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Corrente C, Satkumaran S, Segal A, Butters C, Fernandez C, Babl FE, Orme LM, Thursky K, Haeusler GM. Evaluating the accuracy and efficacy of an electronic medical record alert to identify paediatric patients with low-risk febrile neutropenia. Int J Med Inform 2023; 178:105205. [PMID: 37703799 DOI: 10.1016/j.ijmedinf.2023.105205] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/21/2023] [Accepted: 08/27/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Point-of-care decision support, embedded into electronic medical record (EMR) workflows, has the potential to improve efficiency, reduce unwarranted variation and improve patient outcomes. A clinical-facing best practice advisory (BPA) in the Epic EMR system was developed to identify children admitted with low-risk febrile neutropenia (FN) who should be considered for treatment at home after a brief inpatient stay. We evaluated the accuracy and impact of this BPA and identify areas for improvement. METHODS The low-risk FN BPA was co-designed with key-stakeholders and implemented after a one-month testing phase. Mixed methodology was used to collect and analyse data. The sensitivity and positive predictive value of the BPA was calculated using FN episodes captured in a prospectively collected database. Overall effectiveness was defined as the proportion of alerts resulting in completion of a FN risk assessment flowsheet. RESULTS Over the 12-month period 176 FN episodes were admitted. Overall, the alert had poor sensitivity (58%) and positive predictive value (75%), failing to trigger in 62 (35%) episodes. In the episodes where the alert did trigger, the alert was frequently dismissed by clinicians (76%) and the overall effectiveness was extremely low (3%). Manual review of each FN episode without a BPA identified important design limitations and incorrect workflow assumptions. DISCUSSION Given the poor sensitivity and limited impact on clinician behaviour the low-risk BPA, in its current form, has not been an effective intervention at this site. While work is ongoing to enhance the accuracy of the BPA, alternative EMR workflows are likely required to improve the clinical impact.
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Affiliation(s)
| | | | - Ahuva Segal
- Centre for Health Analytics, Melbourne Children's Campus, Parkville, Australia; Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia
| | - Coen Butters
- Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia
| | - Corinne Fernandez
- Children's Cancer Centre, Royal Children's Hospital, Parkville, Australia
| | - Franz E Babl
- Murdoch Children's Research Institute, Parkville, Australia; Centre for Health Analytics, Melbourne Children's Campus, Parkville, Australia; Department of Emergency Medicine, Royal Children's Hospital, Parkville, Australia; Department of Critical Care, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia
| | - Lisa M Orme
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia; Children's Cancer Centre, Royal Children's Hospital, Parkville, Australia
| | - Karin Thursky
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia; NHMRC National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia; The Paediatric Integrated Cancer Service, Victoria, Australia
| | - Gabrielle M Haeusler
- Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia; Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia; NHMRC National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia; The Paediatric Integrated Cancer Service, Victoria, Australia; Infection Diseases Unit, Department of General Medicine, Royal Children's Hospital, Parkville, Australia.
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2
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Suratwala S, Kommareddy D, Duvvuri P, Woltmann J, Segal A, Krauss E. Cost-effectiveness and clinical utility of universal pre-admission MRSA screening in total joint arthroplasty patients. J Hosp Infect 2023; 138:27-33. [PMID: 37277014 DOI: 10.1016/j.jhin.2023.05.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND For patients undergoing total joint arthroplasty (TJA), pre-admission meticillin-resistant Staphylococcus aureus (MRSA) nasal screening has been widely adopted to prevent postoperative joint infection. However, screening cost-effectiveness and clinical utility have not been adequately evaluated. AIM To assess the MRSA infection rate, associated costs, and costs of screening at our institution, before and after screening implementation. METHODS This was a retrospective cohort study examining patients who underwent TJA at a health system in New York State, between 2005 and 2016. Patients were divided into the 'no-screening' group if the operation occurred prior to adoption of the MRSA screening protocol in 2011 and the 'screening' group if afterwards. The number of MRSA joint infections, cost of each infection, and costs associated with preoperative screening were recorded. Fisher's exact test and cost comparison analysis were performed. FINDINGS The no-screening group had four MRSA infections in 6088 patients over a seven-year period, whereas the screening group had two in 5177 patients over five years. Fisher's exact test showed no significant association between screening and MRSA infection rate (P = 0.694). The cost of postoperative MRSA joint infection treatment was US$40,919.13 per patient, whereas annual nasal screening was US$103,999.97. CONCLUSION At our institution, MRSA screening had little impact on infection rates and led to increased costs, with 2.5 MRSA infections required annually to meet the costs of screening. Therefore, the screening protocol may be best suited for high-risk populations, rather than the average TJA patient. The authors recommend a similar clinical utility and cost-effectiveness analysis at other institutions implementing MRSA screening programmes.
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Affiliation(s)
- S Suratwala
- Center for Orthopaedic Excellence at Syosset Hospital, Syosset, NY, USA
| | - D Kommareddy
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - P Duvvuri
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
| | - J Woltmann
- Center for Orthopaedic Excellence at Syosset Hospital, Syosset, NY, USA
| | - A Segal
- Center for Orthopaedic Excellence at Syosset Hospital, Syosset, NY, USA
| | - E Krauss
- Center for Orthopaedic Excellence at Syosset Hospital, Syosset, NY, USA
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Gutteridge DS, Segal A, McNeil JJ, Beilin L, Brodtmann A, Chowdhury EK, Egan GF, Ernst ME, Hussain SM, Reid CM, Robb CE, Ryan J, Woods RL, Keage HA, Jamadar S. The relationship between long-term blood pressure variability and cortical thickness in older adults. Neurobiol Aging 2023; 129:157-167. [PMID: 37331246 DOI: 10.1016/j.neurobiolaging.2023.05.011] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/02/2023] [Accepted: 05/17/2023] [Indexed: 06/20/2023]
Abstract
High blood pressure variability (BPV) is a risk factor for cognitive decline and dementia, but its association with cortical thickness is not well understood. Here we use a topographical approach, to assess links between long-term BPV and cortical thickness in 478 (54% men at baseline) community dwelling older adults (70-88 years) from the ASPirin in Reducing Events in the Elderly NEURO sub-study. BPV was measured as average real variability, based on annual visits across three years. Higher diastolic BPV was significantly associated with reduced cortical thickness in multiple areas, including temporal (banks of the superior temporal sulcus), parietal (supramarginal gyrus, post-central gyrus), and posterior frontal areas (pre-central gyrus, caudal middle frontal gyrus), while controlling for mean BP. Higher diastolic BPV was associated with faster progression of cortical thinning across the three years. Diastolic BPV is an important predictor of cortical thickness, and trajectory of cortical thickness, independent of mean blood pressure. This finding suggests an important biological link in the relationship between BPV and cognitive decline in older age.
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Affiliation(s)
- D S Gutteridge
- Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), University of South Australia, Adelaide, South Australia, Australia.
| | - A Segal
- Turner Institute for Brain & Mental Health, Monash University, Melbourne, Victoria, Australia
| | - J J McNeil
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - L Beilin
- School of Medicine, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - A Brodtmann
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - E K Chowdhury
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - G F Egan
- Turner Institute for Brain & Mental Health, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - M E Ernst
- Department of Family Medicine, Carver College of Medicine. The University of Iowa, Iowa City, IA, USA; Department of Pharmacy Practice and Science, College of Pharmacy, Carver College of Medicine. The University of Iowa, Iowa City, IA, USA
| | - S M Hussain
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia; Department of Medical Education, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - C M Reid
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia; School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - C E Robb
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - J Ryan
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - R L Woods
- School of Public Health & Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - H A Keage
- Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), University of South Australia, Adelaide, South Australia, Australia
| | - S Jamadar
- Turner Institute for Brain & Mental Health, Monash University, Melbourne, Victoria, Australia; Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
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Massalha I, Segal A, Moskovitz M, Yakobson A, Zabit R, Stemmer S, Shalata W, Dudnik Y, Markel G, Geva-Zatorsky N, Meirovitz A. 76TiP Fecal microbiota transplantation to improve efficacy of immune checkpoint inhibitors in metastatic lung cancer. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00330-1] [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: 04/03/2023]
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Gelbart B, Vidmar S, Stephens D, Cheng D, Thompson J, Segal A, Gadish T, Carlin J. Characteristics and outcomes of children receiving intensive care therapy within 12 hours following a medical emergency team event. CRIT CARE RESUSC 2021; 23:254-261. [PMID: 38046070 PMCID: PMC10692518 DOI: 10.51893/2021.3.oa2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: To describe characteristics and outcomes of children requiring intensive care therapy (ICT) within 12 hours following a medical emergency team (MET) event. Design: Retrospective cohort study. Setting: Quaternary paediatric hospital. Patients: Children experiencing a MET event. Measurements and main results: Between July 2017 and March 2019, 890 MET events occurred in 566 patients over 631 admissions. Admission to intensive care followed 183/890 (21%) MET events. 76/183 (42%) patients required ICT, defined as positive pressure ventilation or vasoactive support in intensive care, within 12 hours. Older children had a lower risk of requiring ICT than infants aged < 1 year (age 1-5 years [risk difference, -6.4%; 95% CI, -11% to -1.6%; P = 0.01] v age > 5 years [risk difference, -8.0%; 95% CI, -12% to -3.8%; P < 0.001]), while experiencing a critical event increased this risk (risk difference, 16%; 95% CI, 3.3-29%; P = 0.01). The duration of respiratory support and intensive care length of stay was approximately double in patients requiring ICT (ratio of geometric means, 2.0 [95% CI, 1.4-3.0] v 2.1 [95% CI, 1.5-2.8]; P < 0.001) and the intensive care mortality increased (risk difference, 9.6%; 95% CI, 2.4-17%; P = 0.01). Heart rate, oxygen saturation and respiratory rate were the most commonly measured vital signs in the 6 hours before the MET event. Conclusions: Approximately one-fifth of MET events resulted in intensive care admission and nearly half of these required ICT within 12 hours. This group had greater duration of respiratory support, intensive care and hospital length of stay, and higher mortality. Age < 1 year and a critical event increased the risk of ICT.
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Affiliation(s)
- Ben Gelbart
- Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia
| | - Suzanna Vidmar
- Clinical Epidemiology Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - David Stephens
- Decision Support Unit, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Daryl Cheng
- Department of Paediatrics, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Jenny Thompson
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Ahuva Segal
- Royal Children's Hospital, Melbourne, VIC, Australia
| | - Tali Gadish
- Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
- University of Melbourne, Melbourne, VIC, Australia
| | - John Carlin
- Clinical Epidemiology Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
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Catalano AC, Pittet LF, Choo S, Segal A, Stephens D, Cranswick NE, Gwee A. Impact of Antibiotic Allergy Labels on Patient Outcomes in a Tertiary Paediatric Hospital. Br J Clin Pharmacol 2021; 88:1107-1114. [PMID: 34388858 DOI: 10.1111/bcp.15038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Antibiotic allergies are reported in 5 to 15% of children. This study aimed to evaluate the impact of common β-lactam antibiotic allergy labels (AALs) on hospital treatment, focussing on length of stay and appropriateness of antibiotic prescribing. STUDY DESIGN Retrospective cohort study over 21-months at the Royal Children's Hospital Melbourne, Australia. A subset of children with the most common β-lactam allergies, and who required admission for intravenous antibiotics over a 12-month period, was analysed for appropriateness of prescribing. Non-allergic patients were matched to evaluate associations between AALs and hospital treatment. RESULTS There were 98,912 children admitted over the study period, of whom 938 (1%) had at least one AAL on first admission. Of all encounters, 5145 (2.5%) were for children with AALs. The most common AALs were to amoxicillin and amoxicillin-clavulanic acid combinations (40.8%), cefalexin (14.4%) and trimethoprim-sulfamethoxazole (9.7%). For the subset, there were 66 admissions for children who required intravenous antibiotics. Documentation was adequate for 27% of AALs. Inappropriate prescribing occurred in almost half (47%). Hospital stay was longer for children with AALs (median 4.7 days; IQR 2.3 to 9.2) compared to non-allergic controls (median 3.9 days; IQR 1.9 to 6.8; P=0.02). Children with AALs were more likely to receive restricted antibiotics (aOR 3.03; 95%CI, 1.45 to 6.30; p=0.003). CONCLUSION This is the first study to demonstrate high rates of inappropriate prescribing in children with AALs. Children with AALs were significantly more likely to receive restricted antibiotics and had a longer length of stay compared with non-allergic controls.
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Affiliation(s)
- Anthony C Catalano
- Departments of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Laure F Pittet
- Departments of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Melbourne, Australia
| | - Sharon Choo
- Departments of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Allergy and Immunology, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Ahuva Segal
- Departments of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Melbourne, Australia
| | - David Stephens
- Departments of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Noel E Cranswick
- Departments of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Amanda Gwee
- Departments of General Medicine, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Australia
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7
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Haeusler GM, Gaynor L, Teh B, Babl FE, Orme LM, Segal A, Mechinaud F, Bryant PA, Phillips B, Lourenco RDA, Slavin MA, Thursky KA. Home-based care of low-risk febrile neutropenia in children-an implementation study in a tertiary paediatric hospital. Support Care Cancer 2020; 29:1609-1617. [PMID: 32740894 DOI: 10.1007/s00520-020-05654-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/24/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Home-based management of low-risk febrile neutropenia (FN) is safe, improves quality of life and reduces healthcare expenditure. A formal low-risk paediatric program has not been implemented in Australia. We aimed to describe the implementation process and evaluate the clinical impact. METHOD This prospective study incorporated three phases: implementation, intervention and evaluation. A low-risk FN implementation toolkit was developed, including a care-pathway, patient information, home-based assessment and educational resources. The program had executive-level endorsement, a multidisciplinary committee and a nurse specialist. Children with cancer and low-risk FN were eligible to be transferred home with a nurse visiting daily after an overnight period of observation for intravenous antibiotics. Low-risk patients were identified using a validated decision rule, and suitability for home-based care was determined using disease, chemotherapy and patient-level criteria. Plan-Do-Study-Act methodology was used to evaluate clinical impact and safety. RESULTS Over 18 months, 292 children with FN were screened: 132 (45%) were low-risk and 63 (22%) were transferred to home-based care. Compared with pre-implementation there was a significant reduction in in-hospital median LOS (4.0 to 1.5 days, p < 0.001) and 291 in-hospital bed days were saved. Eight (13%) patients needed readmission and there were no adverse outcomes. A key barrier was timely screening of all patients and program improvements, including utilising the electronic medical record for patient identification, are planned. CONCLUSION This program significantly reduces in-hospital LOS for children with low-risk FN. Ongoing evaluation will inform sustainability, identify areas for improvement and support national scale-up of the program.
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Affiliation(s)
- Gabrielle M Haeusler
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. .,University of Melbourne, Parkville, Victoria, Australia. .,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia. .,The Paediatric Integrated Cancer Service, Parkville, Victoria, Australia. .,Infection Diseases Unit, Department of General Medicine, Royal Children's Hospital, Parkville, Victoria, Australia. .,Murdoch Children's Research Institute, Parkville, Victoria, Australia.
| | - Lynda Gaynor
- The Paediatric Integrated Cancer Service, Parkville, Victoria, Australia.,Hospital In The Home Department, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Benjamin Teh
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Franz E Babl
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Emergency Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Lisa M Orme
- Children's Cancer Centre, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Ahuva Segal
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Francoise Mechinaud
- Unité d'hématologie immunologie pédiatrique, Hopital Robert Debré, APHP Nord Université de Paris, Paris, France
| | - Penelope A Bryant
- Infection Diseases Unit, Department of General Medicine, Royal Children's Hospital, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Hospital In The Home Department, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Bob Phillips
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, New South Wales, Australia
| | - Monica A Slavin
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.,Department of Medicine, University of Melbourne, Parkville, Victoria, 3010, Australia.,Victorian Infectious Diseases Service, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Karin A Thursky
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.,Department of Medicine, University of Melbourne, Parkville, Victoria, 3010, Australia.,Victorian Infectious Diseases Service, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.,NHMRC National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
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Gelbart B, Bitker L, Segal A, Hutchinson A, Soh N, Maybury T. Haemodynamic response to fluid boluses in children after cardiac surgery: a technical report. CRIT CARE RESUSC 2019; 21:132-138. [PMID: 31142244] [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: 06/09/2023]
Abstract
OBJECTIVE To describe the haemodynamic response to fluid boluses (FB) in children after cardiac surgery. DESIGN A prospective observational pilot study. SETTING Single-centre, paediatric cardiac intensive care unit. PARTICIPANTS Children after cardiac surgery. INTERVENTIONS FB of 0.9% saline, 4% albumin or modified ultrafiltrate blood administered in less than 30 minutes. MAIN OUTCOME MEASURES Heart rate, arterial blood pressure, central venous pressure, oesophageal temperature, and end-tidal carbon dioxide were measured continuously and reported minutely from 5 minutes before and 30 minutes after FB. A mean arterial pressure (MAP)-responsive episode was defined as a 10% increase in MAP from baseline. RESULTS There were 21 FB recorded in 9 patients. Most patients (n = 8) weighed ≤ 6 kg, and three had univentricular circulation. Fourteen FB (67%) were 4% albumin and 15 (71%) were ≤ 7.5 mL/kg. There were nine MAP-responsive episodes (43%). Episodes of MAP responsiveness had a median MAP increment from baseline of 5 mmHg (interquartile range [IQR], 5-7) and 5 mmHg (IQR, 2-17) at 15 minutes and 30 minutes, respectively, significantly higher when compared with non-responsive episodes (median, 1 mmHg [IQR, -2 to 3]; and median, -1 mmHg [IQR, -3 to 1]; P < 0.01). In MAP-responsive episodes, median time to response was 6 minutes (IQR, 3-12) and seven episodes (78%) dissipated at a median of 2 minutes after response (IQR, 1-8). MAP response was not associated with fluid volume nor fluid composition. CONCLUSION In this study, the haemodynamic response to FB in children is infrequent and unsustained. Larger studies are required to demonstrate the pattern of haemodynamic response of FB in critically ill children.
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Affiliation(s)
- Ben Gelbart
- Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, VIC, Australia.
| | - Laurent Bitker
- Department of Intensive Care, Austin Health, Melbourne, VIC, Australia
| | - Ahuva Segal
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Adrian Hutchinson
- Division of Information and Communication Technology, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Norman Soh
- Division of Information and Communication Technology, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Tim Maybury
- Biomedical Engineering Department, Royal Children's Hospital, Melbourne, VIC, Australia
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Amar L, Le M, Ghazawi FM, Rahme E, Segal A, Netchiporouk E, Popradi G, Moreau L, Roshdy O, Sasseville D, Litvinov IV. Prevalence of human T cell lymphotropic virus 1 infection in Canada. ACTA ACUST UNITED AC 2019; 26:e3-e5. [PMID: 30853802 DOI: 10.3747/co.26.4593] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Human T cell lymphotropic virus 1 (htlv-1) is a bloodborne retrovirus that infects at least 5–20 million people around the world [...]
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Affiliation(s)
- L Amar
- Division of Dermatology, McGill University, Montreal, QC
| | - M Le
- Division of Dermatology, McGill University, Montreal, QC
| | - F M Ghazawi
- Division of Dermatology, University of Ottawa, Ottawa, ON
| | - E Rahme
- Division of Dermatology, McGill University, Montreal, QC
| | - A Segal
- Division of Dermatology, McGill University, Montreal, QC
| | - E Netchiporouk
- Division of Dermatology, McGill University, Montreal, QC
| | - G Popradi
- Division of Dermatology, McGill University, Montreal, QC
| | - L Moreau
- Division of Dermatology, McGill University, Montreal, QC
| | - O Roshdy
- Division of Dermatology, McGill University, Montreal, QC
| | - D Sasseville
- Division of Dermatology, McGill University, Montreal, QC
| | - I V Litvinov
- Division of Dermatology, McGill University, Montreal, QC
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Gelbart B, Bitker L, Segal A, Soh N, Maybury T, Hutchinson A. Haemodynamic Response to Fluid Bolus Therapy in Children Following Cardiac Surgery. Aust Crit Care 2019. [DOI: 10.1016/j.aucc.2018.11.036] [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: 11/15/2022] Open
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11
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Alvarez S, Chan J, William J, Felten C, Hanks D, Northrup A, Jaiswal D, Jansson M, Phillips T, Segal A, Satnick I, McDonald H, Little H, Pierce C, Wynne B, Carnahan J, Reddy S, Inzunza H, Oroudjev E. PD-L1 Detection and Assay Performance in Squamous Cell Carcinoma of the Head and Neck Using PD-L1 IHC 28-8 pharmDx. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx374.016] [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: 11/12/2022] Open
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Hjerpe A, Ascoli V, Bedrossian CWM, Boon ME, Creaney J, Davidson B, Dejmek A, Dobra K, Fassina A, Field A, Firat P, Kamei T, Kobayashi T, Michael CW, Önder S, Segal A, Vielh P. Guidelines for the Cytopathologic Diagnosis of Epithelioid and Mixed-Type Malignant Mesothelioma: a secondary publication. Cytopathology 2016; 26:142-56. [PMID: 26052757 DOI: 10.1111/cyt.12250] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma. DATA SOURCES Cytopathologists with an interest in the field involved in the International Mesothelioma Interest Group (IMIG) and the International Academy of Cytology (IAC) contributed to this update. Reference material includes peer-reviewed publications and textbooks. RATIONALE This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in Cape Town.
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Affiliation(s)
- A Hjerpe
- Division of Clinical Pathology/Cytology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Huddinge, Sweden
| | - V Ascoli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Rome, Italy
| | | | - M E Boon
- Leiden Cytology and Pathology Laboratory, Lieveren, The Netherlands
| | - J Creaney
- National Centre for Asbestos Related Disease, School of Medicine and Pharmacology, University of Western Australia, QEII Medical Centre, Perth, WA, Australia
| | - B Davidson
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - A Dejmek
- Department of Laboratory Medicine in Malmö, Lund University, Malmö University Hospital, Malmö, Sweden
| | - K Dobra
- Division of Clinical Pathology/Cytology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Huddinge, Sweden
| | - A Fassina
- Department of Medicine, University of Padova, Padova, Italy
| | - A Field
- Department of Anatomical Pathology, St Vincents Hospital, Sydney, NSW, Australia
| | - P Firat
- Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - T Kamei
- Division of Pathology, Yamaguchi Grand Medical Center, Hofu, Japan
| | - T Kobayashi
- Cancer Education and Research Center, Osaka University Graduate School of Medicine, Osaka, Japan
| | - C W Michael
- Department of Pathology, Case Western Reserve University/University Hospitals Case Medical Center, Cleveland, OH, USA
| | - S Önder
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - A Segal
- Department of Tissue Pathology, PathWest Laboratory Medicine WA, QE2 Medical Centre, Perth, WA, Australia
| | - P Vielh
- Department of Biopathology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
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Nowak AK, Cook AM, McDonnell AM, Millward MJ, Creaney J, Francis RJ, Hasani A, Segal A, Musk AW, Turlach BA, McCoy MJ, Robinson BWS, Lake RA. A phase 1b clinical trial of the CD40-activating antibody CP-870,893 in combination with cisplatin and pemetrexed in malignant pleural mesothelioma. Ann Oncol 2015; 26:2483-90. [PMID: 26386124 DOI: 10.1093/annonc/mdv387] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 09/11/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Data from murine models suggest that CD40 activation may synergize with cytotoxic chemotherapy. We aimed to determine the maximum tolerated dose (MTD) and toxicity profile and to explore immunological biomarkers of the CD40-activating antibody CP-870,893 with cisplatin and pemetrexed in patients with malignant pleural mesothelioma (MPM). PATIENTS AND METHODS Eligible patients had confirmed MPM, ECOG performance status 0-1, and measurable disease. Patients received cisplatin 75 mg/m(2) and pemetrexed 500 mg/m(2) on day 1 and CP-870,893 on day 8 of a 21-day cycle for maximum 6 cycles with up to 6 subsequent cycles single-agent CP-870,893. Immune cell subset changes were examined weekly by flow cytometry. RESULTS Fifteen patients were treated at three dose levels. The MTD of CP-870,893 was 0.15 mg/kg, and was exceeded at 0.2 mg/kg with one grade 4 splenic infarction and one grade 3 confusion and hyponatraemia. Cytokine release syndrome (CRS) occurred in most patients (80%) following CP-870,893. Haematological toxicities were consistent with cisplatin and pemetrexed chemotherapy. Six partial responses (40%) and 9 stable disease (53%) as best response were observed. The median overall survival was 16.5 months; the median progression-free survival was 6.3 months. Three patients survived beyond 30 months. CD19+ B cells decreased over 6 cycles of chemoimmunotherapy (P < 0.001) with a concomitant increase in the proportion of CD27+ memory B cells (P < 0.001) and activated CD86+CD27+ memory B cells (P < 0.001), as an immunopharmacodynamic marker of CD40 activation. CONCLUSIONS CP-870,893 with cisplatin and pemetrexed is safe and tolerable at 0.15 mg/kg, although most patients experience CRS. While objective response rates are similar to chemotherapy alone, three patients achieved long-term survival. AUSTRALIA NEW ZEALAND CLINICAL TRIALS REGISTRY NUMBER ACTRN12609000294257.
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Affiliation(s)
- A K Nowak
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth
| | - A M Cook
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth
| | - A M McDonnell
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth
| | - M J Millward
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth School of Medicine and Pharmacology
| | - J Creaney
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth
| | - R J Francis
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth Department of Nuclear Medicine
| | - A Hasani
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth
| | | | - A W Musk
- School of Medicine and Pharmacology Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth School of Population Health
| | - B A Turlach
- Centre for Applied Statistics, University of Western Australia, Perth
| | - M J McCoy
- School of Medicine and Pharmacology St John of God Hospital, Perth, Australia
| | - B W S Robinson
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth
| | - R A Lake
- School of Medicine and Pharmacology National Research Centre for Asbestos Related Diseases, University of Western Australia, Perth
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Sanelli PC, Kishore S, Gupta A, Mangat H, Rosengart A, Kamel H, Segal A. Delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: proposal of an evidence-based combined clinical and imaging reference standard. AJNR Am J Neuroradiol 2014; 35:2209-14. [PMID: 24263697 DOI: 10.3174/ajnr.a3782] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY Aneurysmal subarachnoid hemorrhage is associated with high morbidity and mortality, with delayed neurologic deficits from delayed cerebral ischemia contributing to a large portion of the adverse outcomes in this patient population. There is currently no consensus reference standard for establishing the diagnosis of delayed cerebral ischemia either in the research or clinical settings, ultimately limiting strategies for preventing delayed infarction and permanent neurologic deficits. There are currently both clinical and imaging-based criteria for the diagnosis of delayed neurologic deficits and vasospasm, respectively, however, neither clinical nor angiographic assessment alone has been shown to identify patients who develop adverse outcomes from delayed infarction. Thus, the purpose of this work is to propose a 3-tiered combined imaging and clinical reference standard based on evidence from the literature to standardize the diagnosis of delayed cerebral ischemia, both to allow consistency across research studies and to ultimately improve outcomes in the clinical setting.
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Affiliation(s)
- P C Sanelli
- From the Departments of Radiology, Division of Neuroradiology (P.C.S., S.K., A.G.) Public Health (P.C.S.)
| | - S Kishore
- From the Departments of Radiology, Division of Neuroradiology (P.C.S., S.K., A.G.)
| | - A Gupta
- From the Departments of Radiology, Division of Neuroradiology (P.C.S., S.K., A.G.)
| | - H Mangat
- Neurology, Division of Stroke and Critical Care (H.M., A.R., H.K., A.S.), NewYork-Presbyterian Hospital-Weill Cornell Campus, New York, New York
| | - A Rosengart
- Neurology, Division of Stroke and Critical Care (H.M., A.R., H.K., A.S.), NewYork-Presbyterian Hospital-Weill Cornell Campus, New York, New York
| | - H Kamel
- Neurology, Division of Stroke and Critical Care (H.M., A.R., H.K., A.S.), NewYork-Presbyterian Hospital-Weill Cornell Campus, New York, New York
| | - A Segal
- Neurology, Division of Stroke and Critical Care (H.M., A.R., H.K., A.S.), NewYork-Presbyterian Hospital-Weill Cornell Campus, New York, New York
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Roberts SE, Rogers S, Segal A, Purcell S, Broomfield H, Fabris G, Calonge-Contreras M, Billet J, Restrick L, Stern M. S113 Long Term Exercise (LTE) For COPD Patients Post-Pulmonary Rehabilitation (PR) Prolongs the Duration of Benefits Derived from PR: Abstract S113 Table 1. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.118] [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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Roberts SE, Kettle G, Rogers S, Segal A, Purcell S, Fabris G, Broomfield H, Calonge-Contreras M, Billet J, Restrick L, Stern M. P149 Piloting and evaluating post-pulmonary rehabilitation (PR) long-term exercise (LTE) for COPD patients. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054c.149] [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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Vermolen FJ, Segal A, Gefen A. A pilot study of a phenomenological model of adipogenesis in maturing adipocytes using Cahn-Hilliard theory. Med Biol Eng Comput 2011; 49:1447-57. [PMID: 21761246 PMCID: PMC3223594 DOI: 10.1007/s11517-011-0802-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 07/02/2011] [Indexed: 11/28/2022]
Abstract
We consider the accumulation and formation of lipid droplets in an adipocyte cell. The process incorporates adipose nucleation (adipogenesis) and growth. At later stages, there will be merging of droplets and growth of larger droplets at the expense of the smaller droplets, which will essentially undergo lipolysis. The process is modeled by the use of the Cahn–Hilliard equation, which is mass-conserving and allows the formation of secondary phases in the context of spinodal decomposition. The volume of fluid (VOF) method is used to determine the total area that is occupied by the lipids in a given cross section. Further, we present an algorithm, applicable to all kinds of grids (structured or unstructured) in two spatial dimensions, to count the number of lipid droplets and the portion of the domain of computation that is occupied by the lipid droplets as a function of time during the process. The results are preliminary and are validated from a qualitative point using experiments carried out on cell cultures. It turns out that the Cahn–Hilliard theory can model many of the features during adipogenesis qualitatively.
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Affiliation(s)
- F J Vermolen
- Delft Institute of Applied Mathematics, Delft University of Technology, Delft, The Netherlands.
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Seldin DC, Andrea N, Berenbaum I, Berk JL, Connors L, Dember LM, Doros G, Fennessey S, Finn K, Girnius S, Lerner A, Libbey C, Meier-Ewert HK, O'Connell R, O'Hara C, Quillen K, Ruberg FL, Sam F, Segal A, Shelton A, Skinner M, Sloan JM, Wiesman JF, Sanchorawala V. High-dose melphalan and autologous stem cell transplantation for AL amyloidosis: recent trends in treatment-related mortality and 1-year survival at a single institution. Amyloid 2011; 18 Suppl 1:127-9. [PMID: 21838459 PMCID: PMC5601311 DOI: 10.3109/13506129.2011.574354047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Treatment with high-dose melphalan chemotherapy supported by hematopoietic rescue with autologous stem cells produces high rates of hematologic responses and improvement in survival and organ function for patients with AL amyloidosis. Ongoing clinical trials explore pre-transplant induction regimens, post-transplant consolidation or maintenance approaches, and compare transplant to non-transplant regimens. To put these studies into context, we reviewed our recent experience with transplant for AL amyloidosis in the Amyloid Treatment and Research Program at Boston Medical Center and Boston University School of Medicine. Over the past 10 years, there was a steady reduction in rates of treatment-related mortality and improvement in 1-year survival, now approximately 5% and 90%, respectively, based upon an intention-to-treat analysis. Median overall survival of patients treated with this approach at our center exceeds 7.5 years.
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Affiliation(s)
- D C Seldin
- Clinical Trials Office, Boston University School of Medicine and Boston Medical Center, Boston, MA 02118, USA
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Dul EC, van Ravenswaaij-Arts CMA, Groen H, van Echten-Arends J, Land JA, Tyulenev Y, Naumenko V, Kurilo L, Shileiko L, Segal A, Klimova R, Kushch A, Ribas-Maynou J, Garcia-Peiro A, Abad C, Amengual MJ, Benet J, Navarro J, Colasante A, Lobascio AM, Scarselli F, Minasi MG, Alviggi E, Rubino P, Casciani V, Pena R, Varricchio MT, Litwicka K, Ferrero S, Zavaglia D, Franco G, Nagy ZP, Greco E, Romany L, Meseguer M, Garcia-Herrero S, Pellicer A, Garrido N, Dam A, Pijnenburg A, Hendriks JC, Westphal JR, Ramos L, Kremer JAM, Eertmans F, Bogaert V, Puype B, Geisler W, Clusmann C, Klopsch I, Strowitzki T, Eggert-Kruse W, Maettner R, Isachenko E, Isachenko V, Strehler E, Sterzik K, Band G, Madgar I, Brietbart H, Naor Z, Cunha-Filho JS, Souza CA, Krebs VG, Santos KD, Koff WJ, Stein A, Hammoud I, Albert M, Bergere M, Bailly M, Boitrelle F, Vialard F, Wainer R, Izard V, Selva J, Cohen - Bacrie P, Belloc S, de mouzon J, Cohen-Bacrie M, Alvarez S, Junca AM, Dumont M, Douard S, Prisant N, Tomita K, Hashimoto S, Akamatsu Y, Satoh M, Mori R, Inoue T, Ohnishi Y, Ito K, Nakaoka Y, Morimoto Y, Smith VJH, Ahuja KK, Atig F, Raffa M, Sfar MT, Saad A, Ajina M, Braga DPAF, Halpern G, Figueira RCS, Setti AS, Iaconelli Jr. A, Borges Jr. E, Medeiros GS, Borges Jr. E, Pasqualotto EB, Pasqualotto FF, Nadalini M, Tarozzi N, Di Santo M, Borini A, Lopez-Fernandez C, Arroyo F, Caballero P, Nunez-Calonge R, Fernandez JL, Gosalvez J, Gosalvez J, Lopez-Fernandez C, Gosalbez A, Cortes S, Caballero P, Nunez-Calonge R, Zikopoulos K, Lazaros L, Vartholomatos G, Kaponis A, Makrydimas G, Plachouras N, Sofikitis N, Kalantaridou S, Hatzi E, Georgiou I, Belloc S, de Mouzon J, Cohen-Bacrie M, Junca AM, Dumont M, Amar E, Cohen-Bacrie P, Vuillaume ML, Brugnon F, Artonne C, Janny L, Pons-Rejraji H, Fedder J, Bosco L, Ruvolo G, Bruccoleri AM, Manno M, Roccheri MC, Cittadini E, Bochev I, Gavrilov P, Kyurkchiev S, Shterev A, Carlomagno G, Colone M, Condorelli RA, Stringaro A, Calogero AE, Zakova J, Kralikova M, Crha I, Ventruba P, Melounova J, Matejovicova M, Vodova M, Lousova E, Sanchez Toledo M, Alvarez LLeo C, Garcia Garrido C, Resta Serra M, Belmonte Andujar LL, Gonzalez de Merlo G, Crha I, Zakova J, Ventruba P, Lousova E, Pohanka M, Huser M, Amiri I, Karimi J, Goodarzi MT, Tavilani H, Filannino A, Magli MC, Boudjema E, Crippa A, Ferraretti AP, Gianaroli L, Robles F, Magli MC, Crippa A, Filannino A, Ferraretti AP, Gianaroli L, Huang H, Yao DJ, Huang HJ, Li JR, Fan SK, Wang ML, Yung-Kuei S, Amer S, Mahran A, Darne J, Shaw R, Boudjema E, Magli MC, Borghi E, Cetera C, Ferraretti AP, Gianaroli L, Shukla U, Ogutu D, Deval B, Jansa M, Savvas M, Narvekar N, Houska P, Dackland AL, Bjorndahl L, Kvist U, Crippa A, Magli MC, Muzii L, Barboni B, Ferraretti AP, Gianaroli L, Samanta L, Kar S, Yakovenko SA, Troshina MN, Rutman BK, Dyakonov SA, Holmes E, Bjorndahl L, Kvist U, Feijo C, Verza Junior S, Esteves SC, Berta CL, Caille AM, Ghersevich SA, Zumoffen C, Munuce MJ, San Celestino M, Agudo D, Alonso M, Sanjurjo P, Becerra D, Bronet F, Garcia-Velasco JA, Pacheco A, Lafuente R, Lopez G, Checa MA, Carreras R, Brassesco M, Oneta M, Savasi V, Parrilla B, Guarneri D, Laureti A, Pagano F, Cetin I, Ekwurtzel E, Bjorndahl L, Kvist U, Morgante G, Piomboni P, Stendardi A, Serafini F, De Leo V, Focarelli R, Dumont M, Belloc S, Junca AM, Benkhalifa M, Cohen-Bacrie M, De Mouzon J, Entezami F, Cohen-Bacrie P, Junca A, Belloc S, Dumont M, Cohen-Bacrie M, Benkhalifa M, De Mouzon JJ, Entezami F, Cohen-Bacrie P, Mangiarini A, Capitanio E, Paffoni A, Restelli L, Guarneri C, Scarduelli C, Ragni G, Harrison K, Irving J, Martin N, Sherrin D, Yazdani A, Almeida C, Correia S, Rocha E, Alves A, Cunha M, Ferraz L, Silva S, Sousa M, Barros A, Perdrix A, Travers A, Milazzo JP, Clatot F, Mousset-Simeon N, Mace B, Rives N, Clarke HS, Callow A, Saxton D, Pacey AA, Sapir O, Oron G, Ben-Haroush A, Garor R, Feldberg D, Pinkas H, Stein A, Wertheimer A, Fisch B, Palacios E, Gonzalvo MC, Clavero A, Ramirez JP, Rosales A, Mozas J, Bjorndahl L, Castilla JA, Mugica J, Ramon O, Valdivia A, Exposito A, Casis L, Matorras R, Bongers R, Gottardo F, Zitzmann M, Kliesch S, Cordes T, Kamischke A, Schultze-Mosgau A, Buendgen N, Diedrich K, Griesinger G, Crisol L, Aspichueta F, Exposito A, Hernandez ML, Ruiz-Sanz JI, Mendoza R, Matorras R, Sanchez-Tusie AA, Bermudez A, Lopez P, Churchill GC, Trevino CL, Maldonado I, Dabbah J. POSTER VIEWING SESSION - ANDROLOGY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.75] [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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Affiliation(s)
| | - K. Gulewicz
- Cornell University, Department of Psychology, Ithaca, NY, USA
| | - A. Segal
- Cornell University, Department of Psychology, Ithaca, NY, USA
| | - M. E. McPhee
- Cornell University, Department of Psychology, Ithaca, NY, USA
| | - R. E. Johnston
- Cornell University, Department of Psychology, Ithaca, NY, USA
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Creaney J, Segal A, Sterrett G, Platten MA, Baker E, Murch AR, Nowak AK, Robinson BWS, Millward MJ. Overexpression and altered glycosylation of MUC1 in malignant mesothelioma. Br J Cancer 2008; 98:1562-9. [PMID: 18454162 PMCID: PMC2391110 DOI: 10.1038/sj.bjc.6604340] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Current interest in the MUC1/EMA mucin relates to its role in malignancy, and its potential as a therapeutic target. MUC1/EMA expression has been observed in the majority of epithelioid mesotheliomas. However, little is known of the characteristics of MUC1/EMA in mesothelioma. Herein, we studied the cell surface and soluble expression of the MUC1/EMA glycoprotein, and determined the mRNA and genomic expression profiles in mesothelioma. We found that the anti-MUC1 antibody, E29, was the most diagnostically useful of seven antibody clones examined with a sensitivity of 84% (16 out of 19 cases) and no false positive results. MUC1 mRNA expression was significantly higher in mesothelioma samples than in benign mesothelial cells. No amplification of the MUC1 gene was observed by FISH. Seven of 9 mesothelioma samples expressed MUC1-secreted mRNA isoform in addition to the archetypal MUC1/transmembrane form. CA15.3 (soluble MUC1) levels were significantly higher in the serum of mesothelioma patients than in healthy controls but were not significantly different to levels in patients with benign asbestos-related disease. CA15-3 in effusions could differentiate malignant from benign effusions but were not specific for mesothelioma. Thus, as in other cancers, alterations in MUC1 biology occur in mesothelioma and these results suggest that specific MUC1 characteristics may be useful for mesothelioma diagnosis and should also be investigated as a potential therapeutic target.
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Affiliation(s)
- J Creaney
- National Research Centre for Asbestos Related Diseases, Western Australian Institute of Medical Research, University of Western Australia, Perth, Western Australia, Australia.
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Valle D, Charoki D, Brugniart C, Scholtes F, Segal A, Ducasse A. 260 Les plaies de paupière. Épidémiologie et prise en charge. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)70857-x] [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: 11/15/2022]
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Gerber A, Kishon I, Korenblit IY, Riss O, Segal A, Karpovski M, Raquet B. Linear positive magnetoresistance and quantum interference in ferromagnetic metals. Phys Rev Lett 2007; 99:027201. [PMID: 17678250 DOI: 10.1103/physrevlett.99.027201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 03/28/2007] [Indexed: 05/16/2023]
Abstract
Positive, linear in field, and isotropic magnetoresistance in fields up to 60 T is found in geometrically constrained ferromagnets, such as thin films of iron, nickel, and cobalt and their granular mixtures with nonmagnetic materials. The resistivity measured as a function of temperature shows a minimum at temperatures reaching a remarkably high 92 K, followed by logarithmic dependence at low temperatures. We propose to explain both phenomena by a modified version of the quantum electron-electron interaction theory. The agreement is only qualitative while the observed magnitude of the magnetoresistance slope is much larger than the calculated one.
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Affiliation(s)
- A Gerber
- Raymond and Beverly Sackler Faculty of Exact Sciences, School of Physics and Astronomy, Tel Aviv University, Ramat Aviv 69978, Tel Aviv, Israel
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Brugniart C, Scholtes F, Ferron A, Segal A, Valle D, Charoki D, Samet Tran I, Ducasse A. 245 Les corps étrangers intra-oculaires. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80057-x] [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: 12/01/2022]
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Valle D, Ferron A, Scholtes F, Brugniart C, Riviere M, Dib F, Segal A, Ducasse A. 236 Traumatologie oculopalpébrale : aspects épidémiologiques. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80048-9] [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: 11/27/2022]
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Lake R, van Bruggen I, Segal A, Robinson B, Sherwood A, Robinson C. 16 An SV40 TAg transgenic model of asbestos‐induced mesothelioma. Lung Cancer 2006. [DOI: 10.1016/s0169-5002(07)70092-2] [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: 11/16/2022]
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Brusche JH, Segal A, Urbach HP. Finite-element model for phase-change recording. J Opt Soc Am A Opt Image Sci Vis 2005; 22:773-786. [PMID: 15839286 DOI: 10.1364/josaa.22.000773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The finite-element method is applied to model phase-change recording in a grooved recording stack. A rigorous model for the scattering of a three-dimensional focused spot by a one-dimensional periodic grating is used to determine the absorbed light in a three-dimensional region inside the phase-change layer. The optical model is combined with a three-dimensional thermal model to compute the temperature distribution. Land and groove recording and polarization dependence are studied, and the model is applied to the Blu-ray Disc.
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Affiliation(s)
- J H Brusche
- Department of Applied Mathematical Analysis, Delft University of Technology, 2628 CD Delft, The Netherlands.
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Julian SL, McGrew M, Segal A. 288 FAMILY PRACTICE RESIDENTS MORE COMPLEMENTARY AND ALTERNATIVE MEDICINE FRIENDLY. J Investig Med 2005. [DOI: 10.2310/6650.2005.00005.287] [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: 11/18/2022]
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31
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Segal A, Katz C, Van Duuren B. Additions and Corrections - Structure and Tumor-Promoting Activity of Anthralin (1,8-Dihydroxy-9-anthrone) and Related Compounds. J Med Chem 2004. [DOI: 10.1021/jm00282a602] [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: 11/29/2022]
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Gips M, Catane R, Heching I, Levitt M, Merimski O, Kuten A, Segal A, Ben Shachar M, Peretz T. The Israeli experience with gefitinib (ZD1839) as single agent treatment of advanced non-small-cell lung cancer -a 3 years report. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.3154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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)
- M. Gips
- Hadassah Medical Center, Jerusalem, Israel; Sheba Medical Center, Tel Aviv, Israel; Soraski Medical Center, Tel Aviv, Israel; Rambam Medical Center, Haifa, Israel; Shaare Zedek Medical Center, Jerusalem, Israel; Naharya Hospital, Naharya, Israel
| | - R. Catane
- Hadassah Medical Center, Jerusalem, Israel; Sheba Medical Center, Tel Aviv, Israel; Soraski Medical Center, Tel Aviv, Israel; Rambam Medical Center, Haifa, Israel; Shaare Zedek Medical Center, Jerusalem, Israel; Naharya Hospital, Naharya, Israel
| | - I. Heching
- Hadassah Medical Center, Jerusalem, Israel; Sheba Medical Center, Tel Aviv, Israel; Soraski Medical Center, Tel Aviv, Israel; Rambam Medical Center, Haifa, Israel; Shaare Zedek Medical Center, Jerusalem, Israel; Naharya Hospital, Naharya, Israel
| | - M. Levitt
- Hadassah Medical Center, Jerusalem, Israel; Sheba Medical Center, Tel Aviv, Israel; Soraski Medical Center, Tel Aviv, Israel; Rambam Medical Center, Haifa, Israel; Shaare Zedek Medical Center, Jerusalem, Israel; Naharya Hospital, Naharya, Israel
| | - O. Merimski
- Hadassah Medical Center, Jerusalem, Israel; Sheba Medical Center, Tel Aviv, Israel; Soraski Medical Center, Tel Aviv, Israel; Rambam Medical Center, Haifa, Israel; Shaare Zedek Medical Center, Jerusalem, Israel; Naharya Hospital, Naharya, Israel
| | - A. Kuten
- Hadassah Medical Center, Jerusalem, Israel; Sheba Medical Center, Tel Aviv, Israel; Soraski Medical Center, Tel Aviv, Israel; Rambam Medical Center, Haifa, Israel; Shaare Zedek Medical Center, Jerusalem, Israel; Naharya Hospital, Naharya, Israel
| | - A. Segal
- Hadassah Medical Center, Jerusalem, Israel; Sheba Medical Center, Tel Aviv, Israel; Soraski Medical Center, Tel Aviv, Israel; Rambam Medical Center, Haifa, Israel; Shaare Zedek Medical Center, Jerusalem, Israel; Naharya Hospital, Naharya, Israel
| | - M. Ben Shachar
- Hadassah Medical Center, Jerusalem, Israel; Sheba Medical Center, Tel Aviv, Israel; Soraski Medical Center, Tel Aviv, Israel; Rambam Medical Center, Haifa, Israel; Shaare Zedek Medical Center, Jerusalem, Israel; Naharya Hospital, Naharya, Israel
| | - T. Peretz
- Hadassah Medical Center, Jerusalem, Israel; Sheba Medical Center, Tel Aviv, Israel; Soraski Medical Center, Tel Aviv, Israel; Rambam Medical Center, Haifa, Israel; Shaare Zedek Medical Center, Jerusalem, Israel; Naharya Hospital, Naharya, Israel
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Sayag D, Gotzamanis A, Brugniart C, Segal A, Ducasse A, Chambre V, Glacet-Bernard A. [Retinal vein occlusion and carotid Doppler imaging]. J Fr Ophtalmol 2002; 25:826-30. [PMID: 12471351] [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: 02/27/2023]
Abstract
PURPOSE To investigate retinal vein occlusion with B-mode ultrasonography carotid and color Doppler imaging. METHODS In 223 patients (225 eyes) presenting with retinal vein occlusion, we retrospectively investigated vascular risk factors (hypertension, diabetes, hyperlipidemia, cardiovascular history, smoking, and glaucoma), standard laboratory tests, and color Doppler imaging of the carotid artery. RESULTS The data from 106 women (47.54%) and 117 men (52.46%), with a mean age of 65 years, were studied, with 169 patients presenting a central retinal vein occlusion (CRVO) and 56 a branch retinal vein occlusion (BRVO). Thirteen patients (6%) had significant carotid artery stenosis (>=70%), which was the single etiology. Forty patients (18%) had nonsignificant carotid artery stenosis (<70%) with a risk of embolism production. Such carotid artery lesions found in color Doppler imaging in the RVO investigations were significantly more frequent in older patients (>65 years) who presented at least two RVO risk factors (p<0.001). CONCLUSION This study has shown the the advantages of carotid Doppler imaging in retinal vein occlusion.
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Affiliation(s)
- D Sayag
- Service d'Ophtalmologie, Hôpital Robert Debré, rue de Général Koenig, 51092 Reims Cedex, France
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Nowak AK, Byrne MJ, Williamson R, Ryan G, Segal A, Fielding D, Mitchell P, Musk AW, Robinson BWS. A multicentre phase II study of cisplatin and gemcitabine for malignant mesothelioma. Br J Cancer 2002; 87:491-6. [PMID: 12189542 PMCID: PMC2376155 DOI: 10.1038/sj.bjc.6600505] [Citation(s) in RCA: 187] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2001] [Revised: 05/09/2002] [Accepted: 06/16/2002] [Indexed: 02/06/2023] Open
Abstract
Our previous phase II study of cisplatin and gemcitabine in malignant mesothelioma showed a 47.6% (95% CI 26.2-69.0%) response rate with symptom improvement in responding patients. Here we confirm these findings in a multicentre setting, and assess the effect of this treatment on quality of life and pulmonary function. Fifty-three patients with pleural malignant mesothelioma received cisplatin 100 mg m(-2) i.v. day 1 and gemcitabine 1000 mg m(-2) i.v. days 1, 8, and 15 of a 28 day cycle for a maximum of six cycles. Quality of life and pulmonary function were assessed at each cycle. The best response achieved in 52 assessable patients was: partial response, 17 (33%, 95% CI 20-46%); stable disease, 31 (60%); and progressive disease, four (8%). The median time to disease progression was 6.4 months, median survival from start of treatment 11.2 months, and median survival from diagnosis 17.3 months. Vital capacity and global quality of life remained stable in all patients and improved significantly in responding patients. Major toxicities were haematological, limiting the mean relative dose intensity of gemcitabine to 75%. This schedule of cisplatin and gemcitabine is active in malignant mesothelioma in a multicentre setting. Investigation of alternative scheduling is needed to decrease haematological toxicity and increase the relative dose intensity of gemcitabine whilst maintaining response rate and quality of life.
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Affiliation(s)
- A K Nowak
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Verdun Street, Nedlands, WA 6009 Australia
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Abstract
BACKGROUND/AIM Irritable bowel syndrome is one of the most common gastrointestinal disorders in Western society, affecting around 15% of the population, especially young adults. The cause(s) of irritable bowel syndrome and effective treatment(s) have remained elusive. This study aimed at exploring the therapeutic value of acupuncture by comparing the responses of irritable bowel syndrome sufferers to true acupuncture versus sham acupuncture in a controlled double-blind study. METHODS Twenty-five patients who fulfilled the Rome criteria (irritable bowel syndrome symptoms persisting for more than 1 year) comprised the final study population. They were recruited through a 'call for' bulletin sent to gastroenterologists practicing in the region of our medical center. True acupuncture was performed at LI-4 (colonic meridian, needle only) and sham acupuncture at BL-60 (urinary vesicle meridian, needle only). Patient assignment to one of the two groups was random. RESULTS The effect of the first true acupuncture on overall symptoms and abdominal pain was a clear and significant improvement (p = 0.05). No comparable effect was seen in the second session. CONCLUSIONS Although the true acupuncture results were consistently better, no difference was found between the two groups in the overall statistical analysis. We could not show a therapeutic benefit of this treatment modality in irritable bowel syndrome.
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Affiliation(s)
- Z Fireman
- Department of Gastroenterology, Hillel Yaffe Medical Center, Hadera, Israel.
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Segal A, Ferrandis JJ. [Eugene de Séré (1828-1870), inventor of the electric lancet]. Hist Sci Med 2001; 32:255-64. [PMID: 11625351] [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: 02/21/2023]
Abstract
The authors relate chiefly medical-officer Eugene de Sere's military career, particuliarly some parts of his work: the invention of a galvano-cautery, an electric cutter including a scale which allows to change current strength whether it is needing to cut flesh or to coagulate blood. That instrument is the forerunner of every modern one.
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Affiliation(s)
- A Segal
- Musée du service de santé des Armées Val-de-Grâce, Paris
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Segal A. [Paleopathology of the relics of Saint Albert of Louvain]. Hist Sci Med 2001; 32:115-22. [PMID: 11637009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
The author recounts St. Albert of Lowen's story who was slaughtered in Reims in 1192 and after buried inside the cathedral's nave. During 1612, at request of the Archduke and Archduchess of Brabant, the King of France and the Reims Archbishop conceded the translation of the relics to Brussels. However an error on the burial place was revealed more ever by the consequences of the Great War. Indeed, the architect Henri Deneux found the genuine tomb of Albert of Lowen. The Belgian people had received the mortal remains of Archbishop Odalric about who skull examination indicated also a traumatic lesion but the death circumstances are ignored. The error of the Reims Cathedral's Canons may be explained by various modifications and above the later transformation, particularly those of the rood-screen.
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Hillemand P, Gilbrin E, Segal A. [Not Available]. Hist Sci Med 2001; 15:159-65. [PMID: 11628678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Segal A. [Not Available]. Hist Sci Med 2001; 13:395-406. [PMID: 11628279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Segal A, Lellouch A. [Maxime Laignel-Lavastine (1875-1953)]. Hist Sci Med 2001; 27:201-6. [PMID: 11634235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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41
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Segal A. [Not Available]. Hist Sci Med 2001; 17:61-4. [PMID: 11612325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Lellouch A, Segal A. [Gerontology and endocrinology at the beginning of the 20th century: Dr. Voronoff (1866-1951)]. Hist Sci Med 2001; 35:425-34. [PMID: 11917919] [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: 02/24/2023]
Abstract
Rejuvenation by monkey testicle transplanting was terribly fashionable in Paris, between years 1925-1930. The manual miracles done by a group of very well-known surgeons, in Paris, (especially Serge Voronoff and Dartigues) rooted in the head of a too credulous public the idea according to it was possible to be made scientifically younger by genital graftings. The "Etude sur la vieillesse et la rajeunissement par la greffe" (1926), written by Voronoff, provided the clinical, histological and iconographical proofs of a such rejuvenation. The paper analyses that was put forward as "proofs", situated in the scientific and cultural context of the time. A possible link between youth, sexual vigour and animality sends back to a mythic history of gerontology and endocrinology, two medical fields which however became scientific specialties in the beginning of the twentieth century.
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Affiliation(s)
- A Lellouch
- Département d'Information Médicale et de Santé Publique, Hôpital de Poissy-Saint-Germain-en-Laye
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Webe WM, Segal A, Vankeerberghen A, Cassiman JJ, Van Driessche W. Different activation mechanisms of cystic fibrosis transmembrane conductance regulator expressed in Xenopus laevis oocytes. Comp Biochem Physiol A Mol Integr Physiol 2001; 130:521-31. [PMID: 11913463 DOI: 10.1016/s1095-6433(01)00427-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 11/20/2022]
Abstract
The cystic fibrosis transmembrane conductance regulator (CFTR) is a cAMP sensitive Cl- channel that is defective in cystic fibrosis (CF). The most frequent mutation, namely deltaF508-CFTR, accounts for 66% of CF. Here we show that cAMP-activation of CFTR occurs via at least two distinct pathways: activation of CFTR molecules already present in the plasma membrane and protein kinase A (PKA)-mediated vesicular transport of new CFTR molecules to the plasma membrane and functional insertion into the membrane. We investigated the mechanisms that are responsible for these activation pathways using the Xenopus laevis oocytes expression system. We expressed CFTR and recorded continuously membrane current (Im), conductance (Gm) and capacitance (Cm), which is a direct measure of membrane surface area. Expression of CFTR alone did not change the plasma membrane surface area. However, activation of CFTR with cAMP increased Im, Gm and Cm while deltaF508-CFTR-expressing oocytes showed no response on cAMP. Inhibition of protein kinase A or buffering intracellular Ca2+ abolished the cAMP-induced increase in Cm while increases of Im and Gm were still present. ATP or the xanthine derivative 8-cyclopentyl-1,3-dipropylxanthine (CPX) did not further activate CFTR. Insertion of pre-formed CFTR into the plasma membrane could be prevented by compounds that interfere with intracellular transport mechanisms such as primaquine, brefeldin A, nocodazole. From these data we conclude that cAMP activates CFTR by at least two distinct pathways: activation of CFTR already present in the plasma membrane and exocytotic delivery of new CFTR molecules to the oocyte membrane and functional insertion into it.
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Affiliation(s)
- W M Webe
- Laboratory of Physiology, K U Leuven, Belgium.
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Sayag D, Ducasse A, Coicaud C, Gotzamanis A, Segal A. [Tarsomarginal graft. Indication and results in palpebral surgery]. J Fr Ophtalmol 2001; 24:724-8. [PMID: 11591912] [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: 02/21/2023]
Abstract
A tarsomarginal graft is indicated in eyelid reconstructive surgery particularly after tumor resection. We reported the results of a retrospective study during the past 13 years with 58 grafts. We found a predominance of basal cell carcinomas localised in the lateral third portion of the lid (42%) and in the lower eyelid (76%). The mean size was 14mm for the tumor and 9.81mm for the graft. Grafts were used to cover a defect larger than 5mm. Complications were rare, and mainly involved suture looseness. The Hubner technique gave good results; repairing the eyelid without having to make a tarsorraphy and providing good cosmetic results. The graft must be covered by a skin flap.
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Affiliation(s)
- D Sayag
- Service d'ophtalmologie, CHR. de Reims, Cedex, France
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Ducasse A, Segal A, Gotzamanis A, Brugniart C, Rossi P. [Tolerance of orbital implants. Retrospective study on 14 years]. J Fr Ophtalmol 2001; 24:277-81. [PMID: 11285443] [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: 02/19/2023]
Abstract
UNLABELLED The authors report the results of enucleations performed from 1985 to 1998 and the different orbital implants used. MATERIAL AND METHODS All patients undergoing enucleation from 1985 to 1998 were studied. RESULTS 68 men and 32 women had an enucleation. The main indication was tumoral diseases, principally choroidal melanomas and ciliary melanomas (respectively, 26 and 8). More rarely the indication was orbital metastasis or eyelid carcinoma. The follow indications were traumatisms and neovascular glaucomas. The orbital implants used were mainly Allen implants, silicone implants and hydroxyapatite implants. The main complication was the expulsion of the implant, which occurred in about 20% of the cases, for the most part in the group of silicone and tunnel implants patient. These expulsions were found less with hydroyxapatite implants. For the hydroxyapatite implants we also noticed the some conjunctival erosion. The expulsion of the implant occurred most often before 2 years. CONCLUSION The authors report on the survey of orbital implants used for 14 years. They noticed the high frequency of expulsions when they used tunnel or silicone implants and better results with hydroxyapatite implant.
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Affiliation(s)
- A Ducasse
- Service d'Ophtalmologie, Hôpital Robert Debré, av. du général Koenig, 51092 Reims
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Weber WM, Segal A, Simaels J, Vankeerberghen A, Cassiman JJ, Van Driessche W. Functional integrity of the vesicle transporting machinery is required for complete activation of cFTR expressed in xenopus laevis oocytes. Pflugers Arch 2001; 441:850-9. [PMID: 11316271 DOI: 10.1007/s004240000497] [Citation(s) in RCA: 14] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We expressed the human cystic fibrosis transmembrane conductance regulator (CFTR) in oocytes of the South African clawed frog Xenopus laevis. We performed simultaneous and continuous recording of membrane current (Im), conductance (Gm) and capacitance (Cm), the latter being a direct measure of membrane surface area. A cAMP-cocktail containing cAMP and isobutylmethylxanthine (IBMX) increased all parameters, demonstrating that CFTR activation was partly achieved by exocytotic delivery and insertion of preformed CFTR molecules into the plasma membrane. CFTR currents after cAMP-cocktail were correlated with the capacitance of the oocytes: oocytes with larger Cm exhibited larger currents. Expression of CFTR itself did not change the Cm of the oocytes. However, activation of CFTR with cAMP-cocktail increased Im and Gm 15- and 20-fold, respectively while membrane surface area increased by about 7%, indicating the functional insertion of preformed CFTR into the plasma membrane. While cAMP-cocktail yielded maximal CFTR stimulation, IBMX alone, but not caffeine or theophylline, was sufficient to stimulate more than half of the increases in Im and Gm as observed with cAMP-cocktail. Since Cm was not significantly stimulated by IBMX, we conclude that IBMX alone activated the CFTR channels already present in the oocyte membrane. CFTR stimulation by cAMP-cocktail was independent of external Ca2+ and ATP had no additional activating potency. The role of protein trafficking in the activation of CFTR evoked by increases of cytoplasmic cAMP was assessed by measuring the effects of brefeldin A (BFA), nocodazole and primaquine on the bioelectric parameters and membrane surface area. All these compounds that interfere with the protein trafficking machinery at different stages prevented the translocation of CFTR from intracellular pools to the plasma membrane. These data confirm and extend our previous observations that CFTR expressed in Xenopus laevis oocytes is activated via dual pathways including direct activation of CFTR already present in the membrane and exocytotic insertion of preformed CFTR channels into the membrane. Furthermore, we show that complete activation of CFTR requires an intact protein trafficking machinery.
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Affiliation(s)
- W M Weber
- Laboratory of Physiology, KU Leugen, Belgium.
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Abstract
OBJECTIVES Migrant studies indicate that the differences in the incidence of colorectal cancer (CRC) are probably environmental and not genetic. There is epidemiological documentation that Israeli-born Arabs have much less CRC than Israeli-born Jews. We investigated these differences among Jews and Arabs living within the same central coastal region in Israel. METHODS The files of pathology-diagnosed patients with CRC hospitalized from 1988 to 1996 were reviewed, and demographic data and incidence and location of malignancies were retrieved for this relative frequency study. RESULTS Of the 527 patients (51.4% men) diagnosed as having CRC, 489 (92.8%) were Jews and 38 (7.2%) were Arabs (p < 0.001), representing 0.46% and 0.04% of the respective populations in the region. The average age at disease diagnosis of the Jews was 73.8 yr and that of the Arabs 61.4 yr (p < 0.001). Both groups shared identical health facilities and habits of attending them. The Arab patients were or had been employed in occupations that involved more physical activity. The site of lesion was on the right colon in 24.9% of all the cases-23.5% of the Jewish patients and 42.1% of the Arab patients (p < 0.001). Rectal cancer was found in 25.7% of the former and 15.8% of the latter (p < 0.001). CONCLUSIONS The lower incidence of CRC among the Arabs persisted over time, and that group had greater right side and lesser rectal involvement than their Jewish neighbors, possible indications of genicity. The incidence of CRC among the Jews rose concomitantly with "Westernization" of their lifestyle, supporting a role for environmental influences.
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Affiliation(s)
- Z Fireman
- Gastroenterology Department, Hillel Yaffe Medical Center, Hadera, Israel
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50
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Abstract
BACKGROUND Distinguishing well differentiated hepatocellular carcinoma (HCC) from benign hepatocellular lesions is a well recognized problem in fine-needle aspiration (FNA) cytology. The endothelial cell marker CD34 is negative in normal hepatic sinusoids and stains vessels diffusely in HCC. This feature is useful in distinguishing benign from malignant hepatocytic lesions in histological specimens, although benign lesions may show focal positivity for CD34 confined to periportal and periseptal areas. In this study, we assess the role of CD34 in cell block and thin core biopsy material from benign and malignant hepatocellular lesions, and compare it with reticulin staining. METHODS Cell blocks and thin core biopsies were assessed from 40 cases of HCC and 25 benign hepatocytic lesions. HCCs were scored for nuclear grade. Sections were stained for CD34 antigen and scored semi-quantitatively. Previously performed reticulin stains were reviewed. RESULTS Thirty three of 40 HCCs (82.5%) showed diffuse positivity for CD34. The other seven cases showed either focal positivity (four cases), minimal positivity (two cases) or negative staining (one case). These results did not correlate with the nuclear grade of the tumor. Two of 25 benign cases (8%) showed diffuse positivity for CD34, 8 showed focal positivity, 11 showed minimal positivity, and 4 showed negative staining. All HCCs showed an abnormal reticulin pattern characterized by expanded trabeculae and islands, or sheets, with decreased or absent reticulin. All of the benign hepatocellular lesions showed a normal trabecular reticulin pattern. CONCLUSIONS Diffusely positive CD34 staining is useful to support a diagnosis of well differentiated HCC, but in our study the reticulin stain distinguished more consistently between benign and malignant lesions.
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Affiliation(s)
- W B de Boer
- Division of Tissue Pathology, The Western Australian Centre for Pathology and Medical Research, WA, Australia
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