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Birnbaum D, Lam VC, Havaei F, Anderson GS. COVID-19 and British Columbia's volunteer search and rescue workers: risk recognition and risk mitigation. Antimicrob Steward Healthc Epidemiol 2023; 3:e195. [PMID: 38028901 PMCID: PMC10654942 DOI: 10.1017/ash.2023.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 12/01/2023]
Abstract
Background Early during COVID-19, British Columbia coordinated collaboration between academic researchers, public healthcare systems, and private sector partners to focus research resources on knowledge gaps in a timely manner, avoid duplication, and identify overlooked aspects. At a collaboration symposium, it became evident that BC's volunteer search & rescue (SAR) cadre was overlooked. Objective Our exploratory project studied volunteer SAR's operational readiness; use and perceived value of information sources; consistency in infection prevention measures among volunteer stations, and with their professional counterparts for comparable first aid medical interventions throughout the pandemic. Methods We partnered with the 2 organizations that govern BC's volunteer SAR stations. Local station leaders completed a short confidential survey. Guidance documents issued by associations governing voluntary and professional first responders were compared. Results Survey responses were received from 33 of 109 local stations, spanning all regions of BC. Most remained operationally ready throughout the entire pandemic (12.1% had to stand down at times). Except for 21% lacking eye protection, all had personal protective equipment commensurate with that of healthcare professionals; however, few used this PPE in a manner consistent with professional counterparts. Usage and perceived usefulness of various information sources differed. There was no communication link between the province's infection control experts and 2 volunteer SAR organizations. Conclusions Search & rescue capability was maintained despite pandemic impacts. Results reveal strengths and opportunities for improvement in the ways volunteers are informed and protected. Infection control experts providing advice for emergency health services professional responders should remember to include their volunteer counterparts.
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Affiliation(s)
- David Birnbaum
- Applied Epidemiology, North Saanich, BC, USA
- The University of British Columbia School of Population & Public Health, Vancouver, BC, USA
| | - Vienna C. Lam
- Centre for Forensic Research, School of Criminology, Simon Fraser University, Burnaby, BC, USA
| | - Farinaz Havaei
- University of British Columbia School of Nursing, Vancouver, BC, USA
| | - Gail S. Anderson
- Centre for Forensic Research, School of Criminology, Simon Fraser University, Burnaby, BC, USA
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Birnbaum D. Caution on mandatory public reporting. Infect Control Hosp Epidemiol 2023:1-2. [PMID: 37129015 DOI: 10.1017/ice.2023.90] [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: 05/03/2023]
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3
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Karam E, Hollenbach M, Ali EA, Auriemma F, Gulla A, Heise C, Regner S, Gaujoux S, Regimbeau JM, Kähler G, Seyfried S, Vaillant JC, De Ponthaud C, Sauvanet A, Birnbaum D, Regenet N, Truant S, Pérez-Cuadrado-Robles E, Bruzzi M, Lupinacci RM, Brunel M, Belfiori G, Barbier L, Salamé E, Souche FR, Schwarz L, Maggino L, Salvia R, Gagniére J, Del Chiaro M, Leung G, Hackert T, Kleemann T, Paik WH, Caca K, Dugic A, Muehldorfer S, Schumacher B, Albers D. Outcomes of rescue procedures in the management of locally recurrent ampullary tumors: A Pancreas 2000/EPC study. Surgery 2023; 173:1254-1262. [PMID: 36642655 DOI: 10.1016/j.surg.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/15/2022] [Accepted: 12/13/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Ampullary lesions are rare and can be locally treated either with endoscopic papillectomy or transduodenal surgical ampullectomy. Management of local recurrence after a first-line treatment has been poorly studied. METHODS Patients with a local recurrence of an ampullary lesion initially treated with endoscopic papillectomy or transduodenal surgical ampullectomy were retrospectively included from a multi-institutional database (58 centers) between 2005 and 2018. RESULTS A total of 103 patients were included, 21 (20.4%) treated with redo endoscopic papillectomy, 14 (13.6%) with transduodenal surgical ampullectomy, and 68 (66%) with pancreaticoduodenectomy. Redo endoscopic papillectomy had low morbidity with 4.8% (n = 1) severe to fatal complications and a R0 rate of 81% (n = 17). Transduodenal surgical ampullectomy and pancreaticoduodenectomy after a first procedure had a higher morbidity with Clavien III and more complications, respectively, 28.6% (n = 4) and 25% (n = 17); R0 resection rates were 85.7% (n = 12) and 92.6% (n = 63), both without statistically significant difference compared to endoscopic papillectomy (P = .1 and 0.2). Pancreaticoduodenectomy had 4.4% (n = 2) mortality. No deaths were registered after transduodenal surgical ampullectomy or endoscopic papillectomy. Recurrences treated with pancreaticoduodenectomy were more likely to be adenocarcinomas (79.4%, n = 54 vs 21.4%, n = 3 for transduodenal surgical ampullectomy and 4.8%, n = 1 for endoscopic papillectomy, P < .0001). Three-year overall survival and disease-free survival were comparable. CONCLUSION Endoscopy is appropriate for noninvasive recurrences, with resection rate and survival outcomes comparable to surgery. Surgery applies more to invasive recurrences, with transduodenal surgical ampullectomy rather for carcinoma in situ and early cancers and pancreaticoduodenectomy for more advanced tumors.
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Affiliation(s)
- Elias Karam
- Department of Visceral Surgery, Hepato-Biliary, Pancreatic and Liver Transplantation Unit, Tours University Hospital, France.
| | - Marcus Hollenbach
- University of Leipzig Medical Center, Medical Department II-Gastroenterology, Hepatology, Infectious Diseases, Pulmonology, Leipzig, Germany
| | - Einas Abou Ali
- Department of Gastroenterology, Digestive Oncology, and Endoscopy, Cochin Hospital, Paris, France
| | - Francesco Auriemma
- Humanitas Clinical and Research Hospital, Rozzano, Digestive Endoscopy Unit, Division of Gastroenterology, Milan, Italy
| | - Aiste Gulla
- Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania; Johns Hopkins University, MedStar Georgetown University Hospital, General Surgery, Washington, DC
| | - Christian Heise
- Martin-Luther University Halle-Wittenberg Department of Medicine I-Gastroenterology, Pulmonology, Halle, Germany
| | - Sara Regner
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - Sébastien Gaujoux
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France; Sorbonne University, Paris, France
| | | | - Jean M Regimbeau
- Department of Digestive Surgery, Center Hospitalo-Universitaire Amiens-Picardie, Amiens, France
| | - Georg Kähler
- Interdisciplinary Endoscopy Unit, Mannheim Medical Center, Ruprecht-Karls-University Heidelberg, Mannheim, Germany; Department of Surgery, Mannheim Medical Center, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Steffen Seyfried
- Interdisciplinary Endoscopy Unit, Mannheim Medical Center, Ruprecht-Karls-University Heidelberg, Mannheim, Germany; Department of Surgery, Mannheim Medical Center, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Jean C Vaillant
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France
| | - Charles De Ponthaud
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France
| | - Alain Sauvanet
- Department of Digestive Surgery, Beaujon Hospital, APHP, Clichy, France
| | - David Birnbaum
- Department of Digestive Surgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Nicolas Regenet
- Department of Digestive Surgery, Centre Hospitalier Universitaire de Nantes, France
| | - Stéphanie Truant
- Deparment of Digestive Surgery, Centre Hospitalo-Universitaire de Lille, France
| | | | - Matthieu Bruzzi
- Department of Digestive Surgery, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - Renato M Lupinacci
- Department of Digestive Surgery, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Martin Brunel
- Department of Digestive Surgery, Hôpital André Mignot, Versailles, France
| | - Giulio Belfiori
- Department of Pancreatic Surgery, Vita Salute San Raffaele University, Milan, Italy
| | - Louise Barbier
- Department of Visceral Surgery, Hepato-Biliary, Pancreatic and Liver Transplantation Unit, Tours University Hospital, France
| | - Ephrem Salamé
- Department of Visceral Surgery, Hepato-Biliary, Pancreatic and Liver Transplantation Unit, Tours University Hospital, France
| | - Francois R Souche
- Department of Digestive Surgery, Centre Hospitalier Universitaire de Montpellier, France
| | - Lilian Schwarz
- Department of Digestive Surgery, Hôpital Charles-Nicolle, Centre Hospitalier Universitaire de Rouen, France
| | - Laura Maggino
- Unit of General and Pancreatic Surgery, The Pancreas Institute Verona, Department of Surgery, Dentistry, Paediatrics, and Gynaecology, University of Verona, Italy
| | - Roberto Salvia
- Unit of General and Pancreatic Surgery, The Pancreas Institute Verona, Department of Surgery, Dentistry, Paediatrics, and Gynaecology, University of Verona, Italy
| | - Johan Gagniére
- Department of Digestive and Hepatobiliary Surgery, Estaing University Hospital, Clermont-Ferrand, France; U1071 Inserm / Clermont-Auvergne University, Clermont-Ferrand, France
| | - Marco Del Chiaro
- Department of Surgery, University of Colorado Anschutz Medical Campus, CO
| | - Galen Leung
- Division of Gastroenterology and Hepatology, University of Pennsylvania Perelman School of Medicine, PA
| | - Thilo Hackert
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Germany
| | - Tobias Kleemann
- Department of Gastroenterology and Rheumatology, Carl-Thiem-Klinikum Cottbus, Germany
| | - Woo H Paik
- Division of Gastroenterology, Department of Internal Medicine, Seoul National University Hospital, Republic of Korea
| | - Karel Caca
- Department of Medicine, Gastroenterology, Hematology, Oncology, Pneumology, Diabetes and Infectious Diseases, RKH Clinic Ludwigsburg, Germany
| | - Ana Dugic
- Department of Gastroenterology, Friedrich-Alexander-University Erlangen-Nuremberg, Medical Campus Oberfranken, Bayreuth, Germany
| | - Steffen Muehldorfer
- Department of Gastroenterology, Friedrich-Alexander-University Erlangen-Nuremberg, Medical Campus Oberfranken, Bayreuth, Germany
| | | | - David Albers
- Department of Medicine and Gastroenterology, Contilia Clinic Essen, Germany
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Lorenzo D, Barthet M, Serrero M, Beyer L, Berdah S, Birnbaum D, Vitton V, Gonzalez JM. Severe acute ischemic colitis: What is the place of endoscopy in the management strategy? Endosc Int Open 2021; 9:E1770-E1777. [PMID: 34790544 PMCID: PMC8589548 DOI: 10.1055/a-1561-2259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and study aims Ischemic colitis (IC) is potentially lethal. Clinical and biology information and results of computed tomography (CT) scan and/or colonoscopy are used to assess its severity. However, decision-making about therapy remains a challenge. Patients and methods This was a retrospective, single-center study between 2006 and 2015. Patients with severe IC who underwent endoscopic evaluation were included. The aims were to determine outcomes depending on endoscopic findings and assess the role of endoscopy in the management. Results A total of 71 patients were included (men = 48 (68%), mean age = 71 ± 13 years). There was hemodynamic instability in 29 patients (41 %) and severity signs on CT scan in 18 (38 %). Twenty-nine patients (41 %) underwent surgery and 24 (34 %) died. The endoscopic grades were: 15 grade 1 (21 %), 32 grade 2 (45 %), and 24 grade 3 (34%). Regarding patients with grade 3 IC, 55 % had hemodynamic instability, 58 % had severity signs on CT scan, 68 % underwent surgery, and 55 % died. The decision to perform surgery was based on hemodynamic status in 62 % of cases, CT scan data in 14 %, endoscopic findings in 10 %, and other in 14 %. Colectomy was more frequent in patients with grade 3 IC ( P < 0.05). A mismatch between mucosal aspect (necrosis) and serous (normal) was observed in 13 patients (46 %). Risk factors for colectomy in univariate analysis were aortic aneurysm surgery, hemodynamic instability, no colic enhancement on CT scan, and endoscopic grade 3. Risk factors for mortality in multivariate analysis were hemodynamic instability, colectomy, and Charlson score > 5 ( P < 0.05). Conclusions This study suggests a low impact of endoscopy on surgical decision making. Hemodynamic instability was the first indication for colectomy. A discrepancy between endoscopic mucosal (necrosis) and surgical serous (normal) aspects was frequently noted.
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Affiliation(s)
- Diane Lorenzo
- Department of Gastroenterology, Aix Marseille University – APHM – Hôpital Nord, Marseille, France
| | - Marc Barthet
- Department of Gastroenterology, Aix Marseille University – APHM – Hôpital Nord, Marseille, France
| | - Mélanie Serrero
- Department of Gastroenterology, Aix Marseille University – APHM – Hôpital Nord, Marseille, France
| | - Laura Beyer
- Department of Visceral Surgery, Aix Marseille University – APHM – Hôpital Nord, Marseille, France
| | - Stéphane Berdah
- Department of Visceral Surgery, Aix Marseille University – APHM – Hôpital Nord, Marseille, France
| | - David Birnbaum
- Department of Visceral Surgery, Aix Marseille University – APHM – Hôpital Nord, Marseille, France
| | - Véronique Vitton
- Department of Gastroenterology, Aix Marseille University – APHM – Hôpital Nord, Marseille, France
| | - Jean Michel Gonzalez
- Department of Gastroenterology, Aix Marseille University – APHM – Hôpital Nord, Marseille, France
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Laurent C, Hamon M, Syrykh C, Adélaï J, Guille A, Parrens M, Dartigues P, Bardet A, Mescam L, Schiano De Colella J, Sujobert P, Besson C, Birnbaum D, Xerri L. RESISTANCE OF B‐CELL LYMPHOMAS TO CAR‐T CELL THERAPY IS ASSOCIATED WITH HISTOPHENOTYPICAL AND GENOMIC TUMOR CHANGES WHICH CAN INDUCE PROFOUND TRANS‐DIFFERENTIATION. Hematol Oncol 2021. [DOI: 10.1002/hon.190_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | - M. Hamon
- Hopital André Mignot Pathology Versailles France
| | | | - J. Adélaï
- IPC, Predictive Oncology/ CRCM Inserm CNRS AMU Marseille France
| | - A. Guille
- CRCM Predictive oncology Marseille France
| | - M. Parrens
- Hopital haut‐Lévéque, Pathology Bordeaux France
| | | | - A. Bardet
- Institut Paoli‐Calmettes pathology Marseille France
| | - L. Mescam
- Institut Paoli‐Calmettes pathology Marseille France
| | | | - P. Sujobert
- CHU Lyon‐Sud, Hématology Pierre‐Bénite France
| | - C. Besson
- Hopital André Mignot Pathology Versailles France
| | | | - L. Xerri
- Institut Paoli‐Calmettes pathology Marseille France
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6
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Collignon A, Hospital MA, Montersino C, Courtier F, Charbonnier A, Saillard C, D'Incan E, Mohty B, Guille A, Adelaïde J, Carbuccia N, Garnier S, Mozziconacci MJ, Zemmour C, Pakradouni J, Restouin A, Castellano R, Chaffanet M, Birnbaum D, Collette Y, Vey N. A chemogenomic approach to identify personalized therapy for patients with relapse or refractory acute myeloid leukemia: results of a prospective feasibility study. Blood Cancer J 2020; 10:64. [PMID: 32488055 PMCID: PMC7266815 DOI: 10.1038/s41408-020-0330-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 12/26/2019] [Revised: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 02/05/2023] Open
Abstract
Targeted next-generation sequencing (tNGS) and ex vivo drug sensitivity/resistance profiling (DSRP) have laid foundations defining the functional genomic landscape of acute myeloid leukemia (AML) and premises of personalized medicine to guide treatment options for patients with aggressive and/or chemorefractory hematological malignancies. Here, we have assessed the feasibility of a tailored treatment strategy (TTS) guided by systematic parallel ex vivo DSRP and tNGS for patients with relapsed/refractory AML (number NCT02619071). A TTS issued by an institutional personalized committee could be achieved for 47/55 included patients (85%), 5 based on tNGS only, 6 on DSRP only, while 36 could be proposed on the basis of both, yielding more options and a better rationale. The TSS was available in <21 days for 28 patients (58.3%). On average, 3 to 4 potentially active drugs were selected per patient with only five patient samples being resistant to the entire drug panel. Seventeen patients received a TTS-guided treatment, resulting in four complete remissions, one partial remission, and five decreased peripheral blast counts. Our results show that chemogenomic combining tNGS with DSRP to determine a TTS is a promising approach to propose patient-specific treatment options within 21 days.
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Affiliation(s)
- A Collignon
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - M A Hospital
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - C Montersino
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, TrGET Preclinical Platform, Aix-Marseille Université, Marseille, France
| | - F Courtier
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - A Charbonnier
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - C Saillard
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - E D'Incan
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - B Mohty
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - A Guille
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - J Adelaïde
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - N Carbuccia
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - S Garnier
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - M J Mozziconacci
- Department of Biopathology, Institut Paoli-Calmettes, Marseille, France
| | - C Zemmour
- Department of Clinical Research & Innovation, Institut Paoli-Calmettes, Biostatistics & Methodology Unit, Aix Marseille Université, INSERM, IRD, SESSTIM, Marseille, France
| | - J Pakradouni
- Department of Clinical Research & Innovation, Sponsor Unit, Institut Paoli-Calmettes, Marseille, France
| | - A Restouin
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, TrGET Preclinical Platform, Aix-Marseille Université, Marseille, France
| | - R Castellano
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, TrGET Preclinical Platform, Aix-Marseille Université, Marseille, France
| | - M Chaffanet
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - D Birnbaum
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France.
| | - Y Collette
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, TrGET Preclinical Platform, Aix-Marseille Université, Marseille, France.
| | - N Vey
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France.
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Desmazes-Dufeu N, Coltey B, Birnbaum D, Serrero M, Dehillotte C, Lemonnier L. ePS2.04 Gastrointestinal surgery in adult patients with cystic fibrosis: observational French prospective study over 11 years. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30294-0] [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: 10/24/2022]
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Takedachi A, Despras E, Scaglione S, Guérois R, Guervilly JH, Blin M, Audebert S, Camoin L, Hasanova Z, Schertzer M, Guille A, Churikov D, Callebaut I, Naim V, Chaffanet M, Borg JP, Bertucci F, Revy P, Birnbaum D, Londoño-Vallejo A, Kannouche PL, Gaillard PHL. Publisher Correction: SLX4 interacts with RTEL1 to prevent transcription-mediated DNA replication perturbations. Nat Struct Mol Biol 2020; 27:604. [PMID: 32409716 DOI: 10.1038/s41594-020-0447-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Affiliation(s)
- A Takedachi
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France.,Inovarion, Paris, France.,Department of Chemistry, Faculty of Science, Fukuoka University, Fukuoka, Japan
| | - E Despras
- CNRS UMR9019, Université Paris-Saclay, Equipe labellisée Ligue contre le Cancer, Gustave Roussy, Villejuif, France
| | - S Scaglione
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France
| | - R Guérois
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, Gif-sur-Yvette, cedex, France
| | - J H Guervilly
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France
| | - M Blin
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France
| | - S Audebert
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France
| | - L Camoin
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France
| | - Z Hasanova
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France.,Institute of Molecular Genetics, Prague, Czech Republic
| | - M Schertzer
- Institut Curie, PSL Research University, CNRS, UMR3244, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, CNRS, UMR3244, Paris, France
| | - A Guille
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France
| | - D Churikov
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France
| | - I Callebaut
- Sorbonne Université, Muséum National d'Histoire Naturelle, UMR CNRS 7590, IRD, Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, IMPMC, Paris, France
| | - V Naim
- CNRS UMR9019, Université Paris-Saclay, Gustave Roussy, Villejuif, France
| | - M Chaffanet
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France
| | - J P Borg
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France
| | - F Bertucci
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France
| | - P Revy
- INSERM UMR 1163, Laboratory of Genome Dynamics in the Immune System, Equipe Labellisée La Ligue contre le Cancer, Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - D Birnbaum
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France
| | - A Londoño-Vallejo
- Institut Curie, PSL Research University, CNRS, UMR3244, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, CNRS, UMR3244, Paris, France
| | - P L Kannouche
- CNRS UMR9019, Université Paris-Saclay, Equipe labellisée Ligue contre le Cancer, Gustave Roussy, Villejuif, France
| | - P H L Gaillard
- Centre de Recherche en Cancérologie de Marseille, CRCM, Inserm, CNRS, Aix-Marseille Université, Institut Paoli-Calmettes, Marseille, France.
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9
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Zawati I, Adouni O, Finetti P, Manai M, Manai M, Gamoudi A, Birnbaum D, Bertucci F, Mezlini A. Adolescents and young adults with classical Hodgkin lymphoma in northern Tunisia: insights from an adult single-institutional study. Cancer Radiother 2020; 24:206-214. [PMID: 32171674 DOI: 10.1016/j.canrad.2020.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/27/2020] [Accepted: 01/30/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE The aim of this study was to extensively describe the epidemiological, clinical and therapeutic outcomes of adolescents and young adults (AYA) population with classical Hodgkin Lymphoma (cHL). Then, a comparison between AYAs and adults and between the subgroups of AYAs treated with the same adult protocol was accomplished to further inform on optimal therapy approach of choice for adolescent patients. MATERIAL AND METHODS In this mono-centric, retrospective study, we reviewed the medical records. We analyzed 112 consecutive North Tunisian patients, including 66 AYAs (15 to 39 years) and 46 adults (≥40years) affected by cHL treated from 2000 to 2015 at Salah Azaiez Institute. Then, we performed a comparative analysis between AYA and 46 adult patients and a subgroup analysis between adolescents and young adults. All patients were treated according to the national protocol for HL, edited by the Tunisian Society of Hematology. The treatment included chemotherapy and involved-field radiotherapy (RT) at a dose of 20 or 30 Grays (Gy) for responders and 36Gy for non-responders. RESULTS AYA patients presented with adverse features with nodular sclerosis subtype (p=3.88×10-02) and mediastinal mass involvement (p=9.40×10-04). At a median follow-up of 51 and 32 months for AYAs and adults, respectively, no statistical difference in terms of 3 and 5-years overall survival (OS) and event-free survival (EFS) was shown. Using the Kaplan-Meier method, in AYAs, the ABVD regimen has an impact on 3-years EFS (p=4.63×10-02). The 36Gy RT was associated with the best 3-years EFS (p=9.24×10-03). Besides, AYA patients with advanced-stage had the worst 3-years OS (76%) (p=2.41×10-02). Although the adolescents and young adults shared similar clinical presentation, we noted that the adolescent group had the worst 3-years EFS (48%), but the best 3-years OS (91%). We identified 15% of primary refractory patients and a rate of toxicity of 5.3% in AYA. CONCLUSION The treatment approach used is well tolerated by adult patients. However, the AYA patients and particularly adolescent subgroup had more advanced disease at diagnosis and should be treated more intensively in dedicated units. RT dose<36Gy and ABVD chemotherapy were associated with lower EFS in this population.
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Affiliation(s)
- I Zawati
- Department of Immunohistocytology, Salah Azaiez Institute, 1006 Tunis, Tunisia; Department of Biology, Mycology, Pathologies and Biomarkers Laboratory (LR16ES05), Faculty of Sciences of Tunis, University of Tunis El Manar, 2092 Ariana, Tunisia.
| | - O Adouni
- Department of Immunohistocytology, Salah Azaiez Institute, 1006 Tunis, Tunisia; Department of Biology, Mycology, Pathologies and Biomarkers Laboratory (LR16ES05), Faculty of Sciences of Tunis, University of Tunis El Manar, 2092 Ariana, Tunisia
| | - P Finetti
- Predictive Oncology Laboratory, Cancer Research Center of Marseille, Aix Marseille University, 13009 Marseille, Tunisia
| | - Ma Manai
- Department of Immunohistocytology, Salah Azaiez Institute, 1006 Tunis, Tunisia; Predictive Oncology Laboratory, Cancer Research Center of Marseille, Aix Marseille University, 13009 Marseille, Tunisia; Human Genetics Laboratory (LR99ES10), Faculty of Medicine of Tunis, University of Tunis, El Manar, 2092 Tunis, Tunisia
| | - M Manai
- Department of Biology, Mycology, Pathologies and Biomarkers Laboratory (LR16ES05), Faculty of Sciences of Tunis, University of Tunis El Manar, 2092 Ariana, Tunisia
| | - A Gamoudi
- Department of Immunohistocytology, Salah Azaiez Institute, 1006 Tunis, Tunisia
| | - D Birnbaum
- Predictive Oncology Laboratory, Cancer Research Center of Marseille, Aix Marseille University, 13009 Marseille, Tunisia
| | - F Bertucci
- Predictive Oncology Laboratory, Cancer Research Center of Marseille, Aix Marseille University, 13009 Marseille, Tunisia; Department of Medical Oncology, Paoli-Calmettes Institute, 13009 Marseille, France; Training and Research Unit of Medicine, Aix Marseille University, 13009 Marseille, France
| | - A Mezlini
- Department of Medical Oncology, Salah Azaiez Institute, 1006 Tunis, Tunisia
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Polage CR, Quan KA, Madey KM, Meyers F, Krishna S, Grein J, Gibbs L, Yokoe DS, Mabalot SC, Chinn R, Hallmark A, Rubin ZA, Fontenot M, Cohen S, Wightman D, Birnbaum D, Huang SS, Torriani FJ. 84. Evaluation of the NHSN Standardized Infection Ratio (SIR) Risk Adjustment for HO-CDI in Oncology and ICU Patients in General Acute Care Hospitals. Open Forum Infect Dis 2019. [PMCID: PMC6808989 DOI: 10.1093/ofid/ofz359.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The NHSN healthcare-facility onset Clostridioides difficile infection (CDI) standardized infection ratio (SIR) is used to compare hospital quality and set hospital reimbursement but inadequate risk adjustment could penalize hospitals unnecessarily. We hypothesized that general hospitals with large oncology and/or ICU populations were not fully adjusted in the 2015 NHSN acute care hospital CDI Laboratory-Identified (LabID) event prediction model and SIRs would be affected.
Methods
We validated a negative binomial regression HO-CDI event prediction model identical to the 2015 published model and used FY2016 data from eight general hospitals in California to test our hypothesis. We compared HO-CDI events and SIR values, with and without oncology/hematopoietic stem cell transplant or ICU unit events, patient-days, admissions, bed counts, and adjustment parameters included.
Results
Seven major teaching and one nonteaching general acute care hospitals were included (see Table). Eight had oncology/hematopoietic stem cell transplant units; seven had ≥43 ICU beds (median: 134; interquartile range [IQR]: 84–161). The median facility unmodified FacWideIn SIR was 1.23 [IQR: 1.15, 1.29]. Removal of oncology unit data resulted in a 15% median facility decrease in HO-CDI events (IQR: 14%, 21%) and −8% median facility decrease in SIR (IQR: −2%, −14%). Removal of ICU unit data resulted in a 22% median facility decrease in HO-CDI events (IQR: 16%, 26%) and 97% median facility increase in SIR at each facility (IQR: 78%, 105%).
Conclusion
The ICU bed adjustment in the 2015 NHSN SIR is a powerful correction that fully adjusted for ICU HO-CDI events at all hospitals in the study. However, the lack of risk adjustment for oncology/hematopoietic stem cell transplant unit HO-CDI events suggests that the current model unfairly penalizes general acute facilities, many of which also provide specialized oncologic care. Thus, the model needs to be re-adjusted to account for this important specialty care population in general acute care facilities.
Disclosures
All Authors: No reported Disclosures.
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Affiliation(s)
| | | | | | | | - Sneha Krishna
- Cedars-Sinai Medical Center, Los Angeles, California
| | | | | | - Deborah S Yokoe
- University of California, San Francisco, San Francisco, California
| | | | - Raymond Chinn
- Sharp Metropolitan Medical Campus, San Diego, California
| | | | | | | | | | | | | | - Susan S Huang
- University of California, Irvine, School of Medicine, Irvine, California
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Bertucci F, Finetti P, Monneur A, Birnbaum D. Pathological grade-independent prediction of chemosensitivity by CINSARC should rehabilitate adjuvant chemotherapy in soft tissue sarcomas of any grade. Ann Oncol 2019; 30:342-343. [PMID: 30535178 DOI: 10.1093/annonc/mdy528] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- F Bertucci
- Predictive Oncology Laboratory, Marseille Cancer Research Center (CRCM), U1068 INSERM, U7258 CNRS, Institut Paoli-Calmettes, Marseille, France; Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France; French Sarcoma Group, Marseille, France; Aix-Marseille University, Marseille, France.
| | - P Finetti
- Predictive Oncology Laboratory, Marseille Cancer Research Center (CRCM), U1068 INSERM, U7258 CNRS, Institut Paoli-Calmettes, Marseille, France
| | - A Monneur
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France; French Sarcoma Group, Marseille, France
| | - D Birnbaum
- Predictive Oncology Laboratory, Marseille Cancer Research Center (CRCM), U1068 INSERM, U7258 CNRS, Institut Paoli-Calmettes, Marseille, France; Aix-Marseille University, Marseille, France
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Laurent C, Nicolae A, Laurent C, Le Bras F, Haioun C, Fataccioli V, Amara N, Adélaïde J, Guille A, Schiano De Colella J, Tesson B, Traverse-Glehen A, Chenard M, Mescam L, Moreau A, Chassagne-Clément C, Somja J, Escudié F, André M, Martin N, Hamy-Petit A, Reyal F, Croix M, Birnbaum D, Brousset P, Xerri L, Gaulard P. JAK-STAT PATHWAY AND EPIGENETIC REGULATORS ARE CRITICAL PLAYERS IN BI-ALCL PATHOGENESIS? Hematol Oncol 2019. [DOI: 10.1002/hon.16_2630] [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: 11/11/2022]
Affiliation(s)
- C. Laurent
- Pathology Department; Institut Universitaire du Cancer Oncopole CHU Toulouse INSERM U1037; Toulouse France
| | - A. Nicolae
- Pathology; Hôpital de Hautepierre; Strasbourg France
| | - C. Laurent
- CALYM - LYSARC; Institut Carnot; Pierre-Bénite France
| | - F. Le Bras
- Lymphoid Malignancies Unit; AP-HP, Groupe Hospitalier Henri Mondor - Albert Chenevier; Créteil France
| | - C. Haioun
- Lymphoid Malignancies Unit; AP-HP, Groupe Hospitalier Henri Mondor-Albert Chenevier, INSERM U955, Université Paris-Est; Créteil France
| | - V. Fataccioli
- Department of Pathology; AP-HP, Groupe Hospitalier Henri Mondor-Albert Chenevier, INSERM U955, Université Paris-Est; Créteil France
| | - N. Amara
- Pathology Department; Institut Universitaire du Cancer Oncopole CHU Toulouse INSERM U1037; Toulouse France
| | - J. Adélaïde
- Department of Predictive Oncology, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm U1068, CNRS UMR7258, Aix-Marseille University, UM 105; Institut Paoli-Calmettes; Marseille France
| | - A. Guille
- Department of Predictive Oncology, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm U1068, CNRS UMR7258, Aix-Marseille University, UM 105; Institut Paoli-Calmettes; Marseille France
| | | | - B. Tesson
- CALYM - LYSARC; Institut Carnot; Pierre-Bénite France
| | - A. Traverse-Glehen
- Pathology Department; Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud; Pierre-Bénite France
| | - M. Chenard
- Pathology; Hôpital de Hautepierre; Strasbourg France
| | - L. Mescam
- Department of Bio-Pathology; Institut Paoli-Calmettes; Marseille France
| | - A. Moreau
- Pathology; CHU Nantes; Nantes France
| | | | - J. Somja
- Pathology and Cytology Department; CHU de Liège; Liège Belgium
| | - F. Escudié
- Pathology Department; Institut Universitaire du Cancer Oncopole CHU Toulouse INSERM U1037; Toulouse France
| | - M. André
- Hematology; CHU UCL Namur; Yvoir Belgium
| | - N. Martin
- IMRB - Institut Mondor de Recherche Biomédicale; INSERM U955; Créteil France
| | - A. Hamy-Petit
- Residual Tumour & Response to Treatment Laboratory; RT2Lab, INSERM, U932, PSL Research University, Translational Research Department, Institut Curie; Paris France
| | - F. Reyal
- Department of Surgical Oncology; Institut Curie; Paris France
| | - M. Croix
- CALYM - LYSARC; Institut Carnot; Pierre-Bénite France
| | - D. Birnbaum
- Department of Predictive Oncology, Centre de Recherche en Cancérologie de Marseille (CRCM), Inserm U1068, CNRS UMR7258, Aix-Marseille University, UM 105; Institut Paoli-Calmettes; Marseille France
| | - P. Brousset
- Pathology Department; Institut Universitaire du Cancer Oncopole CHU Toulouse INSERM U1037; Toulouse France
| | - L. Xerri
- Department of Bio-Pathology and Tumor Immunology, Aix-Marseille University, Centre de Recherche en Cancérologie de Marseille (CRCM); Institut Paoli-Calmettes; Marseille France
| | - P. Gaulard
- Department of Pathology; AP-HP, Groupe Hospitalier Henri Mondor-Albert Chenevier, INSERM U955, Université Paris-Est; Créteil France
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Van Laere S, Finetti P, Rypens C, Birnbaum D, Vermeulen P, Viens P, Dirix L, Bertucci F. The mutational profile of IBC reveals higher mutational burden, deficiency of homologous recombination and NOTCH signalling. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz095.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Birnbaum D, Decker M. It takes a village…. IJHG 2019. [DOI: 10.1108/ijhg-03-2019-072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Birnbaum D, Decker M. Exploring a need to know. IJHG 2018. [DOI: 10.1108/ijhg-12-2018-070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Sabatier R, Pomel C, Colombo PE, Narducci F, Garnier S, Carbuccia N, Guille A, Birnbaum D, Zemmour C, Lambaudie E. Circulating tumour DNA as an early marker of recurrence and treatment efficacy in ovarian carcinoma, the CIDOC study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy316.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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18
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Sabatier R, Garnier S, Carbuccia N, Guille A, Tarpin C, Goncalves A, Birnbaum D. RETROSPHER. ERBB2 amplification detection in the plasma at diagnosis for early high-risk HER2-positive breast cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy316.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Seguin L, Chaffanet M, Sabatier R, Jose A, Garnier S, Carbuccia N, Guille A, Birnbaum D, Bertucci F, Goncalves A. A major response to carboplatin in a metastatic triple-negative breast cancer patient with somatic mutation of BRCA1 and RAD51B: When chemotherapy meets precision medicine. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy314.030] [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: 11/14/2022] Open
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20
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Birnbaum D, Decker M. “Epidemics in a connected world” can come to you. IJHG 2018. [DOI: 10.1108/ijhg-09-2018-067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Birnbaum D, Decker M. Women's Lives Matter… Unfortunately More in Some Places than Others An International Perspective on Investing for Health. IJHG 2018. [DOI: 10.1108/ijhg-06-2018-065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Purpose
Expanding networks of data portals and repositories linked to electronic patient record systems, along with advances in information technology, have created both new opportunities in improving public health and new challenges in protecting patient privacy. The purpose of this paper is to review stakeholder perspectives and provide a framework for promoting implementation of current privacy protection improvement recommendations.
Design/methodology/approach
This paper summarizes a workshop session discussion stemming from the 2017 Information Technology and Communication in Health (ITCH) biennial international conference in Victoria, British Columbia, Canada. The perspectives within health service research, journalism, informatics and privacy protection were represented.
Findings
Problems underlying gaps in privacy protection in the USA and Canada, along with then-current changes recommended by public health leaders as well as Information and Privacy Commissioners, were identified in a session of the 2015 ITCH conference. During the 2017 conference, a workshop outlined the current situation, identifying ongoing challenges and a lack of significant progress. This paper summarizes that 2017 discussion identifying political climate as the major impediment to progress on this issue. It concludes with a framework to guide the path forward.
Originality/value
This paper provides an international perspective to problems, resources and solution pathways with links useful to readers in all countries.
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Abstract
Purpose The aim of this paper is to describe the experience and educational benefits of a course that has several unique educational design features. Design/methodology/approach This includes narrative description of faculty and student experience from participants in a flipped-instructional-design inter-professional education course. Findings "Improving Public Health - An Interprofessional Approach to Designing and Implementing Effective Interventions" is an undergraduate public health course open to students regardless of background. Its student activities mirror the real-life tasks and challenges of working in a public health agency, including team-building and leadership; problem and project definition and prioritization; evidence-finding and critical appraisal; written and oral presentation; and press interviews. Students successfully developed project proposals to address real problems in a wide range of communities and settings and refined those proposals through interaction with professionals from population and public health, journalism and library sciences. Practical implications Undergraduate public health education is a relatively new endeavor, and experience with this new approach may be of value to other educators. Originality/value Students in this course, journalism graduate students who conducted mock interviews with them and instructors who oversaw the course all describe unique aspects and related personal benefit from this novel approach.
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Affiliation(s)
- David Birnbaum
- Applied Epidemiology, Sidney, Canada and School of Population and Public Health, University of British Columbia , Vancouver, Canada
| | - Kathryn Gretsinger
- Graduate School of Journalism, University of British Columbia , Vancouver, Canada
| | - Ursula Ellis
- Woodward Library, University of British Columbia , Vancouver, Canada
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Charafe-Jauffret E, Wicinski J, Cabaud O, Lopez M, Audebert S, Adelaide J, Chaffanet M, Guille A, Goncalves A, Bertucci F, Birnbaum D, Ginestier C. Abstract P5-06-02: Ex vivo CSC assays for personalized testing of drug susceptibility in advanced breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-06-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
In the developing area of personalized medicine, targeted therapies are mainly based on genomic characterization of each tumor, and is currently proposed as promising strategies for advanced breast cancer (ABC). Despite the promises of advanced genome sequencing, many patients still fail therapy, resulting in disease progression, recurrence, and metastases. Cancer stem cells (CSCs) concept illustrates the non-genetic intrinsic resistance, recapitulates tumor heterogeneity that creates hierarchically organized tumor tissues where a subpopulation of self-renewing cancer stem cells (CSCs) sustains the long- term clonal maintenance of the neoplasm. Evidences indicate that CSCs survive many commonly employed cancer therapeutics. Patient-derived tumor xenograft (PDXs) models recapitulate tumor complexity and heterogeneity at cellular and molecular level.
We aimed to specifically address the therapeutic sensitivity in ABC, by using an ex vivo assay based on PDX prospective collection, fully characterized for genomic alterations.
In this work, we aim at defining for each tumor the best therapy to target breast cancer intratumor heterogeneity, the CSC component. For that, we defined a panel of 44 FDA-approved compounds used for cancer treatment, including breast and other types of cancer, cancer stem cell drugs, chemo or targeted therapies. For each drug, we screened the differential sensitivity of the bulk tumor cells and the CSC components for 12 PDX models using an ex vivo screening approach on short term culture. To assess intra tumor heterogeneity, we set up an original dual strategy: for the bulk cells, an ex vivo assay based on IC50, and for breast CSC component a miniaturized Aldefluor assay. First, we demonstrate that bulk cells and CSCs sensitivity may be dissociated for the same drug in the same PDX models. Then, we observed that whereas bulk cell sensitivity may be correlated to tumor genomic abnormalities, CSC drug sensitivity seems not to follow the rule.CSC are selectively sensitive to specific compounds. We are exploring the pathways that sustain this selective sensitivity in the CSCs components. We are currently identifying targets using mass spectrometry in CSCs and bulk cells.Then, we validated the hits predicted from ex vivo screening assays by in vivo treatment of using PDX models for the selected drugs, and in a patient with ABC.
In that work, we demonstrated that CSCs display different sensitivity profiles than bulk cells to the same agents, irrespective to their genomic background and are identifying the CSC specific targets. Here, we propose a new model of precision medicine based on ex vivo CSC assays for personalized testing of drug susceptibility in advanced breast cancer.
Citation Format: Charafe-Jauffret E, Wicinski J, Cabaud O, Lopez M, Audebert S, Adelaide J, Chaffanet M, Guille A, Goncalves A, Bertucci F, Birnbaum D, Ginestier C. Ex vivo CSC assays for personalized testing of drug susceptibility in advanced breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-06-02.
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Affiliation(s)
| | - J Wicinski
- CRCM, Marseille, France; IPC, Marseille, France
| | - O Cabaud
- CRCM, Marseille, France; IPC, Marseille, France
| | - M Lopez
- CRCM, Marseille, France; IPC, Marseille, France
| | - S Audebert
- CRCM, Marseille, France; IPC, Marseille, France
| | - J Adelaide
- CRCM, Marseille, France; IPC, Marseille, France
| | - M Chaffanet
- CRCM, Marseille, France; IPC, Marseille, France
| | - A Guille
- CRCM, Marseille, France; IPC, Marseille, France
| | - A Goncalves
- CRCM, Marseille, France; IPC, Marseille, France
| | - F Bertucci
- CRCM, Marseille, France; IPC, Marseille, France
| | - D Birnbaum
- CRCM, Marseille, France; IPC, Marseille, France
| | - C Ginestier
- CRCM, Marseille, France; IPC, Marseille, France
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Bertucci F, De Nonneville A, Finetti P, Perrot D, Nilbert M, Italiano A, Le Cesne A, Skubitz K, Blay J, Birnbaum D. The Genomic Grade Index predicts postoperative clinical outcome in patients with soft-tissue sarcoma. Ann Oncol 2018; 29:459-465. [DOI: 10.1093/annonc/mdx699] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Bouquot M, Gaujoux S, Cauchy F, Birnbaum D, Dokmak S, Levy P, Soubrane O, Sauvanet A. Pancreatectomy for pancreatic incidentaloma: What are the risks? Pancreatology 2018; 18:114-121. [PMID: 29146108 DOI: 10.1016/j.pan.2017.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 11/05/2017] [Accepted: 11/06/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pancreatic incidentalomas (PI) are nowadays common but the benefit-risk balance of surgery remains difficult to determine. METHODS Monocentric retrospective study of 881 pancreatectomies comparing resected PI with symptomatic lesion. Univariate and multivariate (MV) analyses were done to identify risk factors of malignancy in PI undergoing surgery. RESULTS Overall, 32% of pancreatectomies were performed for PI. Median size of PI was 30 mm (vs 28 mm; p = 0.15) and 49% were cystic (vs 42%; p = 0.197). Resected PI were mostly located in distal pancreas (61% vs 34%; p < 0.001), less frequently malignant (49% vs 59%; p = 0.004). PNETs were more frequent in PI (50% vs 21%; p < 0.001). Distal pancreatectomy (36% vs 23%; p < 0.001) or parenchyma-sparing surgery (34% vs 13%; p < 0.001) were more frequently performed for PI. Overall mortality (1.1% vs 1.2%) and morbidity (70% vs 68%) were not significantly different between both groups. Severe morbidity was lower for PI (15% vs 22%; p = 0.007). In multivariate analysis, age>55 years (HR 6.14; p < 0.001), size >20 mm (HR:26.7; p < 0.001) and biliary dilatation (HR 29.9; p = 0.027) were independent risk factors of malignancy and, when associated, the likelihood of malignancy was above 90%. CONCLUSIONS PI represent about 30% of indications for pancreatectomy and when resected after careful selection are malignant in 50% of cases.
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Affiliation(s)
- Morgane Bouquot
- AP-HP, Hôpital Beaujon, Department of Hepato-Pancreato-Biliary Surgery - DHU Unity, Clichy, 92110, France
| | - Sébastien Gaujoux
- AP-HP, Hôpital Beaujon, Department of Hepato-Pancreato-Biliary Surgery - DHU Unity, Clichy, 92110, France; University Paris Descartes, Paris, France
| | - François Cauchy
- AP-HP, Hôpital Beaujon, Department of Hepato-Pancreato-Biliary Surgery - DHU Unity, Clichy, 92110, France; University Paris Diderot, Paris, France
| | - David Birnbaum
- AP-HP, Hôpital Beaujon, Department of Hepato-Pancreato-Biliary Surgery - DHU Unity, Clichy, 92110, France; University Paris Diderot, Paris, France
| | - Safi Dokmak
- AP-HP, Hôpital Beaujon, Department of Hepato-Pancreato-Biliary Surgery - DHU Unity, Clichy, 92110, France; University Paris Diderot, Paris, France
| | - Philippe Levy
- University Paris Diderot, Paris, France; AP-HP, Hôpital Beaujon, Department of Pancreatology- DHU Unity, Clichy, 92110, France
| | - Olivier Soubrane
- AP-HP, Hôpital Beaujon, Department of Hepato-Pancreato-Biliary Surgery - DHU Unity, Clichy, 92110, France; University Paris Diderot, Paris, France
| | - Alain Sauvanet
- AP-HP, Hôpital Beaujon, Department of Hepato-Pancreato-Biliary Surgery - DHU Unity, Clichy, 92110, France; University Paris Diderot, Paris, France.
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Birnbaum D, Decker M. Another year in review. IJHG 2017. [DOI: 10.1108/ijhg-09-2017-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cervera N, Carbuccia N, Mozziconacci MJ, Adélaïde J, Garnier S, Guille A, Murati A, Chaffanet M, Vey N, Birnbaum D, Gelsi-Boyer V. Revisiting gene mutations and prognosis of ex-M6a-acute erythroid leukemia with regard to the new WHO classification. Blood Cancer J 2017; 7:e594. [PMID: 28841205 PMCID: PMC5596380 DOI: 10.1038/bcj.2017.68] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- N Cervera
- Laboratoire d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille UMR1068 Inserm, Institut Paoli-Calmettes, CNRS UMR7258, Aix-Marseille Université UM105, Marseille, France
| | - N Carbuccia
- Laboratoire d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille UMR1068 Inserm, Institut Paoli-Calmettes, CNRS UMR7258, Aix-Marseille Université UM105, Marseille, France
| | - M-J Mozziconacci
- Laboratoire d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille UMR1068 Inserm, Institut Paoli-Calmettes, CNRS UMR7258, Aix-Marseille Université UM105, Marseille, France.,Département de BioPathologie, Institut Paoli-Calmettes, Marseille, France
| | - J Adélaïde
- Laboratoire d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille UMR1068 Inserm, Institut Paoli-Calmettes, CNRS UMR7258, Aix-Marseille Université UM105, Marseille, France
| | - S Garnier
- Laboratoire d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille UMR1068 Inserm, Institut Paoli-Calmettes, CNRS UMR7258, Aix-Marseille Université UM105, Marseille, France
| | - A Guille
- Laboratoire d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille UMR1068 Inserm, Institut Paoli-Calmettes, CNRS UMR7258, Aix-Marseille Université UM105, Marseille, France
| | - A Murati
- Laboratoire d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille UMR1068 Inserm, Institut Paoli-Calmettes, CNRS UMR7258, Aix-Marseille Université UM105, Marseille, France.,Département de BioPathologie, Institut Paoli-Calmettes, Marseille, France
| | - M Chaffanet
- Laboratoire d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille UMR1068 Inserm, Institut Paoli-Calmettes, CNRS UMR7258, Aix-Marseille Université UM105, Marseille, France
| | - N Vey
- Département d'Hématologie, Institut Paoli-Calmettes, Marseille, France.,Aix-Marseille Université, Marseille, France
| | - D Birnbaum
- Laboratoire d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille UMR1068 Inserm, Institut Paoli-Calmettes, CNRS UMR7258, Aix-Marseille Université UM105, Marseille, France
| | - V Gelsi-Boyer
- Laboratoire d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille UMR1068 Inserm, Institut Paoli-Calmettes, CNRS UMR7258, Aix-Marseille Université UM105, Marseille, France.,Département de BioPathologie, Institut Paoli-Calmettes, Marseille, France
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M-Rabet M, Cabaud O, Josselin E, Finetti P, Castellano R, Farina A, Agavnian-Couquiaud E, Saviane G, Collette Y, Viens P, Gonçalves A, Ginestier C, Charafe-Jauffret E, Birnbaum D, Olive D, Bertucci F, Lopez M. Nectin-4: a new prognostic biomarker for efficient therapeutic targeting of primary and metastatic triple-negative breast cancer. Ann Oncol 2017; 28:769-776. [PMID: 27998973 DOI: 10.1093/annonc/mdw678] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [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: 11/24/2016] [Indexed: 12/17/2022] Open
Abstract
Background Triple-negative breast cancers (TNBCs) are associated with a poor prognosis. In contrast to other molecular subtypes, they have no identified specific target and chemotherapy remains the only available systemic treatment. The adhesion molecule nectin-4 represents a new potential therapeutic target in different cancer models. Here, we have tested the prognostic value of nectin-4 expression and assessed the therapeutic efficiency of an anti-nectin 4 antibody drug conjugate (ADC) on localised and metastatic TNBC in vitro and in vivo. Materials and methods We analysed nectin-4/PVRL4 mRNA expression in 5673 invasive breast cancers and searched for correlations with clinicopathological features including metastasis-free survival (MFS). Immunohistochemistry was carried out in 61 TNBCs and in samples of primary TNBC Patient-Derived Xenografts (PDXs). An anti-nectin-4 antibody eligible for ADC was produced and tested in vitro and in vivo in localised and metastatic TNBC PDXs. Results High nectin-4/PVRL4 mRNA expression was associated with poor-prognosis features including the TN and basal subtypes. High PVRL4 mRNA expression showed independent negative prognostic value for MFS in multivariate analysis in TNBCs. Nectin-4 protein expression was not detected in adult healthy tissues including mammary tissue. Membranous protein expression was found in 62% of TNBCs, with strong correlation with mRNA expression. We developed an ADC (N41mab-vcMMAE) comprising a human anti-nectin-4 monoclonal antibody conjugated to monomethyl auristatin-E (MMAE). In vitro, this ADC bound to nectin-4 with high affinity and specificity and induced its internalisation as well as dose-dependent cytotoxicity on nectin-4-expressing breast cancer cell lines. In vivo, this ADC induced rapid, complete and durable responses on nectin-4-positive xenograft TNBC samples including primary tumours, metastatic lesions, and local relapses; efficiency was dependent on both the dose and the nectin-4 tumour expression level. Conclusion Nectin-4 is both a new promising prognostic biomarker and specific therapeutic target for ADC in the very limited armamentarium against TNBC.
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Affiliation(s)
- M M-Rabet
- Centre de Cancérologie de Marseille, INSERM U1068, Equipe Immunité et Cancer, Institut Paoli-Calmettes, Aix-Marseille Université, CNRS, UMR7258, Marseille, France
| | - O Cabaud
- Molecular Oncology "Equipe labellisée Ligue Contre le Cancer," Aix-Marseille Université, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, 13273 Marseille, France
| | - E Josselin
- CRCM, INSERM, U1068; Institut Paoli-Calmettes; Aix-Marseille Université; CNRS, UMR 7258, Marseille, France
| | - P Finetti
- Aix Marseille Université, CNRS, INSERM , Institut Paoli-Calmettes, CRCM, Equipe Oncologie Moléculaire labellisée 'Ligue contre le cancer' , Marseille , France
| | - R Castellano
- TrGET Platform, Inserm, U1068, Marseille F-13009, France
| | - A Farina
- ICEP Platform, Inserm, U1068, CRCM, Institut Paoli Calmettes, Aix-Marseille Université, UM 105, CNRS, UMR7258
| | - E Agavnian-Couquiaud
- ICEP Platform, Inserm, U1068, CRCM, Institut Paoli Calmettes, Aix-Marseille Université, UM 105, CNRS, UMR7258
| | - G Saviane
- Aix Marseille Université, CNRS, INSERM , Institut Paoli-Calmettes, CRCM, Equipe Oncologie Moléculaire labellisée 'Ligue contre le cancer' , Marseille , France
| | - Y Collette
- TrGET Platform, Inserm, U1068, Marseille F-13009, France
| | - P Viens
- Département d'Oncologie Médicale, Institut Paoli Calmettes, Aix-Marseille Université, UM 105, Marseille, France
| | - A Gonçalves
- Département d'Oncologie Médicale, Institut Paoli Calmettes, Aix-Marseille Université, UM 105, Marseille, France
| | - C Ginestier
- Aix Marseille Université, CNRS, INSERM , Institut Paoli-Calmettes, CRCM, Equipe Oncologie Moléculaire labellisée 'Ligue contre le cancer' , Marseille , France
| | - E Charafe-Jauffret
- Aix Marseille Université, CNRS, INSERM , Institut Paoli-Calmettes, CRCM, Equipe Oncologie Moléculaire labellisée 'Ligue contre le cancer' , Marseille , France
| | - D Birnbaum
- Aix Marseille Université, CNRS, INSERM , Institut Paoli-Calmettes, CRCM, Equipe Oncologie Moléculaire labellisée 'Ligue contre le cancer' , Marseille , France
| | - D Olive
- Centre de Cancérologie de Marseille, INSERM U1068, Equipe Immunité et Cancer, Institut Paoli-Calmettes, Aix-Marseille Université, CNRS, UMR7258, Marseille, France
| | - F Bertucci
- Aix Marseille Université, CNRS, INSERM , Institut Paoli-Calmettes, CRCM, Equipe Oncologie Moléculaire labellisée 'Ligue contre le cancer' , Marseille , France
- Département d'Oncologie Médicale, Institut Paoli Calmettes, Aix-Marseille Université, UM 105, Marseille, France
| | - M Lopez
- Aix Marseille Université, CNRS, INSERM , Institut Paoli-Calmettes, CRCM, Equipe Oncologie Moléculaire labellisée 'Ligue contre le cancer' , Marseille , France
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Birnbaum D, Serfozo R. Convergence of image measures and integrals. ADV APPL PROBAB 2016. [DOI: 10.2307/1426889] [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: 11/10/2022]
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Abstract
Purpose
– The purpose of this paper is to review the literature concerning impact on public health of the dispute resolution system in international trade agreements. Its purpose is to alert readers about controversial aspects of ISDS in these international agreements, aspects that are well-documented in publications likely unfamiliar to most public health professionals.
Design/methodology/approach
– The paper takes the form of a narrative review.
Findings
– While trade agreements offer potential economic benefits overall, the history thus far regarding impact on public health is worrisome. It is not difficult to find examples that deter public health from achieving important health protection regulation.
Practical implications
– There are over 3,000 existing international trade agreements with more on the horizon. New proposed agreements like the Trans-Pacific Partnership increase the number of countries involved; inconsistencies and lack of adequate transparency puts much at stake.
Originality/value
– It is doubtful that the global public health communities, including both public health agencies and academic public health institutions, have sufficiently been involved as stakeholders in past and pending trade agreements.
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Birnbaum D, Decker M. Building upon the past, looking toward the future. International Journal of Health Governance 2016. [DOI: 10.1108/ijhg-03-2016-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Purpose
– This paper is based on the author’s 2015 Northwest Patient Safety Conference presentation, consistent with a conference theme of improving doctor-patient communication. The paper aims to discuss these issues.
Design/methodology/approach
– Ongoing systematic accumulation and critical review of research literature regarding design of effective public information websites, conducted from 2008-2015 while the author was supervising the prototyping, refinement and evaluation of healthcare-associated infections public information websites.
Findings
– In 2005, the US Centers for Medicare and Medicaid Services launched its Hospital Compare website, announced as an enormous step forward by providing objective information to inform consumer choices. Subsequently, many other websites and programs emerged to report quality-of-care ratings of hospitals and doctors, and provide other advice intended to help the public inform their choices. When objectively evaluated to a scientific publication-level standard, websites like Hospital Compare show relatively low usage and disappointing impact; individual providers rank so differently across ratings websites that it is difficult to see how trustworthy conclusions could be drawn; and much of the advice offered through popular media is not supported by believable evidence. Further, research shows healthcare professionals and members of the lay public view concepts of evidence and evidence-based decisions quite differently. Badly informed misguided decisions can have negative consequences for providers, patients and public trust.
Originality/value
– Populism and celebrity seem to have trumped science during recent growth of public information resources for health choices. This paper summarizes serious flaws underlying resulting information products, indicating necessary changes to better serve a legitimate need.
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Birnbaum D, Decker M. Editorial. International Journal of Health Governance 2016. [DOI: 10.1108/ijhg-02-2016-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gonçalves A, Bertucci F, Chaffanet M, Guille A, Garnier S, Adelaide J, Carbuccia N, Brunelle S, Piana G, Cabaud O, Thomassin-Piana J, Paciencia-Gros M, Chereau-Ewald E, Lambaudie E, Sabatier R, Tarpin C, Provansal M, Jalaguier-Coudray A, Extra JM, Sarran A, Pakradouni J, Viens P, Lopez M, Ginestier C, Charafe-Jauffret E, Birnbaum D. Abstract P4-13-23: Next-generation sequencing (NGS), array comparative genomic hybridization (aCGH) and patient-derived tumor xenograft (PDX) for precision medicine in advanced breast cancer: A single-center prospective study. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Genomic-based approaches in advanced breast cancer (ABC) were recently demonstrated as feasible in the clinical practice, but only a limited number of patients were actually treated with targeted therapies matching genomic alterations, with low antitumor activity. We conducted a pilot study to evaluate whether precision medicine using NGS and aCGH could be implemented prospectively at a single center in ABC patients. In addition, we examined whether PDX could be derived from ABC and thus could help inform therapeutic decision.
Methods
ABC patients accessible to tumor biopsy were prospectively enrolled at the Institut Paoli-Calmettes in the BC-BIO study (ClinicalTrials.gov, NCT01521676). Tumor tissue from locally recurrent or metastatic disease was immediately frozen after dedicated biopsy. Genomic profiling included high-resolution 4x180K aCGH (Agilent Technologies, Massy, France) and DNA sequencing, using a library of 365 cancer candidate genes (HaloPlex target enrichment kit, Agilent technologies, Santa Clara, CA, USA) and MiSeq analyzer (Illumina, San Diego, CA, USA) with 2x150-bp, paired-end at about 300x coverage. In a subset of patients, fresh tumor was implanted orthotopically in humanized cleared fat pads of NSG mice for establishing xenotransplants.
Results
A total of 34 ABC patients were included, with the following characteristics: median age 54 years (35-77); molecular subtypes: 11 triple-negative (32%), 12 luminal non-HER2 (35%), 4 luminal HER2 (12%), 3 HER2 non-luminal (9%), and 4 unknown (12%); 33 with previous chemotherapy (97%); 22 with previous endocrine treatment (35%); 7 with previous anti-HER2 (21%). Tumor biopsies were obtained from liver (15), skin (6), peritoneum (4), breast (3), node (3), lung (1), pleura (1), and ascitis (1), with a median tumor cellularity of 70% (range 10-90%). aCGH and NGS were available from 34 and 33 patients, respectively. An actionable target was found in 28 patients (82%), corresponding to 66 targets, including 37 mutations (8 in PIK3CA, 7 TP53, 4 ESR1, 2 AKT1, 2 BRCA2, 2 HER2), 22 amplifications (7 for CCND1, 2 CCNE1, 2 FGFR1, 2 IGF1R) and 7 homozygous deletions (3 for PTEN, 2 CDKN2A/B,1 BRCA2, 1 STK11). A targeted therapeutic proposal was possible, either in a clinical trial (N=18, 52%) or using already registered drugs (N=17, 50%). Ten patients actually received a targeted treatment, 1 of them experienced objective response and 1 showed stable disease for more than 6 months. Of 26 patients subjected to mouse implantation, 10 had successful xenografting (6 triple-negative, 2 HER2, 1 luminal non-HER2, 1 subtype non-attributed), with a median time to reach 10 mm of 148 days. These PDX will be used as models to understand the patient's therapeutic response.
Conclusion
Precision medicine using high-throughput DNA sequencing and aCGH can be implemented at a single center in the context of clinical practice and may allow direct therapeutic proposal in 1/3 of patients, but antitumor activity was minimal. PDX may be obtained in a significant fraction of patients, especially in triple-negative and HER2 subtypes, and could phenotypically complement genomic data.
Citation Format: Gonçalves A, Bertucci F, Chaffanet M, Guille A, Garnier S, Adelaide J, Carbuccia N, Brunelle S, Piana G, Cabaud O, Thomassin-Piana J, Paciencia-Gros M, Chereau-Ewald E, Lambaudie E, Sabatier R, Tarpin C, Provansal M, Jalaguier-Coudray A, Extra J-M, Sarran A, Pakradouni J, Viens P, Lopez M, Ginestier C, Charafe-Jauffret E, Birnbaum D. Next-generation sequencing (NGS), array comparative genomic hybridization (aCGH) and patient-derived tumor xenograft (PDX) for precision medicine in advanced breast cancer: A single-center prospective study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-23.
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Affiliation(s)
- A Gonçalves
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - F Bertucci
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - M Chaffanet
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - A Guille
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - S Garnier
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - J Adelaide
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - N Carbuccia
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - S Brunelle
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - G Piana
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - O Cabaud
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - J Thomassin-Piana
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - M Paciencia-Gros
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - E Chereau-Ewald
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - E Lambaudie
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - R Sabatier
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - C Tarpin
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - M Provansal
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - A Jalaguier-Coudray
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - J-M Extra
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - A Sarran
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - J Pakradouni
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - P Viens
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - M Lopez
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - C Ginestier
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - E Charafe-Jauffret
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
| | - D Birnbaum
- Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Universite, Marseille, France
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Chevrier V, Lembo F, Audebert S, Borg JP, Birnbaum D, Rosnet O. Recruitment of FOR20 and OFD1 onto pericentriolar satellites and centrosomes depends on the formation of a ternary complex with KIAA0753. Cilia 2015. [PMCID: PMC4519072 DOI: 10.1186/2046-2530-4-s1-p69] [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: 12/03/2022] Open
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Abstract
Purpose
– The purpose of this paper is to report on recent developments concerning promotion of initiatives to contain the spread of resistance to antimicrobial drugs.
Design/methodology/approach
– Narrative review.
Findings
– In 2014, an American executive order made combating antimicrobial resistance a national priority. While this and other developments convey a message of growing urgency, the core elements required and challenges ahead are neither new nor unexplored. The quantity and quality of antimicrobial stewardship research over the past decade has added little to what already was known. Suppressing evolution of emerging drug resistance and containing emergence of resistant strains as on-going activities to maintain a balance might be a more realistic statement of the problem than framing it as winning a war. It remains to be seen how well those in the front lines of healthcare epidemiology and infection control shape framing of this problem before American federal and state agencies respond to their presidential directive by relaying marching orders through laws, rules, regulations, financial incentives and penalties. It remains to be seen whether the next decade will be more successful than the last given a more recent emphasis on the strategy of bundling small sets of practical key measures into effect, and the involvement of public health departments in support of antimicrobial stewardship. Unlike a generation ago, it also is clear that international trade and travel make this a global problem. America cannot be expected to resolve emerging drug resistance alone even if containment efforts within its own borders are successful, but like other developed countries it can be expected to have vested self-interests in promoting global solutions to this complex problem.
Originality/value
– This report brings together recent American government policy decisions and insights from two noteworthy interdisciplinary conferences.
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Zarate R, Birnbaum D. Postdischarge Surgical Site Infection Surveillance Practices in Washington Acute Care Hospitals. Infect Control Hosp Epidemiol 2015; 33:87-9. [DOI: 10.1086/663339] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Little is known about postdischarge surveillance practices currently in place among American hospitals. This survey describes practices used by acute care hospitals covered by Washington State's legislated mandate for public reporting of surgical site infections. While the vast majority of facilities use multiple techniques, wide variation in practices was discovered.Infect Control Hosp Epidemiol 2012;33(1):8
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Fortuna JA, Brenneman WA, Storli S, Birnbaum D, Brown KL. The Current State of Validating the Accuracy of Clinical Data Reporting: Lessons to Be Learned from Quality and Process Improvement Scientists. Infect Control Hosp Epidemiol 2015; 34:611-4. [DOI: 10.1086/670636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Background.The standardized infection ratio (SIR) is an indirectly standardized morbidity ratio that has been used to compare the infection rate in a hospital with an expected number of infections from a national standard and is being increasingly promoted as a metric for the public reporting of healthcare-associated infections (HAIs).Objective.To identify potential discrepancies between SIR and other measures of risk.Methods.Hypothetical and real data were compared using relative risk, a directly standardized morbidity ratio, and SIR values across a range of varying hospital population compositions.Results.In real and hypothetical data, other summary statistics were consistent with each other and with underlying HAI incidence density rates. However, use of the SIR frequently led to conclusions inconsistent with these other inherently unbiased estimators.Conclusion.Because of a recognized type of distortion inherent in the calculation of indirectly standardized ratios, use of the SIR can lead to conclusions that differ from those reached when using other traditional measures of risk and to incorrect assessments of conclusions about the performance of hospitals or states. In addition, the tendency to inappropriately arrange SIR values in rank order for comparison makes SIR unsuitable as a statewide metric for monitoring HAIs.
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Abstract
AbstractHow often infection rates should be calculated and how large a change is required for “significance” are pertinent questions in nosocomial infection surveillance programs. A method is presented which establishes outbreak threshold infection frequencies. Comparison is direct and immediate: computation of rates or use of electronic data processing is not required. We have validated this method, using computer systems, by comparing the distributions of mean weekly incidence and prevalence statistics for each ward by nosocomial infection site in an acute care general hospital against both our theoretical outbreak threshold limits and the distribution of proven infection outbreaks. Sensitive and specific distinction between random variation or sporadic cross-infection and true persisting outbreaks requiring intervention is obtained. This approach provides a simple and timely alternative to intuitive after-the-fact interpretation of infection patterns which is applicable to infection surveillance and cost-effective infection control in hospitals of all sizes.
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Zarate R, Birnbaum D. Validity of Self-Declared Teaching Status in Mandatory Public Reporting. Infect Control Hosp Epidemiol 2015; 31:1310-1. [DOI: 10.1086/657585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Klouche LA, Belhadj A, Bendaoud A, Benyelles M, Ziane I, Chaffanet M, Birnbaum D. 303 Genomic and epigenomic analysis identify potential therapeutic targets in luminal B breast cancer molecular subtype. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70429-0] [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: 11/28/2022]
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Coppin E, Gelsi-Boyer V, Morelli X, Cervera N, Murati A, Pandolfi PP, Birnbaum D, Nunès JA. Mutational analysis of the DOK2 haploinsufficient tumor suppressor gene in chronic myelomonocytic leukemia (CMML). Leukemia 2014; 29:500-2. [PMID: 25252871 DOI: 10.1038/leu.2014.288] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- E Coppin
- 1] Inserm U1068, Centre de Recherche en Cancérologie de Marseille, Marseille, France [2] Institut Paoli-Calmettes, Marseille, France [3] CNRS, UMR7258, Centre de Recherche en Cancérologie de Marseille, Marseille, France [4] Aix-Marseille University UM105, Marseille, France
| | - V Gelsi-Boyer
- 1] Inserm U1068, Centre de Recherche en Cancérologie de Marseille, Marseille, France [2] Institut Paoli-Calmettes, Marseille, France [3] CNRS, UMR7258, Centre de Recherche en Cancérologie de Marseille, Marseille, France [4] Aix-Marseille University UM105, Marseille, France
| | - X Morelli
- 1] Inserm U1068, Centre de Recherche en Cancérologie de Marseille, Marseille, France [2] Institut Paoli-Calmettes, Marseille, France [3] CNRS, UMR7258, Centre de Recherche en Cancérologie de Marseille, Marseille, France [4] Aix-Marseille University UM105, Marseille, France
| | - N Cervera
- 1] Inserm U1068, Centre de Recherche en Cancérologie de Marseille, Marseille, France [2] Institut Paoli-Calmettes, Marseille, France [3] CNRS, UMR7258, Centre de Recherche en Cancérologie de Marseille, Marseille, France [4] Aix-Marseille University UM105, Marseille, France
| | - A Murati
- 1] Inserm U1068, Centre de Recherche en Cancérologie de Marseille, Marseille, France [2] Institut Paoli-Calmettes, Marseille, France [3] CNRS, UMR7258, Centre de Recherche en Cancérologie de Marseille, Marseille, France [4] Aix-Marseille University UM105, Marseille, France
| | - P P Pandolfi
- 1] Cancer Genetics and Prevention Program, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA [2] Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA [3] Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - D Birnbaum
- 1] Inserm U1068, Centre de Recherche en Cancérologie de Marseille, Marseille, France [2] Institut Paoli-Calmettes, Marseille, France [3] CNRS, UMR7258, Centre de Recherche en Cancérologie de Marseille, Marseille, France [4] Aix-Marseille University UM105, Marseille, France
| | - J A Nunès
- 1] Inserm U1068, Centre de Recherche en Cancérologie de Marseille, Marseille, France [2] Institut Paoli-Calmettes, Marseille, France [3] CNRS, UMR7258, Centre de Recherche en Cancérologie de Marseille, Marseille, France [4] Aix-Marseille University UM105, Marseille, France
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Bertucci F, Ueno NT, Finetti P, Vermeulen P, Lucci A, Robertson FM, Marsan M, Iwamoto T, Krishnamurthy S, Masuda H, Van Dam P, Woodward WA, Cristofanilli M, Reuben JM, Dirix L, Viens P, Symmans WF, Birnbaum D, Van Laere SJ. Gene expression profiles of inflammatory breast cancer: correlation with response to neoadjuvant chemotherapy and metastasis-free survival. Ann Oncol 2013; 25:358-65. [PMID: 24299959 DOI: 10.1093/annonc/mdt496] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Inflammatory breast cancer (IBC) is an aggressive disease. To date, no molecular feature reliably predicts either the response to chemotherapy (CT) or the survival. Using DNA microarrays, we searched for multigene predictors. PATIENTS AND METHODS The World IBC Consortium generated whole-genome expression profiles of 137 IBC and 252 non-IBC (nIBC) samples. We searched for transcriptional profiles associated with pathological complete response (pCR) to neoadjuvant anthracycline-based CT and distant metastasis-free survival (DMFS) in respective subsets of 87 and 106 informative IBC samples. Correlations were investigated with predictive and prognostic gene expression signatures published in nIBC (nIBC-GES). Supervised analyses tested genes and activation signatures of 19 biological pathways and 234 transcription factors. RESULTS Three of five tested prognostic nIBC-GES and the two tested predictive nIBC-GES discriminated between IBC with and without pCR, as well as two interferon activation signatures. We identified a 107-gene signature enriched for immunity-related genes that distinguished between responders and nonresponders in IBC. Its robustness was demonstrated by external validation in three independent sets including two IBC sets and one nIBC set, with independent significant predictive value in IBC and nIBC validation sets in multivariate analysis. We found no robust signature associated with DMFS in patients with IBC, and neither of the tested prognostic GES, nor the molecular subtypes were informative, whereas they were in our nIBC series (220 stage I-III informative samples). CONCLUSION Despite the relatively small sample size, we show that response to neoadjuvant CT in IBC is, as in nIBC, associated with immunity-related processes, suggesting that similar mechanisms responsible for pCR exist. Analysis of a larger IBC series is warranted regarding the correlation of gene expression profiles and DMFS.
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Damm F, Chesnais V, Nagata Y, Yoshida K, Okuno Y, Birnbaum D, Ogawa S, Bernard O, Fontenay M, Kosmider O. O-007 BCOR and BCORL1 mutations in myelodysplasia: Prevalence, prognosis and clonal hierarchy. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70029-8] [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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Coletta M, Lipskiy N, Birnbaum D, Abellera J. S&I Public Health Reporting Initiative: Improving Standardization of Surveillance. Online J Public Health Inform 2013. [PMCID: PMC3692744] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objective The objective of this panel is to inform the ISDS community of the progress made in the Standards & Interoperability (S&I) Framework Public Health Reporting Initiative (PHRI). Also, it will provide some context of how the initiative will likely affect biosurveillance reporting in Meaningful Use Stage 3 and future harmonization of data standards requirements for public health reporting. Introduction The S&I Framework is an Office of National Coordinator (ONC) initiative designed to support individual working groups who focus on a specific interoperability challenge. One of these working groups within the S&I Framework is the PHRI, which is using the S&I Framework as a platform for a community-led project focused on simplifying public health reporting and ensuring EHR interoperability with public health information systems. PHRI hopes to create a new public health reporting objective for Meaningful Use Stage 3 that is broader than the current program-specific objectives and will lay the ground work for all public health reporting in the future. To date, the initiative received over 30 descriptions of different types of public health reporting that were then grouped into 5 domain categories. Each domain category was decomposed into component elements and commonalities were identified. The PHRI is now working to reconstruct a single model of public health reporting through a consensus process that will soon lead to a pilot demonstration of the most ready reporting types. This panel will outline progress, challenges, and next steps of the initiative as well as describe how the initiative may affect a standard language for biosurveillance reporting. Methods Michael Coletta will provide an introduction and background of the S&I PHRI. He will describe how the PHRI intends to impact reporting in a way that is universal and helpful to both HIT vendors and public health programs. Nikolay Lipskiy will provide an understanding of the ground breaking nature of collaboration and harmonization that is occurring across public health programs. He will describe the data harmonization process, outcomes, and hopes for the future of this work. David Birnbaum has been a very active member of PHRI and has consistently advocated for the inclusion of Healthcare Associated Infections (HAI) reporting in Meaningful Use as a model. David has been representing one of the largest user communities among those farthest along toward automated uploading of data to public health agencies. He will describe the opportunities and challenges of this initiative from the perspective of a participant representing an already highly evolved reporting system (CDC’s National Healthcare Safety Network system). John Abellera has been the steward of the communicable disease reporting user story for the PHRI. He will describe the current challenges to reporting and how the PHRI proposed changes could improve communicable disease reporting efforts. This will be followed by an open discussion with the audience intended to elicit reactions regarding an eventual consolidation from individual report specific specification documents to one core report specification across public health reporting programs which is then supplemented with both program specific specifications and a limited number of implementation specific specifications. Results Plan to engage audience: Have a prepared list of questions to pose to the audience for reactions and discussion (to be supplied if participation is low).
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