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Kaazan P, Seow W, Tan Z, Logan H, Philpott H, Huynh D, Warren N, McIvor C, Holtmann G, Clark SR, Tse E. Deliberate foreign body ingestion in patients with underlying mental illness: A retrospective multicentre study. Australas Psychiatry 2023; 31:619-624. [PMID: 37473424 PMCID: PMC10566206 DOI: 10.1177/10398562231189431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
OBJECTIVE Deliberate foreign body ingestion (DFBI) is characterised by recurrent presentations among patients with mental health conditions, intellectual disabilities and in prisoners. We aimed to profile the characteristics and evaluate the care of such patients in this study. METHODS Adult patients with an endoscopic record of attempted foreign body retrieval between January 2013 and September 2020 were identified at three Australian hospitals. Those with a documented mental health diagnosis were included and their standard medical records reviewed. Presentation history, demographics, comorbidities and endoscopic findings were recorded and described. RESULTS A total of 166 admissions were accounted for by 35 patients, 2/3 of which had borderline personality disorder (BPD). Repetitive presentations occurred in more than half of the cohort. There was an increased trend of hospital admissions throughout the years. At least half of the cohort had a documented mental health review during their admission. An average of 3.3 (2.9) foreign bodies were ingested per single episode. Endoscopic intervention was performed in 76.5% of incidents. The combined Length of stay for all patients was 680 days. CONCLUSION Deliberate foreign body ingestion in mental health patients is a common, recurring and challenging problem that is increasing in frequency and requires collaborative research to further guide holistic management.
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Affiliation(s)
- P Kaazan
- Department of Gastroenterology and Hepatology, The Princess Alexandra Hospital, Brisbane, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; and
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - W Seow
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia; and
- Department of Gastroenterology and Hepatology, The Royal Adelaide Hospital, Adelaide, Australia
| | - Z Tan
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - H Logan
- Department of Gastroenterology and Hepatology, The Princess Alexandra Hospital, Brisbane, Australia; and
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - H Philpott
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - D Huynh
- Department of Gastroenterology and Hepatology, The Queen Elizabeth Hospital, Woodville South, Australia
| | - N Warren
- Faculty of Medicine, The University of Queensland, Brisbane, Australia; and
- Addiction and mental health services, Brisbane, Metro South health
| | - C McIvor
- Department of Gastroenterology and Hepatology, Logan Hospital, Logan, Australia
| | - G Holtmann
- Department of Gastroenterology and Hepatology, The Princess Alexandra Hospital, Brisbane, Australia; and
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - S R Clark
- Faculty of Health and Medical Sciences, University of Adelaide, Brisbane, Australia; and
- Discipline of Psychiatry, Central Adelaide Local Health Network
| | - E Tse
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia; and
- Department of Gastroenterology and Hepatology, The Royal Adelaide Hospital, Adelaide, Australia
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Kearns M, Brann A, White R, Jackson B, Cookish D, Sharaf K, Huynh D, Gernhofer Y, Tran H, Urey M, Adler E, Pretorius V. A Single Center Comparison of DCD Heart Transplantation Using Two Procurement Strategies: Direct Procurement and Perfusion versus Normothermic Regional Perfusion. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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3
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Khanmohammed Z, Fadaee N, Huynh D, Capati I, Towfigh S, Tung R. OC-008 TRENDS IN INGUINAL HERNIA REPAIR: A TAILORED APPROACH. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.020] [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: 11/14/2022]
Abstract
Abstract
Aim
Inguinal hernias (IH) can be repaired via open, laparoscopic, and robotic approaches, with or without mesh. We aim to understand the changing trends in IH repair that may serve as a guideline toward a tailored approach for hernia repair.
Materials & Methods
All patients undergoing primary IH repair from 2009–2021 by a single surgeon at a specialty hernia center were included. Temporal differences were evaluated using Chi-squared, Fisher's exact test, and logistic linear regression.
Results
Over 12 years, 533 patients underwent primary IH repair. Most were males (59.1%), average age 51.7 years, and average BMI 26.6 kg/m2. IHs were repaired via open (28.3%) or minimally invasive (MIS) approaches (71.7%), either with (93.4%) or without mesh (6.6%).
Trends showed a significant increase in females undergoing IH repair (p<0.001) and increase in MIS approach (p<0.001). There was a significant decrease in open approach (p<0.001) and an overall trend away from mesh-based repairs and toward tissue-based repairs (p<0.001).
Conclusions
We present our hernia specialty center's best practices for IH repair, which is a result of a tailored approach. Our 12-year study shows a significant trend toward the use of MIS approach for IH repair. This is aligned with international consensus guidelines, especially for females. While mesh use remains the standard of care in the US, we show a progressive and significant trend away from the overuse of mesh in IH, especially for females.
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Affiliation(s)
- Z Khanmohammed
- Student, University of California , Berkeley, Berkeley , United States
| | - N Fadaee
- Surgery, Beverly Hills Hernia Center , Beverly Hills , United States
| | - D Huynh
- Surgery, Cedars-Sinai Medical Center , Los Angeles , United States
| | - I Capati
- Surgery, Beverly Hills Hernia Center , Beverly Hills , United States
| | - S Towfigh
- Surgery, Beverly Hills Hernia Center , Beverly Hills , United States
| | - R Tung
- Surgery, Beverly Hills Hernia Center , Beverly Hills , United States
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Raja SS, Edwards S, Stewart J, Huynh D. Missed opportunities for hepatitis C treatment at a tertiary care hospital in South Australia. World J Hepatol 2022; 14:1576-1583. [PMID: 36157868 PMCID: PMC9453456 DOI: 10.4254/wjh.v14.i8.1576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/01/2021] [Accepted: 07/11/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatitis C is a global epidemic and an estimated 230 000 Australians were living with chronic hepatitis C in 2016. Through effective public health policy and state commitment, Australia has utilised the advent of direct acting antiviral (DAA) therapy to transform the therapeutic landscape for hepatitis C virus (HCV). However, treatment rates are falling and novel public health approaches are required to maintain momentum for HCV elimination. Contemporary discourse in cascades of care have focused on expanding testing capabilities but less attention has been given to linking previously diagnosed patients back to care. Our simple and focused study rests on the premise that hospital admissions are an excellent opportunity to identify and refer previously diagnosed patients for HCV treatment.
AIM To assess whether inpatients with HCV are appropriately referred on for treatment.
METHODS We conducted a retrospective single centre cohort study that examined all patients with HCV presenting to The Queen Elizabeth Hospital (QEH) inpatient service between January 1 and December 31, 2017. QEH is a tertiary care hospital in South Australia. The main inclusion criteria were patients with active HCV infection who were eligible for DAA therapy. Our study cohort was identified using a comprehensive list of diagnosis based on international classification of diseases-10 AM codes for chronic viral hepatitis. Patients were excluded from the analysis if they had previously received DAA therapy or spontaneously cleared HCV. Patients presenting with decompensated liver cirrhosis or other systemic medical conditions conferring poor short-term prognosis were also excluded from the analysis. The primary outcome of our study was referral of patients for HCV treatment. Secondary outcomes included assessment of factors predicting treatment referral.
RESULTS There were 309 inpatients identified with hepatitis C as a principal or additional diagnosis between January 1 and December 31, 2017. Of these patients, 148 had active HCV infection without prior treatment or spontaneous clearance. Overall, 131 patients were deemed eligible for DAA treatment and included in the main analysis. Mean patient age was 47.75 ± 1.08 years, and 69% of the cohort were male and 13% identified as Aboriginal or Torres Strait Islander. Liver cirrhosis was a complication of hepatitis C in 7% of the study cohort. Only 10 patients were newly diagnosed with HCV infection during the study period with the remainder having been diagnosed prior to the study.
CONCLUSION Under 25% of hepatitis C patients presenting to an Australian tertiary hospital were appropriately referred for treatment. Advanced age, cirrhosis and admission under medical specialties were predictors of treatment referral.
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Affiliation(s)
- Sreecanth Sibhi Raja
- Department of Gastroenterology, The Queen Elizabeth Hospital, Woodville 5011, South Australia, Australia
| | - Suzanne Edwards
- Department of Statistician, School of Public Health, University of Adelaide, Adelaide 5000, South Australia, Australia
| | - Jeffrey Stewart
- Department of Gastroenterology, The Queen Elizabeth Hospital, Woodville 5011, South Australia, Australia
| | - Dep Huynh
- Department of Gastroenterology, The Queen Elizabeth Hospital, Woodville 5011, South Australia, Australia
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Pretorius V, Glenn I, White R, Huynh D, Gernhofer Y, Lee C, Kearns M, Adler E. The Impact of Utilizing DCD Donor Hearts on Heart Transplant Activity and Waitlist Time. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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6
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Yuvaraj J, Lim E, Vo T, Huynh D, Rocco C, Nerlekar N, Cheng K, Lin A, Dey D, Nicholls S, Kangaharan N, Wong D. Pericoronary Adipose Tissue Attenuation on Coronary Computed Tomography Angiography Associates With Male Sex and Indigenous Australian Ethnicity. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.479] [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: 11/24/2022]
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Huynh D, Patlolla A, Patel E, Patel K, Sharma S, Bowling M, Arastu H, Ju A. Geometric and Clinical Factors Affecting Active Fiducial Tracking in Robotic Stereotactic Body Radiation Therapy in the Lung. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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8
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Huynh D, Fadaee N, Al-Aufey B, Capati I, Towfigh S. Robotic iliopubic tract (r-IPT) repair: technique and preliminary outcomes of a minimally invasive tissue repair for inguinal hernia. Hernia 2020; 24:1041-1047. [PMID: 32638244 DOI: 10.1007/s10029-020-02259-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The iliopubic tract repair was first introduced by Nyhus in 1959, as an open non-mesh posterior preperitoneal repair for inguinal hernia. We have adapted this repair using a robotic approach to offer a minimally invasive (MIS) non-mesh inguinal hernia repair, termed the robotic iliopubic tract (r-IPT) repair. The aim of this pilot study is to evaluate the safety and effectiveness of this new technique. METHODS Starting in 2015, patients were enrolled in a Phase I trial of r-IPT repair. Inclusion criteria included low-risk patients with small inguinal hernias. Using a robotic TAPP approach, the direct and/or indirect defects were repaired by approximating the transversalis arch to the iliopubic tract. This trial was then expanded in Phase II to include a wider range of patients. Outcomes were collected prospectively. RESULTS Twenty-four inguinal hernias were repaired in 13 patients via r-IPT as outpatients. Patients were followed for a mean of 24.9 months (range 2.7-55.3, median 24). There were no surgical site occurrences and no recurrences. One (7.7%) patient had acute post-operative genital branch neuralgia, which self-resolved. One (7.7%) patient has chronic pain. CONCLUSION The Nyhus-inspired robotic iliopubic tract (r-IPT) repair is an MIS approach to provide a non-mesh repair in inguinal hernia. The repair is safe with acceptable preliminary outcomes in low-risk patients. We propose the r-IPT repair to be a MIS option for non-mesh inguinal hernia repair in low-risk patients.
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Affiliation(s)
- D Huynh
- Department of Surgery, Cedars-Sinai Health System, Los Angeles, CA, USA
| | - N Fadaee
- Beverly Hills Hernia Center, 450 N Roxbury Drive #224, Beverly Hills, CA, 90210, USA
| | - B Al-Aufey
- Department of Internal Medicine, East Jeddah Hospital, Jeddah, Saudi Arabia
| | - I Capati
- Beverly Hills Hernia Center, 450 N Roxbury Drive #224, Beverly Hills, CA, 90210, USA
| | - S Towfigh
- Beverly Hills Hernia Center, 450 N Roxbury Drive #224, Beverly Hills, CA, 90210, USA.
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9
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Jaung M, Gunter S, Espina I, Bolgiano M, Huynh D, Koradia P, Habet M, Hidalgo J, Mackey J. 194 The Performance of Sepsis Screening Tools in an Urban Emergency Department in Belize. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Haridy J, Wigg A, Muller K, Ramachandran J, Tilley E, Waddell V, Gordon D, Shaw D, Huynh D, Stewart J, Nelson R, Warner M, Boyd M, Chinnaratha MA, Harding D, Ralton L, Colman A, Liew D, Iyngkaran G, Tse E. Real-world outcomes of unrestricted direct-acting antiviral treatment for hepatitis C in Australia: The South Australian statewide experience. J Viral Hepat 2018; 25:1287-1297. [PMID: 29888827 DOI: 10.1111/jvh.12943] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 01/31/2018] [Accepted: 04/30/2018] [Indexed: 02/06/2023]
Abstract
In March 2016, the Australian government offered unrestricted access to direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) to the entire population. This included prescription by any medical practitioner in consultation with specialists until sufficient experience was attained. We sought to determine the outcomes and experience over the first twelve months for the entire state of South Australia. We performed a prospective, observational study following outcomes of all treatments associated with the state's four main tertiary centres. A total of 1909 subjects initiating DAA therapy were included, representing an estimated 90% of all treatments in the state. Overall, SVR12 was 80.4% in all subjects intended for treatment and 95.7% in those completing treatment and follow-up. 14.2% were lost to follow-up (LTFU) and did not complete SVR12 testing. LTFU was independently associated with community treatment via remote consultation (OR 1.50, 95% CI 1.04-2.18, P = .03), prison-based treatment (OR 2.02, 95% CI 1.08-3.79, P = .03) and younger age (OR 0.98, 95% CI 0.97-0.99, P = .05). Of the 1534 subjects completing treatment and follow-up, decreased likelihood of SVR12 was associated with genotype 2 (OR 0.23, 95% CI 0.07-0.74, P = .01) and genotype 3 (OR 0.23, 95% CI 0.12-0.43, P ≤ .01). A significant decrease in treatment initiation was observed over the twelve-month period in conjunction with a shift from hospital to community-based treatment. Our findings support the high responses observed in clinical trials; however, a significant gap exists in SVR12 in our real-world cohort due to LTFU. A declining treatment initiation rate and shift to community-based treatment highlight the need to explore additional strategies to identify, treat and follow-up remaining patients in order to achieve elimination targets.
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Affiliation(s)
- J Haridy
- University of Melbourne, Parkville, Vic., Australia.,Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - A Wigg
- Hepatology and Liver Transplantation Unit, Flinders Medical Centre, Adelaide, SA, Australia
| | - K Muller
- Hepatology and Liver Transplantation Unit, Flinders Medical Centre, Adelaide, SA, Australia
| | - J Ramachandran
- Hepatology and Liver Transplantation Unit, Flinders Medical Centre, Adelaide, SA, Australia
| | - E Tilley
- Hepatology and Liver Transplantation Unit, Flinders Medical Centre, Adelaide, SA, Australia
| | - V Waddell
- Department of Microbiology and Infectious Diseases, Flinders Medical Centre, Adelaide, SA, Australia
| | - D Gordon
- Department of Microbiology and Infectious Diseases, Flinders Medical Centre, Adelaide, SA, Australia.,Flinders University, Bedford Park, SA, Australia
| | - D Shaw
- Department of Infectious Diseases, Royal Adelaide Hospital, Adelaide, SA, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - D Huynh
- Department of Gastroenterology, The Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - J Stewart
- Department of Gastroenterology, The Queen Elizabeth Hospital, Adelaide, SA, Australia.,Department of Infectious Diseases, The Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - R Nelson
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.,Department of Infectious Diseases, The Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - M Warner
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.,Department of Infectious Diseases, The Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - M Boyd
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.,Department of Infectious Diseases, Lyell-McEwin Hospital, Adelaide, SA, Australia
| | - M A Chinnaratha
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.,Department of Gastroenterology, Lyell-McEwin Hospital, Adelaide, SA, Australia
| | - D Harding
- Department of Gastroenterology, Lyell-McEwin Hospital, Adelaide, SA, Australia
| | - L Ralton
- Department of Infectious Diseases, Lyell-McEwin Hospital, Adelaide, SA, Australia
| | - A Colman
- Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - D Liew
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Vic., Australia
| | - G Iyngkaran
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Vic., Australia
| | - E Tse
- Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, SA, Australia
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Manier S, Park J, Capelletti M, Bustoros M, Freeman SS, Ha G, Rhoades J, Liu CJ, Huynh D, Reed SC, Gydush G, Salem KZ, Rotem D, Freymond C, Yosef A, Perilla-Glen A, Garderet L, Van Allen EM, Kumar S, Love JC, Getz G, Adalsteinsson VA, Ghobrial IM. Whole-exome sequencing of cell-free DNA and circulating tumor cells in multiple myeloma. Nat Commun 2018; 9:1691. [PMID: 29703982 PMCID: PMC5923255 DOI: 10.1038/s41467-018-04001-5] [Citation(s) in RCA: 128] [Impact Index Per Article: 21.3] [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: 08/31/2017] [Accepted: 03/27/2018] [Indexed: 12/29/2022] Open
Abstract
Liquid biopsies including circulating tumor cells (CTCs) and cell-free DNA (cfDNA) have enabled minimally invasive characterization of many cancers, but are rarely analyzed together. Understanding the detectability and genomic concordance of CTCs and cfDNA may inform their use in guiding cancer precision medicine. Here, we report the detectability of cfDNA and CTCs in blood samples from 107 and 56 patients with multiple myeloma (MM), respectively. Using ultra-low pass whole-genome sequencing, we find both tumor fractions correlate with disease progression. Applying whole-exome sequencing (WES) to cfDNA, CTCs, and matched tumor biopsies, we find concordance in clonal somatic mutations (~99%) and copy number alterations (~81%) between liquid and tumor biopsies. Importantly, analyzing CTCs and cfDNA together enables cross-validation of mutations, uncovers mutations exclusive to either CTCs or cfDNA, and allows blood-based tumor profiling in a greater fraction of patients. Our study demonstrates the utility of analyzing both CTCs and cfDNA in MM. Circulating tumor cells (CTCs) and cell-free DNA (cfDNA) enables characterization of a patient’s cancer. Here, the authors analyse CTCs, cfDNA, and tumor biopsies from multiple myeloma patients to show these approaches are complementary for mutation detection, together enabling a greater fraction of patient tumors to be profiled.
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Affiliation(s)
- S Manier
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA.,Hematology Department, CHU, Univ. Lille, 59000, Lille, France.,INSERM UMR-S1172, 59000, Lille, France
| | - J Park
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA.,Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - M Capelletti
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA
| | - M Bustoros
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA
| | - S S Freeman
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - G Ha
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - J Rhoades
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - C J Liu
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA
| | - D Huynh
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA
| | - S C Reed
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - G Gydush
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - K Z Salem
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA
| | - D Rotem
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - C Freymond
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA
| | - A Yosef
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA
| | - A Perilla-Glen
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA
| | - L Garderet
- Department of Hematology, St-Antoine University Hospital, Paris, 75000, France
| | - E M Van Allen
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA.,Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - S Kumar
- Department of Hematology, Mayo Clinic, Rochester, MN, 55902, USA
| | - J C Love
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - G Getz
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - V A Adalsteinsson
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA.
| | - I M Ghobrial
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, 02115, USA. .,Brigham and Women's Hospital, Boston, MA, 02115, USA. .,Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA.
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12
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Wong S, Huynh D, Zhang F, Nguyen NQ. Use of aspartate aminotransferase to platelet ratio to reduce the need for FibroScan in the evaluation of liver fibrosis. World J Hepatol 2017; 9:791-796. [PMID: 28660013 PMCID: PMC5474725 DOI: 10.4254/wjh.v9.i17.791] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/06/2017] [Accepted: 04/24/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the performance of aspartate aminotransferase to platelet ratio (APRI) score against FibroScan in predicting the presence of fibrosis.
METHODS Data of patients who concurrently had APRI score, FibroScan and liver biopsy to assess their hepatitis C virus (HCV) and hepatitis B virus (HBV) over 6 years were retrospectively reviewed and details of their disease characteristics and demographics were recorded. Advanced fibrosis was defined as ≥ F3.
RESULTS Of the 3619 patients (47.5 ± 11.3 years, 97M:36F) who had FibroScans and APRI for HCV and HBV, 133 had concurrent liver biopsy. Advanced liver fibrosis was found in 27/133 (20%, F3 = 21 and F4 = 6) patients. Although APRI score (P < 0.001, AUC = 0.83) and FibroScan (P < 0.001, AUC = 0.84) predicted the presence of advanced fibrosis, the sensitivities and specificities were only modest (APRI score: 51.9% sensitivity, 84.9% specificity; FibroScan: 63% sensitivity, 84% specificity). Whilst 13/27 (48%) patients with advanced fibrosis had APRI ≤ 1.0, no patients with APRI ≤ 0.5 had advanced fibrosis, with 100% sensitivity. The use of APRI ≤ 0.5 would avoid the need for FibroScan in 43% of patients.
CONCLUSION APRI score and FibroScan performed equally well in predicting advanced fibrosis. A proposed APRI cut-off score of 0.5 could be used as a screening tool for FibroScan, as cut-off score of 1.0 will miss up to 48% of patients with advanced fibrosis. Further prospective validation studies are required to confirm this finding.
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Sharp A, Gould M, Jones J, Wu I, Huynh D, Kocher K, Shah N. 37 Emergency Department Hospitalization Practices for Community-Acquired Pneumonia Encounters: Validating CURB-65 for Discharged Patients. Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.066] [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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15
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Huynh D, Etzel C, Cox V, Kremer J, Greenberg J, Kavanaugh A. SAT0268 Anti Citrullinated Peptide Antibody (ACPA) in Patients with Psoriatic Arthritis (PSA): Clinical Relevance. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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McNally L, Lathi R, Huynh D, Keller J, Dikan J, Rabinowitz M. Characterization of Patient Recovery After First Trimester Miscarriage: Results From A National Survey. Fertil Steril 2012. [DOI: 10.1016/j.fertnstert.2012.01.066] [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: 10/28/2022]
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Lathi R, Huynh D, Keller J, Dikan J, Rabinowitz M. Patient desire for chromosome analysis of products of conception following miscarriage: a national survey. Fertil Steril 2011. [DOI: 10.1016/j.fertnstert.2011.07.352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Huynh D, Khoo EEW, Roberts-Thomson IC. Education and imaging: hepatobiliary and pancreatic: focal nodular hyperplasia. J Gastroenterol Hepatol 2011; 26:416. [PMID: 21261738 DOI: 10.1111/j.1440-1746.2010.06615.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- D Huynh
- Department of Gastroenterology and Hepatology Department of Radiology, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
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Hovanec-Burns D, Maldonado S, Huynh D, Kubota H, Chuang T. Specific IgE Measurement With Common Tree Nut Allergens. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Three different halogeno-phenylcarbamate derivatives of cellulose have been prepared and coated on silica gel. The coated materials have been immobilized and their chiral recognition ability as chiral stationary phase (CSP) has been evaluated with a set of reference racemates, including several drugs such as lormetazepam, glutethimide, and warfarin, using various mobile phase mixtures. The novel phases were found to exhibit unique enantioselective properties compared with more established polysaccharide-based CSPs. A good resolution of all racemates could be successfully achieved on at least one of the immobilized CSPs. Moreover, it has been pointed out that selectivity may considerably vary with the composition of the mobile phase.
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Affiliation(s)
- E Francotte
- NOVARTIS Pharma AG, Research Department, Central Technologies, WKL-122.P.25, Postfach, CH-4002 Basel, Switzerland.
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Leark R, Dixon D, Hoffman T, Huynh D. An investigation into the effects of malingering on the test of variables of attention (TOVA) in a college aged sample. Arch Clin Neuropsychol 1999. [DOI: 10.1093/arclin/14.8.726b] [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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Franco A, Yokoyama T, Huynh D, Thomson C, Nathenson SG, Grey HM. Fine specificity and MHC restriction of trinitrophenyl-specific CTL. J Immunol 1999; 162:3388-94. [PMID: 10092793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
In this study, the fine specificity and MHC restriction of a CTL response specific to the trinitrophenyl (TNP) hapten was analyzed. Based on the structure of peptide/Kb complexes and ternary TCR/Ag/MHC complexes, four TNP peptides, two octamers, and two nonamers were chosen for eliciting anti-TNP CTL responses. Hapten was conjugated at position 4 in the octamers and at position 5 in the nonamers, positions which should allow engagement of the hapten by TCRs. Potent CTL activity for each of the TNP peptides was obtained that was highly hapten-specific; however, there were considerable differences in the extent of cross-reactivity with other TNP peptides, with the octamers generating more cross-reactive CTL than the nonamers. MHC restriction analysis suggested that anti-hapten responses were less dependent on MHC recognition than anti-peptide responses. This was evidenced by the relative ease of detecting cross-reactivity to haptenated peptides presented by allo-MHC and by the relative insensitivity of anti-hapten vs anti-peptide CTL to mutations in the Kb molecule at potential TCR interaction sites. One potential explanation for this insensitivity to MHC mutation was the finding that the anti-hapten response appeared to be of higher avidity, since a > 100-fold difference in the amount of Ag required to sensitize target cells was found between these two types of Ags.
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Affiliation(s)
- A Franco
- La Jolla Institute for Allergy and Immunology, San Diego, CA 92121, USA
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Presti JC, Moch H, Gelb AB, Huynh D, Waldman FM. Initiating genetic events in small renal neoplasms detected by comparative genomic hybridization. J Urol 1998; 160:1557-61. [PMID: 9751412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To identify the genetic alterations associated with renal adenomas. MATERIALS AND METHODS We analyzed 37 renal adenomas obtained at autopsy (23 papillary and 14 non-papillary) by comparative genomic hybridization. RESULTS In papillary tumors, the median number of gains and losses of genetic material per tumor was 2.0 and 1.0, respectively. Papillary tumors were characterized predominantly by gains of genetic material on chromosomes 7 (57%), 17 (35%), 16 (26%), 12 (26%), 3 (22%), 20 (22%) and loss of a sex chromosome (83%). In 6 papillary tumors less than or equal to 5 mm. in diameter, gain of chromosome 7 occurred in 4 specimens. Initiating events for papillary renal adenomas include gain of chromosome 7 and loss of a sex chromosome. In non-papillary tumors, the median number of gains and losses of genetic material per tumor was 1.0 and 1.0, respectively. Non-papillary tumors were characterized by loss of genetic material on chromosome 3p (50%), loss of a sex chromosome (36%) and a gain of chromosome 5 (43%). The initiating event for non-papillary renal adenomas is the loss of chromosome 3p. CONCLUSIONS Renal adenomas demonstrate similar genetic alterations as clinically detected renal cell carcinomas. Their clinically indolent course may, in part, be a result of the lower number of genetic alterations per tumor than their clinically detected counterparts. Renal adenomas are thus small carcinomas which have not yet acquired the necessary genetic alterations leading to tumor progression.
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Affiliation(s)
- J C Presti
- Department of Urology, University of California, San Francisco 94143-0738, USA
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Abstract
Renal oncocytomas are uncommon tumors of the kidney that are considered to be of low malignant potential. Neither conventional cytogenetic nor restriction fragment length polymorphism analyses have identified consistent genetic alterations in their genomic DNA. The purpose of the present study was to identify the genetic alterations associated with the development of renal oncocytomas. We studied 13 renal oncocytomas by using comparative genomic hybridization, and we identified loss of genetic material from chromosomes 1 and/or 14 in six of these tumors. These alterations may represent early genetic events in the development of these tumors.
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Affiliation(s)
- J C Presti
- Department of Urology, University of California-San Francisco 94143-0738, USA
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Meldrum DR, Cedars MI, Hamilton F, Huynh D, Wisot A, Marr B. Leuprolide acetate elevates prolactin during ovarian stimulation with gonadotropins. J Assist Reprod Genet 1992; 9:251-3. [PMID: 1525456 DOI: 10.1007/bf01203823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The purpose of this study was to determine whether gonadotropin-releasing hormone agonist further increases the prolactin rise accompanying ovarian stimulation. DESIGN Serum prolactin concentrations were compared between cycles with and cycles without the use of leuprolide acetate (LA) matched for estradiol levels. Relationships of prolactin levels to cycle outcomes were examined. SETTING The study took place at a private fertility center. PATIENTS Patients were women receiving stimulation for oocyte retrieval using human menopausal gonadotropins. INTERVENTIONS No interventions were used. MAIN OUTCOME MEASURES Serum prolactin level, fertilization rate, embryo quality, and pregnancy were the main outcome measures. RESULTS Higher serum prolactin was associated with both higher estradiol levels and use of LA but did not have any effects on fertilization rate, embryo quality, or occurrence of pregnancy. CONCLUSION LA stimulates prolactin release during ovarian stimulation but without apparent consequence.
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Affiliation(s)
- D R Meldrum
- AMI South Bay Hospital IVF Center, Redondo Beach, California 90277
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Schoolcraft W, Sinton E, Schlenker T, Huynh D, Hamilton F, Meldrum DR. Lower pregnancy rate with premature luteinization during pituitary suppression with leuprolide acetate. Fertil Steril 1991; 55:563-6. [PMID: 1900481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The relationship of the circulating level of progesterone (P) on the day of human chorionic gonadotropin (hCG) injection to occurrence of clinical pregnancy was examined in 133 leuprolide acetate human menopausal gonadotropin (hMG) in vitro fertilization cycles in women having at least three embryos transferred. Progesterone concentrations greater than 0.5 ng/mL were associated with a significantly lower rate of pregnancy (12/59, 20%) compared with less than 0.5 ng/mL (40/74, 54%, P less than 0.005). The higher P cycles were associated with greater patient age and hMG dose, although these relationships appeared to be indirect. Luteinizing hormone (LH) concentrations remained suppressed. Ovarian stimulation may cause excessive luteinization and an adverse cycle outcome even in the presence of low LH levels. Prospective use of P levels may be helpful to determine optimal hCG timing.
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Affiliation(s)
- D R Meldrum
- AMI South Bay Hospital IVF Center, Redondo Beach, California 90277
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Meldrum DR, Wisot A, Hamilton F, Gutlay AL, Kempton WF, Huynh D. Routine pituitary suppression with leuprolide before ovarian stimulation for oocyte retrieval. Fertil Steril 1989; 51:455-9. [PMID: 2493403 DOI: 10.1016/s0015-0282(16)60553-8] [Citation(s) in RCA: 119] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Pituitary suppression with leuprolide acetate (LA) was used before and during ovarian stimulation with human menopausal gonadotropins in 45 consecutive women having their first cycle of in vitro fertilization embryo transfer (IVF-ET). As anticipated, a low rate of cycle cancellation (6.7%) was necessary for poor responses. Follicles were allowed to develop to a larger diameter than with our prior protocol without LA. On the day of human chorionic gonadotropin (hCG), 11.5 + 0.7 follicles of at least 1.0 cm were visualized; 11.7 + 0.9 oocytes were retrieved; 67.5% fertilized and 6.7 + 0.6 normal embryos were available for transfer. Of the 3.4 + 0.1 embryos transferred per patient, 24.6% implanted. The rates of clinical pregnancy per retrieval and per stimulation were 54% and 47%, respectively, of which 23.8% aborted. Routine use of LA resulted in a highly efficient level of ongoing pregnancy per initiated cycle, and therefore may produce a superior first cycle for IVF-ET.
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Affiliation(s)
- D R Meldrum
- AMI South Bay Hospital, IVF Center, Redondo Beach, California 90277
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Meldrum DR, Wisot A, Hamilton F, Gutlay AL, Huynh D, Kempton W. Timing of initiation and dose schedule of leuprolide influence the time course of ovarian suppression. Fertil Steril 1988; 50:400-2. [PMID: 3137095 DOI: 10.1016/s0015-0282(16)60121-8] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The time course of suppression of ovarian estrogen production and follicular development with leuprolide was examined in 40 normal women before ovarian stimulation for in vitro fertilization (IVF). Initiation of leuprolide during the midluteal phase caused a significantly more prompt suppression than when treatment was started during the early follicular phase (day 1). Injection of the same total amount of leuprolide in two divided doses also caused a significantly more prompt suppression. These two methods were consistent enough to make routine use of leuprolide practical before ovarian stimulation for IVF.
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Affiliation(s)
- D R Meldrum
- AMI-South Bay Hospital In Vitro Fertilization Center, Redondo Beach, California 90277
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