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Takemura A, Hashimoto K, Ho A, Bessinger M, Law S, Schifferle RE, Ciancio SG. Efficacy of new oral rinse containing sodium hyaluronate in xerostomia: A randomized crossover study. Oral Dis 2023; 29:2747-2755. [PMID: 36529530 DOI: 10.1111/odi.14475] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/03/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To evaluate the efficacy of a new oral rinse containing sodium hyaluronate and other functional ingredients in reducing xerostomia-associated symptoms. MATERIALS AND METHODS In this 8-week, double-blind crossover study, xerostomia subjects used all three of GUM®HYDRAL™ Oral Rinse, placebo rinse, and Biotene® Oral Rinse as active control. Visual Analog Scale, a dry mouth questionnaire, Oral Health Impact Profile-14, unstimulated saliva flow rate (USFR), and Revised Oral Assessment Guide (ROAG) were assessed before and after 2 weeks of treatments. RESULTS Thirty-seven patients completed all three treatment modalities. Subjective measurements were significantly decreased by test product and active control; however, no significant difference was observed between the treatments. Test product and active control demonstrated a significant increase in USFR over 0.2 ml/min, a normal threshold of hyposalivation. Both test product and active control improved a total score of ROAG, whereas the effectiveness of the test product was significantly better than that of other two treatments. CONCLUSIONS The new oral rinse may be beneficial to improve the quality of life of xerostomia patients as dry mouth symptoms were reduced for both subjective and objective measurements. Test oral rinse was found to be more effective than placebo or active control for some of the objective measurements.
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Affiliation(s)
| | | | - Alex Ho
- Department of Periodontics and Endodontics, The University at Buffalo, Buffalo, New York, USA
| | - Michele Bessinger
- Department of Periodontics and Endodontics, The University at Buffalo, Buffalo, New York, USA
| | - Sandra Law
- Department of Periodontics and Endodontics, The University at Buffalo, Buffalo, New York, USA
| | - Robert E Schifferle
- Department of Periodontics and Endodontics, The University at Buffalo, Buffalo, New York, USA
| | - Sebastian G Ciancio
- Department of Periodontics and Endodontics, The University at Buffalo, Buffalo, New York, USA
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Bayne J, Craft A, Ho A, Mastromarino Riley J. Adverse Drug Reactions in Moderate Sedation: Process Improvement During a Pandemic. PatientSaf 2023. [DOI: 10.33940/med/2023.3.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Background: A gap analysis identified the need for process improvement surrounding the identification and reporting of adverse drug reactions related to moderate sedation. A change to documentation was selected to address this gap. The challenge was disseminating the change in a meaningful way during a time of high census and limited staffing due to the COVID-19 pandemic. Complex adaptive systems theory was used to plan interventions in the current climate.
Methods: Process improvement was organized into Plan-Do-Study-Act cycles guided by the gap analysis, literature, and aims. Quantitative data analysis was conducted using chart audits and a Likert survey.
Interventions: Adoption of end-user-redesigned documentation was completed over time using one-on-one instruction, brief just-in-time education sessions at huddles, and ongoing feedback.
Results: The survey results demonstrated a significant increase in adverse event knowledge (p = <0.01) and documentation confidence following just-in-time training (p < .01). Chart audits revealed an increase in identification of adverse events (p=0.03).
Conclusions: Using a theory-based approach to implement process improvement is a successful way to create change in a challenging environment. Identification of adverse drug reactions related to moderate sedation increased, which is essential for evaluation and safe administration.
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Cheung T, Lam JYT, Fong KH, Ho YS, Ho A, Cheng CPW, Sittlington J, Xiang YT, Li TMH. The Effectiveness of Electrical Vestibular Stimulation (VeNS) on Symptoms of Anxiety: Study Protocol of a Randomized, Double-Blinded, Sham-Controlled Trial. Int J Environ Res Public Health 2023; 20:4218. [PMID: 36901227 PMCID: PMC10002296 DOI: 10.3390/ijerph20054218] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
The prevalence of symptoms of anxiety is increasing, especially during the COVID-19 pandemic. A home use transdermal neurostimulation device might help to minimize the severity of anxiety disorder. To the best of our knowledge, there is no clinical trial using transdermal neurostimulation to treat individuals with symptoms of anxiety in Asia. This gives us the impetus to execute the first study which aims at evaluating the efficacy of Electrical Vestibular Stimulation (VeNS) on anxiety in Hong Kong. This study proposes a two-armed, double-blinded, randomized, sham-controlled trial including the active VeNS and sham VeNS group. Both groups will be measured at baseline (T1), immediately after the intervention (T2), and at the 1-month (T3) and 3-month follow-up (T4). A total of 66 community-dwelling adults aged 18 to 60 with anxiety symptoms will be recruited in this study. All subjects will be computer randomised into either the active VeNS group or the sham VeNS group in a 1:1 ratio. All subjects in each group will receive twenty 30 min VeNS sessions during weekdays, which will be completed in a 4-week period. Baseline measurements and post-VeNS evaluation of the psychological outcomes (i.e., anxiety, insomnia, and quality of life) will also be conducted on all participants. The 1-month and 3-month follow-up period will be used to assess the long-term sustainability of the VeNS intervention. For statistical analysis, ANOVA with repeated measures will be used to analyze data. Missing data were managed with multiple mutations. The level of significance will be set to p < 0.05. Results of this study will be used to determine whether this VeNS device can be considered as a self-help technological device to reduce perceived anxiety in the general population in the community setting. This clinical Trial was registered with the Clinical Trial government, identifier: NCT04999709.
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Affiliation(s)
- Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- The Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Joyce Yuen Ting Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Kwan Hin Fong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yuen Shan Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Alex Ho
- Integrated Services for Persons with Disabilities, Christian Family Service Centre, Hong Kong SAR, China A
| | | | - Julie Sittlington
- School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK
| | - Yu-Tao Xiang
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Tim Man Ho Li
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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Cheung T, Lam JYT, Fong KH, Cheng CPW, Ho A, Sittlington J, Xiang YT, Li TMH. Evaluating the Efficacy of Electrical Vestibular Stimulation (VeNS) on Insomnia Adults: Study Protocol of a Double-Blinded, Randomized, Sham-Controlled Trial. Int J Environ Res Public Health 2023; 20:3577. [PMID: 36834268 PMCID: PMC9964781 DOI: 10.3390/ijerph20043577] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/27/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Insomnia is a common health problem in the general population. There are different ways to improve sleeping habits and quality of sleep; however, there is no clinical trial using transdermal neurostimulation to treat individuals with symptoms of insomnia in Asia. This gives us the impetus to execute the first study in Asia which aims to evaluate the efficacy of Electrical Vestibular Stimulation (VeNS) on individuals with insomnia in Hong Kong. This study proposes a two-armed, double-blinded, randomized, sham-controlled trial including the active VeNS and sham VeNS group. Both groups will be measured at baseline (T1), immediately after the intervention (T2), and at the 1-month (T3) and 3-month follow-up (T4). A total of 60 community-dwelling adults aged 18 to 60 years, with insomnia symptoms will be recruited in this study. All subjects will be computer randomized into either the active VeNS group or the sham VeNS group on a 1:1 ratio. All subjects in each group will receive twenty 30-min VeNS sessions during weekdays, which will be completed in a 4-week period. Baseline measurements and post-VeNS evaluation of the psychological outcomes (i.e., insomnia severity, sleep quality and quality of life) will also be conducted on all participants. The 1-month and 3-month follow-up period will be used to assess the short-and long-term sustainability of the VeNS intervention. For statistical analysis, a mixed model will be used to analyze the repeated measures data. Missing data will be managed by multiple imputations. The level of significance will be set to p < 0.05. Significance of the study: The results of this study will be used to determine whether this VeNS device can be considered as a self-help technological device to reduce the severity of insomnia in the community setting. We registered this clinical trial with the Clinical trial government, identifier: NCT04452981.
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Affiliation(s)
- Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- The Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Joyce Yuen Ting Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Kwan Hin Fong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Alex Ho
- Integrated Services for Persons with Disabilities, Christian Family Service Centre, Hong Kong SAR, China
| | - Julie Sittlington
- School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK
| | - Yu-Tao Xiang
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Tim Man Ho Li
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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Rammohan N, Ho A, Kruser T, Besson P, Bandt S. Hippocampal Avoidance Confers Protection against Accelerated Brain Aging when Compared to Conventional Whole Brain Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.810] [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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Ho A, Xu M, Millar S. 745 Regional expression of secreted WNT inhibitors dictates formation of hairless and poorly haired skin. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.757] [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: 11/17/2022]
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7
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Rammohan N, Ho A, Bajaj A, Kruser T, Korutz A, Tate M, Sachdev S. MO-0379 Extent of white matter connectivity has prognostic significance in MGMT-unmethylated glioblastoma. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02345-3] [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: 11/26/2022]
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8
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Averbuch D, De Greef J, Duréault A, Wendel L, Tridello G, Lebeaux D, Mikulska M, Gil L, Knelange N, Zuckerman T, Roussel X, Robin C, Xhaard A, Aljurf M, Beguin Y, Le Bourgeois A, Botella-Garcia C, Khanna N, Van Praet J, Kröger N, Blijlevens N, Ducastelle Leprêtre S, Ho A, Roos-Weil D, Yeshurun M, Lortholary O, Fontanet A, de la Camara R, Coussement J, Maertens J, Styczynski J. Nocardia infections in hematopoietic cell transplant recipients: a multicenter international retrospective study of the Infectious Diseases Working Party (IDWP) of the European Society for Blood and Marrow Transplantation (EBMT). Clin Infect Dis 2021; 75:88-97. [PMID: 34596213 DOI: 10.1093/cid/ciab866] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 07/21/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nocardiosis is rare after hematopoietic cell transplantation (HCT). Little is known regarding its presentation, management, and outcome in this population. METHODS In this retrospective international study, we reviewed nocardiosis episodes in HCT recipients (01.01.2000-31.12.2018; 135 transplant centers; 33 countries) and described their clinical, microbiological, radiological, and outcome characteristics. RESULTS We identified 81 nocardiosis episodes in 74 allo- and 7 auto-HCT recipients. Nocardiosis occurred at a median of 8 (IQR 4-18) months post-HCT. The most frequently involved organs were lungs (70/81; 86%) and brain (30/81; 37%); 29 (36%) patients were afebrile; 46/81 (57%) had disseminated infections. The most common lung imaging findings were consolidations (33/68; 49%) or nodules (32/68; 47%); and brain imaging findings were multiple brain abscesses (19/30; 63%). 10/30 (33%) patients with brain involvement lacked neurological symptoms. 14/48 (29%) patients were bacteremic. N. farcinica was the most common among molecularly identified species (27%, 12/44). Highest susceptibility rates were reported to linezolid 45/45 (100%), amikacin 56/57 (98%), trimethoprim-sulfamethoxazole 57/63 (90%), and imipenem 49/57 (86%).One-year and last follow-up (IQR: 4-42.5 months) all-cause mortality were 40% (32/81) and 52% (42/81), respectively. In the multivariable analysis, underlying disease not in complete remission (HR 2.81, 95%CI 1.32-5.95), and prior bacterial infection (HR 3.42, 95%CI 1.62-7.22) were associated with higher one-year all-cause mortality. CONCLUSIONS Nocardiosis is a late post-HCT infection usually manifesting as a pulmonary disease with frequent dissemination, brain infection and bacteremia. Brain imaging should be performed in HCT recipients with nocardiosis regardless of neurological symptoms. Overall mortality is high.
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Affiliation(s)
- D Averbuch
- Pediatric Infectious Diseases Faculty of Medicine, Hebrew University of Jerusalem; Hadassah Medical Center, Jerusalem, Israel
| | - J De Greef
- Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Duréault
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Paris, France
| | - L Wendel
- EBMT Data Office, Leiden, Netherlands
| | - G Tridello
- Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - D Lebeaux
- Université de Paris, F-75006 Paris, France.,Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, Paris, France
| | - M Mikulska
- Division of Infectious Diseases, University of Genoa and Ospedale Policlinico San Martino, Genova, Italy
| | - L Gil
- University of Medical Sciences, Poznan, Poland
| | | | | | - X Roussel
- University hospital of Besançon, hematology department, Besançon, France
| | - C Robin
- Henri Mondor University Hospital, Creteil, France
| | - A Xhaard
- Hematology-transplantation, Hospital St-Louis, Paris Diderot University, Paris, France
| | - M Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Y Beguin
- CHU of Liège and University of Liège, Liège, Belgium
| | | | | | - N Khanna
- Division of Infectious Diseases and Hospital Epidemiology. University and University Hospital of Basel, Basel, Switzerland
| | - J Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - N Kröger
- Department of Stem Cell Transplantation, University Medical Center, Hamburg, Germany
| | - N Blijlevens
- Radboud university medical center, Nijmegen, The Netherlands
| | | | - A Ho
- Singapore General Hospital, Singapore, Singapore
| | - D Roos-Weil
- Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - M Yeshurun
- Institution of Hematology, Rabin medical Center, Petah Tikva, Israel and Sacker School of Medicine, Tel Aviv University, Israel
| | - O Lortholary
- Paris University, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, Necker Enfants malades University Hospital, Paris, France.,National Reference Center for Invasive Mycoses and Antifungals, Molecular Mycology Unit, CNRS UMR 2000, Institut Pasteur, Paris, France
| | - A Fontanet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Global Health Department, Paris, France.,PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| | | | - J Coussement
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.,National Centre for Infection in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Maertens
- Department of Haematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - J Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
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Simon P, Ho A, Shah MD, Shetgiri R. Trends in Mortality From COVID-19 and Other Leading Causes of Death Among Latino vs White Individuals in Los Angeles County, 2011-2020. JAMA 2021; 326:973-974. [PMID: 34279553 PMCID: PMC8290334 DOI: 10.1001/jama.2021.11945] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 11/14/2022]
Abstract
This study compares age-adjusted mortality rates before and during the COVID-19 pandemic (2011-2020) among Latino and White individuals living in Los Angeles County.
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Affiliation(s)
- Paul Simon
- Los Angeles County Department of Public Health, Los Angeles, California
| | - Alex Ho
- Los Angeles County Department of Public Health, Los Angeles, California
| | - Megha D. Shah
- Los Angeles County Department of Public Health, Los Angeles, California
| | - Rashmi Shetgiri
- Los Angeles County Department of Public Health, Los Angeles, California
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10
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Verkerke H, Saeedi BJ, Boyer D, Allen JW, Owens J, Shin S, Horwath M, Patel K, Paul A, Wu S, Wang J, Ho A, Maier CL, Zerra PE, Chonat S, Arthur CM, Roback JD, Neish AS, Lough C, Josephson CD, Stowell SR. Are We Forgetting About IgA? A Re-examination of Coronavirus Disease 2019 Convalescent Plasma. Transfusion 2021; 61:1740-1748. [PMID: 34041759 PMCID: PMC8242454 DOI: 10.1111/trf.16435] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND While convalescent plasma (CP) may benefit patients with COVID-19, fundamental questions remain regarding its efficacy, including the components of CP that may contribute to its therapeutic effect. Most current serological evaluation of CP relies on examination of total immunoglobulin or IgG-specific anti-SARS-CoV-2 antibody levels. However, IgA antibodies, which also circulate and are secreted along the respiratory mucosa, represent a relatively uncharacterized component of CP. STUDY DESIGN AND METHODS Residual samples from patients and CP donors were assessed for IgM, IgG, and IgA anti-SARS-CoV-2 antibody titers against the receptor-binding domain responsible for viral entry. Symptom onset was obtained by chart review. RESULTS Increased IgA anti-SARS-CoV-2 antibody levels correlated with clinical improvement and viral clearance in an infant with COVID-19, prompting a broader examination of IgA levels among CP donors and hospitalized patients. Significant heterogeneity in IgA levels was observed among CP donors, which correlated weakly with IgG levels or the results of a commonly employed serological test. Unlike IgG and IgM, IgA levels were also more likely to be variable in hospitalized patients and this variability persisted in some patients >14 days following symptom onset. IgA levels were also less likely to be sustained than IgG levels following subsequent CP donation. CONCLUSIONS IgA levels can be very heterogenous among CP donors and hospitalized patients and do not necessarily correlate with commonly employed testing platforms. Examining isotype levels in CP and COVID-19 patients may allow for a tailored approach when seeking to fill specific gaps in humoral immunity.
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Affiliation(s)
- Hans Verkerke
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA,Department of PathologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Bejan J. Saeedi
- Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Darra Boyer
- Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Jerry W. Allen
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA,Department of PathologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Joshua Owens
- Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Sooncheon Shin
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Michael Horwath
- Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Kashyap Patel
- Department of PathologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Anu Paul
- Department of PathologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Shang‐Chuen Wu
- Department of PathologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Jianmei Wang
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Alex Ho
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA,Department of PathologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Cheryl L. Maier
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Patricia E. Zerra
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Satheesh Chonat
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Connie M. Arthur
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - John D. Roback
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Andrew S. Neish
- Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | | | - Cassandra D. Josephson
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Sean R. Stowell
- Center for Transfusion Medicine and Cellular Therapies, Emory UniversityAtlantaGeorgiaUSA,Department of Pathology and Laboratory MedicineEmory University School of MedicineAtlantaGeorgiaUSA,Department of PathologyBrigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
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Abstract
Galectins are soluble carbohydrate binding proteins that can bind β-galactose-containing glycoconjugates by means of a conserved carbohydrate recognition domain (CRD). In mammalian systems, galectins have been shown to mediate very important roles in innate and adaptive immunity as well as facilitating host-pathogen relationships. Many of these studies have relied on purified recombinant galectins to uncover key features of galectin biology. A major limitation to this approach is that certain recombinant galectins purified using standard protocols are easily susceptible to loss of glycan-binding activity. As a result, biochemical studies that employ recombinant galectins can be misleading if the overall activity of a galectin remains unknown in a given assay condition. This article examines fundamental considerations when purifying galectins by lactosyl-sepharose and nickel-NTA affinity chromatography using human galectin-4N and -7 as examples, respectively. As other approaches are also commonly applied to galectin purification, we also discuss alternative strategies to galectin purification, using human galectin-1 and -9 as examples. © 2021 Wiley Periodicals LLC. Basic Protocol 1: Purification of galectins using lactosyl-sepharose affinity chromatography Basic Protocol 2: Purification of human galectin-7 using a nickel-NTA affinity chromatography column Alternate Protocol 1: Iodoacetamide alkylation of free sulfhydryls on galectin-1 Alternate Protocol 2: Purification of human galectin-9 using lactosyl-sepharose column chromatography.
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Affiliation(s)
- Shang-Chuen Wu
- Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anu Paul
- Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alex Ho
- Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kashyap R Patel
- Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jerry William Lynn Allen
- Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hans Verkerke
- Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia
| | - Connie M Arthur
- Center for Transfusion Medicine and Cellular Therapies, Emory University School of Medicine, Atlanta, Georgia
| | - Sean R Stowell
- Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Kang J, Tchekmedyian V, Fan M, Wang H, Kitpanit S, Mohamed N, Rybkin A, Lee A, Chen L, Yu Y, Riaz N, McBride S, Tsai C, Ho A, Dunn L, Fetten J, Pfister D, Zhang Z, Lee N, Sherman E. Split High-Dose Cisplatin: An Alternate High-Dose Cisplatin Administration Schedule for Definitive Chemoradiation in Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.279] [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: 10/23/2022]
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13
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Ho A, Pietropaolo A, Hughes T, Way C, Lily W, Prattley S, Somani B. Apnoea is not necessary for flexible ureteroscopy and lasertripsy (FURSL) of renal stones: Prospective study over 6.5 years. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33849-0] [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: 10/23/2022] Open
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14
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Alchawaf A, Dawod M, Al-Ani M, Barriuso J, Ferrera A, Ho A, Braun M, Paton N, Saunders M, Wilson G, Alam N, Hasan J, Marti FM, Kamposioras K, Mullamitha S. P-339 Real-world data (RWD) of the use of trifluridine/tipiracil hydrochloride (TFT) in patients with metastatic colorectal cancer: The Greater Manchester experience. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.421] [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: 10/23/2022] Open
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15
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Abstract
BACKGROUND The COVID-19 pandemic caused by SARS-CoV-2 remains a significant issue for global health, economics and society. A wealth of data has been generated since its emergence in December 2019, and it is vital for clinicians to keep up with this data from across the world at a time of uncertainty and constantly evolving guidelines and clinical practice. OBJECTIVES Here we provide an update for clinicians on the recent developments in the virology, diagnostics, clinical presentation, viral shedding, and treatment options for COVID-19 based on current literature. SOURCES We considered published peer-reviewed papers and non-peer-reviewed pre-print manuscripts on COVID19 and related aspects with an emphasis on clinical management aspects. CONTENT We describe the virological characteristics of SARS-CoV-2 and the clinical course of COVID-19 with an emphasis on diagnostic challenges, duration of viral shedding, severity markers and current treatment options. IMPLICATIONS The key challenge in managing COVID-19 remains patient density. However, accurate diagnosis as well as early identification and management of high-risk severe cases are important for many clinicians. For improved management of cases, there is a need to understand test probability of serology, qRT-PCR and radiological testing, and the efficacy of available treatment options that could be used in severe cases with a high risk of mortality.
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Affiliation(s)
- M Cevik
- Division of Infection and Global Health Research, School of Medicine, University of St Andrews, UK.
| | - C G G Bamford
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - A Ho
- MRC-University of Glasgow Centre for Virus Research, University of Glasgow, Glasgow, UK
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16
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Campbell M, Fathi R, Cheng S, Ho A, Gilbert E. Rhamnus prinoides
(gesho) stem extract prevents co‐culture biofilm formation by
Streptococcus mutans
and
Candida albicans. Lett Appl Microbiol 2020; 71:294-302. [DOI: 10.1111/lam.13307] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 04/16/2020] [Accepted: 04/27/2020] [Indexed: 01/02/2023]
Affiliation(s)
- M. Campbell
- Department of Biology Georgia State University Atlanta GA USA
| | - R. Fathi
- Department of Biology Georgia State University Atlanta GA USA
| | - S.Y. Cheng
- Department of Biology Georgia State University Atlanta GA USA
| | - A. Ho
- Department of Biology Georgia State University Atlanta GA USA
| | - E.S. Gilbert
- Department of Biology Georgia State University Atlanta GA USA
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17
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Riaz N, Sherman E, Pei X, Schoder H, Paudyal R, Katabi N, Ma D, Tsai C, McBride S, Morris L, Boyle J, Singh B, Foote R, Ho A, Wong R, Humm J, Dave A, Pfister D, Reis-Filho J, Lee N. Genetic and micro-environmental factors influencing response to definitive 30Gy chemo-radiotherapy (chemoRT) in HPV Positive Oropharyngeal Cancer (OPC). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.197] [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: 10/24/2022]
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18
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Fan D, Fan M, Wang H, Lee A, Yu Y, Chen L, Tsai C, McBride S, Riaz N, Bernstein M, Mueller B, Gelblum D, Fetten J, Dunn L, Michel L, Pfister D, Ho A, Boyle J, Cohen M, Roman B, Cracchiolo J, Morris L, Ganly I, Singh B, Shaha A, Patel S, Shah J, Wong R, Sherman E, Lee N, Kang J. Last-line Local Treatment with the Quad Shot Regimen for Previously Irradiated Head and Neck Cancers. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2019.11.135] [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: 11/29/2022]
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19
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Gallo C, Foroughi P, Meagher E, Vellody R, Yadav B, Ho A, Heisenberg D, Cleary K, Sharma K. 3:00 PM Abstract No. 156 Computer-assisted needle navigation for pediatric central venous cannulation: a feasibility study. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.191] [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] Open
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20
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Vadas P, Ho A, Zaltzman J. In reply: Assessing the need for a chlorhexidine-containing central venous catheter: balancing the risk of anaphylaxis with infection. Can J Anaesth 2020; 67:915. [PMID: 32103420 DOI: 10.1007/s12630-020-01599-3] [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] [Received: 02/10/2020] [Revised: 02/10/2020] [Accepted: 02/10/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Peter Vadas
- Departments of Medicine and Anesthesia, St. Michael's Hospital, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Alex Ho
- Departments of Medicine and Anesthesia, St. Michael's Hospital, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jeffrey Zaltzman
- Departments of Medicine and Anesthesia, St. Michael's Hospital, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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21
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Ferrarotto R, Ho A, Wirth L, Muzaffar J, Rodriguez C, Dekel E, Walker R, Nadri-Shay C, Vergara-Silva A. ACCURACY a phase (P) II trial of AL101, a pan-Notch inhibitor, in recurrent/metastatic (R/M) adenoid cystic carcinoma (ACC) patients (pts) with Notch activating mutations (Notch act mut): Preliminary safety and efficacy data. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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Tan K, Chow WS, Leung J, Ho A, Ozaki R, Kam G, Li J, Choi CH, Tsang MW, Chan N, Lee KK, Chan KW. Clinical considerations when adding a sodium-glucose co-transporter-2 inhibitor to insulin therapy in patients with diabetes mellitus. Hong Kong Med J 2019; 25:312-319. [PMID: 31416990 DOI: 10.12809/hkmj197802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- K Tan
- Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - W S Chow
- Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong
| | - J Leung
- Department of Integrated Medical Service, Ruttonjee and Tang Shiu Kin Hospitals, Hong Kong
| | - A Ho
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong
| | - R Ozaki
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - G Kam
- Department of Medicine and Geriatrics, United Christian Hospital, Kwun Tong, Hong Kong
| | - J Li
- Department of Medicine, Yan Chai Hospital, Tsuen Wan, Hong Kong
| | - C H Choi
- Department of Medicine, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - M W Tsang
- Specialist in Endocrinology, Private Practice
| | - N Chan
- Specialist in Endocrinology, Private Practice
| | - K K Lee
- Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - K W Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Hong Kong
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23
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Ho A, Zaltzman J, Hare GMT, Chen L, Fu L, Tarlo SM, Vadas P. Severe and near-fatal anaphylactic reactions triggered by chlorhexidine-coated catheters in patients undergoing renal allograft surgery: a case series. Can J Anaesth 2019; 66:1483-1488. [DOI: 10.1007/s12630-019-01441-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 05/04/2019] [Accepted: 05/06/2019] [Indexed: 11/28/2022] Open
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24
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Jackson LH, Price AN, Hutter J, Ho A, Roberts TA, Slator PJ, Clough JR, Deprez M, McCabe L, Malik SJ, Chappell L, Rutherford MA, Hajnal JV. Respiration resolved imaging with continuous stable state 2D acquisition using linear frequency SWEEP. Magn Reson Med 2019; 82:1631-1645. [PMID: 31183892 PMCID: PMC6682494 DOI: 10.1002/mrm.27834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/04/2019] [Accepted: 05/09/2019] [Indexed: 01/31/2023]
Abstract
Purpose To investigate the potential of continuous radiofrequency (RF) shifting (SWEEP) as a technique for creating densely sampled data while maintaining a stable signal state for dynamic imaging. Methods We present a method where a continuous stable state of magnetization is swept smoothly across the anatomy of interest, creating an efficient approach to dense multiple 2D slice imaging. This is achieved by introducing a linear frequency offset to successive RF pulses shifting the excited slice by a fraction of the slice thickness with each successive repeat times (TR). Simulations and in vivo imaging were performed to assess how this affects the measured signal. Free breathing, respiration resolved 4D volumes in fetal/placental imaging is explored as potential application of this method. Results The SWEEP method maintained a stable signal state over a full acquisition reducing artifacts from unstable magnetization. Simulations demonstrated that the effects of SWEEP on slice profiles was of the same order as that produced by physiological motion observed with conventional methods. Respiration resolved 4D data acquired with this method shows reduced respiration artifacts and resilience to non‐rigid and non‐cyclic motion. Conclusions The SWEEP method is presented as a technique for improved acquisition efficiency of densely sampled short‐TR 2D sequences. Using conventional slice excitation the number of RF pulses required to enter a true steady state is excessively high when using short‐TR 2D acquisitions, SWEEP circumvents this limitation by creating a stable signal state that is preserved between slices.
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Affiliation(s)
- L H Jackson
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - A N Price
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - J Hutter
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - A Ho
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom.,Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom
| | - T A Roberts
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - P J Slator
- Centre for Medical Image Computing, University College London, London, United Kingdom
| | - J R Clough
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - M Deprez
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - L McCabe
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - S J Malik
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - L Chappell
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom
| | - M A Rutherford
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
| | - J V Hajnal
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, Kings College London, London, United Kingdom
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25
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Ho A, Xiao S, Madi A, Chihara N, Regev A, Kuchroo V. 087 Molecular and cellular mechanisms of tolerogenic signature induction in CD4+ T cells by apoptotic cells. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.163] [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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26
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Tait E, Byrne O, O'Doherty D, Evans B, Ajithkumar T, Begum G, Ho A. EP-1880 A planning study evaluating the use of 4DCT vs 3DCT in pancreas planning, both conventional and SABR. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32300-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: 10/26/2022]
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27
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McArthur HL, Basho R, Shiao SL, Park D, Mita M, Chung A, Arnold B, Martin C, Dang C, Karlan S, Knott S, Giuliano A, Ho A. Abstract P2-09-07: Preoperative pembrolizumab (Pembro) with radiation therapy (RT) in patients with operable triple-negative breast cancer (TNBC). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-09-07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Radiation therapy (RT) induces immune-mediated cell death and could generate a rich supply of tumor antigens if administered in the pre-operative, curative-intent setting. The addition of PD-1 mediated checkpoint blockade to pre-operative RT could thus, generate robust anti-tumor immune responses, induce long-term tumor-specific memory, and ultimately, improve cure rates. This study aims to establish the safety of pre-operative pembrolizumab (pembro)-mediated immune modulation with a RT “boost” equivalent in patients with operable triple negative breast cancer (TNBC) for whom lumpectomy and adjuvant RT are planned (NCT03366844). Serial research biopsies permit interrogation of conventional biomarkers including tumor infiltrating lymphocytes (TILs) and novel immune correlates as potential predictors of response to pembro alone versus pembro with RT.
Methods: Ten women with operable, primary TNBC >2cm for whom breast-conserving therapy is planned are being enrolled in this single-institution pilot study. Study treatment consists of 1 cycle of pre-operative pembro (200 mg IV) alone, followed 3 weeks later by a RT boost (24 Gy/3 fractions) to the primary breast tumor concurrently with pembro (+/- 5 days). Curative-intent, standard-of-care, neoadjuvant chemotherapy (NAC) or breast-conserving surgery is then undertaken within 8 weeks of study enrollment (i.e. within 5 weeks of pembro #2). Adjuvant RT is administered per standard-of-care after surgery, but without a boost dose. Research blood and fresh tumor biopsies are obtained at baseline and after cycles 1 and 2 of pembro. Co-primary endpoints are: 1) safety/tolerability, as defined by the number of patients who do not necessitate a delay in standard-of-care chemotherapy or surgery and 2) change in TIL score. Secondary endpoints include safety/toxicity up to 19 weeks after study enrollment, pCR rates and disease-free survival. Correlative analysis will include single-cell RNA sequencing of the tumor immune infiltrate and multispectral immunohistochemistry
Results: Seven patients enrolled between 12/19/17 and 7/1/18. As of 7/1/18, 5 patients have completed the experimental pembro/RT phase of the trial and are currently completing standard-of-care NAC; 1 patient is currently being treated in the experimental pembro/RT phase; and 1 patient with a cT2N0 tumor at baseline achieved a pathologic complete response (pCR, ypT0/Tis ypN0) after completing the experimental pembro/RT phase followed by anthracycline- and taxane-based NAC. No grade 3 or 4 toxicities have been observed during pembro/RT in the 6 patients completing the experimental phase to date. Three additional patients will be enrolled
Conclusions: This is the first trial of curative-intent, pre-operative checkpoint blockade with RT in breast cancer and the strategy appears to be well tolerated to date. At the time of presentation, safety, change in TIL score, and pCR rates for all patients completing the experimental and NAC phases of the study will be reported.
Citation Format: McArthur HL, Basho R, Shiao SL, Park D, Mita M, Chung A, Arnold B, Martin C, Dang C, Karlan S, Knott S, Giuliano A, Ho A. Preoperative pembrolizumab (Pembro) with radiation therapy (RT) in patients with operable triple-negative breast cancer (TNBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-09-07.
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Affiliation(s)
- HL McArthur
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - R Basho
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - SL Shiao
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - D Park
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - M Mita
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - A Chung
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - B Arnold
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - C Martin
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - C Dang
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - S Karlan
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - S Knott
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - A Giuliano
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
| | - A Ho
- Cedars-Sinai Medical Center, Los Angeles, CA; Massachusetts General Hospital, Boston, MA
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28
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Pavenski K, Ward SE, Hare GMT, Freedman J, Pulendrarajah R, Pirani RA, Sheppard N, Vance C, White A, Lo N, Waddell JP, Ho A, Schemitsch EH, Kataoka M, Bogoch ER, Saini K, David Mazer C, Baker JE. A rationale for universal tranexamic acid in major joint arthroplasty: overall efficacy and impact of risk factors for transfusion. Transfusion 2018; 59:207-216. [PMID: 30383292 DOI: 10.1111/trf.14995] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 09/05/2018] [Accepted: 09/05/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Tranexamic acid (TXA) therapy is effective in reducing postoperative red blood cell (RBC) transfusion in total joint arthroplasty (TJA), yet uncertainty persists regarding comparative efficacy and safety among specific patient subgroups. We assessed the impact of a universal TXA protocol on RBC transfusion, postoperative hemoglobin (Hb), and adverse outcomes to determine whether TXA is safe and effective in TJA, both overall and in clinically relevant subgroups. STUDY DESIGN AND METHODS A retrospective observational study was performed on patients undergoing TJA at our institution spanning 1 year before and after the implementation of a universal protocol to administer intravenous (IV) TXA. The primary outcome was percentage of patients transfused, and secondary outcomes were perioperative Hb and occurrence of adverse events (death, myocardial infarction, stroke, seizure, pulmonary embolism, deep vein thrombosis, and acute kidney injury ). Outcomes were compared in pre- and post-protocol groups with χ2 analysis. Logistic regression compared risk of transfusion in pre- and post-protocol subgroups of patients with differing risk for transfusion (anemia, body mass index [BMI], and sex). RESULTS No differences were found in baseline patient characteristics across pre- and post-protocol groups (n = 1084 and 912, respectively). TXA use increased from 32.3% to 92.2% while transfusion rates decreased from 10.3% to 4.8% (p < 0.001). Postoperative Day 3 Hb increased from 95.8 to 101.4 g/L (p < 0.001). Logistic regression demonstrated reduced transfusion in post-protocol subgroups regardless of sex, anemia, or BMI (p < 0.001). No increase in adverse events was observed (p = 0.8451). CONCLUSIONS Universal TXA was associated with a reduction of RBC transfusion, overall and in clinically relevant subgroups, strengthening the rationale for universal therapy.
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Affiliation(s)
- Katerina Pavenski
- Department of Laboratory Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.,St. Michael's Hospital Centre of Excellence for Patient Blood Management, Toronto, Ontario, Canada
| | - Sarah E Ward
- Division of Orthopedics, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Gregory M T Hare
- St. Michael's Hospital Centre of Excellence for Patient Blood Management, Toronto, Ontario, Canada.,Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada.,Keenan Research Centre for Biomedical Science, The Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - John Freedman
- Department of Laboratory Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.,Ontario Transfusion Coordinators (ONTraC), Toronto, Ontario, Canada
| | - Robisa Pulendrarajah
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Razak A Pirani
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Nicholas Sheppard
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Colm Vance
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Alexander White
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Nick Lo
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - James P Waddell
- Division of Orthopedics, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Alex Ho
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Emil H Schemitsch
- Division of Orthopedics, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mark Kataoka
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Earl R Bogoch
- Division of Orthopedics, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Kiran Saini
- Department of Pharmacy, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - C David Mazer
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada.,Keenan Research Centre for Biomedical Science, The Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - James E Baker
- Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
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29
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McArthur H, Basho R, Shiao S, Park D, Dang C, Karlan S, Knott S, Mita M, Dilauro Abaya C, Giuliano A, Dadmanesh F, Ho A. Preoperative pembrolizumab (Pembro) with radiation therapy (RT) in patients with operable triple-negative breast cancer (TNBC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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30
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Brodie MA, Pliner EM, Ho A, Li K, Chen Z, Gandevia SC, Lord SR. Big data vs accurate data in health research: Large-scale physical activity monitoring, smartphones, wearable devices and risk of unconscious bias. Med Hypotheses 2018; 119:32-36. [PMID: 30122488 DOI: 10.1016/j.mehy.2018.07.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/29/2018] [Accepted: 07/14/2018] [Indexed: 10/28/2022]
Abstract
Fundamental to the advancement of scientific knowledge is unbiased, accurate and validated measurement techniques. Recent United Nations and landmark Nature publications highlight the global uptake of mobile technology and the staggering potential for big data to encourage people to be physically active and to influence health policy. However, concerns exist about inconsistencies in smartphone health apps. Big data has many benefits, but noisy data may lead to wrong conclusions. In reaction to the increasing availability of low quality data; we call for a rigorous debate into the validity of substituting big data for accurate data in health research. We evaluated the step counting accuracy of a smartphone app previously used by 717,527 people from 111 countries. Our new data (from 48 participants; aged 21-59 years; body mass index 17.7-33.5 kg/m2) revealed significant (15-66%) undercounting by Apple phones. In contrast to the generally positive performances of wearable devices for stereotypical treadmill like walking, we observed extraordinarily large (0-200% of steps taken) error ranges for both Android and Apple phones. Unconscious bias (developers' perceptions of usual behaviour) may be embedded into many unvalidated smartphone apps. Consumer-grade wearable devices appear unsuitable to detect steps in people with slow, short or non-stereotypical gait patterns. Specifically, there is a risk of systematically undercounting the steps by obese people, females or people from different ethnic groups resulting in biases when reporting associations between physical inactivity and obesity. More research is required to develop smartphone apps suitable for all people of the heterogeneous global population.
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Affiliation(s)
- M A Brodie
- Falls Balance & Injury Research Centre, Neuroscience Research Australia, NSW, Australia; Graduate School of Biomedical Engineering, University of New South Wales, NSW, Australia.
| | - E M Pliner
- Falls Balance & Injury Research Centre, Neuroscience Research Australia, NSW, Australia; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - A Ho
- Graduate School of Biomedical Engineering, University of New South Wales, NSW, Australia
| | - Kalina Li
- Graduate School of Biomedical Engineering, University of New South Wales, NSW, Australia
| | - Z Chen
- Graduate School of Biomedical Engineering, University of New South Wales, NSW, Australia
| | - S C Gandevia
- Falls Balance & Injury Research Centre, Neuroscience Research Australia, NSW, Australia; School of Medicine, University of New South Wales, NSW, Australia
| | - S R Lord
- Falls Balance & Injury Research Centre, Neuroscience Research Australia, NSW, Australia; School of Medicine, University of New South Wales, NSW, Australia
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31
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Ho A, Chau N, Garcia IB, Ferte C, Even C, Burrows F, Kessler L, Mishra V, Magnuson K, Scholz C, Gualberto A. Preliminary Results From a Phase 2 Trial of Tipifarnib in HRAS-Mutant Head and Neck Squamous Cell Carcinomas. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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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Osborn V, Tsai C, Sherman E, Pfister D, Baxi S, Dunn L, Ho A, Michel L, Riaz N, Higginson D, Leeman J, Patel S, Xie P, Li X, Lee N, McBride S. Bolus Versus Weekly Chemotherapy in Definitive Chemoradiation for Nasopharyngeal Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2017.12.069] [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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McArthur H, Barker C, Gucalp A, Lebron Zapata L, Wen Y, Phung A, Wilgucki M, Henrich M, Arnold B, Zhang Z, Ho A. A single-arm, phase ii study assessing the efficacy of pembrolizumab (pembro) plus radiotherapy (RT) in metastatic triple negative breast cancer (mTNBC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hehlmann R, Lauseker M, Saußele S, Pfirrmann M, Krause S, Kolb HJ, Neubauer A, Hossfeld DK, Nerl C, Gratwohl A, Baerlocher GM, Heim D, Brümmendorf TH, Fabarius A, Haferlach C, Schlegelberger B, Müller MC, Jeromin S, Proetel U, Kohlbrenner K, Voskanyan A, Rinaldetti S, Seifarth W, Spieß B, Balleisen L, Goebeler MC, Hänel M, Ho A, Dengler J, Falge C, Kanz L, Kremers S, Burchert A, Kneba M, Stegelmann F, Köhne CA, Lindemann HW, Waller CF, Pfreundschuh M, Spiekermann K, Berdel WE, Müller L, Edinger M, Mayer J, Beelen DW, Bentz M, Link H, Hertenstein B, Fuchs R, Wernli M, Schlegel F, Schlag R, de Wit M, Trümper L, Hebart H, Hahn M, Thomalla J, Scheid C, Schafhausen P, Verbeek W, Eckart MJ, Gassmann W, Pezzutto A, Schenk M, Brossart P, Geer T, Bildat S, Schäfer E, Hochhaus A, Hasford J. Assessment of imatinib as first-line treatment of chronic myeloid leukemia: 10-year survival results of the randomized CML study IV and impact of non-CML determinants. Leukemia 2017; 31:2398-2406. [PMID: 28804124 PMCID: PMC5668495 DOI: 10.1038/leu.2017.253] [Citation(s) in RCA: 185] [Impact Index Per Article: 26.4] [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: 06/23/2017] [Accepted: 07/04/2017] [Indexed: 01/06/2023]
Abstract
Chronic myeloid leukemia (CML)-study IV was designed to explore whether treatment with imatinib (IM) at 400 mg/day (n=400) could be optimized by doubling the dose (n=420), adding interferon (IFN) (n=430) or cytarabine (n=158) or using IM after IFN-failure (n=128). From July 2002 to March 2012, 1551 newly diagnosed patients in chronic phase were randomized into a 5-arm study. The study was powered to detect a survival difference of 5% at 5 years. After a median observation time of 9.5 years, 10-year overall survival was 82%, 10-year progression-free survival was 80% and 10-year relative survival was 92%. Survival between IM400 mg and any experimental arm was not different. In a multivariate analysis, risk group, major-route chromosomal aberrations, comorbidities, smoking and treatment center (academic vs other) influenced survival significantly, but not any form of treatment optimization. Patients reaching the molecular response milestones at 3, 6 and 12 months had a significant survival advantage. For responders, monotherapy with IM400 mg provides a close to normal life expectancy independent of the time to response. Survival is more determined by patients' and disease factors than by initial treatment selection. Although improvements are also needed for refractory disease, more life-time can currently be gained by carefully addressing non-CML determinants of survival.
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Affiliation(s)
- R Hehlmann
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - M Lauseker
- IBE, Universität München, Munich, Germany
| | - S Saußele
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - S Krause
- Medizinische Klinik 5, Universitätsklinikum, Erlangen, Germany
| | - H J Kolb
- Medizinische Klinik III, Universität München, Munich, Germany
| | - A Neubauer
- Klinik für innere Medizin, Universitätsklinikum, Marburg, Germany
| | - D K Hossfeld
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | - C Nerl
- Klinikum Schwabing, Munich, Germany
| | | | | | - D Heim
- Universitätsspital, Basel, Switzerland
| | | | - A Fabarius
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | | | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - U Proetel
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - K Kohlbrenner
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - A Voskanyan
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - S Rinaldetti
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - W Seifarth
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - B Spieß
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - M C Goebeler
- Medizinische Klinik und Poliklinik, Universitätsklinikum, Würzburg, Germany
| | - M Hänel
- Klinik für innere Medizin 3, Chemnitz, Germany
| | - A Ho
- Medizinische Klinik V, Universität Heidelberg, Heidelberg, Germany
| | - J Dengler
- Onkologische Schwerpunktpraxis, Heilbronn, Germany
| | - C Falge
- Medizinische Klinik 5, Klinikum Nürnberg-Nord, Nürnberg, Germany
| | - L Kanz
- Medizinische Abteilung 2, Universitätsklinikum, Tübingen, Germany
| | - S Kremers
- Caritas Krankenhaus, Lebach, Germany
| | - A Burchert
- Klinik für innere Medizin, Universitätsklinikum, Marburg, Germany
| | - M Kneba
- 2. Medizinische Klinik und Poliklinik, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - F Stegelmann
- Klinik für Innere Medizin 3, Universitätsklinikum, Ulm, Germany
| | - C A Köhne
- Klinik für Onkologie und Hämatologie, Oldenburg, Germany
| | | | - C F Waller
- Innere Medizin 1, Universitätsklinikum, Freiburg, Germany
| | - M Pfreundschuh
- Klinik für Innere Medizin 1, Universität des Saarlandes, Homburg, Germany
| | - K Spiekermann
- Medizinische Klinik III, Universität München, Munich, Germany
| | - W E Berdel
- Medizinische Klinik A, Universitätsklinikum, Münster, Germany
| | - L Müller
- Onkologie Leer UnterEms, Leer, Germany
| | - M Edinger
- Klinik und Poliklinik für Innere Medizin 3, Universitätsklinikum, Regensburg, Germany
| | - J Mayer
- Masaryk University Hospital, Brno, Czech Republic
| | - D W Beelen
- Klinik für Knochenmarktransplantation, Essen, Germany
| | - M Bentz
- Medizinische Klinik 3, Städtisches Klinikum, Karlsruhe, Germany
| | - H Link
- Klinik für Innere Medizin 3, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - B Hertenstein
- 1. Medizinische Klinik, Klinikum Bremen Mitte, Bremen, Germany
| | | | - M Wernli
- Kantonsspital, Aarau, Switzerland
| | - F Schlegel
- St Antonius-Hospital, Eschweiler, Germany
| | - R Schlag
- Hämatologische-Onkologische Schwerpunktpraxis, Würzburg, Germany
| | - M de Wit
- Vivantes Klinikum Neukölln, Berlin, Germany
| | - L Trümper
- Klinik für Hämatologie und medizinische Onkologie, Universitätsmedizin, Göttingen, Germany
| | - H Hebart
- Stauferklinikum Schwäbisch Gmünd, Mutlangen, Germany
| | - M Hahn
- Onkologie Zentrum, Ansbach, Germany
| | - J Thomalla
- Praxisklinik für Hämatologie und Onkologie, Koblenz, Germany
| | - C Scheid
- Klinik 1 für Innere Medizin, Universitätsklinikum, Köln, Germany
| | - P Schafhausen
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | - W Verbeek
- Ambulante Hämatologie und Onkologie, Bonn, Germany
| | - M J Eckart
- Internistische Schwerpunktpraxis, Erlangen, Germany
| | | | | | - M Schenk
- Barmherzige Brüder, Regensburg, Germany
| | - P Brossart
- Medizinische Klinik 3, Universität, Bonn, Germany
| | - T Geer
- Diakonie, Schwäbisch Hall, Germany
| | - S Bildat
- Medizinische Klinik 2, Herford, Germany
| | - E Schäfer
- Onkologische Schwerpunktpraxis, Bielefeld, Germany
| | - A Hochhaus
- Klinik für Innere Medizin 2, Universitätsklinikum, Jena, Germany
| | - J Hasford
- IBE, Universität München, Munich, Germany
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Strauss RW, Muñoz B, Ho A, Jha A, Michaelides M, Mohand-Said S, Cideciyan AV, Birch D, Hariri AH, Nittala MG, Sadda S, Scholl HPN. Incidence of Atrophic Lesions in Stargardt Disease in the Progression of Atrophy Secondary to Stargardt Disease (ProgStar) Study: Report No. 5. JAMA Ophthalmol 2017; 135:687-695. [PMID: 28542697 DOI: 10.1001/jamaophthalmol.2017.1121] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Importance Outcome measures that are sensitive to disease progression are needed as clinical end points for future treatment trials in Stargardt disease. Objective To examine the incidence of atrophic lesions of the retinal pigment epithelium in patients with Stargardt disease as determined by fundus autofluorescence imaging. Design, Setting, and Participants In this retrospective multicenter cohort study, 217 patients 6 years and older at baseline at tertiary referral centers in Europe, the United States, and the United Kingdom who were harboring disease-causing variants in the adenosine triphosphate (ATP)-binding cassette subfamily A member 4 (ABCA4) gene and who met the following criteria were enrolled: (1) at least 1 well-demarcated area of atrophy with a minimum diameter of 300 µm, with the total area of all atrophic lesions being less than or equal to 12 mm2 in at least 1 eye at the most recent visit, and (2) fundus autofluorescence images for at least 2 visits with a minimum of 6 months between at least 2 visits. Data were collected between August 22, 2013, and December 12, 2014. Data analysis was performed from March 15, 2015, through January 31, 2017. Exposures Images were evaluated by staff at a central reading center. Areas of definitely decreased autofluorescence (DDAF) and questionably decreased autofluorescence (QDAF) were outlined and quantified. Lesion-free survival rates were estimated using Kaplan-Meier survival curves. Main Outcomes and Measures Incidence of atrophic lesions as determined by fundus autofluorescence. Results The 217 patients (mean [SD] age, 21.8 [13.3] years; 127 female [57.5%]; 148 white [68.2%]) contributed 390 eyes for which the mean (SD) follow-up time was 3.9 (1.6) years (range, 0.7-12.1 years). Among eyes without DDAF at first visit, the median time to develop a DDAF lesion was 4.9 years (95% CI, 4.3-5.6 years). Among eyes without QDAF, the median time to develop a QDAF lesion was 6.3 years (95% CI, 5.6-9.7 years). Eyes with a lesion of DDAF at the first visit were less likely to develop a QDAF lesion compared with eyes without a lesion of DDAF (hazard ratio, 0.19; 95% CI, 0.05-0.70; P = .01). Conclusions and Relevance An estimated 50% of the eyes without DDAF at first visit will develop the lesion in less than 5 years, suggesting that incidence of DDAF could serve as an outcome measure for treatment trials.
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Affiliation(s)
- Rupert W Strauss
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland2Moorfields Eye Hospital, National Health Service Foundation Trust, London, England3Department of Ophthalmology, Johannes Kepler University Linz, Linz, Austria4Department of Ophthalmology, Medical University Graz, Graz, Austria5Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - Beatriz Muñoz
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Alex Ho
- Doheny Eye Institute, David Geffen School of Medicine at UCLA (University of California, Los Angeles)
| | - Anamika Jha
- Doheny Eye Institute, David Geffen School of Medicine at UCLA (University of California, Los Angeles)
| | - Michel Michaelides
- Moorfields Eye Hospital, National Health Service Foundation Trust, London, England
| | - Saddek Mohand-Said
- Sorbonne Universités, University Pierre et Marie Curie, Université de Paris 06, Institut national de la santé et de la recherche médicale, Centre national de la recherche scientifique, Institut de la Vision, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France
| | - Artur V Cideciyan
- Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - David Birch
- Retina Foundation of the Southwest, Dallas, Texas
| | - Amir H Hariri
- Doheny Eye Institute, David Geffen School of Medicine at UCLA (University of California, Los Angeles)
| | - Muneeswar G Nittala
- Doheny Eye Institute, David Geffen School of Medicine at UCLA (University of California, Los Angeles)
| | - SriniVas Sadda
- Doheny Eye Institute, David Geffen School of Medicine at UCLA (University of California, Los Angeles)
| | - Hendrik P N Scholl
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland5Department of Ophthalmology, University of Basel, Basel, Switzerland
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de Solis CA, Hosek MP, Holehonnur R, Ho A, Banerjee A, Luong JA, Jones LE, Chaturvedi D, Ploski JE. Adeno-associated viral serotypes differentially transduce inhibitory neurons within the rat amygdala. Brain Res 2017; 1672:148-162. [PMID: 28764932 DOI: 10.1016/j.brainres.2017.07.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/21/2017] [Accepted: 07/26/2017] [Indexed: 11/18/2022]
Abstract
Recombinant adeno-associated viruses (AAV) are frequently used to make localized genetic manipulations within the rodent brain. It is accepted that the different viral serotypes possess differing affinities for particular cell types, but it is not clear how these properties affect their ability to transduce specific neuronal cell sub-types. Here, we examined ten AAV serotypes for their ability to transduce neurons within the rat basal and lateral nuclei of the amygdala (BLA) and the central nucleus of the amygdala (CeA). AAV2 based viral genomes designed to express either green fluorescent protein (GFP) from a glutamate decarboxylase (GAD65) promoter or the far-red fluorescent protein (E2-Crimson) from a phosphate-activated glutaminase (PAG) promoter were created and pseudotyped as AAV2/1, AAV2/4, AAV2/5, AAV2/6, AAV2/7, AAV 2/8, AAV2/9, AAV2/rh10, AAV2/DJ and AAV2/DJ8. These viruses were infused into the BLA and CeA at equal titers and twenty-one days later tissue within the amygdala was examined for viral transduction efficiency. These serotypes transduced neurons with similar efficiency, except for AAV4 and AAV5, which exhibited significantly less efficient neuronal transduction. Notably, AAV4 and AAV5 possess the most divergent capsid protein sequences compared to the other commonly available serotypes. We found that the Gad65-GFP virus did not exclusively express GFP within inhibitory neurons, as assessed by fluorescent in situ hybridization (FISH), but when this virus was used to transduce CeA neurons, the majority of the neurons that expressed GFP were in fact inhibitory neurons and this was likely due to the fact that this nucleus contains a very high percentage of inhibitory neurons.
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Affiliation(s)
- C A de Solis
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - M P Hosek
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - R Holehonnur
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - A Ho
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - A Banerjee
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - J A Luong
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - L E Jones
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - D Chaturvedi
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States
| | - J E Ploski
- School of Behavioral and Brain Sciences and the Department of Molecular & Cell Biology, The University of Texas at Dallas, United States.
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Perrino CM, Ho A, Dall CP, Zynger DL. Utility of GATA3 in the differential diagnosis of pheochromocytoma. Histopathology 2017; 71:475-479. [DOI: 10.1111/his.13229] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/29/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Carmen M Perrino
- Department of Pathology; The Ohio State University Medical Center; Columbus OH USA
| | - Alex Ho
- Department of Pathology; The Ohio State University Medical Center; Columbus OH USA
| | - Christopher P Dall
- Department of Pathology; The Ohio State University Medical Center; Columbus OH USA
| | - Debra L Zynger
- Department of Pathology; The Ohio State University Medical Center; Columbus OH USA
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Pinard J, Roman M, Kurtzman D, Ho A, Femia A, Vleugels R. 401 Cancer risk in clinically amyopathic dermatomyositis: A retrospective cohort study at four tertiary care centers. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.418] [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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Searle A, Spink MJ, Ho A, Chuter VH. Association between ankle equinus and plantar pressures in people with diabetes. A systematic review and meta-analysis. Clin Biomech (Bristol, Avon) 2017; 43:8-14. [PMID: 28167343 DOI: 10.1016/j.clinbiomech.2017.01.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 12/20/2016] [Accepted: 01/30/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Diabetes is one of the most common chronic diseases in the world and is associated with a life-time risk of foot ulcer of 12-25%. Diabetes related restriction in ankle joint range of dorsiflexion is proposed to contribute to elevated plantar pressures implicated in the development of foot ulcers. METHODS A systematic search of EBSCO Megafile Premier (containing MEDLINE, CINAHL, SPORTSdiscus and Academic Search Complete) and The Cochrane Library was conducted to 23rd November 2016. Two authors independently reviewed and selected relevant studies. Meta-analysis of study data were conducted where possible. FINDINGS Fifteen studies met the inclusion criteria. Three studies were eligible to be included in the meta-analysis which found that equinus has a significant, but small, effect on increased plantar pressures (ES=0.26, CI 95% 0.11 to 0.41, p=0.001). Of the remaining studies, eight found evidence of an association between limited ankle dorsiflexion and increased plantar pressures while four studies found no relationship. INTERPRETATION Limited ankle joint dorsiflexion may be an important factor in elevating plantar pressures, independent of neuropathy. Limited ankle dorsiflexion and increased plantar pressures were found in all the studies where the sample population had a history of neuropathic foot ulceration. In contrast, the same association was not found in those studies where the population had neuropathy and no history of foot ulcer. Routine screening for limited ankle dorsiflexion range of motion in the diabetic population would allow for early provision of conservative treatment options to reduce plantar pressures and lessen ulcer risk.
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Affiliation(s)
- A Searle
- School of Health Sciences, Faculty of Health, University of Newcastle, Australia.
| | - M J Spink
- School of Health Sciences, Faculty of Health, University of Newcastle, Australia
| | - A Ho
- School of Psychology, Faculty of Science and Information Technology, University of Newcastle, Australia
| | - V H Chuter
- School of Health Sciences, Faculty of Health, University of Newcastle, Australia
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Naik H, Qiu X, Brown MC, Eng L, Pringle D, Mahler M, Hon H, Tiessen K, Thai H, Ho V, Gonos C, Charow R, Pat V, Irwin M, Herzog L, Ho A, Xu W, Jones JM, Howell D, Liu G. Socioeconomic status and lifestyle behaviours in cancer survivors: smoking and physical activity. ACTA ACUST UNITED AC 2016; 23:e546-e555. [PMID: 28050143 DOI: 10.3747/co.23.3166] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE Smoking cessation and increased physical activity (pa) have been linked to better outcomes in cancer survivors. We assessed whether socioeconomic factors influence changes in those behaviours after a cancer diagnosis. METHODS As part of a cross-sectional study, a diverse group of cancer survivors at the Princess Margaret Cancer Centre (Toronto, ON), completed a questionnaire about past and current lifestyle behaviours and perceptions about the importance of those behaviours with respect to their health. The influence of socioeconomic indicators on smoking status and physical inactivity at 1 year before and after diagnosis were assessed using multivariable logistic regression with adjustment for clinico-demographic factors. RESULTS Of 1222 participants, 1192 completed the smoking component. Of those respondents, 15% smoked before diagnosis, and 43% of those smokers continued to smoke after. The proportion of survivors who continued to smoke increased with lower education level (p = 0.03). Of the 1106 participants answering pa questions, 39% reported being physically inactive before diagnosis, of whom 82% remained inactive afterward. Survivors with a lower education level were most likely to remain inactive after diagnosis (p = 0.003). Lower education level, household income, and occupation were associated with the perception that pa had no effect or could worsen fatigue and quality of life (p ≤ 0.0001). CONCLUSIONS In cancer survivors, education level was a major modifier of smoking and pa behaviours. Lower socioeconomic status was associated with incorrect perceptions about pa. Targeting at-risk survivors by education level should be evaluated as a strategy in cancer survivorship programs.
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Affiliation(s)
- H Naik
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - X Qiu
- Biostatistics, Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - M C Brown
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - L Eng
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - D Pringle
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - M Mahler
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - H Hon
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - K Tiessen
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - H Thai
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - V Ho
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - C Gonos
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - R Charow
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - V Pat
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - M Irwin
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - L Herzog
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - A Ho
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - W Xu
- Biostatistics, Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - J M Jones
- Toronto General Research Institute, Toronto and
| | - D Howell
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto
| | - G Liu
- Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto;; Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
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Ho A, Wei G, Maneval E, Esquibel V, Berger M, Haque S, Patel R, Walsh C, Hornby Z, Multani P, Li G, Drilon A. Overcoming drug resistance to Trk inhibition by rational combination of entrectinib and trametinib: from bench to bedside. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32615-6] [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: 10/20/2022]
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Wong VW, Ho A, Fiakos E, Lau NS, Russell H. Introduction of New South Wales adult subcutaneous insulin-prescribing chart in a tertiary hospital: its impact on inpatient glycaemic control. Intern Med J 2016; 46:1323-1328. [DOI: 10.1111/imj.13229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 07/25/2016] [Accepted: 08/13/2016] [Indexed: 01/08/2023]
Affiliation(s)
- V. W. Wong
- Liverpool Diabetes Collaborative Research Unit; Ingham Institute for Applied Medical Research, SWS Clinical School; Sydney New South Wales Australia
- Diabetes and Endocrine Service; Liverpool Hospital; Sydney New South Wales Australia
| | - A. Ho
- South Western Sydney Clinical School; University of New South Wales; Sydney New South Wales Australia
| | - E. Fiakos
- Pharmacy Department; Liverpool Hospital; Sydney New South Wales Australia
| | - N. S. Lau
- Liverpool Diabetes Collaborative Research Unit; Ingham Institute for Applied Medical Research, SWS Clinical School; Sydney New South Wales Australia
- Diabetes and Endocrine Service; Liverpool Hospital; Sydney New South Wales Australia
| | - H. Russell
- Diabetes and Endocrine Service; Liverpool Hospital; Sydney New South Wales Australia
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Ali S, Fedorchak K, Schrock A, Johnson J, Gowen K, Elvin J, Vergilio JA, Klempner S, Mehra R, Ho A, Pavlick D, Suh J, Bordoni R, Jung D, Stephens P, Chung C, Ross J, Miller V. Advanced acinic cell carcinoma harbors kinase rearrangements including BRAF kinase domain duplications. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw376.32] [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: 11/13/2022] Open
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Tyagi N, Sutton E, Hunt M, Apte A, Zhang J, Oh J, Mechalakos J, Mehrara B, Matros E, Ho A. SU-D-207B-04: Morphological Features of MRI as a Correlate of Capsular Contracture in Breast Cancer Patients with Implant-Based Reconstructions. Med Phys 2016. [DOI: 10.1118/1.4955672] [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: 11/07/2022] Open
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Zhang Z, Ho A, Wang X, Brown P, Guha-Thakurta N, Ferguson S, Fave X, Zhang L, Mackin D, Court L, Li J, Yang J. TU-D-207B-01: A Prediction Model for Distinguishing Radiation Necrosis From Tumor Progression After Gamma Knife Radiosurgery Based On Radiomics Features From MR Images. Med Phys 2016. [DOI: 10.1118/1.4957509] [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: 11/07/2022] Open
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Ho A, Aston S, Jary H, Alaerts M, Menyere M, Mallewa J, Nyirenda M, Everett D, French N, Heyderman R. The impact of HIV infection on the burden and severity of influenza illness in Malawian adults. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.107] [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] Open
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Hamilton AS, Fleming ST, Wang D, Goodman M, Wu XC, Owen JB, Lo M, Ho A, Anderson RT, Thompson T. Clinical and Demographic Factors Associated With Receipt of Non Guideline-concordant Initial Therapy for Nonmetastatic Prostate Cancer. Am J Clin Oncol 2016; 39:55-63. [PMID: 24390274 PMCID: PMC4514560 DOI: 10.1097/coc.0000000000000017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the extent to which initial therapy for nonmetastatic prostate cancer was concordant with nationally recognized guidelines using supplemented cancer registry data and what factors were associated with receipt of nonguideline-concordant care. METHODS Initial therapy for 8229 nonmetastatic prostate cancer cases diagnosed in 2004 from cancer registries in 7 states was abstracted as part of the Centers for Disease Control's Patterns of Care Breast and Prostate Cancer study conducted during 2007 to 2009. The National Comprehensive Cancer Network clinical practice guidelines version 1.2002 was used as the standard of care based on recurrence risk group and life expectancy (LE). A multivariable model was used to determine risk factors associated with receipt of nonguideline-concordant care. RESULTS Nearly 80% with nonmetastatic prostate cancer received guideline-concordant care for initial therapy. Receipt of nonguideline-concordant care (including receiving either less aggressive therapy or more aggressive therapy than indicated) was related to older age, African American race/ethnicity, being unmarried, rural residence, and especially to being in the high recurrence risk group where receiving less aggressive therapy than indicated occurred more often than receiving more aggressive therapy (adjusted OR=4.2; 95% CL, 3.5-5.2 vs. low-risk group). Compared with life table estimates adjusted for comorbidity, physicians tended to underestimate LE. CONCLUSIONS Receipt of less aggressive therapy than indicated among high-risk group men with >5-year LE based on life table estimates adjusted for comorbidity was a concern. Physicians may tend to underestimate 5-year survival among this group and should be alerted to the importance of recommending aggressive therapy when warranted. However, based on more recent guidelines, among those with low-risk disease, the proportion considered to be receiving less aggressive therapy than indicated may now be lower because active surveillance is now considered appropriate.
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Affiliation(s)
- Ann S. Hamilton
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | | | - Dian Wang
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - Michael Goodman
- Department of Epidemiology, Emory University School of Public Health
| | - Xiao-Cheng Wu
- Epidemiology Program, School of Public Health, LSU Health Sciences Center, New Orleans, LA
| | - Jean B. Owen
- American College of Radiology, Clinical Research Center, Philadelphia
| | - Mary Lo
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Alex Ho
- American College of Radiology, Clinical Research Center, Philadelphia
| | - Roger T. Anderson
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Trevor Thompson
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
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Ho A, Hameed H, Lee AW, Shih M. Potential Gains in Life Expectancy from Reductions in Leading Causes of Death, Los Angeles County: a Quantitative Approach to Identify Candidate Diseases for Prevention and Burden Disparities Elimination. J Racial Ethn Health Disparities 2015; 3:431-43. [DOI: 10.1007/s40615-015-0156-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 07/10/2015] [Accepted: 08/06/2015] [Indexed: 11/30/2022]
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Pantuck AJ, Pettaway CA, Dreicer R, Corman J, Katz A, Ho A, Aronson W, Clark W, Simmons G, Heber D. A randomized, double-blind, placebo-controlled study of the effects of pomegranate extract on rising PSA levels in men following primary therapy for prostate cancer. Prostate Cancer Prostatic Dis 2015; 18:242-8. [PMID: 26169045 DOI: 10.1038/pcan.2015.32] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 06/02/2015] [Accepted: 06/02/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND The primary objective of this study was to compare the effects of pomegranate juice on PSA doubling times (PSADT) in subjects with rising PSA levels after primary therapy for prostate cancer. METHODS Double-blind, placebo-controlled multi-institutional study, evaluated the effects of pomegranate liquid extract on serum PSA levels. The primary end point of this study was change in serum PSADT. Additional secondary and exploratory objectives were to evaluate the safety of pomegranate juice and to determine the interaction of manganese superoxide dismutase (MnSOD) AA genotype and pomegranate treatment on PSADT. RESULTS One-hundred eighty-three eligible subjects were randomly assigned to the active and placebo groups with a ratio of 2:1 (extract N=102; placebo N=64; juice N=17). The majority of adverse events were of moderate or mild grade. Median PSADT increased from 11.1 months at baseline to 15.6 months in the placebo group (P<0.001) compared with an increase from 12.9 months at baseline to 14.5 months in the extract group (P=0.13) and an increase from 12.7 at baseline to 20.3 in the juice group (P=0.004). However, none of these changes were statistically significant between the three groups (P>0.05). Placebo AA patients experienced a 1.8 month change in median PSADT from 10.9 months at baseline to 12.7 months (P=0.22), while extract patients experienced a 12 month change in median PSADT from 13.6 at baseline to 25.6 months (P=0.03). CONCLUSIONS Compared with placebo, pomegranate extract did not significantly prolong PSADT in prostate cancer patients with rising PSA after primary therapy. A significant prolongation in PSADT was observed in both the treatment and placebo arms. Men with the MnSOD AA genotype may represent a group that is more sensitive to the antiproliferative effects of pomegranate on PSADT; however, this finding requires prospective hypothesis testing and validation.
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Affiliation(s)
- A J Pantuck
- Department of Urology, Institute of Urologic Oncology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - C A Pettaway
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - R Dreicer
- Cleveland Clinic Foundation, Cleveland, OH, USA
| | - J Corman
- Virginia Mason Medical Center, Seattle, WA, USA
| | - A Katz
- Winthrop University Hospital, Garden City, NY, USA
| | - A Ho
- Winthrop University Hospital, Garden City, NY, USA
| | - W Aronson
- 1] Department of Urology, Institute of Urologic Oncology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA [2] VA Medical Center Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - W Clark
- Alaska Clinical Research Center, Anchorage, AL, USA
| | - G Simmons
- Five Valleys Urology, Missoula, MT, USA
| | - D Heber
- 1] Department of Urology, Institute of Urologic Oncology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA [2] Department of Medicine and Clinical Nutrition, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA
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