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Multi-Institutional Analysis of Metastasis Directed Therapy with or without Androgen Deprivation Therapy in Oligometastatic Castration Sensitive Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e442-e443. [PMID: 37785433 DOI: 10.1016/j.ijrobp.2023.06.1620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Several prospective trials in oligometastatic castration sensitive prostate cancer (omCSPC) have shown metastasis-directed therapy (MDT) can delay time to progression and initiation of androgen deprivation therapy (ADT) compared to observation. However, the optimal integration of ADT with MDT remains unclear. Here we report a multi-national, multi-institutional retrospective cohort of omCSPC treated with MDT to characterize the long-term outcomes of patients treated with MDT alone or in combination with ADT. MATERIALS/METHODS Patients with a controlled primary site and omCSPC (defined as ≤ 5 lesions on conventional imaging) treated with MDT with or without concurrent ADT and with at least 36 months follow-up were retrospectively screened across 13 institutions. The primary endpoints included biochemical progression free survival (bPFS) and radiographic progression free survival (rPFS) calculated using Kaplan-Meier method and stratified by treatment group (MDT alone vs MDT + ADT). Multivariable Cox regression was performed adjusted for variables found to be prognostic on univariate analysis. RESULTS Among 414 patients screened, a total of 263 patients treated between 2003 and 2018 met inclusion criteria and included. Of these, 105 received MDT alone and 158 received MDT+ADT, with median follow-up of 49.5 and 54.5 months, respectively. The majority were metachronous (90%) and had bone lesions (60%). Median ADT duration was 21.3 months (IQR 12.0- 31.9). Patients who received ADT vs. no ADT had poorer prognostic features including 23% vs. 1% synchronous (p<0.001), and 55% vs 40% Gleason 8-10 (p = 0.012). ADT use was associated with a better 5-year bPFS 24% vs 11% (p<0.0001) and rPFS 41% vs 29% (p<0.001). On multivariable Cox regression adjusting for post-MDT PSA nadir and salvage therapy, ADT use maintained significance for both bPFS (HR 0.51 (0.36, 0.71), p<0.001) and rPFS (HR 0.67, 95% CI 0.46-0.96, p = 0.03). CONCLUSION Long-term outcomes with MDT alone suggest a small proportion of patients experience sustained disease control. The addition of ADT appears to improve rPFS, however prospective studies are needed in order to allow for personalization of care in patients with omCSPC.
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[Ethical competence of the radiation therapist in the management of a crisis]. Cancer Radiother 2022; 26:841-845. [PMID: 36075832 DOI: 10.1016/j.canrad.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022]
Abstract
Many situations can be considered as a crisis in radiotherapy (failure of equipment, absenteeism, excessive workload, errors, urgent care, pandemic, etc.). Such events are defined as difficult situations in the course of daily activity, they can at any time escape the vigilance of the concerned actors when they are not prepared for it. The crisis can induce a disruption of balance between the normal course of the radiation therapy and the obligation for the manipulators to reconcile the consequences of the ongoing crisis with the objective of taking charge of all patients scheduled for the program. The crisis and its management will inexorably cause stress, fatigue and, as a consequence, impact patient safety. Management has an essential role to play in maintaining team dynamics when a crisis occurs, the work environment may no longer be the same. The aim of this article is to describe these situations in order to highlight the needs of the teams and more specifically the needs of the radiation therapist. It highlights the organization of patient care in the event of crisis management (Covid-19), during palliative radiotherapy with an opportunity to develop advanced practice. The reflection on the ethical concern of the radiation therapist in the prioritization of patients leads us to analyze the knowledge of medical ethics provided during initial training. When they perform their duties, manipulators seem to be confronted with situations that give rise to ethical dilemmas. It is then a question of understanding how they reflect on their practice in order to make it evolve. Is the radiation therapist confronted with ethical issues in the course of his practice? What solutions can be implemented to deal with these issues?
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Comparison of intrathecal baclofen pump insertion and selective dorsal rhizotomy for nonambulatory children with predominantly spastic cerebral palsy. J Neurosurg Pediatr 2022; 30:217-223. [PMID: 35901772 DOI: 10.3171/2022.4.peds21576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/22/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In nonambulatory children with predominantly spastic cerebral palsy (CP), the authors compared care needs, symptom burden, and complications after surgical treatment with either intrathecal baclofen (ITB) pump insertion or selective dorsal rhizotomy (SDR). The patients were treated at two Canadian centers with variability in practice pertaining to these surgical options. METHODS The authors performed a retrospective analysis of nonambulatory children with predominantly spastic quadriplegic or diplegic CP who underwent treatment with ITB or SDR. These two strategies were retrospectively assessed by comparing patient data from the two treatment groups for demographic characteristics, outcomes, and complications. A partial least-squares analysis was performed to identify patient phenotypes associated with outcomes. RESULTS Thirty patients who underwent ITB and 30 patients who underwent SDR were included for analysis. Patients in the ITB group were older and had lower baseline functional status, with greater burdens of spasticity, dystonia, pain, deformity, bladder dysfunction, and epilepsy than patients in the SDR group. In addition, children who underwent SDR had lower Gross Motor Function Classification System (GMFCS) levels and were less likely to experience complications than those who underwent ITB. However, children treated with SDR had fewer improvements in pain than children treated with ITB. A single significant latent variable explaining 88% of the variance in the data was identified. CONCLUSIONS Considerable baseline differences exist within this pediatric CP patient population. Factors specific to individual children must be taken into account when determining whether ITB or SDR is the appropriate treatment.
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OC-0603 PEACE V – STORM randomized phase II trial for oligorecurrent nodal prostate cancer: acute toxicity. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02625-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Développement et validation d’un questionnaire d’évaluation de la Qualité de Vie Alimentaire (QVA) chez les patients atteints de cancer. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2021.12.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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PO-1871 Prospective study on the feasibility of single-fraction SABR for bone and lymph node metastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08322-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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PH-0268 Precision of image-guided RT for spinal SABR patients and impact of positioning variables. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07283-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Synthesis, crystal structure and magnetic behavior of a new calcium magnesium and iron orthophosphate Ca2MgFe2(PO4)4. J SOLID STATE CHEM 2020. [DOI: 10.1016/j.jssc.2020.121715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Successful pregnancy in a cancer patient previously cured of a gestational trophoblastic tumor by immunotherapy. Ann Oncol 2020; 31:823-825. [PMID: 32171750 DOI: 10.1016/j.annonc.2020.02.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 02/27/2020] [Indexed: 12/26/2022] Open
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10
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Adding ADT to PSMA-PET/CT-guided SBRT for oligometastatic prostate cancer improves distant progression-free survival. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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PV-0256 European survey on electronic patientreported outcomes by the EORTC young Radiation Oncology Group. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30676-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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EP-1621 First results of the first cohort of a phase I dose-escalation trial on SABR for oligometastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32041-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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PO-0882 Outcome and Toxicity of Hypofractionated Image-Guided SABR for Spinal Oligometastases. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Severe renal insufficiency is not an absolute pitfall to autologous stem cell transplantation with BeEAM (bendamustine, etoposide, cytarabine, melphalan) conditioning regimen. Bone Marrow Transplant 2019; 54:1173-1175. [PMID: 30718799 DOI: 10.1038/s41409-019-0467-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/31/2018] [Accepted: 01/22/2019] [Indexed: 11/09/2022]
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Low anterior resection syndrome after surgical treatment of rectal cancer: Associated factors and correlation with the quality of life. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Upper limb position sense quantification using robotics in patients with stroke: Preliminary results. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hematopoietic reconstitution after autologous hematopoietic stem cell transplantation: do CD45 (+) CD34 (+) CD38 (-) progenitors really matter in real life? Transfus Apher Sci 2018; 57:406-408. [PMID: 29709543 DOI: 10.1016/j.transci.2018.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 03/30/2018] [Accepted: 04/04/2018] [Indexed: 10/17/2022]
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OC-0194: Evaluation of an optical surface monitoring system for intrafractional movement during SABR. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30504-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Systematic versus sentinel-lymph-node-driven axillary-lymph-node dissection in clinically node-negative patients with operable breast cancer. Results of the GF-GS01 randomized trial. Breast Cancer Res Treat 2018. [PMID: 29526019 PMCID: PMC5999168 DOI: 10.1007/s10549-018-4733-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Purpose Sentinel-lymph-node (SLN) resection seems to minimize systematic axillary-lymph-node dissection (sALND) side effects in operated breast cancer patients. We explored whether SLN resection achieves similar therapeutic outcomes as sALND but with fewer side effects. Methods A randomized, controlled, open-label trial with parallel-group design compared sALND restricted to cases with positive SLN biopsy (test arm, n = 774) versus SLN biopsy followed by sALND (control arm, n = 770).
Results The five-year overall survivals in control and test arms were 96.42 and 95.64% (P = 0.2925). The estimated difference was nearly zero (precisely, − 0.79%, one-tailed 95% confidence interval (CI) limit − 2.44%). In a multivariate Cox model, the adjusted hazard ratio in the test arm was HR 0.81 (upper 95% CI limit 1.17). Advanced age (HR 1.05 per additional year, CI [1.03–1.08]), negative progesterone receptor (HR 2.17 [1.35–3.45]), SLN metastasis (HR 1.69 [1.03–2.79]), and only one SLN identification technique (HR 4.14 [1.21–14.18]) were associated with lower survival. Patients with ≥ 1 severe side effect at 1 month in control and test arms were 173/703 = 24.6% [21.5–28.0%] and 91/693 = 13.1% [10.7–15.9%] (P < 0.001). The estimated sensitivity of SLN biopsy (control arm) was 145/178 = 81.5% [74.8–86.7%].
Conclusions Restricting ALND to cases with positive SLN biopsy does not affect the overall survival but reduces by 11.5% [7.5–15.6%] (P < 0.001) the risk of severe short-time side effects of sALND.
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Abstract
In Dr. Turner's paper on the classification of insanity in the January number of the Journal occurs this passage: “It is from cases of this class” (epileptic insanity, psychasthenia, morbid obsessions, and impulse) “that subtle dialecticians seek to prove there may be disorder of conduct without disorder of mind.” As I am the only person who has ever made any distinction between disorder of conduct and disorder of mind, or has ever said that the one may be disordered without disorder of the other, it is manifest that I am the subtle dialecticians referred to by Dr. Turner, and I must express to him my obligation for justifying me in the future use of the royal We. We must point out to him, however, that after the manner and habit of members of this Association, he attributes to Us views that We have never expressed and never held. We have, indeed, taught for many years, and iterated and reiterated, that disorder of mind may exist without disorder of conduct, and this view is again expressed in Our paper published in this Journal in October, 1910, but We have never expressed the opinion, subtle dialecticians though We may be, that disorder of conduct ever exists apart from disorder of mind. Perhaps Dr. Turner will be so good another time as to verify his references.
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Two viruses, MCV1 and MCV2, which infect Marinitoga
bacteria isolated from deep-sea hydrothermal vents: functional and genomic analysis. Environ Microbiol 2017; 20:577-587. [DOI: 10.1111/1462-2920.13967] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 09/25/2017] [Accepted: 10/19/2017] [Indexed: 11/27/2022]
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Vorinostat and Mithramycin A in combination therapy as an interesting strategy for the treatment of Sézary T lymphoma: a transcriptomic approach. Arch Dermatol Res 2017; 309:611-623. [PMID: 28695331 DOI: 10.1007/s00403-017-1761-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/07/2017] [Accepted: 07/03/2017] [Indexed: 12/22/2022]
Abstract
SAHA (vorinostat) is a histone deacetylase inhibitor approved by the USA Food and Drug Administration (FDA) for treating advanced refractory cutaneous T cell lymphomas. As SAHA alters the expression of many genes under control of the Sp1 transcription factor, we examined the effect of its association with the FDA-approved anticancer antibiotic Mithramycin A (MTR, plicamycin), a competitive inhibitor of Sp1 binding to DNA. Sézary syndrome (SS) cells, expanded ex vivo from peripheral blood mononuclear cells of 4 patients, were tested for their sensitivity to the drugs regarding cytotoxicity and differential responsive gene expression. Multivariate statistical methods were used to identify genes whose expression is altered by SAHA, MTR, and the synergist effect of the two drugs. MTR, like SAHA, induced the apoptosis of SS cells, while the two drugs in combination showed clear synergy or potentiation. Expression data stressed a likely important role of additive or synergistic epigenetic modifications in the combined effect of the two drugs, while direct inhibition of Sp1-dependent transcription seemed to have only limited impact. Ontological analysis of modified gene expression suggested that the two drugs, either independently or synergistically, counteracted many intertwined pro-survival pathways deregulated in SS cells, resistance of these tumors to intrinsic and extrinsic apoptosis, abnormal adhesion migration, and invasive properties, as well as immunosuppressive behavior. Our findings provide preliminary clues on the individual and combined effects of SAHA and MTR in SS cells and highlight a potential therapeutic interest of this novel pair of drugs for treatment of SS patients.
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Glass-Fiber Networks as an Orbit for Ions: Fabrication of Excellent Antistatic PP/GF Composites with Extremely Low Organic Salt Loadings. ACS APPLIED MATERIALS & INTERFACES 2017; 9:18305-18313. [PMID: 28485141 DOI: 10.1021/acsami.7b04921] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Polypropylene (PP)/glass fiber (GF) composites showing excellent antistatic performance were prepared by a simple melt process blending PP with GF and a small amount of organic salts (OSs). Two types of OSs, tribuyl(octyl)phosphonium bis(trifloromethanesulfonyl)imide (TBOP-TFSI) and lithium bis(trifloromethanesulfonyl)imide (Li-TFSI), with equivalent anions were used as antistatic agents for the composites. It was found that the GF and OSs exhibited significant synergistic effects on the antistatic performance as well as the mechanical properties of the composites. On the one hand, the incorporation of GF significantly enhanced the electric conductivity of the composites at a constant OS loading. On the other hand, the two types of OSs improved the interfacial adhesion between the GF and the PP matrix, which led to an enhancement of the mechanical properties. This study showed that OSs had specific interactions with GFs and were absorbed exclusively on the GF surface. The GF network in the PP matrix provided perfect orbits for the movement of ions, inducing the excellent antistatic performance exhibited by the PP/GF composites at an OS loading of as low as 0.25 wt % when the GF formed a network in the PP matrix.
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Conservative Management of Large Traumatic Supratentorial Epidural Hematoma in the Pediatric Population. Pediatr Neurosurg 2017; 52:168-172. [PMID: 28329751 DOI: 10.1159/000455925] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/08/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Conservative management of traumatic epidural hematomas is being recognized as a safe alternative to surgical treatment in asymptomatic children. There is still debate about the maximal size of epidural hematoma that should be tolerated before deciding for surgery. METHODS We report - through a retrospective cohort study from a single institution - a series of 16 conservatively managed traumatic epidural hematomas of more than 15 mm thickness. RESULTS 14 patients (88%) were successfully treated using conservative management. Two patients required surgery. These 2 patients had the only 2 documented high-velocity injury mechanisms. All patients had a Glasgow Outcome Scale of 5/5 on follow-up. CONCLUSION Conservative management with close observation is a safe alternative even in this population of voluminous hematomas. Injury velocity may be a contributing factor for failure of conservative management in this population.
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Absorption of toluene by vegetable oil–water emulsion in scrubbing tower: Experiments and modeling. Chem Eng Sci 2017. [DOI: 10.1016/j.ces.2016.06.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Erythrocyte deformability and acute phase reactant proteins in arteriosclerosis obliterans patients. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1983-3505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Impact of online visual feedback on motor acquisition and retention when learning to reach in a force field. Neuroscience 2016; 337:267-275. [PMID: 27646292 DOI: 10.1016/j.neuroscience.2016.09.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 09/09/2016] [Accepted: 09/11/2016] [Indexed: 11/30/2022]
Abstract
When subjects learn a novel motor task, several sources of feedback (proprioceptive, visual or auditory) contribute to the performance. Over the past few years, several studies have investigated the role of visual feedback in motor learning, yet evidence remains conflicting. The aim of this study was therefore to investigate the role of online visual feedback (VFb) on the acquisition and retention stages of motor learning associated with training in a reaching task. Thirty healthy subjects made ballistic reaching movements with their dominant arm toward two targets, on 2 consecutive days using a robotized exoskeleton (KINARM). They were randomly assigned to a group with (VFb) or without (NoVFb) VFb of index position during movement. On day 1, the task was performed before (baseline) and during the application of a velocity-dependent resistive force field (adaptation). To assess retention, participants repeated the task with the force field on day 2. Motor learning was characterized by: (1) the final endpoint error (movement accuracy) and (2) the initial angle (iANG) of deviation (motor planning). Even though both groups showed motor adaptation, the NoVFb-group exhibited slower learning and higher final endpoint error than the VFb-group. In some condition, subjects trained without visual feedback used more curved initial trajectories to anticipate for the perturbation. This observation suggests that learning to reach targets in a velocity-dependent resistive force field is possible even when feedback is limited. However, the absence of VFb leads to different strategies that were only apparent when reaching toward the most challenging target.
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Comparison of strength measurements under single-joint and multi-joint conditions in hemiparetic individuals. Clin Rehabil 2016; 19:523-30. [PMID: 16119408 DOI: 10.1191/0269215505cr861oa] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: It has been suggested that the measurement of strength is inappropriate in patients with stroke, in large part because of the presence of abnormal synergy patterns. The aim of the present study was to characterize force production during multi-joint maximal exertion involving different combinations of activation between shoulder and elbow flexors and extensors. Design: Cross-sectional study. Setting: Rehabilitation centre. Subjects: A convenience sample of 16 chronic hemiparetic stroke subjects. Main outcome measures: Maximal torques in flexion and extension at the shoulder and the elbow were measured using static dynamometers (single-joint condition). In addition, the maximal forces produced at the wrist were measured in four directions in the sagittal plane requiring different torque combinations between shoulder and elbow flexors and extensors (multi-joint condition). Results: No difference was found across directions for the ratios of maximal forces (paretic/nonparetic) in the multi-joint condition (p = 0.227; mean ratios (9±SD) for each direction ranging from 0.599±0.23 to 0.689±0.27), suggesting that the ability to produce force did not change as a function of the required torque combination. In addition, relative torques (% of the maximal torque in the single-joint condition) exerted during the multi-joint exertions were similar on the paretic and the nonparetic side. Conclusions: These results do not support the assumption that force production is limited by abnormal synergy patterns between flexors and extensors at the shoulder and the elbow in hemiparetic patients.
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Experimental tonic hand pain modulates the corticospinal plasticity induced by a subsequent hand deafferentation. Neuroscience 2016; 330:403-9. [PMID: 27291642 DOI: 10.1016/j.neuroscience.2016.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 05/30/2016] [Accepted: 06/04/2016] [Indexed: 02/06/2023]
Abstract
Sensorimotor reorganization is believed to play an important role in the development and maintenance of phantom limb pain, but pain itself might modulate sensorimotor plasticity induced by deafferentation. Clinical and basic research support this idea, as pain prior to amputation increases the risk of developing post-amputation pain. The aim of this study was to examine the influence of experimental tonic cutaneous hand pain on the plasticity induced by temporary ischemic hand deafferentation. Sixteen healthy subjects participated in two experimental sessions (Pain, No Pain) in which transcranial magnetic stimulation was used to assess corticospinal excitability in two forearm muscles (flexor carpi radialis and flexor digitorum superficialis) before (T0, T10, T20, and T40) and after (T60 and T75) inflation of a cuff around the wrist. The cuff was inflated at T45 in both sessions and in the Pain session capsaicin cream was applied on the dorsum of the hand at T5. Corticospinal excitability was significantly greater during the Post-inflation phase (p=0.002) and increased similarly in both muscles (p=0.861). Importantly, the excitability increase in the Post-inflation phase was greater for the Pain than the No-Pain condition (p=0.006). Post-hoc analyses revealed a significant difference between the two conditions during the Post-inflation phase (p=0.030) but no difference during the Pre-inflation phase (p=0.601). In other words, the corticospinal facilitation was greater when pain was present prior to cuff inflation. These results indicate that pain can modulate the plasticity induced by another event, and could partially explain the sensorimotor reorganization often reported in chronic pain populations.
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Micafungin as primary antifungal prophylaxis in patients presenting with acute myeloid leukemia. Med Mal Infect 2016; 46:226-9. [PMID: 27126350 DOI: 10.1016/j.medmal.2016.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 01/29/2016] [Accepted: 03/18/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To study the efficacy and safety of micafungin for prophylaxis of invasive fungal infections in patients undergoing induction chemotherapy for acute myeloid leukemia. PATIENTS AND METHODS A prospective observational single-center study of 41 patients from the hematology department between May 2012 and April 2015. Micafungin was administered once daily from the first day of induction chemotherapy to the end of the neutropenic phase. RESULTS Neither Candida nor Aspergillus infection was documented in our 41 patients from the first day of micafungin infusion to the end of the neutropenic phase. Patients were followed for three months after discontinuation of micafungin and none of them contracted an invasive fungal infection. Only one patient presented with grade III-IV hepatic and ionic toxicities. CONCLUSION Micafungin is associated with a good safety profile and is an interesting option for preventing invasive fungal infections in the high-risk population of patients presenting with hematological disorders.
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Perceived and Valued Roles of Adults with Severe Mental Health Problems. The Canadian Journal of Occupational Therapy 2016; 68:112-20. [PMID: 11355616 DOI: 10.1177/000841740106800207] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this article is to convey the findings of two studies related to the perception of past, present and future roles, the value attributed to these roles as well as the role patterns. Both studies were conducted with adults who have schizophrenia and are involved in a rehabilitation or work program. Data were collected from two sources: 1) secondary analysis of a study related to the methodology for validating the French translation (Hachey, Jumoorty, & Mercier, 1995) of the “Role Checklist”, (Barris, Oakley, & Kielhofner, 1988) and 2) a research project on the perception of roles and quality of life. Results showed that the dominant roles assumed by participants regardless of time were family member, friend, home maintainer and hobbyist. The most valued roles were those of friend, worker, and family member. The discussion will address the questions asked and elucidate the role patterns. The conclusion underlines the importance, for occupational therapists and health professionals, of including roles in the daily lives of their clients, taking into consideration the ones they value most highly.
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Association of postoperative furosemide use with a reduced blood transfusion rate in sagittal craniosynostosis surgery. J Neurosurg Pediatr 2016; 17:34-40. [PMID: 26431247 DOI: 10.3171/2015.5.peds14666] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT A major challenge in sagittal craniosynostosis surgery is the high transfusion rate (50%-100%) related to blood loss in small pediatric patients. Several approaches have been proposed to prevent packed red blood cell (PRBC) transfusion, including endoscopic surgery, erythropoietin ortranexamic acid administration, and preoperative hemodilution. The authors hypothesized that a significant proportion of postoperative anemia observed in pediatric patients is actually dilutional. Consequently, since 2005, at CHU Sainte-Justine, furosemide has been administered to correct the volemic status and prevent PRBC transfusion. The purpose of this study was to evaluate the impact of postoperative furosemide administration on PRBC transfusion rates. METHODS This was a retrospective study of 96 consecutive patients with sagittal synostosis who underwent surgery at CHU Sainte-Justine between January 2000 and May 2012. The mean age at surgery was 4.9 ± 1.5 months (range 2.8-8.7 months). Patients who had surgery before 2005 constituted the control group. Those who had surgery in 2005 or 2006 were considered part of an implementation phase because furosemide administration was not routine. Patients who had surgery after 2006 were part of the experimental (or furosemide) group. Transfusion rates among the 3 groups were compared. The impact of furosemide administration on transfusion requirement was also measured while accounting for other variables of interest in a multiple logistic regression model. RESULTS The total transfusion rate was significantly reduced in the furosemide group compared with the control group (31.3% vs 62.5%, respectively; p = 0.009), mirroring the decrease in the postoperative transfusion rate between the groups (18.3% vs 50.0%, respectively; p = 0.003). The postoperative transfusion threshold remained similar throughout the study (mean hemoglobin 56.0 g/dl vs 60.9 g/dl for control and furosemide groups, respectively; p = 0.085). The proportion of nontransfused patients with recorded hemoglobin below 70 g/dl did not differ between the control and furosemide groups (41.7% vs 28.6%, respectively; p = 0.489). Surgical procedure, preoperative hemoglobin level, estimated blood loss, and furosemide administration significantly affected the risk of receiving a postoperative PRBC transfusion. When these variables were analyzed in a multiple logistic regression model, furosemide administration remained strongly associated with a reduced risk of being exposed to a blood transfusion (OR 0.196, p = 0.005). There were no complications related to furosemide administration. CONCLUSIONS A significant part of the postoperative anemia observed in patients who underwent sagittal craniosynostosis surgery was due to hypervolemic hemodilution. Correction of the volemic status with furosemide administration significantly reduces postoperative PRBC transfusion requirements in these patients.
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Measuring ankle proprioception DURING walking using a robotized ankle-foot orthosis: Towards a quantitative method to assess clinical populations. Ann Phys Rehabil Med 2015. [DOI: 10.1016/j.rehab.2015.07.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Reliability of a measure of proprioception at the ankle during walking evaluated using a robotized ankle–foot orthosis. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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DNA metabarcoding diet analysis for species with parapatric vs sympatric distribution: a case study on subterranean rodents. Heredity (Edinb) 2015; 114:525-36. [PMID: 25649502 PMCID: PMC4815513 DOI: 10.1038/hdy.2014.109] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 10/22/2014] [Accepted: 10/27/2014] [Indexed: 11/09/2022] Open
Abstract
Closely related sympatric species commonly develop different ecological strategies to avoid competition. Ctenomys minutus and C. flamarioni are subterranean rodents parapatrically distributed in the southern Brazilian coastal plain, showing a narrow sympatric zone. To gain understanding on food preferences and possible competition for food resources, we evaluated their diet composition performing DNA metabarcoding analyzes of 67 C. minutus and 100 C. flamarioni scat samples, collected along the species geographical ranges. Thirteen plant families, mainly represented by Poaceae, Araliaceae, Asteraceae and Fabaceae, were identified in the diet of C. minutus. For C. flamarioni, 10 families were recovered, with a predominance of Poaceae, Araliaceae and Asteraceae. A significant correlation between diet composition and geographical distance was detected in C. minutus, whereas the diet of C. flamarioni was quite homogeneous throughout its geographical distribution. No significant differences were observed between males and females of each species. However, differences in diet composition between species were evident according to multivariate analysis. Our results suggest some level of diet partitioning between C. flamarioni and C. minutus in the sympatric region. While the first species is more specialized on few plant items, the second showed a more varied and heterogeneous diet pattern among individuals. These differences might have been developed to avoid competition in the region of co-occurrence. Resource availability in the environment also seems to influence food choices. Our data indicate that C. minutus and C. flamarioni are generalist species, but that some preference for Poaceae, Asteraceae and Araliaceae families can be suggested for both rodents.
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Uma discussão sobre o artigo "Ideias imperativas", do Dr. Hack Tuke. REVISTA LATINOAMERICANA DE PSICOPATOLOGIA FUNDAMENTAL 2014. [DOI: 10.1590/1984-0381v17n2a10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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A 15-year-old adolescent with a rare pituitary lesion. Endocrinol Diabetes Metab Case Rep 2014; 2014:140010. [PMID: 24851183 PMCID: PMC4027854 DOI: 10.1530/edm-14-0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 04/02/2014] [Indexed: 11/17/2022] Open
Abstract
Cystic sellar lesions are a rare cause of hypopituitarism and extremely rare in the pediatric age group. The differential diagnosis is large and includes both primary pituitary abscesses and cystic components on pre-existing lesions, such as adenoma, craniopharyngioma, Rathke's cleft cyst, leukemia, granulomatous disease and lymphocytic hypophysitis. In the absence of a definitive diagnosis, treatment can be challenging. We report a case of a 15-year-old female, who presented with headaches, altered consciousness and diplopia after a molar extraction, for which she had received oral antibiotics. Broad-spectrum i.v. antibiotics were given for presumed meningitis. Blood cultures failed to identify pathogens. Cerebral magnetic resonance imaging showed a pituitary cystic lesion. Endocrine studies revealed abnormal pituitary function. In the absence of a therapeutic response, the patient underwent a transsphenoidal biopsy of the pituitary gland, which yielded a purulent liquid, but cultures were negative. Histopathology showed lymphocytic infiltrates but no neutrophils, compatible with an inflammation of autoimmune or infectious origin. High-dose glucocorticoid therapy was started and pursued, along with i.v. antibiotics, for 6 weeks, leading to clinical and radiological improvement but with persistence of endocrine deficits. In conclusion, this is a case of secondary panhypopituitarism due to a cystic pituitary lesion, with a differential diagnosis of lymphocytic hypophysitis vs abscess in a context of decapitated meningitis. Combination therapy with antibiotics and glucocorticoids is a legitimate approach in the face of diagnostic uncertainty, given the morbidity, and even mortality, associated with these lesions.
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Regional transfer; How much do patients know? Heart Lung Circ 2014. [DOI: 10.1016/j.hlc.2014.04.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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[F0 characteristics in Parkinsonian speech: Contrast between the effect of hypodopaminergy due to Parkinson's disease and that of the therapeutic delivery of L-Dopa]. REVUE DE LARYNGOLOGIE - OTOLOGIE - RHINOLOGIE 2014; 135:63-70. [PMID: 26521344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Voice and speech impairments are frequent in Parkinson's disease, particularly when the disease is at an advanced stage. These impairments affect spoken communication and may become a serious disability for someone with Parkinson's disease. Many studies based on auditory-perceptual or acoustic methods have been carried out to characterize dysarthria. The heterogeneity of evaluation methods and experimental bias however make results difficult to understand. For instance, in terms of phonatory impairments and with regard to F0, results are contradictory: PD speech may be characterized by either higher F0 or lower F0 compared to control subjects, or there may be no difference at all between the two population. In this study, we aim to provide a conceptual and methodological framework which allows for interpreting the results obtained from 44 speakers (29 PD and 15 control subjects) in relation to physiological (gender, age, PD subjects' pharmacologic state) and linguistic (speech production tasks) constraints. For the present corpus, we did not observe any F0 mean difference between the two groups. Our results however reveal a significant increase in F0 mean in PD subjects under L-dopa. We assume a double and opposite effect on F0 mean during drug withdrawal: low sub-glottal pressure, due to PD, results in a decrease in F0, while laryngeal rigidity leads to an increase in F0. These two effects thus mutually annihilate. Under L-Dopa, however, the drug effect increases sub-glottal pressure, which combined with an increase in F0 due to rigidity, leads to a global increase in F0.
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O49 La dénutrition chez l’enfant hospitalisé : toujours d’actualité en 2013. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70321-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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DNA metabarcoding multiplexing and validation of data accuracy for diet assessment: application to omnivorous diet. Mol Ecol Resour 2013; 14:306-23. [DOI: 10.1111/1755-0998.12188] [Citation(s) in RCA: 347] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 09/23/2013] [Accepted: 09/27/2013] [Indexed: 01/08/2023]
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Classification CNGOF du rythme cardiaque fœtal : obstétriciens et sages-femmes au tableau ! ACTA ACUST UNITED AC 2013; 42:509-10. [DOI: 10.1016/j.jgyn.2013.07.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 07/05/2013] [Indexed: 11/30/2022]
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Radicellectomie sensitive partielle basée sur des observations cliniques : description des critères de décision et effet sur la marche des enfants avec paralysie cérébrale. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Twenty-five years of selective dorsal rhizotomy based on clinical observations instead of intraoperative electrophysiological monitoring: The Sainte-Justine hospital experience. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Characteristics of major Escherichia coli reductases involved in aerobic nitro and azo reduction. J Appl Microbiol 2013; 115:1012-22. [PMID: 23795903 DOI: 10.1111/jam.12294] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 06/14/2013] [Accepted: 06/20/2013] [Indexed: 12/26/2022]
Abstract
AIMS Escherichia coli is able to reduce azo compounds such as methyl red (MR) and nitro compounds such as 7-nitrocoumarin-3-carboxylic acid (7NCCA). The aim of this study was to clarify the specificity of the major E. coli reductases. METHODS AND RESULTS Enzymatic assays with pure enzymes obtained after cloning, overproduction and purification under native or denaturing conditions were performed on three enzymes: AzoR, NfsA and NfsB. Their dependence on putative cofactors such as flavin mononucleotide (FMN), NADH and NADPH was studied as well as the reductase capacity of E. coli mutants depleted for one, two or three of the corresponding genes. CONCLUSIONS AzoR was able to reduce both MR and 7NCCA, whereas NfsA and NfsB could only reduce the nitro compound. AzoR and NfsB were strictly FMN dependent in contrast to NfsA. At a low oxygen concentration, the three proteins were not mandatory for azo reduction and nitro reduction, but in optimal aerobic conditions, azoR was essential for MR reduction, and an nfsA/nfsB combination was important for 7NCCA reduction. Overexpression of azoR gene was able to compensate for the loss of nfsA and nfsB under aerobic conditions. SIGNIFICANCE AND IMPACT OF STUDY These data provide new insights into the substrate specificity of major E. coli nitroreductases and demonstrate that oxygen is an important parameter to take into account in studies of nitroreductase activity.
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Évaluation comportementale et neuropsychologique d’une population d’enfants atteints de neurofibromatose de type 1 traites par méthylphenidate : une étude en plan croisé, randomisée en double insu du méthylphenidate versus placebo. Arch Pediatr 2013. [DOI: 10.1016/j.arcped.2013.01.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sarcoplasmic reticulum: a key factor in cardiac contractility of sea bass Dicentrarchus labrax and common sole Solea solea during thermal acclimations. J Comp Physiol B 2012; 183:477-89. [PMID: 23263664 DOI: 10.1007/s00360-012-0733-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 11/19/2012] [Accepted: 11/23/2012] [Indexed: 01/24/2023]
Abstract
This study investigated the effects of acclimation temperature upon (i) contractility of ventricular strips (ii) calcium movements in ventricular cardiomyocytes during excitation-contraction coupling (ECC), and (iii) the role of the sarcoplasmic reticulum (SR) in myocardial responses, in two marine teleosts, the sea bass (Dicentrarchus labrax) and the common sole (Solea solea). Because of the different sensitivities of their metabolism to temperature variation, both species were exposed to different thermal ranges. Sea bass were acclimated to 10, 15, 20, and 25 °C, and common sole to 6, 12, 18, and 24 °C, for 1 month. Isometric tension developed by ventricular strips was recorded over a range of physiological stimulation frequencies, whereas the depolarization-induced calcium transients were recorded on isolated ventricular cells through hyperpotassic solution application (at 100 mM). The SR contribution was assessed by ryanodine (RYAN) perfusion on ventricular strips and by caffeine application (at 10 mM) on isolated ventricular cells. Rates of contraction and relaxation of ventricular strip, in both species, increased with increasing acclimation temperature. At a low range of stimulation frequency, ventricular strips of common sole developed a positive force-frequency relationship at high acclimation temperature. In both the species, SR Ca(2+)-cycling was dependent on fish species, acclimation temperature and pacing frequency. The SR contribution was more important to force development at low acclimation temperatures in sea bass but at high acclimation temperatures in common sole. The results also revealed that high acclimation temperature causes an increase in the maximum calcium response amplitude on ventricular cells in both the species. Although sea bass and common sole occupy similar environments and tolerate similar environmental temperatures, this study indicated that sea bass and common sole can acclimatize to new thermal conditions, adjusting their cellular process in a different manner.
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L’administration postopératoire de furosémide réduit les taux de transfusion pour la chirurgie de la scaphocéphalie. Neurochirurgie 2012. [DOI: 10.1016/j.neuchi.2012.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Toxoplasma gondii secretory proteins bind to sulfated heparin structures. Glycobiology 2012; 23:106-20. [DOI: 10.1093/glycob/cws134] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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