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Heyman S, Perman M, Radu C. Reduction of elective lymph node volume in radiotherapy of early anal squamous cell cancer: a comparative study between two Swedish university hospitals. Acta Oncol 2024; 63:118-124. [PMID: 38587061 DOI: 10.2340/1651-226x.2024.20336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/17/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Anal squamous cell cancer (ASCC) in early stages (T1-2N0M0) is treated with chemoradiotherapy with a 3-year overall survival (OS) exceeding 90%. In Swedish guidelines, it has been optional to include the external iliac and presacral lymph node (LN) stations in radiotherapy (RT) treatment fields in early ASCC. Two Swedish hospitals treating ASCC (SU: Sahlgrenska University Hospital; UU: Uppsala University Hospital) have chosen different approaches since 2010. MATERIAL AND METHODS This study included consecutive patients with early ASCC (T1-2N0M0) treated between 2010 and 2017 at both sites (SU n = 70; UU n = 46). Data were retrieved from medical records and RT charts. RESULTS At SU, the external iliac and presacral LN stations were included in elective LN irradiation in 96.8% (n = 60) and 95.2% (n = 59) patients compared to 2.4% (n = 1) and 29.3% (n = 12) at UU. The mean elective LN volume was 2,313 cc (interquartile range [IQR] 1,951-2,627) in the SU cohort compared to 1,317 cc (IQR 1,192-1,528) in the UU cohort, p < 0.0001. No case of regional LN recurrence was seen in either cohort. Disease specific survival (DSS) at 5 years was 95.7% (confidence interval [CI] 90.1-100.0) in the SU cohort and 97.8% (CI 93.2-100.0) in the UU cohort (p 0.55). OS at 5 years was 84.5% (CI 76.1-93.0) in the SU cohort and 82.6% (CI 69.6-89.1) in the UU cohort (p 0.8). INTERPRETATION We found no differences in regional recurrence, DSS or OS between the cohorts treated with different elective LN volumes. In this population-based study, reduction of RT volume in early ASCC did not lead to inferior outcome.
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Affiliation(s)
- Sofia Heyman
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Oncology, Sahlgrenska University Hospital, Region Västra Götaland, Göteborg, Sweden.
| | - Mats Perman
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Oncology, Sahlgrenska University Hospital, Region Västra Götaland, Göteborg, Sweden
| | - Calin Radu
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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Nilsson MP, Undseth C, Albertsson P, Eidem M, Havelund BM, Johannsson J, Johnsson A, Radu C, Serup-Hansen E, Spindler KL, Zakrisson B, Guren MG, Kronborg C. Nordic anal cancer (NOAC) group consensus guidelines for risk-adapted delineation of the elective clinical target volume in anal cancer. Acta Oncol 2023; 62:897-906. [PMID: 37504978 DOI: 10.1080/0284186x.2023.2240490] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
Background: To date, anal cancer patients are treated with radiotherapy to similar volumes despite a marked difference in risk profile based on tumor location and stage. A more individualized approach to delineation of the elective clinical target volume (CTVe) could potentially provide better oncological outcomes as well as improved quality of life. The aim of the present work was to establish Nordic Anal Cancer (NOAC) group guidelines for delineation of the CTVe in anal cancer.Methods: First, 12 radiation oncologists reviewed the literature in one of the following four areas: (1) previous delineation guidelines; (2) patterns of recurrence; (3) anatomical studies; (4) common iliac and para-aortic recurrences and delineation guidelines. Second, areas of controversy were identified and discussed with the aim of reaching consensus.Results: We present consensus-based recommendations for CTVe delineation in anal cancer regarding (a) which regions to include, and (b) how the regions should be delineated. Some of our recommendations deviate from current international guidelines. For instance, the posterolateral part of the inguinal region is excluded, decreasing the volume of irradiated normal tissue. For the external iliac region and the cranial border of the CTVe, we agreed on specifying two different recommendations, both considered acceptable. One of these recommendations is novel and risk-adapted; the external iliac region is omitted for low-risk patients, and several different cranial borders are used depending on the individual level of risk.Conclusion: We present NOAC consensus guidelines for delineation of the CTVe in anal cancer, including a risk-adapted strategy.
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Affiliation(s)
- Martin P Nilsson
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | | | - Per Albertsson
- Department of Oncology, Sahlgrenska University Hospital, Region Västra Götaland, and Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Monika Eidem
- Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Norway
| | - Birgitte Mayland Havelund
- Department of Oncology, University Hospital of Southern Denmark, Lillebaelt Hospital, Vejle, Denmark
| | - Jakob Johannsson
- Department of Radiation Oncology, Landspitali University Hospital, Reykjavik, Iceland
| | - Anders Johnsson
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Calin Radu
- Department of Immunology, Genetics and Pathology, Uppsala University, Sweden
| | - Eva Serup-Hansen
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | | | - Björn Zakrisson
- Department of radiation sciences - oncology, Umeå University
| | - Marianne G Guren
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Camilla Kronborg
- Danish, Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Castellani C, Morillas Becerril L, Luisetto R, Radu C, Barison I, Fedrigo M, Giarraputo A, Virzì G, Tomaz Do Nascimento M, Simioni P, Papini E, Tavano R, Vescovo G, Mancin F, Angelini A. Optimization and Safety of Lipoic Acid F127@pla Nanoparticles as New Therapeutic Vector for Rna Delivery in Cardiovascular Diseases. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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4
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Steinke J, Jordan C, Rossides S, Minnaar H, Yu J, Franklin A, Rockall T, Dhadda AS, Andrew Hunter I, Mills J, Chadwick E, Silverman R, Folkesson J, Radu C, Myint AS, Stewart AJ. Planned organ preservation for elderly patients with rectal cancer using short course radiotherapy and a contact brachytherapy boost-an International multi-institution analysis. Clin Transl Radiat Oncol 2023; 39:100580. [PMID: 36686563 PMCID: PMC9852541 DOI: 10.1016/j.ctro.2023.100580] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
Background and purpose The use of external beam radiotherapy (EBRT) and contact X-Ray brachytherapy (CXB) is emerging as an effective alternative in patients with early stage rectal cancer with the intent of organ preservation (OP). Short course radiotherapy (SCRT) is an alternative EBRT schedule for patients not fit for chemotherapy or for longer courses of EBRT. There are no multicentre studies that have reported on the outcomes of SCRT with a CXB boost, therefore we present these from patients from centres from the UK and Sweden. Materials and methods From the Guildford Colorectal Database or local databases, 258 patients who underwent SCRT and CXB with the intent of OP from five centres treated between 2007 and 2019 were identified. Response and survival data was analysed and presented. Results With a median age of 81, 226 patients were treated with radiotherapy alone (RTA) and 32 immediately after local excision (ILE). Median follow-up was 24 months. 70% and 97% of patients in the RTA and ILE groups respectively had a complete clinical response (cCR) after SCRT with CXB. Of those, local relapse was seen in 16% of the RTA and 3% of the ILE group. Median survival was 40 months after CXB in the RTA and 52 months in the ILE group. 94% of patients remained stoma-free to the point of latest follow-up. Conclusion This data suggests that CXB when combined with SCRT, in a mainly elderly and comorbid population, provides good palliation with stoma-avoidance. Oncological outcomes compare with previously published work. A greater focus is required on quality of life outcomes after OP.
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Affiliation(s)
- Jacqueline Steinke
- St Luke’s Cancer Centre, Royal Surrey County Hospital, Guildford, England, United Kingdom,University of Surrey, Guildford, England, United Kingdom,Corresponding author at: Minimal Access Therapy Training Unit, The Leggett Building, Daphne Jackson Road, Guildford, Surrey GU2 7WG, United Kingdom.
| | - Chloe Jordan
- St Luke’s Cancer Centre, Royal Surrey County Hospital, Guildford, England, United Kingdom
| | - Savvas Rossides
- St Luke’s Cancer Centre, Royal Surrey County Hospital, Guildford, England, United Kingdom
| | - Helen Minnaar
- St Luke’s Cancer Centre, Royal Surrey County Hospital, Guildford, England, United Kingdom
| | - Jimmy Yu
- St Luke’s Cancer Centre, Royal Surrey County Hospital, Guildford, England, United Kingdom
| | - Adrian Franklin
- St Luke’s Cancer Centre, Royal Surrey County Hospital, Guildford, England, United Kingdom
| | - Tim Rockall
- St Luke’s Cancer Centre, Royal Surrey County Hospital, Guildford, England, United Kingdom,University of Surrey, Guildford, England, United Kingdom
| | - Amandeep Singh Dhadda
- Queens Centre for Oncology and Haematology, Castle Hill Hospital, Hull, England, United Kingdom
| | - Iain Andrew Hunter
- Queens Centre for Oncology and Haematology, Castle Hill Hospital, Hull, England, United Kingdom
| | - Jamie Mills
- Nottingham City Hospital, Nottingham, England, United Kingdom
| | - Eliot Chadwick
- Nottingham City Hospital, Nottingham, England, United Kingdom
| | | | - Joakim Folkesson
- Uppsala University Hospital, Akademiska sjukhuset S-751 85, Uppsala, Sweden
| | - Calin Radu
- Uppsala University Hospital, Akademiska sjukhuset S-751 85, Uppsala, Sweden
| | - Arthur Sun Myint
- Clatterbridge Cancer Centre, Liverpool, England, United Kingdom,University of Liverpool, Liverpool, England, United Kingdom
| | - Alexandra J. Stewart
- St Luke’s Cancer Centre, Royal Surrey County Hospital, Guildford, England, United Kingdom,University of Surrey, Guildford, England, United Kingdom
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5
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Dijkstra EA, Hospers GAP, Kranenbarg EMK, Fleer J, Roodvoets AGH, Bahadoer RR, Guren MG, Tjalma JJJ, Putter H, Crolla RMPH, Hendriks MP, Capdevila J, Radu C, van de Velde CJH, Nilsson PJ, Glimelius B, van Etten B, Marijnen CAM. Quality of life and late toxicity after short-course radiotherapy followed by chemotherapy or chemoradiotherapy for locally advanced rectal cancer - The RAPIDO trial. Radiother Oncol 2022; 171:69-76. [PMID: 35447283 DOI: 10.1016/j.radonc.2022.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 02/01/2022] [Revised: 04/06/2022] [Accepted: 04/10/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND PURPOSE The RAPIDO trial demonstrated a decrease in disease-related treatment failure (DrTF) and an increase in pathological complete responses (pCR) in locally advanced rectal cancer (LARC) patients receiving total neoadjuvant treatment (TNT) compared to conventional chemoradiotherapy. This study examines health-related quality of life (HRQL), bowel function, and late toxicity in patients in the trial. MATERIALS AND METHODS Patients were randomized between short-course radiotherapy followed by pre-operative chemotherapy (EXP), or chemoradiotherapy and optional post-operative chemotherapy (STD). The STD group was divided into patients who did (STD+) and did not (STD-) receive post-operative chemotherapy. Three years after surgery patients received HRQL (EORTC QLQ-C30, QLQ-CR29 and QLQ-CIPN20) and LARS questionnaires. Patients who experienced a DrTF event before the toxicity assessments (6, 12, 24, or 36 months) were excluded from analyses. RESULTS Of 574 eligible patients, 495 questionnaires were returned (86%) and 453 analyzed (79% completed within time limits). No significant differences were observed between the groups regarding QLQ-C30, QLQ-CR29 or LARS scores. Sensory-related symptoms occurred significantly more often in the EXP group compared to all STD patients, but not compared to STD+ patients. Any toxicity of any grade and grade ≥ 3 toxicity was comparable between the EXP and STD groups at all time-points. Neurotoxicity grade 1-2 occurred significantly more often in the EXP and STD+ group at all time-points compared to the STD- group. CONCLUSION The results demonstrate that TNT for LARC, yielding improved DrTF and pCRs, does not compromise HRQL, bowel functional or results in more grade ≥3 toxicity compared to standard chemoradiotherapy at three years after surgery in DrTF-free patients.
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Affiliation(s)
- Esmée A Dijkstra
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, the Netherlands.
| | - Geke A P Hospers
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, the Netherlands
| | | | - Joke Fleer
- Department of Health Sciences, Section Health Psychology, University Medical Center Groningen, University of Groningen, the Netherlands
| | | | - Renu R Bahadoer
- Department of Surgery, Leiden University Medical Center, the Netherlands
| | | | - Jolien J J Tjalma
- Department of General Practice, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Hein Putter
- Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, the Netherlands
| | | | - Mathijs P Hendriks
- Department of Medical Oncology, Northwest Clinics, Alkmaar, the Netherlands
| | - Jaume Capdevila
- Department of Medical Oncology, Vall Hebron Institute of Oncology (VHIO), Vall Hebron University Hospital, Autonomous University of Barcelona (UAB), Spain
| | - Calin Radu
- Department of Immunology, Genetics and Pathology, Uppsala University, Sweden
| | | | - Per J Nilsson
- Department of Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Sweden
| | - Boudewijn van Etten
- Department of Surgery, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Corrie A M Marijnen
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands
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6
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Backlund E, Yang M, Grozman V, Masucci G, Falkenius J, Eriksson H, Jovanovic B, Hammarlund K, Isacsson U, Radu C, Abel E, Karlsson K, Palanco Zamora R, Wersäll P, Edbäck U, Wickström S, Darai Ramqvist E, Egyhazi Brage S, Kiessling R, Viktorsson K, Franzén B, Lewensohn R, Olofsson Bagge R, Ullenhag GJ, Ny L, Lindberg K, Helgadottir H. Precision radiation of immune checkpoint therapy resistant melanoma metastases (PROMMEL study): study protocol for a phase II open-label multicenter trial. Acta Oncol 2022; 61:869-873. [PMID: 35638255 DOI: 10.1080/0284186x.2022.2079959] [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: 11/01/2022]
Affiliation(s)
- Ellen Backlund
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Muyi Yang
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Vitali Grozman
- Department of Diagnostic Radiology, Karolinska University Hospital, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Giuseppe Masucci
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Johan Falkenius
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Eriksson
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Braslav Jovanovic
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | | | - Ulf Isacsson
- Medical Radiation Physics, Uppsala University Hospital, Uppsala, Sweden
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Calin Radu
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Edvard Abel
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Kristin Karlsson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ricardo Palanco Zamora
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Peter Wersäll
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Ulrika Edbäck
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Stina Wickström
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Eva Darai Ramqvist
- Department of Clinical Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Rolf Kiessling
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | | | - Bo Franzén
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Rolf Lewensohn
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Roger Olofsson Bagge
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gustav J. Ullenhag
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- Department of Oncology, Uppsala University Hospital, Uppsala, Sweden
| | - Lars Ny
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karin Lindberg
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Hildur Helgadottir
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
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Johnsson A, Norman D, Angenete E, Cavalli-Björkman N, Lagerbäck C, Leon O, Lindh B, Lydrup ML, Nilsson MP, Perman M, Radu C, Zackrisson B. Anal cancer in Sweden 2015-2019. Implementation of guidelines, structural changes, national registry and early results. Acta Oncol 2022; 61:575-582. [PMID: 35274596 DOI: 10.1080/0284186x.2022.2048069] [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: 11/01/2022]
Abstract
BACKGROUND Squamous cell cancer of the anus is an uncommon malignancy, usually caused by human papilloma virus (HPV). Chemoradiotherapy (CRT) is the recommended treatment in localized disease with cure rates of 60-80%. Local failures should be considered for salvage surgery. With the purpose of improving and equalizing the anal cancer care in Sweden, a number of actions were taken between 2015 and 2017. The aim of this study was to describe the implementation of guidelines and organizational changes and to present early results from the first 5 years of the Swedish anal cancer registry (SACR). METHODS The following were implemented: (1) the first national care program with treatment guidelines, (2) standardized care process, (3) centralization of CRT to four centers and salvage surgery to two centers, (4) weekly national multidisciplinary team meetings where all new cases are discussed, (5) the Swedish anal cancer registry (SACR) was started in 2015. RESULTS The SACR included 912 patients with a diagnosis of anal cancer from 2015 to 2019, reaching a national coverage of 95%. We could show that guidelines issued in 2017 regarding staging procedures and radiotherapy dose modifications were rapidly implemented. At baseline 52% of patients had lymph node metastases and 9% had distant metastases. Out of all patients in the SACR 89% were treated with curative intent, most of them with CRT, after which 92% achieved a local complete remission and the estimated overall 3-year survival was 85%. CONCLUSIONS This is the first report from the SACR, demonstrating rapid nation-wide implementation of guidelines and apparently good treatment outcome in patients with anal cancer in Sweden. The SACR will hopefully be a valuable source for future research.
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Affiliation(s)
- Anders Johnsson
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | | | - Eva Angenete
- Department of Surgery, Sahlgrenska University Hospital and Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | | | - Otilia Leon
- Department of Oncology, Skåne University Hospital, Lund, Sweden
| | - Birgitta Lindh
- Department of Oncology, University Hospital of Northern Sweden, Umeå, Sweden
| | | | | | - Mats Perman
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Calin Radu
- Department of Oncology, Akademiska Sjukhuset, Uppsala, Sweden
| | - Björn Zackrisson
- Department of Oncology, University Hospital of Northern Sweden, Umeå, Sweden
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Erlandsson J, Fuentes S, Radu C, Frödin JE, Johansson H, Brandberg Y, Holm T, Glimelius B, Martling A. Radiotherapy regimens for rectal cancer: long-term outcomes and health-related quality of life in the Stockholm III trial. BJS Open 2021; 5:6510898. [PMID: 35040942 PMCID: PMC8765334 DOI: 10.1093/bjsopen/zrab137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/26/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The Stockholm III trial randomly assigned 840 patients to short-course radiotherapy of 5 × 5 Gy with surgery within 1 week (SRT), short-course radiotherapy of 5 × 5 Gy with surgery after 4-8 weeks (SRT-delay), or long-course radiotherapy of 25 × 2 Gy with surgery after 4-8 weeks (LRT-delay). This study details the long-term oncological outcomes and health-related quality of life (HRQoL). METHODS Patients with biopsy-proven resectable adenocarcinoma of the rectum were included. Primary outcome was time to local recurrence (LR), and secondary endpoints were distant metastases (DMs), overall survival (OS), recurrence-free survival (RFS), and HRQoL. Patients were analysed in a three-arm randomization and a short-course radiotherapy comparison. RESULTS From 1998 to 2013, 357, 355, and 128 patients were randomized to the SRT, SRT-delay, and LRT-delay groups respectively. Median follow-up time was 5.7 (range 5.3-7.6) years. Comparing patients in the three-arm randomization, the incidence of LR was three of 129 patients, four of 128, and seven of 128, and DM 31 of 129 patients, 38 of 128, and 38 of 128 in the SRT, SRT-delay, and LRT-delay groups respectively. In the short-course radiotherapy comparison, the incidence of LR was 11 of 357 patients and 13 of 355, and DM 88 of 357 patients and 82 of 355 in the SRT and SRT-delay groups respectively. No comparisons showed statistically significant differences. Median OS was 8.1 (range 6.9-11.2), 10.3 (range 8.2-12.8), and 10.5 (range 7.0-11.3) years after SRT, SRT-delay, and LRT-delay respectively. Median OS was 8.1 (range 7.2-10.0) years after SRT and 10.2 (range 8.5-11.7) years after SRT-delay. There were no statistically significant differences in HRQoL. CONCLUSION After a follow-up of 5 years, delaying surgery for 4-8 weeks after radiotherapy treatment with 5 × 5 Gy was oncologically safe. Long-term HRQoL was similar among the treatment arms. TRIAL REGISTRATION NUMBER NTC00904813.
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Affiliation(s)
- Johan Erlandsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Stina Fuentes
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Calin Radu
- Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Uppsala University, Uppsala, Sweden
| | - Jan-Erik Frödin
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Hemming Johansson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Brandberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Torbjörn Holm
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Uppsala University, Uppsala, Sweden
| | - Anna Martling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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9
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Henriksson A, Johansson B, Radu C, Berntsen S, Igelström H, Nordin K. Is it safe to exercise during oncological treatment? A study of adverse events during endurance and resistance training - data from the Phys-Can study. Acta Oncol 2021; 60:96-105. [PMID: 33339484 DOI: 10.1080/0284186x.2020.1851046] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Few studies have systematically evaluated the risk of adverse events (AEs) among persons exercising during oncological treatment. We aimed to describe incidence and types of AEs during exercise for persons undergoing oncological treatment, and associations to exercise intensity, exercise adherence, chemotherapy treatment, initial aerobic fitness. A second aim was to compare incidence of lymphedema, periphery inserted central catheter (PICC) complications, and other new medical conditions (any illness or injury occurred during the exercise trial) between high-intensity vs low-to-moderate exercise and usual care (UC). METHODS This descriptive, comparative study was based on data from an observational study including patients in an UC setting (n = 90) and a randomized exercise trial (n = 577) in which participants exercised at high-intensity (HI) or low-moderate intensity (LMI). Persons with breast, prostate, or colorectal cancer undergoing neo/adjuvant treatment were included. AEs were reported by exercise coaches, participants, and identified in medical records, as were lymphedema, PICC-complications, and new medical conditions. RESULTS Coaches reported AEs for 20% of the participants, while 28% of participants self-reported AEs. The most common coach- and participant reported AEs were musculoskeletal and the majority (97%) were considered minor. HI had higher likelihood of AEs than LMI, according to both coaches (OR: 1.9 [95%CI 1.16-3.21], p=.011) and participants (OR: 3.36 [95%CI 2.00-5.62], ≤.001). Lymphedema rates were low (4-9%) and PICC complications ranged from 15% in LMI to 23% in UC and there were no statistically significant differences between HI, LMI, and UC. There were no statistically significant differences between HI and LMI regarding new medical conditions. CONCLUSIONS Exercise during treatment is safe for these patient groups in this setting, even HI exercise can be recommended if no medical contraindications are present. Similar to healthy populations, a higher risk of having minor AEs when exercising at HI in comparison to LMI may exist.
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Affiliation(s)
- Anna Henriksson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Birgitta Johansson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Calin Radu
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Sveinung Berntsen
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | | | - Karin Nordin
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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10
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Mezdari Z, Pini M, Czibik G, Ternacle J, Riant E, Radu C, Zhang Y, Clerc F, Adnot S, Derumeaux G, Sawaki D. Role of adipose tissue macrophages in the cross-talk between visceral adipose tissue and heart during high fat diet. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2020.03.096] [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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11
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Wemmert C, Fourreau F, Radu C, Balan A, Gomart C, Fiore A, La Martire G, Decousser J, Lepeule R. Traitement médical des sternites post sternotomie : 21 jours suffisent ? Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.240] [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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12
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Crisan D, Grigorescu M, Crisan N, Craciun R, Lupsor M, Radu C, Grigorescu MD, Suciu A, Epure F, Avram L, Leach N. Association between PNPLA3[G]/I148M variant, steatosis and fibrosis stage in hepatitis C virus - genetic matters. J Physiol Pharmacol 2019; 70. [PMID: 31642820 DOI: 10.26402/jpp.2019.4.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/28/2019] [Indexed: 11/03/2022]
Abstract
There is an established correlation between the PNPLA3 rs738409 C > G single nucleotide polymorphism (SNP) and hepatic steatosis and fibrosis in hepatitis C virus (HCV) infected patients. However not all data is convergent regarding the exact impact of this SNP on the pattern of disease progression in different clinical settings. In this study, we aimed to further bridge the knowledge gap on this topic by investigating the role of the G allele in promoting steatosis, fibrosis and disease progression in relation to other metabolic and anthropometric host factors. Two hundred and fifty consecutive patients, previously diagnosed with chronic hepatitis C (CHC) underwent liver biopsy. Histology was assessed using the Metavir scoring system. Transient elastography was used for follow-up. Ninety-eight patients were genotyped for PNPLA3 rs738409 and followed up for fibrosis progression. PNPLA3 rs738409[G] allele was significantly correlated with severe steatosis (P = 0.04), severe fibrosis at the time of enrollment (P = 0.0005) and fibrosis progression with an OR of 10.31 (95% CI 1.06 - 99.59, P = 0.04), after a mean follow-up time of 62.85 (95%CI: 52.21 - 76.15) months. Severe steatosis at the time of enrollment had an OR of 11.02 (95% CI 1.48 - 82.09, P = 0.01) for the association with fibrosis progression. The HOMA-IR index was also positively correlated with severe fibrosis (P = 0.03) and fibrosis progression on univariate analysis (P = 0.02). PNPLA3 rs738409[G] allele is a reliable predictor for steatosis and fibrosis in CHC. The presence of G allele, along with severe steatosis and insulin resistance are significant predictors for fibrosis progression.
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Affiliation(s)
- D Crisan
- Fifth Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Municipal Clinical Hospital, Cluj-Napoca, Romania
| | - M Grigorescu
- Third Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,"Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Romania
| | - N Crisan
- Municipal Clinical Hospital, Cluj-Napoca, Romania. .,Department of Surgical Specialties, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - R Craciun
- "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Romania.
| | - M Lupsor
- "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Romania.,Department of Medical Imaging, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - C Radu
- Third Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,"Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Romania
| | - M D Grigorescu
- "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Romania
| | - A Suciu
- "Prof. Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology Cluj-Napoca, Romania
| | - F Epure
- Department of Medical Imaging, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - L Avram
- Fifth Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Municipal Clinical Hospital, Cluj-Napoca, Romania
| | - N Leach
- Fourth Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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13
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Flores A, Sandoval-Gonzalez S, Takahashi R, Krall A, Sathe L, Wei L, Radu C, Joly JH, Graham NA, Christofk HR, Lowry WE. Author Correction: Increased lactate dehydrogenase activity is dispensable in squamous carcinoma cells of origin. Nat Commun 2019; 10:1449. [PMID: 30914644 PMCID: PMC6435690 DOI: 10.1038/s41467-019-09435-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- A Flores
- Department of Molecular Cell and Developmental Biology, UCLA, Los Angeles, 90095, CA, USA.,Broad Center for Regenerative Medicine, UCLA, Los Angeles, 90095, CA, USA.,Mork Family Department of Chemical Engineering and Materials Science, University of Southern California, Los Angeles, 90089, CA, USA
| | - S Sandoval-Gonzalez
- Department of Molecular Cell and Developmental Biology, UCLA, Los Angeles, 90095, CA, USA
| | - R Takahashi
- Division of Dermatology, David Geffen School of Medicine, UCLA, Los Angeles, 90095, CA, USA
| | - A Krall
- Department of Biological Chemistry, UCLA, Los Angeles, 90095, CA, USA
| | - L Sathe
- Department of Molecular Cell and Developmental Biology, UCLA, Los Angeles, 90095, CA, USA
| | - L Wei
- Department of Pharmacology, UCLA, Los Angeles, 90095, CA, USA
| | - C Radu
- Department of Pharmacology, UCLA, Los Angeles, 90095, CA, USA
| | - J H Joly
- Department of Engineering, USC, Los Angeles, 90089, CA, USA.,Mork Family Department of Chemical Engineering and Materials Science, University of Southern California, Los Angeles, 90089, CA, USA
| | - N A Graham
- Department of Engineering, USC, Los Angeles, 90089, CA, USA.,Mork Family Department of Chemical Engineering and Materials Science, University of Southern California, Los Angeles, 90089, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, 90089, CA, USA
| | - H R Christofk
- Department of Biological Chemistry, UCLA, Los Angeles, 90095, CA, USA. .,Department of Pharmacology, UCLA, Los Angeles, 90095, CA, USA. .,Molecular Biology Institute, UCLA, Los Angeles, 90095, CA, USA. .,Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, 90095, CA, USA.
| | - W E Lowry
- Department of Molecular Cell and Developmental Biology, UCLA, Los Angeles, 90095, CA, USA. .,Broad Center for Regenerative Medicine, UCLA, Los Angeles, 90095, CA, USA. .,Division of Dermatology, David Geffen School of Medicine, UCLA, Los Angeles, 90095, CA, USA. .,Molecular Biology Institute, UCLA, Los Angeles, 90095, CA, USA. .,Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, 90095, CA, USA.
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14
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Flores A, Sandoval-Gonzalez S, Takahashi R, Krall A, Sathe L, Wei L, Radu C, Joly JH, Graham NA, Christofk HR, Lowry WE. Increased lactate dehydrogenase activity is dispensable in squamous carcinoma cells of origin. Nat Commun 2019; 10:91. [PMID: 30626875 PMCID: PMC6327029 DOI: 10.1038/s41467-018-07857-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 03/15/2018] [Accepted: 12/04/2018] [Indexed: 12/17/2022] Open
Abstract
Although numerous therapeutic strategies have attempted to target aerobic glycolysis to inhibit tumor progression, these approaches have not resulted in effective clinical outcomes. Murine squamous cell carcinoma (SCC) can be initiated by hair follicle stem cells (HFSCs). HFSCs utilize aerobic glycolysis, and the activity of lactate dehydrogenase (Ldh) is essential for HFSC activation. We sought to determine whether Ldh activity in SCC is critical for tumorigenesis or simply a marker of the cell type of origin. Genetic abrogation or induction of Ldh activity in HFSC-mediated tumorigenesis shows no effect on tumorigenesis as measured by number, time to formation, proliferation, volume, epithelial to mesenchymal transition, gene expression, or immune response. Ldha-null tumors show dramatically reduced levels of glycolytic metabolites by metabolomics, and significantly reduced glucose uptake by FDG-PET live animal imaging. These results suggest that squamous cancer cells of origin do not require increased glycolytic activity to generate cancers. Most tumours are characterized by increased aerobic glycolytic activity. Here the authors show that elevated aerobic glycolysis is not essential for cancer initiation by testing the effect of lactate dehydrogenase depletion on the ability of hair follicle stem cells (HFSCs) to form squamous cell carcinoma (SCC) in mouse genetic models.
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Affiliation(s)
- A Flores
- Department of Molecular Cell and Developmental Biology, UCLA, Los Angeles, 90095, CA, USA.,Broad Center for Regenerative Medicine, UCLA, Los Angeles, 90095, CA, USA.,Mork Family Department of Chemical Engineering and Materials Science, University of Southern California, Los Angeles, 90089, CA, USA
| | - S Sandoval-Gonzalez
- Department of Molecular Cell and Developmental Biology, UCLA, Los Angeles, 90095, CA, USA
| | - R Takahashi
- Division of Dermatology, David Geffen School of Medicine, UCLA, Los Angeles, 90095, CA, USA
| | - A Krall
- Department of Biological Chemistry, UCLA, Los Angeles, 90095, CA, USA
| | - L Sathe
- Department of Molecular Cell and Developmental Biology, UCLA, Los Angeles, 90095, CA, USA
| | - L Wei
- Department of Pharmacology, UCLA, Los Angeles, 90095, CA, USA
| | - C Radu
- Department of Pharmacology, UCLA, Los Angeles, 90095, CA, USA
| | - J H Joly
- Department of Engineering, USC, Los Angeles, 90089, CA, USA.,Mork Family Department of Chemical Engineering and Materials Science, University of Southern California, Los Angeles, 90089, CA, USA
| | - N A Graham
- Department of Engineering, USC, Los Angeles, 90089, CA, USA.,Mork Family Department of Chemical Engineering and Materials Science, University of Southern California, Los Angeles, 90089, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, 90089, CA, USA
| | - H R Christofk
- Department of Biological Chemistry, UCLA, Los Angeles, 90095, CA, USA. .,Department of Pharmacology, UCLA, Los Angeles, 90095, CA, USA. .,Molecular Biology Institute, UCLA, Los Angeles, 90095, CA, USA. .,Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, 90095, CA, USA.
| | - W E Lowry
- Department of Molecular Cell and Developmental Biology, UCLA, Los Angeles, 90095, CA, USA. .,Broad Center for Regenerative Medicine, UCLA, Los Angeles, 90095, CA, USA. .,Division of Dermatology, David Geffen School of Medicine, UCLA, Los Angeles, 90095, CA, USA. .,Molecular Biology Institute, UCLA, Los Angeles, 90095, CA, USA. .,Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, 90095, CA, USA.
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15
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Mezdari Z, Pini M, Czibik G, Ternacle J, Radu C, Zhang Y, Adnot S, Henegar C, Derumeaux GA, Sawaki D. P2536Role of adipose tissue macrophages in the cross-talk between visceral adipose tissue and heart during high fat diet. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Z Mezdari
- University Hospital Henri Mondor, DHU ATVB, APHP, UPEC, Creteil, France
| | - M Pini
- University Hospital Henri Mondor, DHU ATVB, APHP, UPEC, Creteil, France
| | - G Czibik
- University Hospital Henri Mondor, DHU ATVB, APHP, UPEC, Creteil, France
| | - J Ternacle
- University Hospital Henri Mondor, DHU ATVB, APHP, UPEC, Creteil, France
| | - C Radu
- University Hospital Henri Mondor, DHU ATVB, APHP, UPEC, Creteil, France
| | - Y Zhang
- University Hospital Henri Mondor, DHU ATVB, APHP, UPEC, Creteil, France
| | - S Adnot
- University Hospital Henri Mondor, DHU ATVB, APHP, UPEC, Creteil, France
| | - C Henegar
- University Hospital Henri Mondor, DHU ATVB, APHP, UPEC, Creteil, France
| | - G A Derumeaux
- Inserm U886, University Claude Bernard Lyon 1, Lyon, France
| | - D Sawaki
- University Hospital Henri Mondor, DHU ATVB, APHP, UPEC, Creteil, France
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16
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Khayath N, Radu C, Choual I, Jilani S, Vecellio L, Domis N, De Blay F. [Environmental exposure chambers (EEC): A novel tool for pathophysiological and pharmaceutical research]. Rev Mal Respir 2018; 35:390-402. [PMID: 29731373 DOI: 10.1016/j.rmr.2018.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 09/15/2017] [Indexed: 01/27/2023]
Abstract
Airborne allergic diseases (allergic asthma, rhinitis and conjunctivitis) have reached epidemic proportions and are a great burden for both society and individuals. Therefore we need to better understand the physiopathological mechanisms and to increase clinical research in these diseases. However, traditional outpatient studies are difficult and have number of limitations, in particular the variability of allergen exposure. Yet allergen provocation tests, especially bronchial challenges in asthma, are excellent tools to measure the efficiency of anti-allergic therapies. Environmental exposure chambers (EEC) allow the performance of controlled allergen provocation tests on a large scale with remarkable sensitivity, specificity and reproducibility. Moreover, they allow a precise collection of allergic symptoms, making them interesting tools for patho-physiological and clinical studies. During the last thirty years, they have assisted the study of anti-allergic therapies and provided data on their pharmacodynamic characteristics, particularly in allergic rhinitis. However, there are still no EEC tests centered on asthma. The EEC of Strasbourg (ALYATEC®) was developed to fulfill two objectives: to allow standardized allergenic and non-allergenic exposures with better control of the parameters than in other EEC and to offer a place to study asthma and anti-asthmatic therapies safely.
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Affiliation(s)
- N Khayath
- Service de pneumologie, pôle de pathologie thoracique, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France; Fédération de médecine translationnelle, université de Strasbourg, BP426, 67091 Strasbourg, France
| | - C Radu
- Service de pneumologie, pôle de pathologie thoracique, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France; Alyatec, Biocluster-des-Haras, 23, rue des Glacières, 67000 Strasbourg, France
| | - I Choual
- Alyatec, Biocluster-des-Haras, 23, rue des Glacières, 67000 Strasbourg, France
| | - S Jilani
- Alyatec, Biocluster-des-Haras, 23, rue des Glacières, 67000 Strasbourg, France
| | - L Vecellio
- Université François-Rabelais, 37020 Tours cedex, France
| | - N Domis
- Alyatec, Biocluster-des-Haras, 23, rue des Glacières, 67000 Strasbourg, France
| | - F De Blay
- Service de pneumologie, pôle de pathologie thoracique, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67000 Strasbourg, France; Fédération de médecine translationnelle, université de Strasbourg, BP426, 67091 Strasbourg, France.
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17
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Pini M, Czibik G, Sawaki D, Mercedes R, Ternacle J, Henegar C, Braud L, Mezdari Z, Radu C, Dubois-Randé J, Adnot S, Foresti R, Motterlini R, Derumeaux G. Exercise rescues obesity-induced adipose tissue premature aging and restores cardio-metabolic homeostasis. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2018.02.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Fard D, D’humières T, Bergoend E, Radu C, Deux J, Benhaiem N, Oliver L, Brault-Meslin O, Couetil J, Dubois-Randé J, Lim P, Ternacle J. A new modality for assessing aortic calcium score by 3D trans-esophageal echocardiography. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.315] [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: 11/30/2022]
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19
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De Blay F, Radu C, Choual I, Khayath N, Jilani S, Beck N, Smet S, Domis N. Validation clinique de la chambre d’exposition environnementale de Strasbourg (ALYATEC ® ) chez des patients asthmatiques allergiques aux acariens. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.134] [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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20
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Damy T, Galat A, Rouffiac S, Guendouz S, Kharoubi M, Ayad K, De Nadai N, Plante-Bordeneuve V, Lebras F, Amiot A, Radu C, Dubois-Rande J, Bodez D. P5845Prognosis of patients with cardiac amyloidosis referred in the French cardiac amyloidosis expert center. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5845] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T. Damy
- AP-HP - University Hospital Henri Mondor, Creteil, France
| | - A. Galat
- GRC-Amyloid Research Institute - APHP - INSERM, Creteil, France
| | - S. Rouffiac
- GRC-Amyloid Research Institute - APHP - INSERM, Creteil, France
| | - S. Guendouz
- GRC-Amyloid Research Institute - APHP - INSERM, Creteil, France
| | - M. Kharoubi
- GRC-Amyloid Research Institute - APHP - INSERM, Creteil, France
| | - K. Ayad
- GRC-Amyloid Research Institute - APHP - INSERM, Creteil, France
| | - N. De Nadai
- GRC-Amyloid Research Institute - APHP - INSERM, Creteil, France
| | | | - F. Lebras
- GRC-Amyloid Research Institute - APHP - INSERM, Creteil, France
| | - A. Amiot
- GRC-Amyloid Research Institute - APHP - INSERM, Creteil, France
| | - C. Radu
- GRC-Amyloid Research Institute - APHP - INSERM, Creteil, France
| | | | - D. Bodez
- GRC-Amyloid Research Institute - APHP - INSERM, Creteil, France
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21
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Crisan D, Radu C, Suciu A, Leach N, Stefanescu H, Avram L, Crisan N, Grigorescu M. Hepatitis C in nonobese nondiabetic patients: Insulin resistance and the metabolic syndrome make a difference. J Viral Hepat 2017; 24:86-87. [PMID: 27700001 DOI: 10.1111/jvh.12610] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- D Crisan
- 5th Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Clinical Municipal Hospital, Cluj-Napoca, Romania
| | - C Radu
- 3rd Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Hepatology Unit, Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - A Suciu
- 3rd Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - N Leach
- 4th Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - H Stefanescu
- Hepatology Unit, Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
| | - L Avram
- Clinical Municipal Hospital, Cluj-Napoca, Romania
| | - N Crisan
- Clinical Municipal Hospital, Cluj-Napoca, Romania.,Department of Surgery, Iuliu-Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - M Grigorescu
- Hepatology Unit, Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
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22
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Affiliation(s)
- C Radu
- Department of Chest Disease, University Hospital of Strasbourg, France
| | - C Barnig
- Department of Chest Disease, University Hospital of Strasbourg, France.,Federation of Translational Medicine, EA3072, University of Strasbourg, France
| | - F de Blay
- Department of Chest Disease, University Hospital of Strasbourg, France.,Federation of Translational Medicine, EA3072, University of Strasbourg, France
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23
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Kremer T, Cordts T, Hirche C, Hernekamp F, Radu C, Kneser U. [Reconstruction of Defects after Oncologic Resection and Radiation - Indications for Microsurgical Reconstruction]. HANDCHIR MIKROCHIR P 2015; 47:353-8. [PMID: 26676555 DOI: 10.1055/s-0041-108197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The surgical treatment of soft tissue sarcomas in the extremities frequently requires radiation therapy to achieve local tumour control. However, both adjuvant and neoadjuvant radiation are associated with significant morbidity caused by impaired wound healing, ulcers or osteonecrosis with subsequent fractures. This is due to altered local cell mediator levels, fibrosis occurring simultaneously with decreased cell division rates and diminished vascularity. This article describes a number of local conservative treatment options, all of which have limited success rates. In addition, it describes plastic surgical treatment options for radiation-induced local morbidity. Surgical reconstruction includes the full range of plastic reconstructive techniques. However, less complex options such as random pattern flaps or split thickness skin grafts are often associated with complications. Therefore, a large number of cases require free tissue transfer.
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Affiliation(s)
- T Kremer
- BG Unfallklinik Ludwigshafen und Ruprecht-Karls-Universität Heidelberg, Klinik für Hand, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Klinik für Plastische Chirurgie, Ludwigshafen
| | - T Cordts
- BG Unfallklinik Ludwigshafen und Ruprecht-Karls-Universität Heidelberg, Klinik für Hand, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Klinik für Plastische Chirurgie, Ludwigshafen
| | - C Hirche
- BG Unfallklinik Ludwigshafen und Ruprecht-Karls-Universität Heidelberg, Klinik für Hand, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Klinik für Plastische Chirurgie, Ludwigshafen
| | - F Hernekamp
- BG Unfallklinik Ludwigshafen und Ruprecht-Karls-Universität Heidelberg, Klinik für Hand, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Klinik für Plastische Chirurgie, Ludwigshafen
| | - C Radu
- BG Unfallklinik Ludwigshafen und Ruprecht-Karls-Universität Heidelberg, Klinik für Hand, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Klinik für Plastische Chirurgie, Ludwigshafen
| | - U Kneser
- BG Unfallklinik Ludwigshafen und Ruprecht-Karls-Universität Heidelberg, Klinik für Hand, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Klinik für Plastische Chirurgie, Ludwigshafen
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Bugiardini R, Badimon L, Manfrini O, Boytsov S, Bozidarka K, Daullxhiu I, Dilic M, Dorobantu M, Erglis A, Gafarov V, Gale CP, Goncalvesova E, Goudev A, Gustiene O, Hall A, Karpova I, Kedev S, Manak N, Milicic D, Ostojic M, Parkhomenko AN, Popovici M, Studenkan M, Toth K, Trninic D, Vasiljevic Z, Zakke I, Zaliunas R, Bugiardini R, Vaccarino V, Manfrini O, Badimon L, Manak N, Karpova I, Dilic M, Trninic D, Goudev A, Milicic D, Toth K, Daullxhiu I, Erglis A, Zakke I, Zaliunas R, Gustiene O, Kedev S, Popovici M, Knezevic B, Boytsov S, Gafarov V, Dorubantu M, Vasiljevic Z, Ojstoic M, Goncalvesova E, Studencan M, Parkhomenko AN, Hall A, Gale C, Karpova I, Manak N, Lovric M, Korac R, Mandic D, Vujovic V, Blagojevic M, Milekic J, Trendafilova E, Somleva D, Krivokapic L, Rajovic G, Sahmanovic O, Saranovic M, Radoman C, Tomic SC, Ljubic V, Velickovic M, Radojicic S, Arsenescu-Georfescu C, Garbea S, Radu C, Olinic D, Calin P, Chifor A, Babes K, lonescu DD, Craiu E, Petrescu H, Magda I, Luminita S, Benedek I, Marinescu S, Tiberiu N, Gheorghe G, Malaescu I, Trocan N, Doina D, Macarie C, Putnikovic B, Arandjelovic A, Nikolic NM, Zdravkovic M, Saric J, Radovanovic S, Matic I, Srbljak N, Davidovic G, Simovic S, Zivkovic S, Petkovic-Curic S, Studencan M, Parkhomenko AN. Perspectives: Rationale and design of the ISACS-TC (International Survey of Acute Coronary Syndromes in Transitional Countries) project. Eur Heart J Suppl 2014. [DOI: 10.1093/eurheartj/sut002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Capilna B, Radu C. The association of month of birth with allergic sensitization in pediatric patients with asthma in Mureş County, Romania. Clin Transl Allergy 2013. [PMCID: PMC3723735 DOI: 10.1186/2045-7022-3-s3-p165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Radu C, Norrlid O, Brændengen M, Hansson K, Isacsson U, Glimelius B. Integrated peripheral boost in preoperative radiotherapy for the locally most advanced non-resectable rectal cancer patients. Acta Oncol 2013; 52:528-37. [PMID: 23113591 DOI: 10.3109/0284186x.2012.737022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Few studies have explored the potential clinical advantages of dose escalation and integrated boosts for patients with non-resectable locally advanced rectal cancer. The possibility of escalating dose to non-resectable regions in these patients was the aim of this study. PATIENTS AND METHODS Seven patients with locally very advanced rectal tumours (sacrum overgrowth or growth into pelvic side walls) were evaluated. Intensity modulated photon and pencil beam scanning proton plans with simultaneously integrated boosts (45 Gy to elective lymph nodes, 50 Gy to tumour and 62.5 Gy to boost area in 25 fractions) were compared. RESULTS Target coverage was achieved with both photon and proton plans. Estimated risks of acute side effects put the two patients with the largest tumours at unacceptable risk for intestinal toxicity, regardless of modality. The remaining five patients had beneficial sparing of dose to the small intestine with protons. CONCLUSIONS Adding boost to areas where rectal tumours infiltrate adjacent non-resectable organs is an attractive option which appears possible using both photon and proton irradiation. Proton plans reduced dose to organs at risk. Integrated peripheral boosts should be considered more frequently in these very advanced tumours.
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Affiliation(s)
- Calin Radu
- Department of Radiology, Oncology and Radiation Science, Uppsala University,
Uppsala, Sweden
| | - Ola Norrlid
- Department of Radiology, Oncology and Radiation Science, Uppsala University,
Uppsala, Sweden
| | - Morten Brændengen
- Department of Oncology and Pathology, Karolinska Institutet,
Stockholm, Sweden
- Department of Oncology, Oslo University Hospital,
Oslo, Norway
| | - Karl Hansson
- Department of Diagnostic Radiology, Karolinska University Hospital,
Solna, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet,
Stockholm, Sweden
| | - Ulf Isacsson
- Department of Radiology, Oncology and Radiation Science, Uppsala University,
Uppsala, Sweden
| | - Bengt Glimelius
- Department of Radiology, Oncology and Radiation Science, Uppsala University,
Uppsala, Sweden
- Department of Oncology and Pathology, Karolinska Institutet,
Stockholm, Sweden
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Spiezia L, Visentin S, Radu C, Bon M, Woodhams B, Cosmi E, Simioni P. P-036 Changes in plasma levels of factor VIIa-antithrombin complex during normal pregnancy and in pre-eclampsia. Thromb Res 2013. [DOI: 10.1016/s0049-3848(13)70082-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Senzolo M, Rodriguez-Castro KI, Rossetto V, Radu C, Gavasso S, Carraro P, Zerbinati P, Sartori MT, Simioni P. Increased anticoagulant response to low-molecular-weight heparin in plasma from patients with advanced cirrhosis. J Thromb Haemost 2012; 10:1823-9. [PMID: 22712870 DOI: 10.1111/j.1538-7836.2012.04824.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Cirrhotic patients may present thrombotic complications that warrant anticoagulant therapy. However, the efficacy of low-molecular-weight heparin (LMWH) in this clinical setting is still unclear. AIMS/METHODS To evaluate the in vitro effect of LMWH on thrombin generation (TG) in cirrhotic patients at different stages of liver disease. Thirty cirrhotics (10 Child Pugh A, 10 Child Pugh B and 10 Child Pugh C), 10 subjects with inherited type 1 antithrombin (AT) defect and 10 healthy controls were studied. TG was determined at baseline and with anti-Xa levels after the addition of enoxaparin at 0.35 and 0.7 U anti-Xa mL. The endogenous thrombin potential (ETP) ratio at 0.35 and 0.7 U anti-Xa mL was obtained by dividing ETP with LMWH by ETP at baseline. RESULTS Mean AT levels in all cirrhotic subgroups and in patients with AT deficiency were significantly lower than in controls. The 0.35 ETP ratio was significantly lower in cirrhotic patients than in controls (0.26 ± 0.1 vs. 0.48 ± 0.1, P < 0.001) and the reduction paralleled the severity of liver disease, in spite of the concomitant decrease in AT and anti-Xa activity. AT-deficient subjects showed a significantly increased 0.35 ETP ratio compared with both cirrhotic patients and controls (0.69 ± 1 vs. 0.26 ± 0.1, P < 0.001, and vs. 0.48 ± 0.1, P = 0.04 respectively). LMWH at 0.7 U anti-Xa mL completely inhibited TG in 9/30 cirrhosis patients with more advanced liver disease (Child Pugh B and C), whereas complete TG abolition was seen in only 1/10 controls. CONCLUSIONS Cirrhotic patients show an increased response to LMWH, which correlates with the severity of liver disease, in spite of reduced AT and anti-Xa activity levels. Thrombin generation may be a useful tool to monitor the response to LMWH in cirrhotic patients.
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Affiliation(s)
- M Senzolo
- Multivisceral Transplant Unit, Department of Surgical and Gastroenterological Sciences. Padua University Hospital, Padua, Italy.
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Grigorescu M, Crisan D, Radu C, Grigorescu MD, Sparchez Z, Serban A. A novel pathophysiological-based panel of biomarkers for the diagnosis of nonalcoholic steatohepatitis. J Physiol Pharmacol 2012; 63:347-353. [PMID: 23070083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 07/17/2012] [Indexed: 06/01/2023]
Abstract
Non-invasive biochemical markers are useful to distinguish between nonalcoholic steatohepatitis (NASH) and simple steatosis. The aim of this study was to test the diagnostic value of a panel of biomarkers derived from the pathophysiological events involved in the development of NASH. A total of 79 patients: 20 not-NASH and 59 NASH were included in the study. Definitive NASH was defined according to Kleiner's classification. In all subjects, parameters of the metabolic syndrome, insulin resistance (HOMA-IR), adiponectin, interleukin-6 (IL-6) and total cytokeratin-18 (M65 antigen) were determined. Univariate and multivariate analysis were used to identify independent predictors of NASH. In multivariate analysis three markers were independently predictors of NASH: adiponectin, IL-6 and M65 levels. In decreasing order, the independent predictors of NASH (NAS≥5) were M65 with an AUROC of 0.791, IL-6 with an AUROC of 0.727 and adiponectin with an AUROC of 0.709. The combination of two biomarkers yelded an AUROC of 0.828 for M65 and IL-6, 0.841 for adiponectin and M65 and 0.852 for adiponectin and IL-6. The best value was obtained by triple combination: adiponectin, M65 and IL-6 with and AUROC of 0.903, Sp=85.7% (PPV=94.2%) and Se=84.5% (NPV=66.7%). In conclusion, a novel pathophysiological - based panel of biomarkers combining total CK-18, IL-6 and adiponectin may be useful to predict NASH.
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Affiliation(s)
- M Grigorescu
- Regional Institute of Gastroenterology and Hepatology, 3rd Medical Clinic, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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Spiezia L, Radu C, Bulato C, Tognin G, Gavasso S, Barillari G, Pradella P, De Angelis V, Simioni P. Platelet factor V levels in moderate to severe congenital factor V deficiency. Haemophilia 2011; 18:e53-5. [PMID: 22176589 DOI: 10.1111/j.1365-2516.2011.02717.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pisla D, Gherman B, Plitea N, Gyurka B, Vaida C, Vlad L, Graur F, Radu C, Suciu M, Szilaghi A, Stoica A. PARASURG hybrid parallel robot for minimally invasive surgery. Chirurgia (Bucur) 2011; 106:619-625. [PMID: 22165061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This paper presents the parallel hybrid robot, PARASURG 9M, for robotically assisted surgery, a robot which was entirely designed and produced in Romania. It is a versatile robot, being composed of a positioning and orientation module, PARASURG 5M with five degrees of freedom, having the possibility of attaching at its end either a laparoscope or an active surgical instrument for cutting/grasping, PARASIM, with four degrees of freedom. Based on its mathematical modelling, the first low-cost experimental model of the surgical robot has been built. The robot is part of the surgical robotic system, PARAMIS, with three arms, one used as a laparoscope holder, and other two for manipulating active instruments. When it is used as a manipulator of the camera, the user has the possibility to give commands in a large area for the positioning of the laparoscope using different interfaces: joystick, microphone, keyboard & mouse and haptic device. If the active surgical instrument, PARASIM, is attached, the robot commands are given through a haptic device. The main features that make the PARASURG 9M surgical robot suited for minimally invasive surgery are: precision, the elimination of the natural tremor of the surgeon, direct control over a smooth, precise, stable view of the internal surgical field for the surgeon. It also eliminates the need of a second surgeon to be present for the entire procedure (in the case of using the robot as a camera holder). In addition, there is improvement of surgeon dexterity in the case of using the PARASIM active instrument and better ergonomics in using the robot (in the case of the classic laparoscopy, the surgeon must adopt a difficult position for a long period of time, while the robot never gets tired). Having a relatively easy to understand, intuitive commanding system, the surgeons can rapidly adapt to the use of the PARASURG 9M robot in surgical procedures.
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Affiliation(s)
- D Pisla
- Technical University of Cluj-Napoca, Romania
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Castoldi E, Duckers C, Radu C, Spiezia L, Rossetto V, Tagariello G, Rosing J, Simioni P. Homozygous F5 deep-intronic splicing mutation resulting in severe factor V deficiency and undetectable thrombin generation in platelet-rich plasma. J Thromb Haemost 2011; 9:959-68. [PMID: 21320286 DOI: 10.1111/j.1538-7836.2011.04237.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Coagulation factor (F) V deficiency is associated with a bleeding tendency of variable severity, but phenotype determinants are largely unknown. Recently, we have shown that three patients with undetectable plasma FV and mild bleeding symptoms had sufficient residual platelet FV to support thrombin generation in platelet-rich plasma (PRP). Therefore, we hypothesized that FV-deficient patients with severe bleeding manifestations may lack platelet FV. OBJECTIVES To characterize a FV-deficient patient with a severe bleeding diathesis. PATIENTS/METHODS We performed FV mutation screening and functional studies in a 31-year-old male (FV:C < 1%) with umbilical bleeding at birth, recurrent hemarthrosis and muscle hematomas, and a recent intracranial hemorrhage. RESULTS The proband was homozygous for a deep-intronic mutation (F5 IVS8 +268A→G) causing the inclusion of a pseudo-exon with an in-frame stop codon in the mature F5 mRNA. Although platelet FV antigen was detectable by immunoprecipitation followed by Western blotting, no FV activity could be demonstrated in the proband's plasma or platelets with a prothrombinase-based assay. Moreover, no thrombin generation was observed in PRP triggered with 1-50 pm tissue factor (even in the presence of platelet agonists), whereas an acquired FV inhibitor was excluded. Clot formation in the proband's whole blood, as assessed by thromboelastometry, was markedly delayed but not abolished. CONCLUSIONS This is the first report of a pathogenic deep-intronic mutation in the F5 gene. Our findings indicate that the minimal FV requirement for viability is extremely low and suggest that thrombin generation in PRP may predict bleeding tendency in patients with undetectable plasma FV.
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Affiliation(s)
- E Castoldi
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
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Rossetto V, Spiezia L, Dabrilli P, Radu C, Gavasso S, Simioni P. P.50 Effect of low dose LMWH “in vitro” addition on thrombin generation potential in healthy pregnant and non pregnant women. Thromb Res 2011. [DOI: 10.1016/s0049-3848(11)70105-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Radu C, Schachner M, Tränkle M, Germann G, Sauerbier M. Funktionelle Ergebnisse nach Handgelenksdenervation. HANDCHIR MIKROCHIR P 2010; 42:279-86. [DOI: 10.1055/s-0030-1249060] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Castoldi E, Maurissen LFA, Tormene D, Spiezia L, Gavasso S, Radu C, Hackeng TM, Rosing J, Simioni P. Similar hypercoagulable state and thrombosis risk in type I and type III protein S-deficient individuals from mixed type I/III families. Haematologica 2010:haematol.2009.021923. [DOI: 10.3324/haematol.2009.021923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Spiezia L, Radu C, Gavasso S, Rossetto V, Abalotti C, Fadin M, Dabrilli P, Woodhams B, Simioni P. PO-30 Procoagulant phospholipids in patients with venous thromboembolism and cancer. Thromb Res 2010. [DOI: 10.1016/s0049-3848(10)70080-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pettersson D, Cedermark B, Holm T, Radu C, Påhlman L, Glimelius B, Martling A. Interim analysis of the Stockholm III trial of preoperative radiotherapy regimens for rectal cancer. Br J Surg 2010. [PMID: 20155787 DOI: 10.1002/bjs.691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND To address issues regarding the fractionation of radiotherapy (RT) and timing of surgery for rectal cancer, a multicentre trial has randomized patients to preoperative short-course RT with two different intervals to surgery, or long-course RT with delayed surgery. The present interim analysis assessed feasibility, compliance and complications after RT and surgery. METHODS Some 303 patients were randomized to either short-course RT (5 x 5 Gy) and surgery within 1 week (group 1), short-course RT and surgery after 4-8 weeks (group 2) or long-course RT (25 x 2 Gy) and surgery after 4-8 weeks (group 3). RESULTS Demographic data were similar between groups and there were few protocol violations (5.0-6 per cent). Eight patients (2.6 per cent) developed radiation-induced acute toxicity. There were no significant differences in postoperative complications between groups (46.6, 40.0 and 32 per cent in groups 1, 2 and 3 respectively; P = 0.164). Patients receiving short-course RT with surgery 11-17 days after the start of RT had the highest complication rate (24 of 37). CONCLUSION Compliance was acceptable and severe acute toxicity was low, irrespective of fractionation. Short-course RT with immediate surgery had a tendency towards more postoperative complications, but only if surgery was delayed beyond 10 days after the start of RT. REGISTRATION NUMBER NCT00904813 (http://www.clinicaltrials.gov).
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Affiliation(s)
- D Pettersson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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Pettersson D, Cedermark B, Holm T, Radu C, Påhlman L, Glimelius B, Martling A. Interim analysis of the Stockholm III trial of preoperative radiotherapy regimens for rectal cancer. Br J Surg 2010; 97:580-7. [PMID: 20155787 DOI: 10.1002/bjs.6914] [Citation(s) in RCA: 194] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND To address issues regarding the fractionation of radiotherapy (RT) and timing of surgery for rectal cancer, a multicentre trial has randomized patients to preoperative short-course RT with two different intervals to surgery, or long-course RT with delayed surgery. The present interim analysis assessed feasibility, compliance and complications after RT and surgery. METHODS Some 303 patients were randomized to either short-course RT (5 x 5 Gy) and surgery within 1 week (group 1), short-course RT and surgery after 4-8 weeks (group 2) or long-course RT (25 x 2 Gy) and surgery after 4-8 weeks (group 3). RESULTS Demographic data were similar between groups and there were few protocol violations (5.0-6 per cent). Eight patients (2.6 per cent) developed radiation-induced acute toxicity. There were no significant differences in postoperative complications between groups (46.6, 40.0 and 32 per cent in groups 1, 2 and 3 respectively; P = 0.164). Patients receiving short-course RT with surgery 11-17 days after the start of RT had the highest complication rate (24 of 37). CONCLUSION Compliance was acceptable and severe acute toxicity was low, irrespective of fractionation. Short-course RT with immediate surgery had a tendency towards more postoperative complications, but only if surgery was delayed beyond 10 days after the start of RT. REGISTRATION NUMBER NCT00904813 (http://www.clinicaltrials.gov).
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Affiliation(s)
- D Pettersson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
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Acalovschi M, Buzas C, Radu C, Grigorescu M. Hepatitis C virus infection is a risk factor for gallstone disease: a prospective hospital-based study of patients with chronic viral C hepatitis. J Viral Hepat 2009; 16:860-6. [PMID: 19486279 DOI: 10.1111/j.1365-2893.2009.01141.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [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: 02/06/2023]
Abstract
We evaluated the prevalence and the risk factors for gallstone disease in patients with chronic hepatitis C infection. We investigated 453 consecutively admitted patients with chronic infection with hepatitis C virus (HCV) (cirrhosis excluded) and 879 patients without liver disease (October 2006-April 2007). Gallstone disease was diagnosed if gallstones were present at ultrasonography or if there had been a previous cholecystectomy. Variables evaluated were age, gender, gallstone heredity, body mass index, waist circumference, parity, serum lipids, fatty liver, arterial hypertension, diabetes mellitus and metabolic syndrome (International Diabetes Federation criteria). Informed consent was obtained from all patients. We found that 88 of 453 (19%) patients with chronic HCV hepatitis (age 50.1 +/- 11.7 years) and 153 of 879 (17%) controls (age 60.6 +/- 12.6 years) had gallstone disease (GD). Abdominal obesity (OR = 2.108, 95% CI 1.287-3.452) and steatosis (OR = 3.699, 95% CI 2.277-6.008) were risk factors for GD in HCV patients. Gallstone heredity, dyslipidaemia, type 2 diabetes mellitus and metabolic syndrome increased the risk for GD in controls vs HCV patients. Our study shows that even HCV patients with chronic hepatitis but not cirrhosis have an increased prevalence of gallstones. Compared with controls, gallstones are present in HCV patients at a younger age and are associated with central obesity and liver steatosis, but not with gallstone heredity, dyslipidaemia, diabetes mellitus or metabolic syndrome. Although we could not establish a temporal relationship, the association between HCV infection and gall stone disease is real and appears to be causally linked, at least in predisposed individuals (obese and with liver steatosis).
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Affiliation(s)
- M Acalovschi
- 3rd Medical Clinic, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
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Radu C. WE-D-210A-04: Novel PET Probes to Image the Immune System and Cancer - From Discovery to Clinical Applications. Med Phys 2009. [DOI: 10.1118/1.3182549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Campello E, Spiezia L, Castelli M, Rossetto V, Radu C, Tormene D, Simioni P. O5 Microparticles plasma levels in women with venous thromboembolism and cancer. Thromb Res 2009. [DOI: 10.1016/s0049-3848(09)70030-1] [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: 10/21/2022]
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Radu C, Berglund Å, Påhlman L, Glimelius B. Short-course preoperative radiotherapy with delayed surgery in rectal cancer – A retrospective study. Radiother Oncol 2008; 87:343-9. [DOI: 10.1016/j.radonc.2007.11.025] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2007] [Revised: 11/23/2007] [Accepted: 11/25/2007] [Indexed: 12/20/2022]
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Radu C, Berglund A, Påhlman L, Glimelius B. Short-course preoperative radiotherapy with delayed surgery in rectal cancer - a retrospective study. Radiother Oncol 2008. [PMID: 18093674 DOI: 10.1016/j.radonc.2007.11.025343-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
PURPOSE In the most advanced, non-resectable primary rectal cancers, conventional long-course radiotherapy (RT) (1.8-2Gyx25-28), frequently combined with chemotherapy, has been used since tumour regression is needed in order to allow a radical (R0) resection. In Uppsala, short-course 5x5Gy with planned delayed surgery has been used in patients with contraindications to long-course RT (+/-chemotherapy). The aim is to describe our experience of using this approach in patients not eligible for standard treatment. PATIENTS AND METHODS During 2002 and 2005, 46 patients with non-resectable rectal cancer (+/-synchronous distant metastases) were treated with 5x5Gy and delayed surgery if possible. The clinical records were retrospectively evaluated. The first group (A) had no metastases (T4NXM0), whereas the other two groups (B+C) had metastases (T4NXM1). In group (B), the patients had predominantly loco-regional disease and were not candidates for combination chemotherapy (high age, co-morbidities), and in group (C) up-front combination chemotherapy was given, with the intention to have surgery of both the primary and the secondaries if sufficient regression at both sites were seen. RESULTS The patients in the first two groups (A+B) were old (median 79 and 76 years, respectively), and had several co-morbidities. In group (C), median age was 63 years. The 5x5Gy RT was well tolerated by most patients, but grade IV diarrhoea was recorded in three elderly patients. One patient in the group (C) died from neutropenic fever. Many patients were reported to have less local symptoms after the treatment given. Delayed surgery was performed in all but nine patients. Radical surgery (R0+R1) was performed in 22 (92%) (group A), 4 (44%) (group B), and 6 (46%) (group C) patients, respectively. A pCR was seen in four patients (two in group A and two in group C). No postoperative deaths occurred. CONCLUSIONS Considering the very high age and presence of co-morbidity, the 5x5Gy schedule is well tolerated. Further, considering the very advanced local stage, the schedule has considerable anti-tumour activity and can result in radical surgery in a high proportion of patients.
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Affiliation(s)
- Calin Radu
- Department of Oncology, Radiology and Clinical Immunology, Uppsala University Hospital, Upssala, Sweden.
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Böhler T, Alex C, Becker E, Becker R, Hoffmann S, Hutzler D, Jung C, Laufersweiler-Lochmann F, Radu C. Qualitätskriterien für ambulante Schulungsprogramme für übergewichtige und adipöse Kinder und Jugendliche. Gesundheitswesen 2004; 66:748-53. [PMID: 15562345 DOI: 10.1055/s-2004-813772] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND In Germany, 9 to 12 % of all children between five and seven years of age have been shown to be overweight at school entry; 2.5 to 3.5 % of them are obese. Therapeutic intervention for obese children and adolescents is considered to be indicated especially in cases where an increased body mass index (BMI) is accompanied by a disease the effective treatment of which requires weight loss. Furthermore, the child and its family must be willing to actively change their habits. OBJECTIVE A multitude of health care providers have begun to offer multidisciplinary group programme for prevention and treatment of obesity to affected individuals and their families. The Medical Service of the Statutory Health Insurance (MDK) has therefore developed a list of quality and assessment criteria for such programme. METHODS A systematic search for information in international and national publications was performed using standard methodology of evidence-based medicine. Data were extracted and assessed according to pre-defined criteria taking into consideration previously published clinical guidelines and opinions of expert panels. RESULTS Nearly all available studies were of low internal validity and mostly of poor methodological quality. Therefore, no binding recommendations for the design of health education programme for overweight and obese children and adolescents can be given. Potentially successful intervention should combine the following 4 modules: nutrition, physical activity, change of eating habits, physical activity habits and life style using methods of behavioural therapy, and involvement of parents. Such combinations may have the potential to reduce or stabilise the BMI at least during a defined period of time. In younger children, the beneficial effect will be more pronounced if the parents are actively involved. CONCLUSION Up to now informative studies have not reliably shown that the effect of ambulatory health education programmes for overweight and obese children and adolescents and their parents may last for more than one or two years. Therefore, a controlled clinical trial determining the long-term effectiveness of such programme is imperative. The decision whether a defined programmes should be included in such a study could be taken on the basis of the quality indicators and assessment criteria described here.
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Hutzler D, Böhler T, Alex C, Becker R, Hoffmann S, Jung C, Laufersweiler-Lochmann F, Radu C. Wie sind ambulante Adipositas-Programme für Kinder und Jugendliche zu bewerten? Gesundheitswesen 2004. [DOI: 10.1055/s-2004-833837] [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: 10/19/2022]
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Doran H, Pătraşcu T, Radu C. [Acute abdomen in diabetic patients --diagnostical questions]. Chirurgia (Bucur) 2003; 98:119-25. [PMID: 14992132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The acute abdominal diseases in diabetic patients have some typical clinical features, which may be responsible for delated or even erroneous diagnosis. Severe anatomo-pathological forms of these diseases may advance, despite a rather discreet clinical evidence. The authors analyze a series of 132 diabetic patients with acute abdomen, operated between 1996 and 2001 in Surgical Clinic "I. Juvara", from Clinical Hospital "Dr. I. Cantacuzino"-Bucharest. The difficulties and also the inadvertences of diagnosis are detailed. Finally, a set of indices is presented, in order to help the differential diagnosis between acute abdomen and abdominal signs of the diabetic ketoacidosis.
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Affiliation(s)
- H Doran
- Clinica de Chirurgie I. Juvara, Spitalul Clinic Dr. I. Cantacuzino, Str. I. Movilă, nr.5-7, sector 2, Bucureşti
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Cantini M, Giurisato E, Radu C, Tiozzo S, Pampinella F, Senigaglia D, Zaniolo G, Mazzoleni F, Vitiello L. Macrophage-secreted myogenic factors: a promising tool for greatly enhancing the proliferative capacity of myoblasts in vitro and in vivo. Neurol Sci 2002; 23:189-94. [PMID: 12536288 DOI: 10.1007/s100720200060] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In this work we set out to determine if the murine macrophage J774 cell line can be used to produce myogenic growth factors. Activated J774 macrophages were grown in serum-free conditions. The macrophage-conditioned medium (MCM) was then used to treat cultures of primary myoblasts and regenerating muscle tissue, in vitro and in vivo respectively. MCM activity in vitro was tested by analyzing the expression of muscle-specific transcription factors, in parallel with the proliferation and differentiation rates of the cells. The macrophage-secreted factors greatly enhanced the proliferative potential of both rat and human primary myoblasts and were found to be highly muscle-specific. In vivo, MCM administration markedly enhanced the regenerative processes in damaged muscles. The ability to produce large amounts of macrophage-secreted myogenic factor(s) in the absence of serum holds great promise for its biochemical characterization and successive application in therapeutic protocols, both for ex vivo gene therapy and for muscle repair.
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Affiliation(s)
- M Cantini
- Department of Experimental Biomedical Sciences, University of Padua, Via Bassi 58/B, I-35121 Padua, Italy
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Grypiotis P, Ruffatti A, Tonello M, Winzler C, Radu C, Zampieri S, Favaro M, Calligaro A, Todesco S. [Clinical significance of fluoroscopic patterns specific for the mitotic spindle in patients with rheumatic diseases]. Reumatismo 2002; 54:232-7. [PMID: 12404031 DOI: 10.4081/reumatismo.2002.232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To determine the clinical significance of anti-NuMA and anti-HsEg5 antibodies in a group of patients affected with rheumatic diseases. MATERIALS AND METHODS Indirect immunofluorescence on HEp-2000 cells at serum dilution of 1:40 was used to examine 26 sera which had previously showed a "mitotic spindle" fluoroscopic pattern type during laboratory routine. RESULTS 21 sera (80,7%) were identified with NuMA and 5 (19,3%) with HsEg5 patterns alone or associated with other ANA patterns. However only patients with isolated positivity and that is 15 with NuMA and 4 with HsEg5 stainings were included in this study. Of the NuMA positive patients 5 were affected with arthropathies associated to different forms of thyroiditis, 2 with seronegative arthritis, 2 with antiphospholipid syndrome, 1 with systemic lupus erythematosus (SLE), 1 with rheumatoid arthritis, 1 with sicca syndrome, 1 with undifferentiated connective tissue disease, 1 with Mycoplasma pneumoniae infection and 1 with retinal thrombosis. Of the HsEg5 positive patients 3 were affected with SLE and 1 with seronegative arthritis. CONCLUSIONS NuMA does not prevail in any defined rheumatic disease, while HsEg5 staining were more frequent (75%) in patients affected with SLE all of whom showing high antibody titres.
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MESH Headings
- Adenocarcinoma/pathology
- Antibodies, Antinuclear/immunology
- Antigens, Nuclear
- Antiphospholipid Syndrome/blood
- Antiphospholipid Syndrome/immunology
- Arthritis/blood
- Arthritis/immunology
- Arthritis, Rheumatoid/blood
- Arthritis, Rheumatoid/immunology
- Autoantibodies/blood
- Autoantibodies/immunology
- Autoimmune Diseases/blood
- Autoimmune Diseases/immunology
- Cell Cycle
- Cell Cycle Proteins
- Centrosome/immunology
- Connective Tissue Diseases/blood
- Connective Tissue Diseases/immunology
- Fluorescent Antibody Technique, Indirect
- Fluorescent Dyes/analysis
- Humans
- Kinesins/analysis
- Kinesins/immunology
- Laryngeal Neoplasms/pathology
- Lupus Erythematosus, Systemic/blood
- Lupus Erythematosus, Systemic/immunology
- Microscopy, Fluorescence
- Nuclear Matrix-Associated Proteins
- Nuclear Proteins/analysis
- Nuclear Proteins/immunology
- Pneumonia, Mycoplasma/blood
- Pneumonia, Mycoplasma/immunology
- Sjogren's Syndrome/blood
- Sjogren's Syndrome/immunology
- Spindle Apparatus/immunology
- Thrombosis/blood
- Thrombosis/immunology
- Thyroiditis, Autoimmune/blood
- Thyroiditis, Autoimmune/immunology
- Tumor Cells, Cultured/immunology
- Tumor Cells, Cultured/ultrastructure
- Xenopus Proteins/analysis
- Xenopus Proteins/immunology
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Affiliation(s)
- P Grypiotis
- Cattedra e Divisione di Reumatologia, Università degli Studi di Padova.
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Pătraşcu T, Doran H, Beluşică L, Marin I, Muşat O, Crihană V, Radu C. [Small bowel tumors -- peculiarities of diagnosis and evolution]. Chirurgia (Bucur) 2002; 97:133-8. [PMID: 12731223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
The authors analyze 13 cases of small bowel tumors. There are emphasized the difficulties of diagnosis, which is rarely established before the laparotomy. In the same time, clinical features are few and operations are often performed too late, in emergency, due to tumors complications (perforation, bleeding, occlusion). There are also presented new etiopathogenic hypothesis, recently mentioned in literature. Surgical treatment is followed by many post-operative complications. Five-years survival is low, under 40% of patients.
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Affiliation(s)
- Tr Pătraşcu
- Clinica de Chirurgie Prof. I. Juvara, Spitalul Clinic Dr. I. Cantacuzino Str. I. Movilă, nr. 5-7, sect. 2, Bucureşti
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