University, London, Canada
| | - Paul S Reyes
- Department of Microbiology and Immunology, Western University, London, Canada
| | | | - Fred Kyeyune
- Center for AIDS Research Uganda Laboratories, Joint Clinical Research Centre, Kampala, Uganda
| | - Immaculate Nankya
- Center for AIDS Research Uganda Laboratories, Joint Clinical Research Centre, Kampala, Uganda
| | | | - Eric J Arts
- Department of Microbiology and Immunology, Western University, London, Canada
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Madhav N, Bosa HK, Agyarko RD, Stephenson N, Miller K, Gallivan M, Lam C, Meadows A, Sridharan V, Bah A, Béavogui M. Development of a risk modeling approach to enhance the effectiveness of epidemic preparedness, response, and financing strategies in African countries. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Rodino-Klapac L, Pozsgai E, Lewis S, Griffin D, Meadows A, Lehman K, Church K, Miller N, Iammarino M, Lowes L, Mendell J. LIMB GIRDLE MUSCULAR DYSTROPHIES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rodino-Klapac L, Pozsgai E, Lewis S, Griffin D, Meadows A, Lehman K, Church K, Miller N, Iammarino M, Lowes L, Mendell J. CLINICAL TRIAL HIGHLIGHTS. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mitchell G, Anderson D, Meadows A, Morris Z, Ludy M. Bacterial Presence on Common Objects at Bar-and-Grille Restaurants. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Meadows A, Lee JH, Wu CS, Wei Q, Pradhan G, Yafi M, Lu HC, Sun Y. Deletion of G-protein-coupled receptor 55 promotes obesity by reducing physical activity. Int J Obes (Lond) 2016; 40:417-24. [PMID: 26447738 DOI: 10.1038/ijo.2015.209] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 09/02/2015] [Accepted: 09/21/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND/OBJECTIVES Cannabinoid receptor 1 (CB1) is the best-characterized cannabinoid receptor, and CB1 antagonists are used in clinical trials to treat obesity. Because of the wide range of CB1 functions, the side effects of CB1 antagonists pose serious concerns. G-protein-coupled receptor 55 (GPR55) is an atypical cannabinoid receptor, and its pharmacology and functions are distinct from CB1. GPR55 regulates neuropathic pain, gut, bone, immune functions and motor coordination. GPR55 is expressed in various brain regions and peripheral tissues. However, the roles of GPR55 in energy and glucose homeostasis are unknown. Here we have investigated the roles of GPR55 in energy balance and insulin sensitivity using GPR55-null mice (GPR55(-/-)). METHODS Body composition of the mice was measured by EchoMRI. Food intake, feeding behavior, energy expenditure and physical activity of GPR55(-/-) mice were determined by indirect calorimetry. Muscle function was assessed by forced treadmill running test. Insulin sensitivity was evaluated by glucose and insulin tolerance tests. Adipose inflammation was assessed by flow cytometry analysis of adipose tissue macrophages. The expression of inflammatory markers in adipose tissues and orexigenic/anorexigenic peptides in the hypothalamus was also analyzed by real-time PCR. RESULTS GPR55(-/-) mice had normal total energy intake and feeding pattern (i.e., no changes in meal size, meal number or feeding frequency). Intriguingly, whereas adult GPR55(-/-) mice only showed a modest increase in overall body weight, they exhibited significantly increased fat mass and insulin resistance. The spontaneous locomotor activity of GPR55(-/-) mice was dramatically decreased, whereas resting metabolic rate and non-shivering thermogenesis were unchanged. Moreover, GPR55(-/-) mice exhibited significantly decreased voluntary physical activity, showing reduced running distance on the running wheels, whereas muscle function appeared to be normal. CONCLUSIONS GPR55 has an important role in energy homeostasis. GPR55 ablation increases adiposity and insulin resistance by selectively decreasing physical activity, but not by altering feeding behavior as CB1.
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Affiliation(s)
- A Meadows
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Division of Pediatric Endocrinology, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, TX, USA
| | - J H Lee
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - C-S Wu
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Q Wei
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Division of Endocrinology, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China
| | - G Pradhan
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - M Yafi
- Division of Pediatric Endocrinology, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, TX, USA
| | - H-C Lu
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Y Sun
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Huffington Center on Aging, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
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Meadows A, Wright S. AB1209-HPR Annual Review for Psoriatic Arthritis, Time to Act Now? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Li X, Meadows A, Babitsky V, Parkin R. Optimization of a universal matchbox on an ultrasonic vibrating system. Ultrasonics 2014; 54:2193-2198. [PMID: 24953432 DOI: 10.1016/j.ultras.2014.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 03/31/2014] [Accepted: 06/01/2014] [Indexed: 06/03/2023]
Abstract
The main scope of the article is to investigate the effect of ferrite cores gap in a universal matchbox on an ultrasonic vibrating system. A gapped transformer mechanism in a universal matchbox has been thoroughly studied. Characteristics of an ultrasonic vibrating system have been recorded such as mechanical vibrations, inductance, resonant frequencies, current and voltage levels as the gap of ferrite cores gradually increases. In addition, the phase difference between the supplied voltage and the current is also computed and displayed in a Lissajous curve in order to determine the optimal gap between two ferrite cores in the universal matchbox. Explanations supplement the experiment results.
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Affiliation(s)
- X Li
- Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Leicestershire LE11 3TU, UK.
| | - A Meadows
- Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Leicestershire LE11 3TU, UK
| | - V Babitsky
- Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Leicestershire LE11 3TU, UK.
| | - R Parkin
- Wolfson School of Mechanical and Manufacturing Engineering, Loughborough University, Leicestershire LE11 3TU, UK
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Meadows A, Kaambwa B, Novielli N, Huissoon A, Fry-Smith A, Meads C, Barton P, Dretzke J. A systematic review and economic evaluation of subcutaneous and sublingual allergen immunotherapy in adults and children with seasonal allergic rhinitis. Health Technol Assess 2014; 17:vi, xi-xiv, 1-322. [PMID: 23827204 DOI: 10.3310/hta17270] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Severe allergic rhinitis uncontrolled by conventional medication can substantially affect quality of life. Immunotherapy involves administering increasing doses of a specific allergen, with the aim of reducing sensitivity and symptomatic reactions. Recent meta-analyses have concluded that both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are more effective than placebo in reducing symptoms. It is uncertain which route of administration is more effective and whether or not treatment is cost-effective. OBJECTIVE To determine the comparative clinical effectiveness and cost-effectiveness of SCIT and SLIT for seasonal allergic rhinitis in adults and children. DATA SOURCES Electronic databases {MEDLINE, EMBASE, The Cochrane Library [Cochrane Central Register of Controlled Trials (CENTRAL)], NHS Economic Evaluation Database (NHS EED)} and trial registries (from inception up to April 2011). REVIEW METHODS Standard systematic review methods were used for study selection, data extraction and quality assessment. Double-blind randomised, placebo-controlled trials of SCIT or SLIT, or of SCIT compared with SLIT, and economic evaluations were included. Meta-analysis and indirect comparison meta-analysis and meta-regression were carried out. A new economic model was constructed to estimate cost-utility. RESULTS Meta-analyses found statistically significant effects for SCIT and SLIT compared with placebo across a number of outcome measures and for the vast majority of subgroup analyses (type and amount of allergen, duration of treatment). There was less evidence for children, but some results in favour of SLIT were statistically significant. Indirect comparisons did not provide conclusive results in favour of either SCIT or SLIT. Economic modelling suggested that, when compared with symptomatic treatment (ST), both SCIT and SLIT may become cost-effective at a threshold of £20,000-30,000 per quality-adjusted life-year (QALY) from around 6 years, or 5 years for SCIT compared with SLIT (NHS and patient perspective). LIMITATIONS It is uncertain to what extent changes in the outcome measures used in the trials translate into clinically meaningful benefits. Cost-effectiveness estimates are based on a simple model, limited data and a number of assumptions, and should be seen as indicative only. CONCLUSIONS A benefit from both SCIT and SLIT compared with placebo has been consistently demonstrated, but the extent of this effectiveness in terms of clinical benefit is unclear. Both SCIT and SLIT may be cost-effective compared with ST from around 6 years (threshold of £20,000-30,000 per QALY). Further research is needed to establish the comparative effectiveness of SCIT compared with SLIT and to provide more robust cost-effectiveness estimates. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- A Meadows
- Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
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Meadows A. SP0197 Screening and assessing cardiovascular risk in inflammatory arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jaussaud N, Chitsaz S, Meadows A, Wintermark M, Cambronero N, Azadani AN, Saloner DA, Chuter TA, Tseng EE. Acute type A aortic dissection intimal tears by 64-slice computed tomography: a role for endovascular stent-grafting? J Cardiovasc Surg (Torino) 2013; 54:373-381. [PMID: 22820738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The goal of this study was to identify physical characteristics of primary intimal tears in patients arriving to the hospital alive with acute type A aortic dissection using 64-multislice computerized tomography (MSCT) in order to determine anatomic feasibility of endovascular stent-grafting (ESG) for future treatment. METHODS Radiology database was screened for acute type A aortic dissection since the time of acquisition of the 64-slice CT scanner and cross-referenced with surgical database. Seventeen patients met inclusion criteria. Images were reviewed for number, location, and size of intimal tears and aortic dimensions. Potential obstacles for ESG were determined. RESULTS Ascending aorta (29%) and sinotubular junction (29%) were the most frequent regions where intimal tears originated. Location of intimal tears in nearly 75% of patients was inappropriate for ESG, and 94% of patients did not have sufficient proximal or distal landing zone required for secure fixation. Only 71% of patients underwent surgical aortic dissection repair after imaging and 86% of entry tears detected on MSCT were confirmed on intraoperative documentation. Only one patient would have met all technical criteria for ESG using currently available devices. CONCLUSION Location of intimal tear, aortic valve insufficiency, aortic diameter>38 mm are major factors limiting use of ESG for acute type A dissection. Available stents used to treat type B aortic dissection do not address anatomic constraints present in type A aortic dissection in the majority of cases, such that development of new devices would be required.
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Affiliation(s)
- N Jaussaud
- Division of Cardiothoracic Surgery, Department of Surgery, University of California at San Francisco Medical Center, San Francisco, CA 94143, USA
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Henderson TO, Oeffinger KC, Whitton J, Leisenring W, Neglia J, Meadows A, Crotty C, Rubin DT, Diller L, Inskip P, Smith SA, Stovall M, Constine LS, Hammond S, Armstrong GT, Robison LL, Nathan PC. Summaries for patients. Increased risk for gastrointestinal cancer in childhood cancer survivors. Ann Intern Med 2012; 156:I-36. [PMID: 22665822 DOI: 10.7326/0003-4819-156-11-201206050-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Thapper M, Roussou E, Jandial S, Pearson J, Foster HE, Thompson B, Orr J, Platt P, Birrell F, Sritharan M, Croft A, Justice E, Carruthers D, Walker D, Robinson S, Jagatsinh Y, Adebajo A, Helliwell P, Rahman A, Shah P, Snowden N, Dexter H, Dornan T, Singh D, Meadows A, Frusher J, Sampson C, Sheehan NJ, Dahiya S, Croft AP, Sritharan M, Justice EA, Carruthers DM, Little J, Melath S, Procter S, Horne Z, Dahiya S, Lauder A, McCabe C, Rodham K. Education Research [291-300]: 291. Medical Students' Attitude Towards Rheumatology Training at Fy1 And Fy2 Level: Results from a National Survey. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tang YJ, Martin HG, Dehal PS, Deutschbauer A, Llora X, Meadows A, Arkin A, Keasling JD. Metabolic flux analysis ofShewanellaspp. reveals evolutionary robustness in central carbon metabolism. Biotechnol Bioeng 2009; 102:1161-9. [DOI: 10.1002/bit.22129] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Teir J, Koduri G, Meadows A, Griffin J, Kelsey C, Kola A, Persey M, Sinclair H, Yuksel F, Moshtaghi P, Ramabhadram B, Poole K, Pradeep J, Lane S, Pountain G, Scott DGI, Sheehan NJ, Stodell M, Young A, Hall FC. An audit of recording cardiovascular risk factors in patients with rheumatoid arthritis and systemic lupus erythematosus in centres in East Anglia and the South East. Rheumatology (Oxford) 2008; 47:1252-4. [PMID: 18573801 DOI: 10.1093/rheumatology/ken232] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Henderson TO, Rajaraman P, Stovall M, Smith S, Mertens A, Meadows A, Neglia JP, Inskip P, Whitton J, Robison LL, Diller L. New primary sarcomas in survivors of childhood cancer: A detailed analysis of the effects of treatment: a report from the Childhood Cancer Survivor Study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.10007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ronckers C, Sigurdson A, Stovall M, Smith S, Sklar C, Land C, Neglia J, Mertens A, Hammond S, Meadows A, Robison L, Inskip P. 042: Radiation and Thyroid Cancer in the Childhood Cancer Survivor Study: A Detailed Evaluation of Dose-Response and its Modifiers. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s11a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Ronckers
- National Cancer Institute, Bethesda, MD 20892
| | - A Sigurdson
- National Cancer Institute, Bethesda, MD 20892
| | - M Stovall
- National Cancer Institute, Bethesda, MD 20892
| | - S Smith
- National Cancer Institute, Bethesda, MD 20892
| | - C Sklar
- National Cancer Institute, Bethesda, MD 20892
| | - C Land
- National Cancer Institute, Bethesda, MD 20892
| | - J Neglia
- National Cancer Institute, Bethesda, MD 20892
| | - A Mertens
- National Cancer Institute, Bethesda, MD 20892
| | - S Hammond
- National Cancer Institute, Bethesda, MD 20892
| | - A Meadows
- National Cancer Institute, Bethesda, MD 20892
| | - L Robison
- National Cancer Institute, Bethesda, MD 20892
| | - P Inskip
- National Cancer Institute, Bethesda, MD 20892
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Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows A, Marina N, Kadan-Lottick N, Leisenring W, Robison LL. Prevalence and severity of chronic diseases in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- K. C. Oeffinger
- Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of Minnesota, Minneapolis, MN; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Fred Hutchinson Cancer Research Ctr, Seattle, WA; St. Jude Children’s Research Hosp, Memphis, TN; Univ of Pennsylvania, Philadelphia, PA; Stanford Univ Medcl Ctr, Palo Alto, CA; Yale Univ, New Haven, CT
| | - A. C. Mertens
- Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of Minnesota, Minneapolis, MN; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Fred Hutchinson Cancer Research Ctr, Seattle, WA; St. Jude Children’s Research Hosp, Memphis, TN; Univ of Pennsylvania, Philadelphia, PA; Stanford Univ Medcl Ctr, Palo Alto, CA; Yale Univ, New Haven, CT
| | - C. A. Sklar
- Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of Minnesota, Minneapolis, MN; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Fred Hutchinson Cancer Research Ctr, Seattle, WA; St. Jude Children’s Research Hosp, Memphis, TN; Univ of Pennsylvania, Philadelphia, PA; Stanford Univ Medcl Ctr, Palo Alto, CA; Yale Univ, New Haven, CT
| | - T. Kawashima
- Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of Minnesota, Minneapolis, MN; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Fred Hutchinson Cancer Research Ctr, Seattle, WA; St. Jude Children’s Research Hosp, Memphis, TN; Univ of Pennsylvania, Philadelphia, PA; Stanford Univ Medcl Ctr, Palo Alto, CA; Yale Univ, New Haven, CT
| | - M. M. Hudson
- Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of Minnesota, Minneapolis, MN; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Fred Hutchinson Cancer Research Ctr, Seattle, WA; St. Jude Children’s Research Hosp, Memphis, TN; Univ of Pennsylvania, Philadelphia, PA; Stanford Univ Medcl Ctr, Palo Alto, CA; Yale Univ, New Haven, CT
| | - A. Meadows
- Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of Minnesota, Minneapolis, MN; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Fred Hutchinson Cancer Research Ctr, Seattle, WA; St. Jude Children’s Research Hosp, Memphis, TN; Univ of Pennsylvania, Philadelphia, PA; Stanford Univ Medcl Ctr, Palo Alto, CA; Yale Univ, New Haven, CT
| | - N. Marina
- Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of Minnesota, Minneapolis, MN; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Fred Hutchinson Cancer Research Ctr, Seattle, WA; St. Jude Children’s Research Hosp, Memphis, TN; Univ of Pennsylvania, Philadelphia, PA; Stanford Univ Medcl Ctr, Palo Alto, CA; Yale Univ, New Haven, CT
| | - N. Kadan-Lottick
- Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of Minnesota, Minneapolis, MN; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Fred Hutchinson Cancer Research Ctr, Seattle, WA; St. Jude Children’s Research Hosp, Memphis, TN; Univ of Pennsylvania, Philadelphia, PA; Stanford Univ Medcl Ctr, Palo Alto, CA; Yale Univ, New Haven, CT
| | - W. Leisenring
- Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of Minnesota, Minneapolis, MN; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Fred Hutchinson Cancer Research Ctr, Seattle, WA; St. Jude Children’s Research Hosp, Memphis, TN; Univ of Pennsylvania, Philadelphia, PA; Stanford Univ Medcl Ctr, Palo Alto, CA; Yale Univ, New Haven, CT
| | - L. L. Robison
- Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of Minnesota, Minneapolis, MN; Memorial Sloan-Kettering Cancer Ctr, New York, NY; Fred Hutchinson Cancer Research Ctr, Seattle, WA; St. Jude Children’s Research Hosp, Memphis, TN; Univ of Pennsylvania, Philadelphia, PA; Stanford Univ Medcl Ctr, Palo Alto, CA; Yale Univ, New Haven, CT
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Henderson T, Robison L, Mertens A, Neglia J, Hammond S, Meadows A, Whitton J, Cook EF, Stovall M, Diller L. Sarcomas as a subsequent malignancy in survivors of pediatric malignancy:The Childhood Cancer Survivor Study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- T. Henderson
- Dana-Farber Cancer Inst, Boston, MA; Univ of Minnesota, Minneapolis, MN; Ohio State Univ Sch of Medicine, Columbus, OH; Children’s Hosp of Philadelphia, Philadelphia, PA; Fred Hutchinson Cancer Research Ctr, Seattle, WA; Harvard Sch of Public Health, Boston, MA; M.D. Anderson Cancer Ctr, Houston, TX
| | - L. Robison
- Dana-Farber Cancer Inst, Boston, MA; Univ of Minnesota, Minneapolis, MN; Ohio State Univ Sch of Medicine, Columbus, OH; Children’s Hosp of Philadelphia, Philadelphia, PA; Fred Hutchinson Cancer Research Ctr, Seattle, WA; Harvard Sch of Public Health, Boston, MA; M.D. Anderson Cancer Ctr, Houston, TX
| | - A. Mertens
- Dana-Farber Cancer Inst, Boston, MA; Univ of Minnesota, Minneapolis, MN; Ohio State Univ Sch of Medicine, Columbus, OH; Children’s Hosp of Philadelphia, Philadelphia, PA; Fred Hutchinson Cancer Research Ctr, Seattle, WA; Harvard Sch of Public Health, Boston, MA; M.D. Anderson Cancer Ctr, Houston, TX
| | - J. Neglia
- Dana-Farber Cancer Inst, Boston, MA; Univ of Minnesota, Minneapolis, MN; Ohio State Univ Sch of Medicine, Columbus, OH; Children’s Hosp of Philadelphia, Philadelphia, PA; Fred Hutchinson Cancer Research Ctr, Seattle, WA; Harvard Sch of Public Health, Boston, MA; M.D. Anderson Cancer Ctr, Houston, TX
| | - S. Hammond
- Dana-Farber Cancer Inst, Boston, MA; Univ of Minnesota, Minneapolis, MN; Ohio State Univ Sch of Medicine, Columbus, OH; Children’s Hosp of Philadelphia, Philadelphia, PA; Fred Hutchinson Cancer Research Ctr, Seattle, WA; Harvard Sch of Public Health, Boston, MA; M.D. Anderson Cancer Ctr, Houston, TX
| | - A. Meadows
- Dana-Farber Cancer Inst, Boston, MA; Univ of Minnesota, Minneapolis, MN; Ohio State Univ Sch of Medicine, Columbus, OH; Children’s Hosp of Philadelphia, Philadelphia, PA; Fred Hutchinson Cancer Research Ctr, Seattle, WA; Harvard Sch of Public Health, Boston, MA; M.D. Anderson Cancer Ctr, Houston, TX
| | - J. Whitton
- Dana-Farber Cancer Inst, Boston, MA; Univ of Minnesota, Minneapolis, MN; Ohio State Univ Sch of Medicine, Columbus, OH; Children’s Hosp of Philadelphia, Philadelphia, PA; Fred Hutchinson Cancer Research Ctr, Seattle, WA; Harvard Sch of Public Health, Boston, MA; M.D. Anderson Cancer Ctr, Houston, TX
| | - E. F. Cook
- Dana-Farber Cancer Inst, Boston, MA; Univ of Minnesota, Minneapolis, MN; Ohio State Univ Sch of Medicine, Columbus, OH; Children’s Hosp of Philadelphia, Philadelphia, PA; Fred Hutchinson Cancer Research Ctr, Seattle, WA; Harvard Sch of Public Health, Boston, MA; M.D. Anderson Cancer Ctr, Houston, TX
| | - M. Stovall
- Dana-Farber Cancer Inst, Boston, MA; Univ of Minnesota, Minneapolis, MN; Ohio State Univ Sch of Medicine, Columbus, OH; Children’s Hosp of Philadelphia, Philadelphia, PA; Fred Hutchinson Cancer Research Ctr, Seattle, WA; Harvard Sch of Public Health, Boston, MA; M.D. Anderson Cancer Ctr, Houston, TX
| | - L. Diller
- Dana-Farber Cancer Inst, Boston, MA; Univ of Minnesota, Minneapolis, MN; Ohio State Univ Sch of Medicine, Columbus, OH; Children’s Hosp of Philadelphia, Philadelphia, PA; Fred Hutchinson Cancer Research Ctr, Seattle, WA; Harvard Sch of Public Health, Boston, MA; M.D. Anderson Cancer Ctr, Houston, TX
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Streffer C, Shore R, Konermann G, Meadows A, Uma Devi P, Preston Withers J, Holm LE, Stather J, Mabuchi K. Biological effects after prenatal irradiation (embryo and fetus). A report of the International Commission on Radiological Protection. Ann ICRP 2004; 33:5-206. [PMID: 12963090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
In its 1990 recommendations, the ICRP considered the radiation risks after exposure during prenatal development. This report is a critical review of new experimental animal data on biological effects and evaluations of human studies after prenatal radiation published since the 1990 recommendations.Thus, the report discusses the effects after radiation exposure during pre-implantation, organogenesis, and fetogenesis. The aetiology of long-term effects on brain development is discussed, as well as evidence from studies in man on the effects of in-utero radiation exposure on neurological and mental processes. Animal studies of carcinogenic risk from in-utero radiation and the epidemiology of childhood cancer are discussed, and the carcinogenic risk to man from in-utero radiation is assessed. Open questions and needs for future research are elaborated. The report reiterates that the mammalian embryo and fetus are highly radiosensitive. The nature and sensitivity of induced biological effects depend upon dose and developmental stage at irradiation. The various effects, as studied in experimental systems and in man, are discussed in detail. It is concluded that the findings in the report strengthen and supplement the 1990 recommendations of the ICRP.
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West R, Hajek P, Nilsson F, Foulds J, May S, Meadows A. Individual differences in preferences for and responses to four nicotine replacement products. Psychopharmacology (Berl) 2001; 153:225-30. [PMID: 11205423 DOI: 10.1007/s002130000577] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
RATIONALE With several different forms of nicotine replacement therapy available for smokers, it is useful to know about factors that may influence choice of form. OBJECTIVE To examine factors associated with preference for different nicotine replacement products and effectiveness of these products. The simple comparison of success rates between the products has been reported previously. METHODS Five hundred and four smokers were invited to rank order four products (gum, patch, nasal spray and inhaler) in terms of preference and were then randomly allocated to receive one of the products for a smoking cessation attempt. They were followed up 1 week, 4 weeks, 12 weeks and 15 weeks later. Ratings of the products were repeated 1 week after the quit date. Mood and physical symptoms were assessed at baseline and at each follow-up visit. Urges to smoke were assessed at all post-quit date sessions. Abstinence was assessed by self-report with expired air carbon monoxide verification. RESULTS The patch was the most popular product initially, followed by the spray and inhaler and then the gum. The difference was greater for women than men. However, all smokers quickly came to like whichever product they had been allocated. Smokers who initially preferred the spray or inhaler were heavier smokers than those who preferred the gum or patch. Prior experience of the gum was associated with lower initial preference for it, but did not affect outcome. Prior experience with the patch had no effect on preference or outcome. Being allocated to the preferred product did not increase success at stopping smoking. Women were more successful at stopping smoking on the inhaler than the gum. Among highly dependent smokers, those on the inhaler had a lower relapse rate than those on the other products. CONCLUSIONS Regardless of initial preferences, whether patients obtain their preferred form of NRT or one selected for them did not seem to affect outcome. This may be because smokers came to like particular products as they got used to them. Other things being equal, women may be better advised to use inhaler rather than gum and men vice versa.
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Affiliation(s)
- R West
- St George's Hospital Medical School, Cranmer Terrace, London, UK.
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26
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Meadows A, Hall N, Shah-Desai S, Low JL, Manners R. The House-Brackmann system and assessment of corneal risk in facial nerve palsy. Eye (Lond) 2000; 14 ( Pt 3A):353-7. [PMID: 11026999 DOI: 10.1038/eye.2000.87] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The House-Brackmann (HB) facial nerve grading system is widely used by ENT/head and neck surgeons, but is perhaps of less value to the ophthalmologist. Our aim was to assess the value of the numeric portion of this system in identifying those patients with facial nerve palsy who are at risk of corneal complications. We also sought to identify other factors that might be predictive of such complications. METHODS Forty-two patients (43 palsies) were studied prospectively. The HB grade was recorded together with measurements of levator function, upper lid closure, Bell's phenomenon, lagophthalmos, ectropion, lower lid retraction and corneal sensation. Conjunctival injection and corneal staining were also graded. ROC (receiver operating characteristic) curves were used to assess the value of each parameter as a screening test for corneal complications. RESULTS There was no cut-off of HB grade, levator function, Bell's phenomenon, ectropion or lower lid retraction that was sufficiently sensitive and specific to screen for corneal complications. However, on assessing lagophthalmos and upper lid closure, cut-offs with more favourable sensitivities and specificities were identified. CONCLUSIONS The numeric portion of the HB grading system is not a useful guide in identifying those patients with facial nerve palsy who are at risk of corneal complications. Measurements of lagophthalmos and upper lid closure, alone or in combination with other tests, may be of more value.
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Affiliation(s)
- A Meadows
- Southampton Eye Unit, Southampton General Hospital, UK
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27
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West R, Hajek P, Foulds J, Nilsson F, May S, Meadows A. A comparison of the abuse liability and dependence potential of nicotine patch, gum, spray and inhaler. Psychopharmacology (Berl) 2000; 149:198-202. [PMID: 10823399 DOI: 10.1007/s002130000382] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
RATIONALE Nicotine replacement therapy (NRT) in varying forms is becoming widely used. Clinicians, therapists and regulatory authorities are interested in the abuse liability and dependence potential of the different forms. OBJECTIVES To compare the abuse liability and dependence potential of nicotine gum, transdermal patch, spray and inhaler. METHODS 504 male and female smokers seeking help with stopping smoking were randomly allocated to the four products. Measures were taken at the designated quit date, then 1 week, 4 weeks, 12 weeks and 15 weeks later. Smokers were advised to use the product for up to 12 weeks. Those still using the product at the 12-week visit were advised to cease use by week 14. Measures included: pleasantness and satisfaction ratings at weeks 1 and 4 (used as a marker of abuse liability); ratings of feeling dependent on NRT at weeks 1, 4, 12 and 15 (used as a marker of subjective dependence); mood and physical symptoms ratings at weeks 12 and 15 (the change being used to assess physical dependence on NRT), continued usage of NRT at week 15 (used as an marker of behavioural dependence). RESULTS Average ratings of pleasantness were low. The nicotine patch was rated as less unpleasant to use than all other products. There were no significant differences between the products in terms of satisfaction or subjective dependence except at week 15 when no patch users rated themselves as dependent. Continued use of NRT at week 15 was related to rate of delivery of nicotine from the products - 2% for patch, 7% for gum and inhaler, 10% for spray (P<0.05 for linear association). Among those
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Affiliation(s)
- R West
- St George's Hospital Medical School, London, UK.
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28
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Bertsch H, Rudoler S, Needle MN, Malloy P, Sutton L, Belasco J, Meadows A, Goldwein J. Emergent/urgent therapeutic irradiation in pediatric oncology: patterns of presentation, treatment, and outcome. Med Pediatr Oncol 1998; 30:101-5. [PMID: 9403018 DOI: 10.1002/(sici)1096-911x(199802)30:2<101::aid-mpo6>3.0.co;2-m] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE We reviewed all pediatric cases referred for emergent/urgent therapy (requiring treatment within 48 hours) to identify frequency, patterns of presentation, and efficacy of therapy. We defined five categories of emergent/urgent therapy based on irradiated site and/or signs: Group I, spinal cord compression; Group II, respiratory compromise; Group III, infradiaphagmatic distress; Group IV, intracranial signs; Group V, pain. MATERIALS AND METHODS From 2/1/88-3/1/ 94, 104 children with 115 problems were referred by specialists at the Children's Hospital of Philadelphia. Diagnosis, nature of the emergency, and response were examined. Responses were categorized as complete resolution, improvement or stabilization, and progression. RESULTS The 104 children represented 12% of referrals during the study period. The most common tumors were CNS PNET and gliomas (20%); and neuroblastoma (20%). Forty-five problems occurred with newly diagnosed tumors and 70 after progression. Ninety-one episodes were managed with radiation therapy and 24 with other modalities. Patients with spinal cord/cauda equina (n = 33) compression improved (55%) or stabilized (30%). Patients with respiratory compromise from thoracic (n = 14) or abdominal (n = 5) disease had a response rate of 72%. Eight patients in group III had a 66% response. In Group IV (n = 16), 63% had complete responses and 19% had stabilization. Group V (n = 15) patients had a complete or partial response of 93%. CONCLUSION Approximately 10% of children referred for radiation therapy required emergent/urgent treatment. Eighty percent of patients achieved stabilization or showed improvement in signs and symptoms, indicating that radiotherapy is a valuable and reliable component of multimodal care in such situations.
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Affiliation(s)
- H Bertsch
- Department of Radiation Oncology, University of Pennsylvania Medical Center, Philadelphia 19104, USA
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29
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Abstract
OBJECTIVE The diagnosis and treatment of childhood cancer are extremely stressful experiences, with psychological sequelae which can persist many years after the end of treatment. This study investigated the relative contributions of general anxiety, treatment intensity, medical sequelae of treatment, and the subjective appraisal of life threat and treatment intensity to later posttraumatic stress symptoms, such as intrusive memories, avoidance, and hypervigilance. METHOD One hundred eighty-six childhood cancer survivors ages 8 through 20 years, off of treatment for more than 1 year, and their parents completed questionnaires. Medical sequelae of treatment and intensity of treatment were rated by a pediatric oncologist. RESULTS Significant, independent predictors of persistent posttraumatic stress symptoms included: 1) the survivor's retrospective subjective appraisal of life threat at the time of treatment, and the degree to which the survivor experienced the treatment as "hard" or "scary"; 2) the child's general level of anxiety; 3) history of other stressful experiences; 4) time since the termination of treatment (negative association); 5) female gender; and 6) family and social support. Mother's perception of treatment and life threat contributed to anxiety and subjective appraisal for the survivor, but did not independently contribute to posttraumatic stress symptoms. CONCLUSIONS Symptoms of posttraumatic stress seem to decrease with time, but are persistent in a subset of childhood cancer survivors. Other than time and gender, the predictors of posttraumatic stress symptoms are primarily subjective factors (ie, anxiety and subjective appraisal) rather than objective stressors of treatment and medical sequelae.
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Affiliation(s)
- M L Stuber
- UCLA School of Medicine, Los Angeles, California 90024-1759, USA
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30
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Hamre M, Hedberg J, Buckley J, Bhatia S, Finlay J, Meadows A, Nesbit M, Smithson A, Robison L. Langerhans cell histiocytosis: an exploratory epidemiologic study of 177 cases. Med Pediatr Oncol 1997; 28:92-7. [PMID: 8986144 DOI: 10.1002/(sici)1096-911x(199702)28:2<92::aid-mpo2>3.0.co;2-n] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
There is little information available regarding epidemiologic risk factors for Langerhans cell histiocytosis (LCH). An exploratory investigation was conducted using information obtained from parents of 177 cases of LCH diagnosed before 21 years of age (median 2 years). Utilizing data available from the Children's Cancer Group, LCH cases were compared to two matched control groups including 614 patients diagnosed with a variety of childhood cancers and 318 community controls. Questionnaire data included information on demographics, prenatal and perinatal factors, complications in the neonatal period, environmental exposures, family medical history, and childhood exposures. Factors found to be statistically significantly associated with an increased risk of LCH included: maternal urinary tract infection during the index pregnancy, feeding problems during infancy, and blood transfusions during infancy. Use of supplemental vitamins was associated with a significantly decreased risk of LCH. Results from this exploratory study provide a basis for speculation on potential etiologic risk factors for LCH. Future epidemiologic investigations of LCH need to consider the presenting disease characteristics in assessing possible etiologic factors.
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Affiliation(s)
- M Hamre
- Division of Hematology and Oncology, Children's Memorial Hospital, Chicago, Illinois, USA
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31
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Moshang T, Rundle AC, Graves DA, Nickas J, Johanson A, Meadows A. Brain tumor recurrence in children treated with growth hormone: the National Cooperative Growth Study experience. J Pediatr 1996; 128:S4-7. [PMID: 8627468 DOI: 10.1016/s0022-3476(96)70002-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
As of October 1993 the National Cooperative Growth Study included 1262 children with brain tumor who were treated with growth hormone. The type of brain tumor was specified in 947 (75%) of these children. The most common types were glioma, medulloblastoma, and craniopharyngioma, accounting for 91.3% of all those for which type was specified. Brain tumor recurred in 83 (6.6%) of the 1262 children over a total of 6115 patient-years at risk. The frequencies of tumor recurrence in children with low-grade glioma (18.1%), medulloblastoma (7.2%), and craniopharyngioma (6.4%) are lower than those in published reports of tumor recurrence in the general pediatric population with the same types of tumors. The analysis cannot conclusively show that no increased risk of tumor recurrence exists, however, because of the potential incompleteness of data reporting in the National Cooperative Growth Study. Nevertheless the findings are reassuring that children with the more common types of brain tumor who are treated with growth hormone do not seem to be at excessive risk for tumor recurrence.
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Affiliation(s)
- T Moshang
- Division of Endocrinology, Children's Hospital of Philadelphia, PA 19104, USA
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32
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Sklar C, Mertens A, Walter A, Mitchell D, Nesbit M, O'Leary M, Hutchinson R, Meadows A, Robison L. Final height after treatment for childhood acute lymphoblastic leukemia: comparison of no cranial irradiation with 1800 and 2400 centigrays of cranial irradiation. J Pediatr 1993; 123:59-64. [PMID: 8320626 DOI: 10.1016/s0022-3476(05)81537-9] [Citation(s) in RCA: 119] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We analyzed growth and final heights in 127 patients (68 female patients) treated for childhood acute lymphoblastic leukemia. Central nervous system prophylaxis included either no cranial radiation therapy (CRT) (n = 38), irradiation with 1800 centigrays (cGy) (n = 36), or irradiation with 2400 cGy (n = 53). None of the patients received spinal irradiation. Mean (+/- SEM) age at diagnosis was 6.4 +/- 0.25 years, mean height standard deviation score (SDS) at diagnosis was 0.28 +/- 0.12, and mean age at final height was 18.26 +/- 0.19 years. The change in height SDS between diagnosis and achievement of final height was significant for all treatment groups: -0.49 +/- 0.14, no CRT; -0.65 +/- 0.15, 1800 cGy; and -1.38 +/- 0.16, 2400 cGy. Irradiated patients had a greater loss in height SDS compared with the nonirradiated patients (p < 0.01), and those treated with 2400 cGy CRT had a greater decrease in final height SDS than the patients treated with 1800 cGy (p < 0.01). Both younger age and female sex were significantly associated with a greater decrease in height SDS in the patients treated with CRT; girls < or = 4 years of age at diagnosis had a mean loss in height SDS that was more than twice that observed for others treated with the same dose of CRT. Thus, although modern regimens for acute lymphoblastic leukemia (no CRT or 1800 cGy CRT) appear overall to have only a modest impact on final height, patients, especially girls, treated with 1800 cGy CRT at a young age remain at risk for clinically significant growth failure.
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Affiliation(s)
- C Sklar
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021
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Huff V, Reeve AE, Leppert M, Strong LC, Douglass EC, Geiser CF, Li FP, Meadows A, Callen DF, Lenoir G. Nonlinkage of 16q markers to familial predisposition to Wilms' tumor. Cancer Res 1992; 52:6117-20. [PMID: 1356625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Wilms' tumor (WT), a childhood cancer of the kidney, occurs in both familial and sporadic forms. Chromosome 11 genes have been implicated in the etiology of WT, and mutations in a gene at chromosomal band 11p13, WT1, have been identified in a few WT cases. However, 11p13 has been excluded as the site of the predisposition mutation segregating in several large WT families, which implies the existence of a non-11p familial predisposition gene. Recently, loss of heterozygosity for 16q markers located between chromosomal bands 16q13 and 16q22 has been reported in approximately 20% of sporadic Wilms' tumors. To determine if this region of 16q harbors the non-11p familial WT gene, a genetic linkage study of five WT families was undertaken. Using multipoint analyses, we ruled out genetic linkage of familial WT predisposition to 16q.
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Affiliation(s)
- V Huff
- Department of Biochemistry and Molecular Biology, University of Texas M.D. Anderson Cancer Center, Houston 77030
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34
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LaQuaglia MP, Stolar CJ, Krailo M, Exelby P, Siegel S, Meadows A, Hammond D. The role of surgery in abdominal non-Hodgkin's lymphoma: experience from the Childrens Cancer Study Group. J Pediatr Surg 1992; 27:230-5. [PMID: 1564623 DOI: 10.1016/0022-3468(92)90318-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
To determine the appropriate role of surgical intervention in non-Hodgkin's lymphoma primary to the abdomen, we analyzed the effect of multiple prognostic determinants on event-free survival for patients entered into the CCG-551 study. Eighty-four patients were identified with abdominal lymphoma and of these adequate data for analysis was available on 68 (81%). Variables of interest included: extent of disease at diagnosis, completeness of resection, use of bowel resection, radiation to the primary site, and sex/age/race. The median age on study was 8 years; 79% of patients were white and 85% were male. Thirty-three patients (49%) presented with localized disease. Laparotomy was performed in 67 children (99%) with complete gross resection in 28 (42%). Of the 10 reported surgical complications, 8 occurred in those with extensive disease who were incompletely resected. Radiation to the primary site was given in 60% of patients with median dose of 2,000 cGy. Analysis was performed both for the overall group and for the subgroup receiving optimal chemotherapy for histopathology. Variables with significant predictive effect on event-free survival in univariate analysis included extent of disease (P less than or equal to .001), complete resection (P less than or equal to .002), and use of bowel resection (P less than or equal to .004). However, in multivariate analysis, only extent of disease was an independent predictor of outcome. The data support a role for complete operative excision of localized lymphomas especially when accomplished with bowel resection. Aggressive attempts at debulking extensive retroperitoneal or mesenteric lymphomas are contraindicated.
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Affiliation(s)
- M P LaQuaglia
- Lymphoma Strategy Group, Childrens Cancer Study Group, Arcadia, CA
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35
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Huff V, Meadows A, Riccardi VM, Strong LC, Saunders GF. Parental origin of de novo constitutional deletions of chromosomal band 11p13. Am J Hum Genet 1990; 47:155-60. [PMID: 1971994 PMCID: PMC1683741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
One-half of all cases of Wilms tumor (WT), a childhood kidney tumor, show loss of heterozygosity at chromosomal band 11p13 loci, suggesting that mutation of one allele and subsequent mutation or loss of the homologous allele are important events in the development of these tumors. The previously reported nonrandom loss of maternal alleles in these tumors implied that the primary mutation occurred on the paternally derived chromosome and that it was "unmasked" by loss of the normal maternal allele. This, in turn, suggests that the paternally derived allele is more mutable than the maternal one. To investigate whether germinal mutations are seen with equal frequency in maternally versus paternally inherited chromosomes, we determined the parental origin of the de novo germinal 11p13 deletions in eight children by typing lymphocyte DNA from these children and from their parents for 11p13 RFLPs. In seven of the eight cases, the de novo deletion was of paternal origin. The one case of maternal origin was unremarkable in terms of the size or extent of the 11p13 deletion, and the child did develop WT. Transmission of 11p13 deletions by both maternal and paternal carriers of balanced translocations has been reported, although maternal inheritance predominates. These data, in addition to the general preponderance of paternally derived, de novo mutations at other loci, suggest that the increased frequency of paternal deletions we observed is due to an increased germinal mutation rate in males.
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Affiliation(s)
- V Huff
- Department of Biochemistry and Molecular Biology, University of Texas, M. D. Anderson Cancer Center, Houston 77030
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36
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Bleyer WA, Fallavollita J, Robison L, Balsom W, Meadows A, Heyn R, Sitarz A, Ortega J, Miller D, Constine L. Influence of age, sex, and concurrent intrathecal methotrexate therapy on intellectual function after cranial irradiation during childhood: a report from the Children's Cancer Study Group. Pediatr Hematol Oncol 1990; 7:329-38. [PMID: 2268533 DOI: 10.3109/08880019009033410] [Citation(s) in RCA: 66] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Standard IQ tests were performed in 70 children and adolescents 3.5-10 years (median 5 yrs) after 24 Gy cranial irradiation, with or without concurrent intrathecal methotrexate, for central nervous system prophylaxis of acute lymphoblastic leukemia. Lower IQ scores correlated with younger age, female gender, and concomitant intrathecal methotrexate therapy. Multivariate analysis identified age as the most important determinant of the three factors. The lowest IQ scores were observed in girls who were less than 5 years old at the time of irradiation and who received concurrent intrathecal methotrexate. The observed adverse contribution of simultaneous intrathecal methotrexate therapy on IQ outcome may have significant implications for school performance, peer relationships, and occupational expectations.
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Affiliation(s)
- W A Bleyer
- Childrens Cancer Study Group, Pasadena, California 91101
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37
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Wilson JF, Kjeldsberg CR, Sposto R, Jenkin RD, Chilcote RR, Coccia P, Exelby RR, Kersey J, Meadows A, Siegel S. The pathology of non-Hodgkin's lymphoma of childhood: II. Reproducibility and relevance of the histologic classification of "undifferentiated" lymphomas (Burkitt's versus non-Burkitt's). Hum Pathol 1987; 18:1008-14. [PMID: 3653876 DOI: 10.1016/s0046-8177(87)80217-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The Children's Cancer Study Group conducted prospective clinical trials of 608 children with non-Hodgkin's lymphoma from 1977 to 1983. In 1980, significant differences in survival of children with disseminated disease correlated with histologic diagnosis and the randomized treatment employed. A pathology reproducibility review showed the lymphoblastic lymphoma cases to be virtually 100 per cent distinguishable histologically from the nonlymphoblastic lymphomas (Burkitt's, non-Burkitt's, and "histiocytic"). However, diagnostic reproducibility of the pathologist-of-record was 59 per cent in the Burkitt's and non-Burkitt's lymphoma group. Therefore, 159 cases, agreed on by the pathologist-of-record and the "lymphoma panel" as Burkitt's (77 cases) or non-Burkitt's lymphoma (82 cases) and designated as the "reference diagnosis," were blindly reviewed twice each by two hematopathologists to yield the "review diagnoses." Consensus agreement was achieved in 67 per cent of cases overall, 82 per cent of Burkitt's and 54 per cent of non-Burkitt's lymphoma. Using the "reference diagnoses," we found that the relative frequency of Burkitt's and non-Burkitt's lymphoma was associated with the extent of disease at diagnosis (P = 0.06) but not with other prognostic factors. Despite the difficulties in histologic classification, analyses that used either "reference diagnoses" or "consensus review diagnoses" and that were adjusted for extent of disease consistently demonstrated significantly shorter event-free survival for patients having Burkitt's lymphoma; their failure rate was four times that for patient's with non-Burkitt's lymphoma. Newer cell biologic techniques hopefully will enhance histopathologic distinctions that remain the basis for diagnosis.
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Affiliation(s)
- J F Wilson
- Children's Cancer Study Group, Pasadena, CA 91101
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Littman P, Rosenstock J, Gale G, Krisch RE, Meadows A, Sather H, Coccia P, DeCamargo B. The somnolence syndrome in leukemic children following reduced daily dose fractions of cranial radiation. Int J Radiat Oncol Biol Phys 1984; 10:1851-3. [PMID: 6593316 DOI: 10.1016/0360-3016(84)90261-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A group of children with acute lymphocytic leukemia was studied to investigate if a reduction in daily dose fraction of cranial radiation would reduce the incidence of somnolence syndrome. Thirty-one evaluable patients received 100 rad X 18 cranial radiation therapy. Sixty-six similar evaluable patients were given 180 rad X 10. Both groups received the same chemotherapy including intrathecal methotrexate. Clinically detectable somnolence appeared in 58% of ech group without significant differences in the overall frequency or severity of somnolence (p greater than 0.5). This study failed to substantiate a radiation dose fraction size dependence for somnolence syndrome in children with acute lymphocytic leukemia.
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Wilson JF, Jenkin RD, Anderson JR, Chilcote RR, Coccia P, Exelby PR, Kersey J, Kjeldsberg CR, Kushner J, Meadows A. Studies on the pathology of non-Hodgkin's lymphoma of childhood. I. The role of routine histopathology as a prognostic factor. A report from the Children's Cancer Study Group. Cancer 1984; 53:1695-704. [PMID: 6697306 DOI: 10.1002/1097-0142(19840415)53:8<1695::aid-cncr2820530813>3.0.co;2-u] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Between April 1977, and August 1980, the Children's Cancer Study Group (CCSG) conducted a clinical trial of childhood non-Hodgkin's lymphoma (NHL), randomizing 256 patients to one of two treatment regimens. A 4-drug regimen (regimen 1, modified cyclophosphamide, Oncorin [vincristine], methotrexate, prednisone [COMP] ) was compared with a 10-drug regimen (regimen 2, modified LSA2-L2). Using the Rappaport classification, the review pathologist diagnosed the 213 evaluable tissue specimens as follows: lymphoblastic (LC), 73; Burkitt's tumor (BT), 40; "undifferentiated" non-Burkitt's type (NB), 67; large cell or "histiocytic" lymphoma (HI), 29; and other types (OT), 4. Concurrence in classification between the review and institutional pathologists was poor when using the above four categories; however, concurrence was 88% between the review pathologist and other hematopathologists, and 99% when classifying the specimens as lymphoblastic or nonlymphoblastic. For patients with nonlocalized disease, this randomized controlled study demonstrated a new important correlation of histopathology with the effectiveness of treatment. When analyzed without stratification into lymphoblastic and nonlymphoblastic types, the two regimens showed identical relapse free survival (RFS) curves for patients with nonlocalized involvement. However, when patients were stratified according to histologic classification, regimen 2 was superior to regimen 1 for patients with lymphoblastic lymphoma, achieving 74% RFS at 30 months compared to 31% for regimen 1 (P = 0.001). Conversely, those with nonlymphoblastic types (BT, NB, HI) treated with regimen 1 had a 58% RFS at 30 months compared to 32% for those treated on regimen 2 (P = 0.01). This study demonstrates that proper, routine histopathologic classification of NHL is the best criterion for choice of therapy in children with nonlocalized involvement. As a result of this study, all patients with nonlocalized disease, diagnosed after August 1980, were no longer randomized but were assigned to the appropriate treatment regimen based on prospective review of histopathology.
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Mahboubi S, Meadows A, Chatten J. Fibrous lesion of the bowel complicating the management of bilateral Wilms' tumor. Pediatr Radiol 1981; 11:49-51. [PMID: 6265856 DOI: 10.1007/bf00972045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A 31 month old black male with known bilateral Wilms' tumor, who had right nephrectomy and left lower pole heminephrectomy developed a palpable mass in the left lower quadrant. Several studies could not clearly determine the nature of the mass lesion, a laparotomy was performed, a keloid-like lesion was found in the bowel wall.
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D'Angio GJ, Meadows A, Miké V, Harris C, Evans A, Jaffe N, Newton W, Schweisguth O, Sutow W, Morris-Jones P. Decreased risk of radiation-associated second malignant neoplasms in actinomycin-D-treated patients. Cancer 1976; 37:1177-85. [PMID: 1253130 DOI: 10.1002/1097-0142(197602)37:2+<1177::aid-cncr2820370829>3.0.co;2-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
One hundred two long-term survivors of childhood cancers with second malignant neoplasms (SMNs) were collected from 10 institutions. Forty-seven cases fulfilling study criteria were studied to determine the risk of developing a SMN in irradiated fields after exposure to various chemotherapeutic agents. The case control method was used. The risk of developing such tumors was decreased by a factor of 7 in patients receiving actinomycin-D (AMD). The "protective" effect of AMD was more pronounced in patients receiving repeated courses of the agent. No change in relative risk was found for children given antifolates, the vinca alkaloids, or alkylating agents. AMD "protection" is an unexpected finding because the agent is an oncogen in animals and an enhancer of radiation, the latter being a known carcinogen. Possible mechanisms, which remain speculative, are discussed. These results indicate the need for careful long-term observation of cancer survivors to gain understanding of the late effects of multimodal treatments.
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Meadows A. An Address Delivered at the Opening of the Section of Obstetric Medicine. West J Med 1886; 2:356-8. [DOI: 10.1136/bmj.2.1338.356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Meadows A. An Address on the Progress and Work of the British Gynaecological Society. West J Med 1886; 1:181-3. [DOI: 10.1136/bmj.1.1309.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Meadows A. An Address on the British Gynaecological Society: Its Foundation and Objects. West J Med 1885; 1:646-50. [DOI: 10.1136/bmj.1.1265.646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Meadows A. Ovarian Menorrhagia. West J Med 1879; 2:45-7. [DOI: 10.1136/bmj.2.967.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Meadows A, Clarke WF. The Abuse of Hospitals. West J Med 1876. [DOI: 10.1136/bmj.2.833.807-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Meadows A. The Abuse of Hospitals. West J Med 1875. [DOI: 10.1136/bmj.1.737.222-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Meadows A, Scott J, Heath C, Edis AW, Squarey CE. The Hospital for Women, Soho Square. West J Med 1874. [DOI: 10.1136/bmj.1.700.726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Meadows A. Out-Patient Hospital Reform. West J Med 1871. [DOI: 10.1136/bmj.1.539.461-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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