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Dumont J, Bou-Gharios J, Keller A, Chambrelant I, Pamart G, Mascaux C, Falcoz PE, Antoni D, Olland A, Pietta GA, Noël G. Impact of adjuvant radiotherapy and chemotherapy on thymoma. Cancer Radiother 2024; 28:174-181. [PMID: 38182482 DOI: 10.1016/j.canrad.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 01/07/2024]
Abstract
PURPOSE Thymoma is a rare tumour. The most common treatment for thymoma is surgical resection, while the use of radiotherapy and chemotherapy remains controversial. PATIENTS AND METHODS We conducted a monocentric observational study of 31 patients diagnosed with thymoma from June 2004 to July 2020 at cancer centre in Strasbourg, France. We analysed the outcomes of the patients. RESULTS The 2- and 5- year locoregional relapse-free survival rates were 96.3% (95% confidence interval [CI]: 76.5-99.5%) and 68.0% (95% CI: 43.8-83.5%), respectively. Radiotherapy and chemotherapy significantly improved local tumour control (P=0.0008 and 0.04, respectively), while a larger initial tumour size significantly worsened local control rates (P=0.04). The 5- and 10-year overall survival rates were 87.1% (95% CI: 69.2-95%) and 81.7% (95% CI: 60.3-92.2%), respectively. The median overall survival was not reached, and no favourable factor was retrieved. For relapsed patients, the median overall survival after relapse was 115 months. CONCLUSION Despite the inherent limitations of retrospective studies with a limited patient sample size, we demonstrated that chemotherapy and radiotherapy in addition to surgery were effective in achieving local control and contributed to improving patient outcomes in thymoma. Notably, an aggressive treatment strategy at the time of relapse resulted in favourable outcomes for retreated patients.
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Affiliation(s)
- J Dumont
- Chest Diseases Department, Hôpital Hautepierre, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - J Bou-Gharios
- Radiation Therapy Department, Institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - A Keller
- Radiation Therapy Department, Oncopole, Toulouse, France
| | - I Chambrelant
- Radiation Therapy Department, Institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - G Pamart
- Chest Diseases Department, Hôpital Hautepierre, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - C Mascaux
- Chest Diseases Department, Hôpital Hautepierre, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France
| | - P-E Falcoz
- Department of Thoracic Surgery, Hôpital Hautepierre, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67200 Strasbourg, France
| | - D Antoni
- Radiation Therapy Department, Institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - A Olland
- Department of Thoracic Surgery, Hôpital Hautepierre, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67200 Strasbourg, France
| | - G A Pietta
- Radiation Therapy Department, Institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - G Noël
- Radiation Therapy Department, Institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France.
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Abdelhakiem MK, Keller A, Bajpai RR, Smith RP, Beriwal S, Benoit R. Long-Term Urinary Toxicity Follow-Up of Combined External Beam Radiation and Cs-131 LDR Brachytherapy Boost for Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e361. [PMID: 37785244 DOI: 10.1016/j.ijrobp.2023.06.2450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate and update our institutional data on chronic patient-reported urinary symptoms in patients with prostate cancer treated with combined external beam radiation therapy (EBRT) and Cesium-131 (Cs-131) LDR brachytherapy boost. MATERIALS/METHODS Patients treated from September 2006-July 2022 and with at least 6 months of follow-up were analyzed. Patients filled out the Expanded Prostate Cancer Index Composite (EPIC) questionnaire pre-treatment and at each scheduled follow-up. Mean EPIC urinary scores were calculated for urinary summary, urinary function, urinary bother, urinary incontinence, and urinary irritative/obstructive domains. Changes of 7-points or more in mean domain scores were deemed clinically significant. The prevalence of urinary bleeding was calculated and bleeding occurring more than "about once a week" ("more than once a week", "about once a day", and "more than once a day") was deemed clinically significant. Outcomes were analyzed at each follow-up timepoint using paired t-test. RESULTS A total of 341 patients with prostate cancer were included in the analysis of which 183 were intermediate-risk and 158 high-risk. 174 patients were treated with tri-modality therapy, and SpaceOAR was used in 108 patients. Long-term statistically significant decreases in mean EPIC QOL scores were seen in urinary summary, urinary function, urinary bother, urinary incontinence, and urinary irritative/obstructive domains at 6 months, with clinically and statistically significant decreases in urinary function and urinary incontinence at 6 months (86±17.4, 83.4±22.2 respectively) and up to 18 months post-treatment (84.8±17.4, 83.6±20.7 respectively) compared with pre-treatment scores (93.1±10.7, 90.8±14.8 respectively), with both domains returning to clinical baseline at 24 months. Urinary irritative/obstructive mean scores clinically and significantly decreased at 9 months (77±17.4) compared to pre-treatment (84.7±13.5), returning to clinical baseline at 12 months. The prevalence of clinically significant urinary bleeding at 6, 12, 24, 36, 48, and 60 months was 1.3%, 2.6%, 3.7%, 0.7%, 0.9%, and 2.3% respectively. At the median follow-up of 42 months (IQR 54, 18-72), mean EPIC scores were clinically improved (≥7-point increase) from pre-treatment baseline in 15-30% of patients across the analyzed urinary domains. CONCLUSION Long-term patient-reported clinically significant decreases in urinary function and urinary incontinence mean EPIC scores occurred up to 18 months following combined external beam radiation and Cs-131 prostate brachytherapy and returned to baseline at 24 months, while clinically significant decrease in urinary irritability/obstructive mean scores occurred at 9 months and returned to baseline at 12 months. At 42 months follow-up, mean urinary domain scores improved from pre-treatment baseline in 15-30% of patients.
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Affiliation(s)
- M K Abdelhakiem
- UPMC Hillman Cancer Center, Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - A Keller
- Radiation Oncology, AdventHealth Cancer Institute, Orlando, FL
| | - R R Bajpai
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - R P Smith
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - S Beriwal
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
| | - R Benoit
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Kuntz L, Le Fèvre C, Jarnet D, Keller A, Meyer P, Thiery A, Cebula H, Noel G, Antoni D. Changes in the characteristics of patients treated for brain metastases with repeat stereotactic radiotherapy (SRT): a retrospective study of 184 patients. Radiat Oncol 2023; 18:21. [PMID: 36717863 PMCID: PMC9885681 DOI: 10.1186/s13014-023-02200-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 01/03/2023] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Brain metastases (BMs) are the leading cause of intracranial malignant neoplasms in adults. WHO, Karnofsky performance status (KPS), age, number of BMs, extracerebral progression (ECP), recursive partitioning analysis (RPA), diagnosis-specific graded prognostic assessment (Ds-GPA) are validated prognostic tools to help clinicians decide on treatment. No consensus exists for repeat stereotactic radiotherapy (SRT) for BMs. The aim of this study was to review the changes in patient characteristics treated with repeated SRTs. METHODS AND MATERIALS The data of patients treated between 2010 and 2020 with at least two courses of SRT without previous whole brain radiotherapy (WBRT) were reviewed. Age, WHO, KPS, ECP, type of systemic treatment, number of BMs were recorded. RPA, Ds-GPA and brain metastasis velocity (BMV) were calculated. RESULTS 184 patients were treated for 915 BMs and received two to six SRTs for local or distant brain recurrence. The median number of BMs treated per SRT was 1 (range: 1-6), for a median of 4 BMs treated during all sessions (range: 2-19). WHO, Ds-GPA and RPA were stable between each session of SRT, whereas KPS was significantly better in SRT1 than in the following SRT. The number of BMs was not significantly different between each SRT, but there was a tendency for more BM at SRT1 (p = 0.06). At SRT1, patients had largest BM and undergo more surgery than during the following SRT (p < 0.001). 6.5%, 37.5% and 56% of patients were classified as high, intermediate, and low BMV, respectively, at the last SRT session. There was almost perfect concordance between the BMV-grade calculated at the last SRT session and at SRT2 (r = 0.89; p < 0.001). CONCLUSION Repeated SRT doesn't lead to a marked alteration in the general condition, KPS was maintained at over 70% for more than 95% of patients during all SRTs. Long survival can be expected, especially in low-grade BMV patients. WBRT shouldn't be aborted, especially for patients developing more than twelve BMs annually.
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Affiliation(s)
- L. Kuntz
- grid.512000.6Department of Radiation Therapy, Institut de Cancérologie Strasbourg Europe (ICANS), 17 Rue Albert Calmette, 67200 Strasbourg, France
| | - C. Le Fèvre
- grid.512000.6Department of Radiation Therapy, Institut de Cancérologie Strasbourg Europe (ICANS), 17 Rue Albert Calmette, 67200 Strasbourg, France
| | - D. Jarnet
- grid.512000.6Medical Physics Unit, Institut de Cancérologie Strasbourg Europe (ICANS), 17 Rue Albert Calmette, 67200 Strasbourg, France
| | - A. Keller
- grid.512000.6Department of Radiation Therapy, Institut de Cancérologie Strasbourg Europe (ICANS), 17 Rue Albert Calmette, 67200 Strasbourg, France
| | - P. Meyer
- grid.512000.6Medical Physics Unit, Institut de Cancérologie Strasbourg Europe (ICANS), 17 Rue Albert Calmette, 67200 Strasbourg, France
| | - A. Thiery
- grid.512000.6Medical Information Department, Institut de Cancérologie Strasbourg Europe (ICANS), 3 Rue de La Porte de L’Hôpital, 67065 Strasbourg Cedex, France
| | - H. Cebula
- grid.412220.70000 0001 2177 138XDepartment of Neurosurgery, University Hospitals of Strasbourg, 1 Avenue Molière, 67200 Strasbourg, France
| | - G. Noel
- grid.512000.6Department of Radiation Therapy, Institut de Cancérologie Strasbourg Europe (ICANS), 17 Rue Albert Calmette, 67200 Strasbourg, France
| | - D. Antoni
- grid.512000.6Department of Radiation Therapy, Institut de Cancérologie Strasbourg Europe (ICANS), 17 Rue Albert Calmette, 67200 Strasbourg, France
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Kuntz L, Le Fèvre C, Jarnet D, Keller A, Meyer P, Thiery A, Cebula H, Noel G, Antoni D. Acute toxicities and cumulative dose to the brain of repeated sessions of stereotactic radiotherapy (SRT) for brain metastases: a retrospective study of 184 patients. Radiat Oncol 2023; 18:7. [PMID: 36627646 PMCID: PMC9830690 DOI: 10.1186/s13014-022-02194-0] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Stereotactic radiation therapy (SRT) is a focal treatment for brain metastases (BMs); thus, 20 to 40% of patients will require salvage treatment after an initial SRT session, either because of local or distant failure. SRT is not exempt from acute toxicity, and the acute toxicities of repeated SRT are not well known. The objective of this study was to analyze the acute toxicities of repeated courses of SRT and to determine whether repeated SRT could lead to cumulative brain doses equivalent to those of whole-brain radiotherapy (WBRT). MATERIAL AND METHODS Between 2010 and 2020, data from 184 patients treated for 915 BMs via two to six SRT sessions for local or distant BM recurrence without previous or intercurrent WBRT were retrospectively reviewed. Patients were seen via consultations during SRT, and the delivered dose, the use of corticosteroid therapy and neurological symptoms were recorded and rated according to the CTCAEv4. The dosimetric characteristics of 79% of BMs were collected, and summation plans of 76.6% of BMs were created. RESULTS 36% of patients developed acute toxicity during at least one session. No grade three or four toxicity was registered, and grade one or two cephalalgy was the most frequently reported symptom. There was no significant difference in the occurrence of acute toxicity between consecutive SRT sessions. In the multivariate analysis, acute toxicity was associated with the use of corticosteroid therapy before irradiation (OR = 2.6; p = 0.01), BMV grade (high vs. low grade OR = 5.17; p = 0.02), and number of SRT sessions (3 SRT vs. 2 SRT: OR = 2.64; p = 0.01). The median volume equivalent to the WBRT dose (VWBRT) was 47.9 ml. In the multivariate analysis, the VWBRT was significantly associated with the total GTV (p < 0.001) and number of BMs (p < 0.001). Even for patients treated for more than ten cumulated BMs, the median BED to the brain was very low compared to the dose delivered during WBRT. CONCLUSION Repeated SRT for local or distant recurrent BM is well tolerated, without grade three or four toxicity, and does not cause more acute neurological toxicity with repeated SRT sessions. Moreover, even for patients treated for more than ten BMs, the VWBRT is low.
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Affiliation(s)
- L. Kuntz
- grid.512000.6Radiation Therapy University Department, Institut de Cancérologie Strasbourg Europe (ICANS), 17 rue Albert Calmette, 67200 Strasbourg, France
| | - C. Le Fèvre
- grid.512000.6Radiation Therapy University Department, Institut de Cancérologie Strasbourg Europe (ICANS), 17 rue Albert Calmette, 67200 Strasbourg, France
| | - D. Jarnet
- grid.512000.6Medical Physics Unit, Institut de Cancérologie Strasbourg Europe (ICANS), 17 rue Albert Calmette, 67200 Strasbourg, France
| | - A. Keller
- grid.512000.6Radiation Therapy University Department, Institut de Cancérologie Strasbourg Europe (ICANS), 17 rue Albert Calmette, 67200 Strasbourg, France
| | - P. Meyer
- grid.512000.6Medical Physics Unit, Institut de Cancérologie Strasbourg Europe (ICANS), 17 rue Albert Calmette, 67200 Strasbourg, France
| | - A. Thiery
- grid.512000.6Medical Information Department, Institut de Cancérologie Strasbourg Europe (ICANS), 3 rue de la Porte de L’Hôpital, 67065 Strasbourg Cedex, France
| | - H. Cebula
- grid.412220.70000 0001 2177 138XDepartment of Neurosurgery, University Hospitals of Strasbourg, 1 Avenue Molière, 67200 Strasbourg, France
| | - G. Noel
- grid.512000.6Radiation Therapy University Department, Institut de Cancérologie Strasbourg Europe (ICANS), 17 rue Albert Calmette, 67200 Strasbourg, France
| | - D. Antoni
- grid.512000.6Radiation Therapy University Department, Institut de Cancérologie Strasbourg Europe (ICANS), 17 rue Albert Calmette, 67200 Strasbourg, France
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Mulherkar R, Keller A, Houser C, Kim H, Vargo J, Barry P, Beriwal S. Outcomes of 3D MRI Based HDR Brachytherapy with Hybrid Multichannel Vaginal Cylinder Applicator and Freehand Needles for Treatment of Vaginal Disease. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hartmann J, Keller A, Enk A, Gholam P. Hemodynamic changes during conventional and daylight photodynamic therapy of actinic keratoses - a randomized controlled trial. J DERMATOL TREAT 2022; 33:3022-3027. [PMID: 35775704 DOI: 10.1080/09546634.2022.2097160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is an effective treatment for actinic keratosis (AK). However, pain and hypertension are important side effects of conventional PDT (c-PDT). Several studies have demonstrated that daylight PDT (dl-PDT) is less painful while being as effective as c-PDT. OBJECTIVE To observe the effect of c-PDT and dl-PDT on different hemodynamic parameters (systolic blood pressure and diastolic blood pressure, pulse rate, and peripheral oxygen saturation). METHODS Fifty patients with AK on the head were enrolled into this prospective, randomized, controlled study and treated with c-PDT or dl-PDT in a 1:1 ratio. Hemodynamic parameters were measured at four different time points during treatment. Pain was quantified using a visual analog scale. AK was counted before treatment and after one month. RESULTS C-PDT is associated with significantly more pain, a significant increase in blood pressure and a higher rate of patients with grade 3 hypertension. Whereas dl-PDT is almost painless and does not lead to any changes in hemodynamic parameters. For both treatments, a similar lesion response rate was found after one month. CONCLUSIONS dl-PDT has a better tolerability while being as effective as c-PDT and therefore may be the more favorable treatment option in certain patient groups.
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Affiliation(s)
- J Hartmann
- Department of Dermatology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - A Keller
- Department of Dermatology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - A Enk
- Department of Dermatology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - P Gholam
- Department of Dermatology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
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Musunuru H, Keller A, Lin S, Mohan R, Ellsworth S. Modeling Potential Lymphocyte-Sparing Effect of Involved-Field Radiotherapy in Rectal Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.996] [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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Keller A, Freiwald T, Buchholz H, Hohendorf S, Herdlitschka T, Zentel A, Odenwald A, Gödde M. Model‐Based Safety for Semi‐Batch Processes. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- A. Keller
- BASF SE 67056 Ludwigshafen am Rhein Germany
| | | | | | | | | | - A. Zentel
- BASF SE 67056 Ludwigshafen am Rhein Germany
| | | | - M. Gödde
- BASF SE 67056 Ludwigshafen am Rhein Germany
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Kuntz L, Le Fèvre C, Jarnet D, Keller A, Meyer P, Cox DG, Bund C, Antoni D, Cebula H, Noel G. Radionecrosis after repeated courses of radiotherapy under stereotactic conditions for brain metastases: Analysis of clinical and dosimetric data from a retrospective cohort of 184 patients. Cancer Radiother 2022; 26:692-702. [PMID: 35715354 DOI: 10.1016/j.canrad.2022.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 08/26/2021] [Revised: 12/27/2021] [Accepted: 01/05/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Between 10 and 40% of patients with cancer will develop one or more brain metastases (BMs). Stereotactic radiotherapy (SRT) is part of the therapeutic arsenal for the treatment of de novo or recurrent BM. Its main interest is to delay whole brain radiation therapy (WBRT), which may cause cognitive toxicity. However, SRT is not exempt from long-term toxicity, and the most widely known SRT is radionecrosis (RN). The objective of this study was to analyze the occurrence of RN per BM and per patient. MATERIAL AND METHODS Between 2010 and 2020, data from 184 patients treated for 915 BMs by two to six SRT sessions for local or distant brain recurrence without previous or intercurrent WBRT were retrospectively reviewed. RN was examined on trimestral follow-up MRI and potentially confirmed by surgery or nuclear medicine. For each BM and SRT session plan, summation V12Gy, V14Gy, V21Gy and V23Gy isodoses were collected. Volumes of intersections were created between the 12Gy isodose at the first SRT and the 18Gy isodose of the following SRT (V18-12Gy). RESULTS At the end of follow-up, 23.0% of patients presented RN, and 6.3% of BM presented RN. Median follow-up of BM was 13.3 months (95%CI 18.3-20.8). The median interval between BM irradiation and RN was 8.7 months (95% CI 9.2-14.7). Six-, 12- and 24-month RN-free survival rates per BM were 75%, 54% and 29%, respectively. The median RN-free survival per patient was 15.3 months (95% CI 13.6-18.1). In multivariate analysis, the occurrence of RN per BM was statistically associated with local reirradiation (P<0.001) and the number of SRTs (P<0.001). In univariate analysis, the occurrence of RN per patient was statistically associated with the sum of all V18-12Gy (P=0.02). No statistical association was found in multivariate analysis. A sum of all V18-12Gy of less than 1.5ml was associated with a 14.6% risk of RN, compared with 35.6% when the sum of all V18-12Gy was superior to 1.5ml. The sum of all V18-12Gy larger than 1.5ml was associated with a 74% specificity and 53% sensitivity of RN (P<0.001). CONCLUSION Based on these results, a small number of BMs show RN during repeated SRT for local or distant recurrent BMs. Local reirradiation was the most predictive factor of brain RN. A V18-12Gy larger than 7.6ml in the case of local reirradiation or larger than 1.5ml in proximity reirradiation were prognostic factors of RN. The more BM patients need radiation therapy, and the longer they survive after irradiation, the higher their individual risk of developing RN.
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Affiliation(s)
- L Kuntz
- Radiation Therapy University Department, Institut de Cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - C Le Fèvre
- Radiation Therapy University Department, Institut de Cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - D Jarnet
- Medical Physics Unit, Institut de Cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - A Keller
- Radiation Therapy University Department, Institut de Cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - P Meyer
- Medical Physics Unit, Institut de Cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - D G Cox
- IRFAC, Inserm U1113, 3, avenue Molière, 67000 Strasbourg, France; Research and Development in Precision Medicine, Institut de Cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - C Bund
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - D Antoni
- Radiation Therapy University Department, Institut de Cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - H Cebula
- Department of Neurosurgery, University Hospitals of Strasbourg, 1, avenue Molière, 67200 Strasbourg, France
| | - G Noel
- Radiation Therapy University Department, Institut de Cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France.
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Jain R, Peng G, Taylor-Cousar J, Lee M, Keller A, West N, Kazmerski T, Goralski J, Aitken M, Roe A, Hadjiliadis D, Uluer A, Foil K, Flume P, Mody S, Bray L. WS04.04 Impact of planned versus unplanned pregnancy in people with cystic fibrosis. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00174-6] [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: 11/25/2022]
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Pifer P, Jaishankar S, Bhargava R, Keller A, Musunuru H, Cohen M, Sukumvanich P, Courtney-Brooks M, Boisen M, Berger J, Taylor S, Olawaiye A, Lesnock J, Edwards R, Vargo J, Beriwal S. PD-0913 Is substantial LVSI prognostic in patients with pathological lymph node-negative endometrial cancer? Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02992-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jaishankar S, Pifer PM, Bhargava R, Keller A, Musunuru HB, Patel AK, Sukumvanich P, Boisen M, Berger JL, Taylor S, Courtney-Brooks M, Olawaiye A, Lesnock J, Edwards R, Vargo JA, Beriwal S. Is Substantial Lymphovascular Space Invasion Prognostic for Clinical Outcomes in Type II Endometrial Cancer? Clin Oncol (R Coll Radiol) 2022; 34:452-458. [PMID: 35264314 DOI: 10.1016/j.clon.2022.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/03/2021] [Revised: 01/26/2022] [Accepted: 02/21/2022] [Indexed: 11/03/2022]
Abstract
AIMS Substantial lymphovascular space invasion (LVSI) compared with none or focal LVSI is predictive of lymph node involvement and worse clinical outcomes in endometrioid-type endometrial carcinoma. We aimed to quantify the incidence of substantial LVSI in type II (clear cell and serous) endometrial cancer and correlate the extent of LVSI with clinical outcomes. MATERIALS AND METHODS A retrospective review was conducted on type II endometrial cancer patients who underwent surgical management from July 2017 to December 2019 using the three-tier LVSI scoring system. Binary logistic regression and Cox regression were used to analyse predictors of lymph node involvement or survival outcomes, respectively. The Kaplan-Meier method and Log-rank test were used to analyse differences in locoregional disease-free survival (LR-DFS), distant metastasis disease-free survival (DM-DFS) and overall survival between patients with substantial versus none/focal LVSI. RESULTS In 79 patients with type II endometrial carcinoma, no LVSI, focal LVSI and substantial LVSI was present in 48.1%, 15.2% and 36.7% of patients, respectively. Lymph nodes were involved in 0.0% with no LVSI, 20.0% with focal LVSI and 60.0% with substantial LVSI (P < 0.001). The median follow-up was 22.2 months. In patients with none/focal versus substantial LVSI, the 2-year LR-DFS and DM-DFS rates were 91.5% versus 71.4% (P = 0.01) and 90.2% versus 63.8% (P = 0.005), respectively. On univariate analysis, myometrial invasion ≥50%, tumour size ≥3.6 cm, substantial versus none/focal LVSI, lymph node involvement and omission of adjuvant radiotherapy were significant predictors for worse LR-DFS and DM-DFS (P < 0.05). DISCUSSION Substantial LVSI has a high incidence in type II pathology at our institution and predicts for lymph node involvement and worse clinical outcomes.
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Affiliation(s)
- S Jaishankar
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - P M Pifer
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - R Bhargava
- Department of Pathology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - A Keller
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - H B Musunuru
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - A K Patel
- Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA
| | - P Sukumvanich
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - M Boisen
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - J L Berger
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - S Taylor
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - M Courtney-Brooks
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - A Olawaiye
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - J Lesnock
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - R Edwards
- Department of Gynecologic Oncology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - J A Vargo
- Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - S Beriwal
- Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA; Varian Medical Systems, Charlottesville, VA, USA.
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Keller A, Sterner P, Hlawitschka M, Bart HJ. Extraction kinetics of cobalt and manganese with D2EHPA from lithium-ion battery recyclate. Chem Eng Res Des 2022. [DOI: 10.1016/j.cherd.2022.01.005] [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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14
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Parreño MA, Alaux C, Brunet JL, Buydens L, Filipiak M, Henry M, Keller A, Klein AM, Kuhlmann M, Leroy C, Meeus I, Palmer-Young E, Piot N, Requier F, Ruedenauer F, Smagghe G, Stevenson PC, Leonhardt SD. Critical links between biodiversity and health in wild bee conservation. Trends Ecol Evol 2021; 37:309-321. [PMID: 34955328 DOI: 10.1016/j.tree.2021.11.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 06/25/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 11/29/2022]
Abstract
Wild bee populations are declining due to human activities, such as land use change, which strongly affect the composition and diversity of available plants and food sources. The chemical composition of food (i.e., nutrition) in turn determines the health, resilience, and fitness of bees. For pollinators, however, the term 'health' is recent and is subject to debate, as is the interaction between nutrition and wild bee health. We define bee health as a multidimensional concept in a novel integrative framework linking bee biological traits (physiology, stoichiometry, and disease) and environmental factors (floral diversity and nutritional landscapes). Linking information on tolerated nutritional niches and health in different bee species will allow us to better predict their distribution and responses to environmental change, and thus support wild pollinator conservation.
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Affiliation(s)
- M A Parreño
- Plant-Insect Interactions, TUM School of Life Science Systems, Technical University of Munich (TUM), Freising, Germany.
| | - C Alaux
- INRAE, Abeilles et Environnement, Avignon, France
| | - J-L Brunet
- INRAE, Abeilles et Environnement, Avignon, France
| | - L Buydens
- Laboratory of Agrozoology, Department of Plants and Crops, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - M Filipiak
- Faculty of Biology, Institute of Environmental Sciences, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland.
| | - M Henry
- INRAE, Abeilles et Environnement, Avignon, France
| | - A Keller
- Center for Computational and Theoretical Biology, and Department of Bioinformatics, Biocenter, University of Würzburg, 97074 Würzburg, Germany
| | - A-M Klein
- Chair of Nature Conservation and Landscape Ecology, University of Freiburg, Freiburg, Germany
| | - M Kuhlmann
- Zoological Museum of Kiel University, Kiel, Germany
| | - C Leroy
- INRAE, Abeilles et Environnement, Avignon, France
| | - I Meeus
- Laboratory of Agrozoology, Department of Plants and Crops, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - E Palmer-Young
- US Department of Agriculture (USDA) Agricultural Research Service Bee Research Laboratory, Beltsville, MD, USA
| | - N Piot
- Laboratory of Agrozoology, Department of Plants and Crops, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - F Requier
- Université Paris-Saclay, CNRS, IRD, UMR Évolution, Génomes, Comportement, et Écologie, 91198 Gif-sur-Yvette, France
| | - F Ruedenauer
- Plant-Insect Interactions, TUM School of Life Science Systems, Technical University of Munich (TUM), Freising, Germany
| | - G Smagghe
- Laboratory of Agrozoology, Department of Plants and Crops, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - P C Stevenson
- Royal Botanic Gardens, Kew, Surrey TW9 3AE, UK; University of Greenwich, London, UK
| | - S D Leonhardt
- Plant-Insect Interactions, TUM School of Life Science Systems, Technical University of Munich (TUM), Freising, Germany.
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Donovan E, Albuquerque K, Mantz C, Beriwal S, Keller A, Chen H, Lo S, Leung E. The Role of Stereotactic Body Radiotherapy (SBRT) in Oligometastatic and Oligoprogressive Gynecologic Malignancies: A Multi-Institutional Pooled Analysis. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.310] [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: 10/20/2022]
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16
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17
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Lalonde R, Keller A, Huq S. Dosimetric Parameters Related to Local Control and Rate of Distant Metastases in NSCLC SBRT Patients. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Musunruu H, Keller A, Celebrezze J, Beriwal S. Wait and Watch Approach for Patients With Rectal Cancer Following Neoadjuvant Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.410] [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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19
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Jain R, Keller A, Lee M, West N, Kazmerski T, Aitken M, Roe A, Hadjiliadis D, Uluer A, Mody S, Flume P, Bray L, Taylor-Cousar J. 169: Effect of pregnancy on lung function: Impact of CFTR modulators. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01594-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Koerner S, Baig T, Kim H, Rodriguez-Lopez J, Keller A, Beriwal S. Can We Avoid Ureters as Organs at Risk With MRI-Based Brachytherapy for Cervical Cancer? A Dosimetric Feasibility Study. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1637] [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: 10/20/2022]
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21
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Keller A, Kim H, Beriwal S, Smith K, Vargo J. Cost-Effectiveness of Prophylactic Cranial Irradiation vs. MRI Surveillance for Extensive Stage Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Millenaar DN, Dillmann M, Fehlmann T, Flohr A, Mehran R, Al-Lamee R, Lauder L, Ukena C, Boehm M, Keller A, Mahfoud F. Sex differences in cardiovascular research. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Women are underrepresented in cardiovascular publications. We sought to investigate sex-specific differences in cardiovascular research over the last decade.
Methods and results
All 387,463 cardiovascular publications between 2010–2019 were retrieved from Web-of-Science and analyzed regarding the authors' sex, the average impact factor (IF), the number of citations, co-authors per article, and international collaborations. The number of cardiovascular research articles increased between 2010–2019 from 19,960 to 29,604 articles per year. The number of articles written by female first authors increased by 48.3% (6434 articles in 2010 and 11,343 articles in 2019) and by 35.0% for male first authors (13,526 articles in 2010 and 18,261 articles in 2019). The last/senior author was more likely to be female in articles with female first authors compared with male first authors (28.2% vs. 14.1%; odds ratio 2.48, 95% confidence interval 2.43–2.53, p<0.001). The average IF for articles by female first authors was lower compared to male (3.1±3.8 vs. 3.5±4.9, p<0.001). Likewise, the H-Index was lower for female than male first authors (1.07±0.74 vs. 1.25±0.98, p<0.001), as was the number of citations per articles (14.0±31.1 vs. 18.0±68.8 citations, p<0.001). Female first authors had fewer co-authors per article than their male peers (7.4±19.6 vs. 8.2±35.2; p<0.001) and were less represented in articles with >15 co-authors (3,623 articles by female and 8,941 by male first authors; ratio female to male 0.41). Scientific advancement as the ratio between female to male first authorships was highest in publications from Latin America (ratio 0.92) and lowest in Asia (ratio 0.40). Female authorship articles reached the highest IF in North America (average IF 3.7), the lowest Africa (average IF 1.8).
Conclusions
Publications in cardiovascular research have increased over the last decade, particularly by female authors. Female researchers are cited less often compared with their male peers and publish with fewer co-authors. The IF remains lower for articles by female researchers. Efforts to further increase women-led research activities are needed
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): German Cardiac SocietyGerman Research Foundation (DFG)
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Affiliation(s)
- D N Millenaar
- Saarland University Hospital, Dept. of Internal Medicine III,Cardiology, Angiology & Intensive Care, Homburg, Germany
| | - M Dillmann
- Saarland University, Chair for Clinical Bioinformatics, Saarbruecken, Germany
| | - T Fehlmann
- Saarland University, Chair for Clinical Bioinformatics, Saarbruecken, Germany
| | - A Flohr
- Saarland University, Chair for Clinical Bioinformatics, Saarbruecken, Germany
| | - R Mehran
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - R Al-Lamee
- Imperial College London, London, United Kingdom
| | - L Lauder
- Saarland University Hospital, Dept. of Internal Medicine III,Cardiology, Angiology & Intensive Care, Homburg, Germany
| | - C Ukena
- Saarland University Hospital, Dept. of Internal Medicine III,Cardiology, Angiology & Intensive Care, Homburg, Germany
| | - M Boehm
- Saarland University Hospital, Dept. of Internal Medicine III,Cardiology, Angiology & Intensive Care, Homburg, Germany
| | - A Keller
- Saarland University, Chair for Clinical Bioinformatics, Saarbruecken, Germany
| | - F Mahfoud
- Saarland University Hospital, Dept. of Internal Medicine III,Cardiology, Angiology & Intensive Care, Homburg, Germany
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Keller A, Shah K, Delgado D, Vallakati A, Akinboboye O, Towne M, Olugemo K, Narayana A. Clinical characteristics of patients with hereditary transthyretin mutations primarily associated with cardiomyopathy and other rare transthyretin mutations: insights from a genetic testing programme. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Hereditary transthyretin amyloidosis (hATTR; ATTRv) is a progressive, fatal disease caused by mutations in the transthyretin gene (TTR) that results in deposition of amyloid throughout the body, including in the heart. The p.V142I and p.T80A mutations typically manifest with a cardiomyopathy (CM) phenotype. Early diagnosis, which can be facilitated by genetic testing, is key to achieving optimal patient outcomes.
Purpose
To characterise the clinical profile and symptom burden of patients with hereditary transthyretin mutations associated primarily with a CM phenotype and rare hereditary transthyretin mutations.
Methods
This analysis used data from hATTR Compass, a genetic testing programme in the United States and Canada for patients suspected of having hATTR with polyneuropathy (PN) and patients with a family history of hATTR. Sequencing was performed using a TTR single-gene test, a gene panel of inherited cardiovascular disorders (CardioNext), or a gene panel of inherited neuromuscular disorders (NeuropathySelect). Akcea is aware of isolated data quality issues. Importantly, these do not affect the conclusions of this analysis.
Results
Cardiology specialists referred 466 patients with p.V142I, 15 with p.T80A, and 28 with rare TTR mutations to this programme. Of patients who reported sex, 57%, 53%, and 52% with p.V142I, p.T80A, and rare mutations, respectively, were male. Of patients who reported ethnicity, most with p.V142I were African American (94%), whereas the majority of patients with p.T80A and rare TTR mutations were Caucasian (100% and 69%, respectively). 24%, 60%, and 50%, of patients with p.V142I, p.T80A, and rare TTR mutations, respectively, had a family history of hATTR. The majority of patients with p.V142I (74%), p.T80A (53%), and rare TTR (54%) mutations were 65 years of age or older. Although most patients with p.V142I, p.T80A, and rare TTR mutations experienced symptoms/manifestations of heart disease (94% vs 100% vs 85%), many also presented with bilateral carpal tunnel syndrome (23% vs 44% vs 30%) and with sensory (27% vs 44% vs 65%), motor (15% vs 11% vs 25%), and autonomic (19% vs 11% vs 30%) dysfunction.
Conclusion
Most patients with the p.V142I mutation were African American, whereas many with p.T80A and other rare TTR mutations were Caucasian. Family history of hATTR was more common among patients with p.T80A and other rare TTR mutations than among patients with p.V142I. Regardless of the underlying mutation variant, many hATTR patients can present with various symptoms/manifestations aside from CM, such as PN and bilateral carpal tunnel syndrome. Recognising the neurological symptoms that can occur alongside CM and performing subsequent genetic testing facilitates diagnosis of hATTR. Early diagnosis is critical in hATTR because it is progressive and fatal, and early initiation of disease-modifying therapy is essential to optimising patient outcomes.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): This study was sponsored by Akcea Therapeutics, an affiliate of Ionis Pharmaceuticals, Inc.
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Affiliation(s)
- A Keller
- University of Pennsylvania, Philadelphia, United States of America
| | - K Shah
- VCU Health Systems, Richmond, United States of America
| | - D Delgado
- University Health Network, Toronto, Canada
| | - A Vallakati
- The Ohio State University, Columbus, United States of America
| | - O Akinboboye
- Laurelton Heart Specialist PC, Rosedale, United States of America
| | - M Towne
- Ambry Genetics, Aliso Viejo, United States of America
| | - K Olugemo
- Akcea Therapeutics, Boston, United States of America
| | - A Narayana
- Akcea Therapeutics, Boston, United States of America
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Droff N, Clavier JB, Brahimi Y, Keller A, Vigneron C, Eugène R, Guihard S. Description monocentrique de la toxicité aiguë et tardive des irradiations mammaires par une technique de Tomodirect et comparaison avec des techniques de radiothérapie tridimensionnelle et d’autres radiothérapies conformationnelles avec modulation d’intensité par une méthode de data farming. Cancer Radiother 2021. [DOI: 10.1016/j.canrad.2021.07.011] [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: 10/20/2022]
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25
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Georges N, Le Fevre C, Loit M, Keller A, Cebula H, Antoni D, Thiery A, Constans J, Proust F. PH-0605 Role of hippocampal location and radiation dose in glioblastoma patients with hippocampal atrophy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07377-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Beck K, Vincent A, Becker C, Keller A, Cam H, Schaefert R, Reinhardt T, Sutter R, Tisljar K, Bassetti S, Schuetz P, Hunziker S. Prevalence and factors associated with psychological burden in COVID-19 patients and their relatives: A prospective observational cohort study. PLoS One 2021; 16:e0250590. [PMID: 33951085 PMCID: PMC8099094 DOI: 10.1371/journal.pone.0250590] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 04/11/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Due to the dramatic measures accompanying isolation and the general uncertainty and fear associated with COVID-19, patients and relatives may be at high risk for adverse psychological outcomes. Until now there has been limited research focusing on the prevalence of psychological distress and associated factors in COVID-19 patients and their relatives. The objective of our study was to assess psychological distress in COVID-19 patients and their relatives 30 days after hospital discharge. METHODS In this prospective observational cohort study at two Swiss tertiary-care hospitals we included consecutive adult patients hospitalized between March and June 2020 for a proven COVID-19 and their relatives. Psychological distress was defined as symptoms of anxiety and/or depression measured with the Hospital Anxiety and Depression Scale (HADS), i.e., a score of ≥8 on the depression and/or anxiety subscale. We further evaluated symptoms of post-traumatic stress disorder (PTSD), defined as a score of ≥1.5 on the Impact of Event Scale-Revised (IES-R). RESULTS Among 126 included patients, 24 (19.1%) had psychological distress and 10 (8.7%) had symptoms of PTSD 30 days after hospital discharge. In multivariate logistic regression analyses three factors were independently associated with psychological distress in patients: resilience (OR 0.82; 95%CI 0.71 to 0.94; p = 0.005), high levels of perceived stress (OR 1.21; 95%CI 1.06 to 1.38; p = 0.006) and low frequency of contact with relatives (OR 7.67; 95%CI 1.42 to 41.58; p = 0.018). The model showed good discrimination, with an area under the receiver-operating characteristic curve (AUC) of 0.92. Among 153 relatives, 35 (22.9%) showed symptoms of psychological distress, and 3 (2%) of PTSD. For relatives, resilience was negatively associated (OR 0.85; 95%CI 0.75 to 0.96; p = 0.007), whereas perceived overall burden caused by COVID-19 was positively associated with psychological distress (OR 1.72; 95%CI 1.31 to 2.25; p<0.001). The overall model also had good discrimination, with an AUC of 0.87. CONCLUSION A relevant number of COVID-19 patients as well as their relatives exhibited psychological distress 30 days after hospital discharge. These results might aid in development of strategies to prevent psychological distress in COVID-19 patients and their relatives.
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Affiliation(s)
- Katharina Beck
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Alessia Vincent
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Christoph Becker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Emergency Department, University Hospital Basel, Basel, Switzerland
| | - Annalena Keller
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Hasret Cam
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Rainer Schaefert
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Department for Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Medical Faculty of the University of Basel, Basel, Switzerland
| | - Thomas Reinhardt
- Human Resources & Leadership Development, University Hospital Basel, Basel, Switzerland
| | - Raoul Sutter
- Medical Faculty of the University of Basel, Basel, Switzerland
- Intensive Care Unit, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Kai Tisljar
- Intensive Care Unit, University Hospital Basel, Basel, Switzerland
| | - Stefano Bassetti
- Medical Faculty of the University of Basel, Basel, Switzerland
- Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Philipp Schuetz
- Medical Faculty of the University of Basel, Basel, Switzerland
- Division of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Sabina Hunziker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Department for Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Medical Faculty of the University of Basel, Basel, Switzerland
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Keller A, Rodríguez-López J, Patel A, Kim H, Houser C, Sukumvanich P, Berger J, Boisen M, Edwards R, Taylor S, Courtney-Brooks M, Olawaiye A, Orr B, Beriwal S. PO-0178 Feasibility and Outcomes for Cervical Cancer Patients Treated with Hybrid Brachytherapy Applicators. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06337-4] [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: 10/21/2022]
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28
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Ghanta S, Keller A, Rodríguez-López JL, Patel A, Beriwal S. Utility of Prophylactic Cranial Irradiation for Limited Stage Small Cell Lung Cancer in the Modern Era with Magnetic Resonance Imaging Surveillance. Clin Oncol (R Coll Radiol) 2021; 33:e323-e330. [PMID: 33888381 DOI: 10.1016/j.clon.2021.03.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/03/2021] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
AIMS To retrospectively analyse the impact of prophylactic cranial irradiation (PCI) on survival and intracranial progression in patients with limited stage small cell lung cancer (LS-SCLC) in the modern era of widespread magnetic resonance imaging brain screening. MATERIALS AND METHODS Patients with LS-SCLC treated within our network between 2009 and 2020 who responded to initial therapy were stratified by receipt of PCI and stage of disease. A propensity score match analysis was carried out for stage II-III patients. Overall and neurological survival were defined as time to death and presumed death due to uncontrolled intracranial disease, respectively. Brain metastasis-free survival and symptomatic brain metastasis-free survival were defined as freedom from intracranial progression and symptomatic intracranial progression, respectively. The effect of PCI on these outcomes was assessed using Kaplan-Meier and Cox proportional hazards models. RESULTS In total, 243 (69.6%) of 349 patients received PCI. On multivariate analysis in the propensity matched stage II-III cohort, PCI was a significant predictor of improved neurological survival (hazard ratio 0.23, 95% confidence interval 0.08-0.65; P = 0.01), brain metastasis-free survival (hazard ratio 0.25, 95% confidence interval 0.12-0.51; P < 0.01) and symptomatic brain metastasis-free survival (hazard ratio 0.21, 95% confidence interval 0.08-0.55; P < 0.01), but not improved overall survival. Two-year neurological survival estimates within the propensity matched cohort were 96.8% (95% confidence interval 87.6-99.2%) with PCI and 77.2% (95% confidence interval 63.0-86.4%) without PCI and 1- and 2-year estimates of incidence of brain metastases were 3.9% (95% confidence interval 1.3-11.7%) and 11.7% (95% confidence interval 5.6-23.5%) in the PCI group and 31.6% (95% confidence interval 22.1-43.9%) and 40.4% (95% confidence interval 29.2-54.0%) in the no PCI group, respectively. CONCLUSIONS In the modern era of magnetic resonance imaging screening, PCI was associated with reduced incidence of intracranial progression in patients with stage II-III LS-SCLC who respond to initial therapy. This, importantly, translated to a decreased risk of neurological death within our propensity matched cohort, without significant improvement in overall survival.
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Affiliation(s)
- S Ghanta
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - A Keller
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - J L Rodríguez-López
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - A Patel
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA
| | - S Beriwal
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA.
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Groot J, Keller A, Joensen A, Nguyen TL, Andersen AMN, Strandberg-Larsen K. Housing and youth mental health during a COVID-19 lockdown. Eur Psychiatry 2021. [PMCID: PMC9480333 DOI: 10.1192/j.eurpsy.2021.1938] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction Declines in mental health among youth in the COVID-19 pandemic have been observed, yet longitudinal studies on how housing may impact these declines are lacking. Objectives Our aim was to determine whether changes in mental health among Danish youth were dependent on their housing conditions. Methods Young participants from the Danish National Birth Cohort, who had responded to an online questionnaire at 18 years of age, and later during the initial national Danish lockdown, were included. Associations between housing conditions (direct access to outdoor spaces, urbanicity, household density, and household composition) and changes in mental health (mental well-being, quality of life (QoL) and loneliness) were examined in multivariate linear and logistic regression analyses. Results We included 7455 participants. Greater decreases in mental well-being were observed for youth with no access to direct outdoor spaces and those living in denser households (mean difference -0.83 [95 % CI -1.19, -0.48], -0.30 [-0.43, -0.18], respectively). Onset of low mental well-being was associated with no access and living alone (odds ratios (OR) 1.68 [1.15, 2.47] and OR 1.47 [1.05, 2.07], respectively). Household density was negatively associated with QoL (mean difference -0.21 [-0.30, -0.12]). Youth living alone experienced more loneliness (OR 2.12 [95 % CI 1.59, 2.82]). Conclusions How youth’s mental health changed from before to during lockdown was associated with housing conditions. Among the Danish youth in our study, greater decreases in mental health during lockdown were observed among youth without access to outdoor spaces, living alone, or living in denser households. Disclosure No significant relationships.
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Mariette C, Lorenc M, Cailleau H, Collet E, Guérin L, Volte A, Trzop E, Bertoni R, Dong X, Lépine B, Hernandez O, Janod E, Cario L, Ta Phuoc V, Ohkoshi S, Tokoro H, Patthey L, Babic A, Usov I, Ozerov D, Sala L, Ebner S, Böhler P, Keller A, Oggenfuss A, Zmofing T, Redford S, Vetter S, Follath R, Juranic P, Schreiber A, Beaud P, Esposito V, Deng Y, Ingold G, Chergui M, Mancini GF, Mankowsky R, Svetina C, Zerdane S, Mozzanica A, Bosak A, Wulff M, Levantino M, Lemke H, Cammarata M. Strain wave pathway to semiconductor-to-metal transition revealed by time-resolved X-ray powder diffraction. Nat Commun 2021; 12:1239. [PMID: 33623010 PMCID: PMC7902810 DOI: 10.1038/s41467-021-21316-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 04/22/2020] [Accepted: 01/13/2021] [Indexed: 11/09/2022] Open
Abstract
One of the main challenges in ultrafast material science is to trigger phase transitions with short pulses of light. Here we show how strain waves, launched by electronic and structural precursor phenomena, determine a coherent macroscopic transformation pathway for the semiconducting-to-metal transition in bistable Ti3O5 nanocrystals. Employing femtosecond powder X-ray diffraction, we measure the lattice deformation in the phase transition as a function of time. We monitor the early intra-cell distortion around the light absorbing metal dimer and the long range deformations governed by acoustic waves propagating from the laser-exposed Ti3O5 surface. We developed a simplified elastic model demonstrating that picosecond switching in nanocrystals happens concomitantly with the propagating acoustic wavefront, several decades faster than thermal processes governed by heat diffusion.
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Affiliation(s)
- C Mariette
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France.
| | - M Lorenc
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France.
| | - H Cailleau
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - E Collet
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - L Guérin
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - A Volte
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - E Trzop
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - R Bertoni
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - X Dong
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - B Lépine
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - O Hernandez
- Univ Rennes, CNRS, ISCR (Institut des Sciences Chimiques de Rennes)-UMR 6226, Rennes, France
| | - E Janod
- Institut des Matériaux Jean Rouxel (IMN), Université de Nantes, CNRS, Nantes, France
| | - L Cario
- Institut des Matériaux Jean Rouxel (IMN), Université de Nantes, CNRS, Nantes, France
| | - V Ta Phuoc
- GREMAN-UMR 7347 CNRS, Université de Tours, Tours, France
| | - S Ohkoshi
- Department of Chemistry, School of Science, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - H Tokoro
- Department of Chemistry, School of Science, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Materials Science, Faculty of Pure and Applied Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - L Patthey
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Babic
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - I Usov
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - D Ozerov
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - L Sala
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - S Ebner
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - P Böhler
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Keller
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Oggenfuss
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - T Zmofing
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - S Redford
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - S Vetter
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - R Follath
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - P Juranic
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Schreiber
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - P Beaud
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - V Esposito
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland.,Institute for Materials and Energy Science, Stanford University and SLAC National Accelerator Laboratory, Menlo Park, CA, USA
| | - Y Deng
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - G Ingold
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - M Chergui
- Laboratory of Ultrafast Spectroscopy, Lausanne Center for Ultrafast Science (LACUS), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - G F Mancini
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland.,Laboratory of Ultrafast Spectroscopy, Lausanne Center for Ultrafast Science (LACUS), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - R Mankowsky
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - C Svetina
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - S Zerdane
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Mozzanica
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Bosak
- European Synchrotron Radiation Facility, Grenoble, France
| | - M Wulff
- European Synchrotron Radiation Facility, Grenoble, France
| | - M Levantino
- European Synchrotron Radiation Facility, Grenoble, France
| | - H Lemke
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - M Cammarata
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France. .,European Synchrotron Radiation Facility, Grenoble, France.
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Becker C, Manzelli A, Marti A, Cam H, Beck K, Vincent A, Keller A, Bassetti S, Rikli D, Schaefert R, Tisljar K, Sutter R, Hunziker S. Association of medical futility with do-not-resuscitate (DNR) code status in hospitalised patients. J Med Ethics 2021; 47:medethics-2020-106977. [PMID: 33514639 DOI: 10.1136/medethics-2020-106977] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
Guidelines recommend a 'do-not-resuscitate' (DNR) code status for inpatients in which cardiopulmonary resuscitation (CPR) attempts are considered futile because of low probability of survival with good neurological outcome. We retrospectively assessed the prevalence of DNR code status and its association with presumed CPR futility defined by the Good Outcome Following Attempted Resuscitation score and the Clinical Frailty Scale in patients hospitalised in the Divisions of Internal Medicine and Traumatology/Orthopedics at the University Hospital of Basel between September 2018 and June 2019. The definition of presumed CPR futility was met in 467 (16.2%) of 2889 patients. 866 (30.0%) patients had a DNR code status. In a regression model adjusted for age, gender, main diagnosis, nationality, language and religion, presumed CPR futility was associated with a higher likelihood of a DNR code status (37.3% vs 7.1%, adjusted OR 2.99, 95% CI 2.31 to 3.88, p<0.001). In the subgroup of patients with presumed futile CPR, 144 of 467 (30.8%) had a full code status, which was independently associated with younger age, male gender, non-Christian religion and non-Swiss citizenship. We found a significant proportion of hospitalised patients to have a full code status despite the fact that CPR had to be considered futile according to an established definition. Whether these decisions were based on patient preferences or whether there was a lack of patient involvement in decision-making needs further investigation.
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Affiliation(s)
- Christoph Becker
- Medical Communication and Psychosomatics, Universitatsspital Basel, Basel, Switzerland
- Emergency Department, Universitatsspital Basel, Basel, Switzerland
| | - Alessandra Manzelli
- Medical Communication and Psychosomatics, Universitatsspital Basel, Basel, Switzerland
| | - Alexander Marti
- Medical Communication and Psychosomatics, Universitatsspital Basel, Basel, Switzerland
| | - Hasret Cam
- Medical Communication and Psychosomatics, Universitatsspital Basel, Basel, Switzerland
| | - Katharina Beck
- Medical Communication and Psychosomatics, Universitatsspital Basel, Basel, Switzerland
| | - Alessia Vincent
- Medical Communication and Psychosomatics, Universitatsspital Basel, Basel, Switzerland
| | - Annalena Keller
- Medical Communication and Psychosomatics, Universitatsspital Basel, Basel, Switzerland
| | - Stefano Bassetti
- Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Daniel Rikli
- Faculty of Medicine, University of Basel, Basel, Switzerland
- Division of Traumatology & Orthopedics, University Hospital Basel, Basel, Switzerland
| | - Rainer Schaefert
- Medical Communication and Psychosomatics, Universitatsspital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Kai Tisljar
- Division of Critical Care Medicine, University Hospital Basel, Basel, Switzerland
| | - Raoul Sutter
- Faculty of Medicine, University of Basel, Basel, Switzerland
- Division of Critical Care Medicine, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Sabina Hunziker
- Medical Communication and Psychosomatics, Universitatsspital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
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Kuntz L, Le Fèvre C, Hild C, Keller A, Gharbi M, Mathelin C, Pivot X, Noël G, Antoni D. [Overall survival and survival without local recurrence in case of radiotherapy of the tumor bed of ductal carcinomas in situ of the breast: Review of the literature]. ACTA ACUST UNITED AC 2021; 49:255-265. [PMID: 33401020 DOI: 10.1016/j.gofs.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Carcinomas in situ represent more than 15 to 20% of breast cancers. Radiotherapy of whole breast is part of the therapeutic standard and follows surgery. However, the indication of tumor bed irradiation is still controversial and heterogeneous according to international practice even though it is a very frequent clinical situation. The aim of this study is to define the indications of tumor bed irradiation in the context of ductal carcinomas in situ and to discuss accelerated partial irradiation of the breast. METHOD The selected papers were published between 2015 and 2020 and included as MeSH terms "ductal carcinoma in situ" and "boost" for the analysis of tumor bed irradiation, and "ductal carcinoma in situ" and "accelerated partial breast irradiation" for the analysis of accelerated partial irradiation. RESULTS Boost was more often performed when risk factors for local recurrence were present, such as age less than 40 or 50 years old, clinical mode of detection, tumor size greater than 15 to 20mm, high nuclear grade, presence of necrosis, positive or insufficient surgical margins, associated atypical hyperplastic lesions, and lobular carcinoma in situ. Accelerated partial irradiation is an option for favorable or intermediate prognosis CCIS, further studies involving more patients are required. CONCLUSION Radiotherapy of the mammary gland in the context of DCIS has shown its effectiveness in terms of local and locoregional control of the disease, thus reducing in situ and infiltrating recurrences. However, the indication of operating bed irradiation is still debated, and the practice is very heterogeneous depending on the country. Another possible alternative for patients with a favorable prognosis and a small tumor bed volume would be IPA.
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Affiliation(s)
- L Kuntz
- Radiotherapy department, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - C Le Fèvre
- Radiotherapy department, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - C Hild
- Gynaecological and breast surgery department, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - A Keller
- Radiotherapy department, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - M Gharbi
- Gynaecological and breast surgery department, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - C Mathelin
- Gynaecological and breast surgery department, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - X Pivot
- Medical oncology department, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
| | - G Noël
- Radiotherapy department, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France.
| | - D Antoni
- Radiotherapy department, institut de cancérologie Strasbourg Europe (ICANS), 17, rue Albert-Calmette, 67200 Strasbourg, France
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Keller A, Rodriguez-Lopez J, Beriwal S. Utilization of Prophylactic Cranial Irradiation for Extensive Stage Small Cell Lung Cancer–Is There a Benefit in the MRI Screening Era? Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1172] [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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Keller A, Rodríguez-López JL, Patel AK, Vargo JA, Kim H, Houser CJ, Sukumvanich P, Berger JL, Boisen MM, Edwards RP, Taylor SE, Courtney-Brooks MB, Orr BC, Olawaiye AB, Beriwal S. Early outcomes after definitive chemoradiation therapy with Vienna/Venezia hybrid high-dose rate brachytherapy applicators for cervical cancer: A single-institution experience. Brachytherapy 2020; 20:104-111. [PMID: 32952053 DOI: 10.1016/j.brachy.2020.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 06/08/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The Vienna and Venezia (Elekta) are hybrid intracavitary/interstitial brachytherapy (BT) applicators for cervical cancers unsuitable for intracavitary BT alone to improve target coverage or reduce critical organ dose. There is limited outcome data with the use of these applicators outside published experience of the EMBRACE group. We report feasibility and early outcomes with the use of these hybrid applicators at our institution. METHODS AND MATERIALS Hybrid applicators were used to treat 61 patients with cervical cancer from November 2011 to December 2019. Indications for hybrid applicator use were involvement of the vagina in 10 patients (16%), residual central or parametrial disease in 46 patients (75%), and a narrow introitus in 5 patients (9%). Toxicities were graded using the CTCAE v4.0. Outcomes were assessed with the Kaplan-Meier method. RESULTS Median follow-up was 16 months (IQR 9-32 mos). Median HRCTV volume was 31.6 cm3 (IQR 25-48 cm3). Median HRCTV D90 was 86.1 Gy (IQR 84.3-88.0 Gy). In 54 patients with follow-up PET/CT at 3 months, complete initial imaging response locally was seen in 46 patients.Estimated 12-month Kaplan-Meier overall survival, locoregional control, distant control, and recurrence-free survival estimates were 86.9%, 80.6%, 73.8%, and 65.9%, respectively. The 12-month incidence of Grade 3+ GI/GU chronic toxicities was 5.7%, consisting of vesicovaginal fistula, rectovaginal fistula, and ureterovesical fistula. CONCLUSIONS Our single-institution data support the use of the hybrid applicators, as an alternative to traditional BT applicators when clinically warranted. Use of hybrid applicators is feasible with adequate coverage of disease in the vagina and parametrium.
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Affiliation(s)
- A Keller
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - J L Rodríguez-López
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - A K Patel
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - J A Vargo
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - H Kim
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - C J Houser
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - P Sukumvanich
- Department of Gynecologic Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA
| | - J L Berger
- Department of Gynecologic Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA
| | - M M Boisen
- Department of Gynecologic Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA
| | - R P Edwards
- Department of Gynecologic Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA
| | - S E Taylor
- Department of Gynecologic Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA
| | - M B Courtney-Brooks
- Department of Gynecologic Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA
| | - B C Orr
- Department of Gynecologic Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA
| | - A B Olawaiye
- Department of Gynecologic Oncology, UPMC Magee-Womens Hospital, Pittsburgh, PA
| | - S Beriwal
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA.
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Affiliation(s)
- A. Keller
- TU Kaiserslautern TVT Gottlieb-Daimler-Str. 44 67663 Kaiserslautern Deutschland
| | - M. W. Hlawitschka
- TU Kaiserslautern TVT Gottlieb-Daimler-Str. 44 67663 Kaiserslautern Deutschland
- JKU Linz Chemische Verfahrenstechnik Altenbergerstr. 69 4040 Linz Österreich
| | - H.-J. Bart
- TU Kaiserslautern TVT Gottlieb-Daimler-Str. 44 67663 Kaiserslautern Deutschland
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Ferrand H, de Faucal S, Janin H, Ollivier Y, Chartier A, Keller A, Laboure G, Gauche B, Marion A. Impact de la formation des prescripteurs sur le bon usage des fluoroquinolones dans un centre hospitalier général. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.099] [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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Latta L, Ludwig N, Krammes L, Stachon T, Fries FN, Mukwaya A, Szentmáry N, Seitz B, Wowra B, Kahraman M, Keller A, Meese E, Lagali N, Käsmann-Kellner B. Abnormal neovascular and proliferative conjunctival phenotype in limbal stem cell deficiency is associated with altered microRNA and gene expression modulated by PAX6 mutational status in congenital aniridia. Ocul Surf 2020; 19:115-127. [PMID: 32422284 DOI: 10.1016/j.jtos.2020.04.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 03/09/2020] [Accepted: 04/26/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE To evaluate conjunctival cell microRNA (miRNAs) and mRNA expression in relation to observed phenotype of progressive limbal stem cell deficiency in a cohort of subjects with congenital aniridia with known genetic status. METHODS Using impression cytology, bulbar conjunctival cells were sampled from 20 subjects with congenital aniridia and 20 age and sex-matched healthy control subjects. RNA was extracted and miRNA and mRNA analyses were performed using microarrays. Results were related to severity of keratopathy and genetic cause of aniridia. RESULTS Of 2549 miRNAs, 21 were differentially expressed in aniridia relative to controls (fold change ≤ -1.5 or ≥ +1.5). Among these miR-204-5p, an inhibitor of corneal neovascularization, was downregulated 26.8-fold in severely vascularized corneas. At the mRNA level, 539 transcripts were differentially expressed (fold change ≤ -2 or ≥ +2), among these FOSB and FOS were upregulated 17.5 and 9.7-fold respectively, and JUN by 2.9-fold, all being components of the AP-1 transcription factor complex. Pathway analysis revealed enrichment of PI3K-Akt, MAPK, and Ras signaling pathways in aniridia. For several miRNAs and transcripts regulating retinoic acid metabolism, expression levels correlated with keratopathy severity and genetic status. CONCLUSION Strong dysregulation of key factors at the miRNA and mRNA level suggests that the conjunctiva in aniridia is abnormally maintained in a pro-angiogenic and proliferative state, and these changes are expressed in a PAX6 mutation-dependent manner. Additionally, retinoic acid metabolism is disrupted in severe, but not mild forms of the limbal stem cell deficiency in aniridia.
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Affiliation(s)
- L Latta
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany.
| | - N Ludwig
- Department of Human Genetics, Saarland University, Homburg, Saar, Germany; Center for Human and Molecular Biology, Saarland University, Homburg, Saar, Germany
| | - L Krammes
- Department of Human Genetics, Saarland University, Homburg, Saar, Germany
| | - T Stachon
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany
| | - F N Fries
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany
| | - A Mukwaya
- Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden
| | - N Szentmáry
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany; Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - B Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany
| | - B Wowra
- Chair and Clinical Department of Ophthalmology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland
| | - M Kahraman
- Chair for Clinical Bioinformatics, Saarland University, Saarbruecken, Germany
| | - A Keller
- Chair for Clinical Bioinformatics, Saarland University, Saarbruecken, Germany
| | - E Meese
- Department of Human Genetics, Saarland University, Homburg, Saar, Germany
| | - N Lagali
- Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden; Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway.
| | - B Käsmann-Kellner
- Department of Ophthalmology, Saarland University Medical Center, Homburg, Saar, Germany
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Herzog N, Laager R, Thommen E, Widmer M, Vincent AM, Keller A, Becker C, Beck K, Perrig S, Bernasconi L, Neyer P, Marsch S, Schuetz P, Sutter R, Tisljar K, Hunziker S. Association of Taurine with In-Hospital Mortality in Patients after Out-of-Hospital Cardiac Arrest: Results from the Prospective, Observational COMMUNICATE Study. J Clin Med 2020; 9:jcm9051405. [PMID: 32397548 PMCID: PMC7290691 DOI: 10.3390/jcm9051405] [Citation(s) in RCA: 4] [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: 05/01/2020] [Revised: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Studies have suggested that taurine may have neuro- and cardio-protective functions, but there is little research looking at taurine levels in patients after out-of-hospital cardiac arrest (OHCA). Our aim was to evaluate the association of taurine with mortality and neurological deficits in a well-defined cohort of OHCA patients. Methods: We prospectively measured serum taurine concentration in OHCA patients upon admission to the intensive care unit (ICU) of the University Hospital Basel (Switzerland). We analyzed the association of taurine levels and in-hospital mortality (primary endpoint). We further evaluated neurological outcomes assessed by the cerebral performance category scale. We calculated logistic regression analyses and report odds ratios (OR) and 95% confidence intervals (CI). We calculated different predefined multivariable regression models including demographic variables, comorbidities, initial vital signs, initial blood markers and resuscitation measures. We assessed discrimination by means of area under the receiver operating curve (ROC). Results: Of 240 included patients, 130 (54.2%) survived until hospital discharge and 110 (45.8%) had a favorable neurological outcome. Taurine levels were significantly associated with higher in-hospital mortality (adjusted OR 4.12 (95%CI 1.22 to 13.91), p = 0.02). In addition, a significant association between taurine concentration and a poor neurological outcome was observed (adjusted OR of 3.71 (95%CI 1.13 to 12.25), p = 0.03). Area under the curve (AUC) suggested only low discrimination for both endpoints (0.57 and 0.57, respectively). Conclusion: Admission taurine levels are associated with mortality and neurological outcomes in OHCA patients and may help in the risk assessment of this vulnerable population. Further studies are needed to assess whether therapeutic modulation of taurine may improve clinical outcomes after cardiac arrest.
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Affiliation(s)
- Naemi Herzog
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, 4031 Basel, Switzerland; (N.H.); (R.L.); (E.T.); (M.W.); (A.M.V.); (A.K.); (C.B.); (K.B.); (S.P.)
| | - Rahel Laager
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, 4031 Basel, Switzerland; (N.H.); (R.L.); (E.T.); (M.W.); (A.M.V.); (A.K.); (C.B.); (K.B.); (S.P.)
| | - Emanuel Thommen
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, 4031 Basel, Switzerland; (N.H.); (R.L.); (E.T.); (M.W.); (A.M.V.); (A.K.); (C.B.); (K.B.); (S.P.)
| | - Madlaina Widmer
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, 4031 Basel, Switzerland; (N.H.); (R.L.); (E.T.); (M.W.); (A.M.V.); (A.K.); (C.B.); (K.B.); (S.P.)
| | - Alessia M. Vincent
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, 4031 Basel, Switzerland; (N.H.); (R.L.); (E.T.); (M.W.); (A.M.V.); (A.K.); (C.B.); (K.B.); (S.P.)
| | - Annalena Keller
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, 4031 Basel, Switzerland; (N.H.); (R.L.); (E.T.); (M.W.); (A.M.V.); (A.K.); (C.B.); (K.B.); (S.P.)
| | - Christoph Becker
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, 4031 Basel, Switzerland; (N.H.); (R.L.); (E.T.); (M.W.); (A.M.V.); (A.K.); (C.B.); (K.B.); (S.P.)
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland; (S.M.); (P.S.); (R.S.)
- Emergency Department, University Hospital Basel, 4031 Basel, Switzerland
| | - Katharina Beck
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, 4031 Basel, Switzerland; (N.H.); (R.L.); (E.T.); (M.W.); (A.M.V.); (A.K.); (C.B.); (K.B.); (S.P.)
| | - Sebastian Perrig
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, 4031 Basel, Switzerland; (N.H.); (R.L.); (E.T.); (M.W.); (A.M.V.); (A.K.); (C.B.); (K.B.); (S.P.)
| | - Luca Bernasconi
- Institute of Laboratory Medicine, Kantonsspital Aarau, 5000 Aarau, Switzerland; (L.B.); (P.N.)
| | - Peter Neyer
- Institute of Laboratory Medicine, Kantonsspital Aarau, 5000 Aarau, Switzerland; (L.B.); (P.N.)
| | - Stephan Marsch
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland; (S.M.); (P.S.); (R.S.)
- Department of Intensive Care, University Hospital Basel, 4031 Basel, Switzerland;
| | - Philipp Schuetz
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland; (S.M.); (P.S.); (R.S.)
- Department of Internal Medicine, Kantonsspital Aarau, 5000 Aarau, Switzerland
| | - Raoul Sutter
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland; (S.M.); (P.S.); (R.S.)
- Department of Intensive Care, University Hospital Basel, 4031 Basel, Switzerland;
- Department of Neurology, University Hospital Basel, 4031 Basel, Switzerland
| | - Kai Tisljar
- Department of Intensive Care, University Hospital Basel, 4031 Basel, Switzerland;
| | - Sabina Hunziker
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, 4031 Basel, Switzerland; (N.H.); (R.L.); (E.T.); (M.W.); (A.M.V.); (A.K.); (C.B.); (K.B.); (S.P.)
- Faculty of Medicine, University of Basel, 4031 Basel, Switzerland; (S.M.); (P.S.); (R.S.)
- Department of Intensive Care, University Hospital Basel, 4031 Basel, Switzerland;
- Correspondence: ; Tel.: +41-61-265-25-25
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Widmer M, Thommen EB, Becker C, Beck K, Vincent AM, Perrig S, Keller A, Bernasconi L, Neyer P, Marsch S, Pargger H, Sutter R, Tisljar K, Hunziker S. Association of acyl carnitines and mortality in out-of-hospital-cardiac-arrest patients: Results of a prospective observational study. J Crit Care 2020; 58:20-26. [PMID: 32279017 DOI: 10.1016/j.jcrc.2020.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Out-of-hospital cardiac arrest (OHCA) is a leading cause of mortality, yet the prediction of its outcome remains challenging. Serum Acyl Carnitines (ACs), a biomarker of beta-oxidation, have been associated with cardiovascular events. We evaluated the association of different AC species with mortality and neurological outcome in a cohort of OHCA patients. MATERIAL AND METHODS We consecutively included OHCA patients in this prospective observational study upon admission to the intensive care unit. We studied the association of thirty-nine different ACs measured at admission and 30-day mortality (primary endpoint), as well as neurological outcome at hospital discharge (secondary endpoint) using the Cerebral Performance Category scale. Multivariate models were adjusted for age, gender, comorbidities and shock markers. RESULTS Of 281 included patients, 137 (48.8%) died within 30 days and of the 144 survivors (51.2%), 15 (10.4%) had poor neurological outcome. While several ACs were associated with mortality, AC C2 had the highest prognostic value for mortality (fully-adjusted odds ratio 4.85 (95%CI 1.8 to 13.06, p < .01), area under curve (AUC) 0.65) and neurological outcome (fully-adjusted odds ratio 3.96 (95%CI 1.47 to 10.66, p < .01), AUC 0.63). CONCLUSIONS ACs are interesting surrogate biomarkers that are associated with mortality and poor neurological outcome in patients after OHCA and may help to improve the understanding of pathophysiological mechanisms and risk stratification.
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Affiliation(s)
- Madlaina Widmer
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031 Basel, Switzerland
| | - Emanuel B Thommen
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031 Basel, Switzerland
| | - Christoph Becker
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031 Basel, Switzerland; Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland; Emergency Department, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Katharina Beck
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031 Basel, Switzerland
| | - Alessia M Vincent
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031 Basel, Switzerland
| | - Sebastian Perrig
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031 Basel, Switzerland
| | - Annalena Keller
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031 Basel, Switzerland
| | - Luca Bernasconi
- Institute of Laboratory Medicine, Kantonsspital Aarau, Tellstrasse 25, 5001 Aarau, Switzerland
| | - Peter Neyer
- Institute of Laboratory Medicine, Kantonsspital Aarau, Tellstrasse 25, 5001 Aarau, Switzerland
| | - Stephan Marsch
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland; Departement of Intensive Care, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Hans Pargger
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland; Departement of Intensive Care, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Raoul Sutter
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland; Departement of Intensive Care, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland; Department of Neurology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Kai Tisljar
- Departement of Intensive Care, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Sabina Hunziker
- Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, Klingelbergstrasse 23, 4031 Basel, Switzerland; Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland; Departement of Intensive Care, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.
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Noel G, Keller A, Antoni D. [Stereotactic radiotherapy of brain metastases in complex situations]. Cancer Radiother 2019; 23:708-715. [PMID: 31477442 DOI: 10.1016/j.canrad.2019.07.146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 07/11/2019] [Indexed: 02/07/2023]
Abstract
Stereotactic radiation therapy of brain metastases is a treatment recognized as effective, well tolerated, applicable for therapeutic indications codified and validated by national and international guidelines. However, the effectiveness of this irradiation, the evolution of patient care and the technical improvements enabling its implementation make it possible to consider it in more complex situations: proximity of brain metastases to organs at risk; large, cystic, haemorrhagic or multiple brain metastases, combination with targeted therapies and immunotherapy, stereotactic radiotherapy in patients with a pacemaker. This article aims to put forward the arguments available to date in the literature and those resulting from clinical practice to provide decision support for the radiation oncologists.
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Affiliation(s)
- G Noel
- Department of radiotherapy, comprehensive cancer center Paul-Strauss, UNICANCER, 3, rue de la porte de l'Hôpital, 67065 Strasbourg cedex, France; Strasbourg University, CNRS, IPHC UMR 7178, Centre Paul-Strauss, UNICANCER, 67000 Strasbourg, France.
| | - A Keller
- Department of radiotherapy, comprehensive cancer center Paul-Strauss, UNICANCER, 3, rue de la porte de l'Hôpital, 67065 Strasbourg cedex, France
| | - D Antoni
- Department of radiotherapy, comprehensive cancer center Paul-Strauss, UNICANCER, 3, rue de la porte de l'Hôpital, 67065 Strasbourg cedex, France; Strasbourg University, CNRS, IPHC UMR 7178, Centre Paul-Strauss, UNICANCER, 67000 Strasbourg, France
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Sim A, Ahmed K, Keller A, Figura N, Oliver D, Sarangkasiri S, Robinson T, Johnstone P, Yu M, Naghavi A. Outcomes and the Role of Primary Histology Following LINAC-based Stereotactic Radiosurgery (SRS) and Fractionated Stereotactic Radiotherapy (FSRT) for Sarcoma Brain Metastases. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2235] [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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Keller A, Ling D, Vargo J, Sukumvanich P, Berger J, Boisen M, Edwards R, Taylor S, Courtney-Brooks M, Olawaiye A, Orr B, Beriwal S. Adjuvant Bone-Marrow Sparing IMRT in Endometrial Cancer Patients Treated with Sequential Chemotherapy- Does it Help with Completion Rate? Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1674] [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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Merritt V, Jurick S, Crocker L, Keller A, Hoffman S, Jak A. B-75 A Preliminary Investigation of Predictors of Employment and Perception of Ability to Work in Combat-Exposed Veterans. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.158] [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: 11/14/2022] Open
Abstract
Abstract
Objective
The purpose of this study was twofold: (1) to evaluate whether perception of one’s ability to work (a subjective rating) predicts employment status (an objective marker of functioning) in a sample of combat-exposed Veterans, and (2) to examine predictors of employment status and perception of work ability to determine whether the same sets of variables that predict employment status also predict perception of one’s ability to work.
Method
Combat-exposed Operation Enduring Freedom/Operation Iraqi Freedom Veterans (N = 83) completed self-report questionnaires assessing demographic characteristics, combat-related experiences, and psychiatric and neurobehavioral/health-related symptoms. Veterans also underwent a comprehensive neuropsychological assessment. Primary outcomes of interest were employment status (unemployed versus employed) and Veterans’ rating of a perceived decline in work ability (yes versus no).
Results
Logistic regression analyses showed that perception of work ability significantly predicted employment status (p = .046). Moreover, psychiatric and neurobehavioral/health-related symptoms significantly predicted employment status and perception of work ability (p = .001-.017), whereas demographic characteristics (i.e., service-connection disability rating) and combat-related experiences (i.e., number of traumatic brain injuries) only predicted perception of work ability (p = .010-.029). Cognition was not significantly associated with employment status or perception of work ability (p’s > .05).
Conclusions
Altogether, these findings support the notion that perception of one’s ability to work plays an important role in employment-related outcomes in combat-exposed Veterans. Future studies using larger samples are needed to confirm these findings, but our preliminary results suggest that perception of work ability may be a particularly important treatment target in this population.
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Merritt V, Jurick S, Crocker L, Hoffman S, Keller A, Jak A. Effects of Multiple Mild TBIs on Neuropsychological Functioning, Psychiatric Symptoms, and Neurobehavioral/Health-Related Symptoms in Combat-Exposed Veterans. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.19] [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: 11/12/2022] Open
Abstract
Abstract
Objective
The purpose of this study was to examine the influence of multiple mild traumatic brain injuries (mTBI) on objective neuropsychological functioning and subjective symptom reporting in a sample of combat-exposed Veterans.
Method
Participants included 80 combat-exposed Iraq/Afghanistan Veterans (91.3% male; age: M = 34.33, SD = 6.44) divided into three groups based on mTBI history: 0 mTBIs (n = 33), 1-2 mTBIs (n = 26), and 3+ mTBIs (n = 21). Veterans with mTBI were assessed, on average, 7.5 years following their most recent mTBI. Participants underwent comprehensive neuropsychological testing and completed self-report measures assessing psychiatric and neurobehavioral/health-related symptoms.
Results
ANCOVAs adjusting for level of combat exposure showed no group differences on the memory and attention/executive functioning composite scores (p’s>.05). Additionally, groups did not differ with respect to symptoms of posttraumatic stress and depression (p’s>.05). In contrast, there were significant group differences on all neurobehavioral/health-related symptoms, including post-concussive symptom clusters (p’s < .001-.005), sleep problems (p = .024), pain symptoms (p < .001), and pain catastrophizing (p = .049). In general, Veterans with 3+ mTBIs self-reported the most severe symptoms, followed by Veterans with 1-2 mTBIs and 0 mTBIs.
Conclusions
History of multiple, remote mTBIs is associated with elevated subjective neurobehavioral/health-related symptoms in a dose-dependent fashion, but is not associated with objective neuropsychological functioning or ratings of psychiatric distress in combat-exposed Veterans. These results advance understanding of the long-term consequences of multiple mTBIs in this population and suggest that Veterans with 3 or more mTBIs may especially benefit from (1) early treatments aimed at ameliorating sleep and pain symptoms and (2) therapies that provide tools to temper catastrophic thinking about these symptoms.
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Jurick S, Merritt V, Crocker L, Iverson G, Hoffman S, Keller A, Jak A. The Role of Potentially Malleable Factors in Post-Concussive Symptoms and Objective Cognitive Outcomes in Iraq and Afghanistan Veterans with History of Mild TBI. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.18] [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: 11/14/2022] Open
Abstract
Abstract
Objective
We examined whether potentially malleable factors are associated with post-concussive symptoms (PCS) and cognition in Veterans with mild traumatic brain injury (mTBI) histories.
Method
Combat-exposed Iraq and Afghanistan Veterans with remote history of mTBI (N=48) completed a neuropsychological assessment and self-report questionnaires. Hierarchical linear regressions predicting PCS (Rivermead Post-Concussion Symptoms Questionnaire) and objective cognition included relevant demographic, injury, and psychiatric symptom variables in the first block and five malleable factors (TBI knowledge, self-efficacy, coping style, attribution of symptoms to mTBI, and uncommonly-endorsed symptoms [mild Brain Injury Atypical Symptoms (mBIAS) scale]) in the second block. Those with valid performance validity tests (n = 42) were included in the cognitive test analyses.
Results
With psychiatric symptoms and lifetime history of mTBIs entered first, malleable factors accounted for 14-17% of additional variance in PCS (p < .001). Lower self-efficacy (B = -.53, p < .001) and greater attribution of symptoms to mTBI (B = .21, p = .05) were associated with higher PCS, whereas an approach style of coping, TBI knowledge, and the mBIAS were not (p’s>.05). Regarding cognition, the malleable factors block accounted for 25% of additional variance in executive functioning (p = .04) with premorbid intelligence entered first. Specifically, higher mBIAS scores significantly predicted worse executive functioning (B = -.50, p = .004). No significant associations emerged when predicting attention/processing speed or memory (p’s>.05).
Conclusions
In combat-exposed Veterans with mTBI histories, potentially malleable factors contribute to clinical outcomes even after accounting for psychiatric symptoms. These malleable features are prime targets to augment during psychoeducation (e.g., uncommonly-endorsed symptoms, attribution of symptoms) and cognitive behavioral therapy (e.g., self-efficacy) in the context of chronic PCS.
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Crocker L, Keller A, Jurick S, Merritt V, Hoffman S, Jak A. A-18 Executive Dysfunction is Associated with Suicidal Ideation in Iraq/Afghanistan-era Combat-exposed Veterans. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.18] [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: 11/13/2022] Open
Abstract
Abstract
Objective
Suicidal ideation (SI) is highly prevalent in Veterans and reducing Veteran suicide is a national priority. The present study examined factors associated with SI in combat-exposed Veterans in order to inform suicide prevention efforts.
Method
Combat-exposed Iraq/Afghanistan-era Veterans (N = 77) completed questionnaires detailing demographic characteristics and combat-related experiences, as well as structured interviews assessing history of mild traumatic brain injury (mTBI), current posttraumatic stress disorder (PTSD), and suicidality in the past month. Veterans also underwent a comprehensive neuropsychological assessment. Analyses examined differences between endorsers versus non-endorsers of current SI, as well as predictors of SI, with a focus on cognitive variables.
Results
There were no SI group differences in demographic variables, levels of combat exposure, or rates of PTSD, or mTBI history. However, independent samples t-tests indicated that those who endorsed SI demonstrated worse executive functioning relative to those who denied SI (t(75) = 2.74, p = .008), whereas no group differences were observed on measures of attention/processing speed or memory. A logistic regression analysis predicting SI indicated that executive functioning remained a significant predictor of SI (B = .94, OR = 2.55, p = .047) even when adjusting for age, years of education, level of combat exposure, history of mTBI, and PTSD diagnosis.
Conclusions
Executive dysfunction may make it difficult for Veterans to inhibit maladaptive negative thoughts (particularly suicidal thoughts), regulate emotions, and problem solve in stressful situations, thus contributing to suicidality. Interventions addressing executive dysfunction in combat-exposed Veterans with SI may be a promising adjunct to current suicide prevention efforts.
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Markouli C, Couvreu De Deckersberg E, Regin M, Nguyen HT, Zambelli F, Keller A, Dziedzicka D, De Kock J, Tilleman L, Van Nieuwerburgh F, Franceschini L, Sermon K, Geens M, Spits C. Gain of 20q11.21 in Human Pluripotent Stem Cells Impairs TGF-β-Dependent Neuroectodermal Commitment. Stem Cell Reports 2019; 13:163-176. [PMID: 31178415 PMCID: PMC6627003 DOI: 10.1016/j.stemcr.2019.05.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 05/06/2019] [Accepted: 05/06/2019] [Indexed: 02/06/2023] Open
Abstract
Gain of 20q11.21 is one of the most common recurrent genomic aberrations in human pluripotent stem cells. Although it is known that overexpression of the antiapoptotic gene Bcl-xL confers a survival advantage to the abnormal cells, their differentiation capacity has not been fully investigated. RNA sequencing of mutant and control hESC lines, and a line transgenically overexpressing Bcl-xL, shows that overexpression of Bcl-xL is sufficient to cause most transcriptional changes induced by the gain of 20q11.21. Moreover, the differentially expressed genes in mutant and Bcl-xL overexpressing lines are enriched for genes involved in TGF-β- and SMAD-mediated signaling, and neuron differentiation. Finally, we show that this altered signaling has a dramatic negative effect on neuroectodermal differentiation, while the cells maintain their ability to differentiate to mesendoderm derivatives. These findings stress the importance of thorough genetic testing of the lines before their use in research or the clinic. Bcl-xL overexpression drives the transcriptomic profile of 20q11.21 mutant lines 20q11.21 mutant lines downregulate CHCHD2, a known TGF-β pathway modulator Mutant lines differentially express genes involved in TGF-β and SMAD signaling Mutant lines show impaired ectoderm commitment due to TGF-β signaling deregulation
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Affiliation(s)
- C Markouli
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - E Couvreu De Deckersberg
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - M Regin
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - H T Nguyen
- Center for Molecular Biology, Institute of Research and Development, Duy Tan University, K7/25 Quang Trung, Danang 550000, Vietnam
| | - F Zambelli
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium; Clínica EUGIN, Travessera de les Corts 322, 08029 Barcelona, Spain
| | - A Keller
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - D Dziedzicka
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - J De Kock
- Department of In Vitro Toxicology & Dermato-Cosmetology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - L Tilleman
- Laboratory of Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - F Van Nieuwerburgh
- Laboratory of Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - L Franceschini
- Laboratory of Molecular & Cellular Therapy, Department of Immunology - Physiology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - K Sermon
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - M Geens
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - C Spits
- Research Group Reproduction and Genetics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium.
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Pin Y, Antoni D, Keller A, Truntzer P, Clavier J, Schaeffer O, Schmitt M, Waissi W, Noël G. OC-0419 Evaluation of Metabrain: a semi-automated delineation tool for edema surrounding brain metastasis. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30839-4] [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: 10/26/2022]
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Harvell CD, Montecino-Latorre D, Caldwell JM, Burt JM, Bosley K, Keller A, Heron SF, Salomon AK, Lee L, Pontier O, Pattengill-Semmens C, Gaydos JK. Disease epidemic and a marine heat wave are associated with the continental-scale collapse of a pivotal predator ( Pycnopodia helianthoides). Sci Adv 2019; 5:eaau7042. [PMID: 30729157 PMCID: PMC6353623 DOI: 10.1126/sciadv.aau7042] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 12/17/2018] [Indexed: 05/19/2023]
Abstract
Multihost infectious disease outbreaks have endangered wildlife, causing extinction of frogs and endemic birds, and widespread declines of bats, corals, and abalone. Since 2013, a sea star wasting disease has affected >20 sea star species from Mexico to Alaska. The common, predatory sunflower star (Pycnopodia helianthoides), shown to be highly susceptible to sea star wasting disease, has been extirpated across most of its range. Diver surveys conducted in shallow nearshore waters (n = 10,956; 2006-2017) from California to Alaska and deep offshore (55 to 1280 m) trawl surveys from California to Washington (n = 8968; 2004-2016) reveal 80 to 100% declines across a ~3000-km range. Furthermore, timing of peak declines in nearshore waters coincided with anomalously warm sea surface temperatures. The rapid, widespread decline of this pivotal subtidal predator threatens its persistence and may have large ecosystem-level consequences.
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Affiliation(s)
- C. D. Harvell
- Department of Ecology and Evolutionary Biology, Cornell University, Ithaca, NY 14853, USA
- Corresponding author.
| | - D. Montecino-Latorre
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - J. M. Caldwell
- Department of Biology, Stanford University, Stanford, CA 94040, USA
| | - J. M. Burt
- School of Resource and Environmental Management, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Hakai Institute, Heriot Bay, BC V0P 1H0, Canada
| | - K. Bosley
- Fishery Resource Analysis and Monitoring Division, Northwest Fisheries Science Center, National Marine Fisheries Service, National Oceanic and Atmospheric Administration (NOAA), 2032 SE OSU Drive, Newport, OR 97365, USA
| | - A. Keller
- Fishery Resource Analysis and Monitoring Division, Northwest Fisheries Science Center, National Marine Fisheries Service, NOAA, 2725 Montlake Boulevard East, Seattle, WA 98112, USA
| | - S. F. Heron
- NOAA Coral Reef Watch, College Park, MD 20740, USA
- ReefSense Pty Ltd., Townsville, Queensland, Australia
- Marine Geophysical Laboratory, Physics, College of Science and Technology, James Cook University, Townsville, Queensland, Australia
| | - A. K. Salomon
- School of Resource and Environmental Management, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Hakai Institute, Heriot Bay, BC V0P 1H0, Canada
| | - L. Lee
- School of Resource and Environmental Management, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Hakai Institute, Heriot Bay, BC V0P 1H0, Canada
| | - O. Pontier
- Hakai Institute, Heriot Bay, BC V0P 1H0, Canada
| | | | - J. K. Gaydos
- The SeaDoc Society, Karen C. Drayer Wildlife Health Center–Orcas Island Office, University of California, Davis, 942 Deer Harbor Road, Eastsound, WA 98245, USA
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50
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Menoux I, Antoni D, Truntzer P, Keller A, Massard G, Noël G. Stereotactic body radiation therapy for stage I non-small cell lung carcinomas: Moderate hypofractionation optimizes outcome. Lung Cancer 2018; 126:201-207. [PMID: 30527188 DOI: 10.1016/j.lungcan.2018.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 10/05/2018] [Revised: 11/04/2018] [Accepted: 11/09/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES In case of inoperability or refusal of surgery, stereotactic body radiation therapy (SBRT) is the most effective treatment for a stage I non-small cell lung carcinoma (NSCLC). The results obtained by this irradiation technique are considerably superior to those observed in the time of conventional 3D irradiation and its toxicities are much less important, which makes it possible in elderly patients, or those presenting cardio-pulmonary comorbidities and a poor perfomance status. MATERIALS AND METHODS This study is a retrospective analysis of 90 patients who underwent SBRT for a stage I NSCLC between 2010 and 2015. Its purpose is to describe its effectiveness in term of overall survival (OS), specific survival (SS), local control (LC), regional control (RC) and metastatic control (MC) as well as their prognostic factors, and its tolerance. RESULTS LC, RC, MC as well as OS and SS rate at 4 years were comparable to the main prospective studies, respectively 89%, 92%, 70%, 33% and 66%. No LC prognostic factor could be identified. Radiation pneumonitis was observed with a rate of 61.5%, of which 56% were asymptomatic, and 4% of the patients had a rib fracture. CONCLUSIONS SBRT is an efficient and well-tolerated treatment for stage I non-small cell lung carcinomas.
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Affiliation(s)
- I Menoux
- Department of Radiotherapy, Centre Paul Strauss, 3, rue de la porte de l'hôpital, BP 42, 67065, Strasbourg cedex, France.
| | - D Antoni
- Department of Radiotherapy, Centre Paul Strauss, 3, rue de la porte de l'hôpital, BP 42, 67065, Strasbourg cedex, France; Laboratory of Radiobiology, EA 3430, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg University, Strasbourg, France.
| | - P Truntzer
- Department of Radiotherapy, Centre Paul Strauss, 3, rue de la porte de l'hôpital, BP 42, 67065, Strasbourg cedex, France.
| | - A Keller
- Department of Radiotherapy, Centre Paul Strauss, 3, rue de la porte de l'hôpital, BP 42, 67065, Strasbourg cedex, France.
| | - G Massard
- Department of Thoracic surgery, Nouvel hôpital Civil, 1, place de l'hôpital, 67000, Strasbourg, France.
| | - G Noël
- Department of Radiotherapy, Centre Paul Strauss, 3, rue de la porte de l'hôpital, BP 42, 67065, Strasbourg cedex, France; Laboratory of Radiobiology, EA 3430, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg University, Strasbourg, France.
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