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Peña-Galo EM, Wurzelmann D, Alcedo J, Peña R, Cortes L, Morgan D. Enduring association between irritable bowel syndrome and war trauma during the Nicaragua civil war period: A population-based study. World J Gastroenterol 2023; 29:5953-5961. [PMID: 38130999 PMCID: PMC10731151 DOI: 10.3748/wjg.v29.i45.5953] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/13/2023] [Accepted: 11/27/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome (IBS), including in war veterans, whereas war exposure in civilians is unclear. Nicaragua experienced two wars, 1970-1990: The Sandinistas Revolution (1970s) and The Contra War (1980s). Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system (11000 households). AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua. METHODS We conducted a nested population-based, cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria. 1617 adults were randomly selected. The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua. War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects. Multiple exposures were defined by ≥ 3 measures. RESULTS The prevalence of IBS was 15.2% [Female (F) 17.1%, Male (M) 12.0%], war exposure 19.3% (F 9.3%, M 36.7%), and post-traumatic stress disorder (PTSD) 5.6% (F 6.4%, M 4.3%). Significant associations with IBS in the civilian population were observed (adjusted by gender, age, socioeconomic status, education): physical and psychological abuse [adjusted odds ratio (aOR): 2.25; 95% confidence interval: 1.1-4.5], witnessed execution (aOR: 2.4; 1.1-5.2), family member death (aOR: 2.2; 1.2-4.2), and multiple exposures (aOR: 2.7; 1.4-5.1). PTSD was independently associated with IBS (aOR: 2.6; 1.2-5.7). CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS. Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.
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Affiliation(s)
- Edgar M Peña-Galo
- Department of Digestive Diseases, Miguel Servet University Hospital, Zaragoza 50009, Aragon, Spain
- Aragon Health Research Institute, IIS Aragon, Zaragoza 50009, Aragon, Spain
| | - Daniel Wurzelmann
- Department of Mental Health, Carolina Partners, Durham, NC 27707, United States
| | - Javier Alcedo
- Department of Digestive Diseases, Miguel Servet University Hospital, Zaragoza 50009, Aragon, Spain
- Aragon Health Research Institute, IIS Aragon, Zaragoza 50009, Aragon, Spain
| | - Rodolfo Peña
- Department of Data Analysis, CIDE (Research, Development and Epidemiology Center), Tegucigalpa 11101, Francisco Morazán, Honduras
| | - Loreto Cortes
- School of Medicine, National Autonomous University of Nicaragua, Leon 21000, Leon, Nicaragua
| | - Douglas Morgan
- Department of Gastroenterology and Hepatology, UAB University of Alabama Birmingham, Birmingham, AL 35233, United States
- School of Medcine, The University of North Carolina, Chapel Hill, NC 9500, United States
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Morgan D, Spiess C, Millington G, Schmidt A, Smith H, Okwuone DDD, Berggren K, Lominska CE, Markiewicz MA, Yelder T, Gao H, Wang J, Gan GN. Investigating the Role of MK2 in Head and Neck Squamous Cell Carcinoma Growth, Metastasis and STING Pathway Activation. Int J Radiat Oncol Biol Phys 2023; 117:S159. [PMID: 37784399 DOI: 10.1016/j.ijrobp.2023.06.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Our prior work demonstrated that inhibition of MAPKAPK2 (MK2) can enhance radiation (RT)-mediated in vivo head and neck squamous cell carcinoma (HNSCC) tumor control and survival in preclinical immune incompetent models. The cytosolic DNA sensor cyclic GMP-AMP synthetase (cGAS) and its downstream adaptor protein, stimulator of interferon genes (STING), are conserved proteins within the innate immune signaling pathways and are important for mediating host defense against microbial infection and can play a role in anti-cancer immunity. We hypothesized that loss of MK2 enhances radiation-induced cGAS-STING pathway activation leading to improved tumor control and survival. MATERIALS/METHODS MK2 shRNA knockdown human (Tu167, CAL27) and MK2 Cas9/CRISPR knockout (KO) syngeneic murine (Ly2, MLM3) HNSCC cell lines were treated with 10 Gy irradiation. Micronuclei were quantitated by DAPI-immunofluorescence (IF). Protein changes in cGAS-STING were evaluated by immunoblot. Inflammatory cytokine production including Type I IFNβ1 were evaluated by RT-qPCR. Ly2 and MLM3 cells were orthotopically or flank engrafted into immune competent mice (Balb/c, C57Bl/6, respectively) for animal tumor control-survival studies. Tumor immune cell infiltrate was examined using FACS and immunohistochemistry. Selected drug studies using the MK2 inhibitor, ATI-450, were performed with RT. RESULTS Loss of MK2 in HNSCC (Tu167, CAL27, Ly2, MLM3) treated with RT led to a significant increase in micronuclei formation compared to control cells. MK2-enhanced micronuclei generation following RT could be inhibited with the actin filament polymerization inhibitor, cytochalasin B. RT treatment of MK2 shRNA cells led to increased cGAS and phospho-STING levels compared to either treatment alone. IFNβ1 levels were significantly higher in HNSCC cell lines treated with RT and with MK2 inhibited by an MK2 inhibitor (ATI-450) or genetic reduction compared to either treatment alone. In-vivo implantation of MLM3 cells into C57Bl/6 comparing control vs MK2 KO tumors treated with ±8 Gy RT demonstrated improved mouse survival favoring RT+MK2 KO over RT, MK2 KO or parental (63, 58, 58.5, 35 days, respectively). FACS analysis of MLM3 WT v KO tumors 3 days post RT showed an overall increase in the number of CD3/CD8 T-cells infiltrating into the tumor in all groups except for parental tumors. Further analysis demonstrated that loss of MK2 reversed CD8 T-cell exhaustion and when combined with radiotherapy led to increased CD8 T-cell activation. Furthermore, activated CD4 and CD8 T cells were reduced in WT+RT cells compared to WT tumors whereas no reduction was seen in the KO or KO+RT. CONCLUSION HNSCC tumor MK2 inhibition enhances RT-mediated micronuclei formation and subsequent cGAS-STING-IFNβ1 levels. Loss of HNSCC MK2 leads to increased CD4-CD8 T-cell infiltration into the tumor and this effect is enhanced following RT. Targeting tumor MK2 may facilitate improved tumor control.
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Affiliation(s)
- D Morgan
- Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS
| | | | - G Millington
- Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS
| | - A Schmidt
- Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS
| | - H Smith
- Tulane University, New Orleans, KS
| | | | - K Berggren
- University of New Mexico School of Medicine, Albuquerque, NM
| | - C E Lominska
- Department of Radiation Oncology, University of Kansas School of Medicine, Kansas City, KS
| | - M A Markiewicz
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, KS
| | - T Yelder
- KUCC Masonic Cancer Alliance, Kansas City, KS
| | - H Gao
- Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS
| | - J Wang
- Department of Medicinal Chemistry, The University of Kansas, Kansas City, KS
| | - G N Gan
- Department of Radiation Oncology, University of Kansas School of Medicine, Kansas City, KS
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Montalvan-Sanchez E, Gonzalez-Pons M, Norwood D, Dominguez R, Wilson K, Cruz-Correa M, Morgan D. Abstract A016: Successful design and execution of two gastric cancer chemoprevention trials in Central America and Puerto Rico. Cancer Prev Res (Phila) 2022. [DOI: 10.1158/1940-6215.tacpad22-a016] [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: 12/03/2022]
Abstract
Abstract
Gastric adenocarcinoma (GAC) is the third leading global cause of cancer mortality and leading infection-associated cancer. The high incidence regions are Latin America, East Asia, and Eastern Europe. In the U.S., GAC represents a major cancer disparity, double the incidence rates in all non-white populations, the opposite of Barrett’s Esophagus and EAC. Immigrants from high incidence regions maintain the risk profile of their nations of origin. In a paradigm shift, recent guidelines now recommend surveillance endoscopy (eg, 3 years) for patients with high-risk gastric premalignant conditions (GPMCs). Clinical trials of chemoprevention agents for patients with GPMCs are lacking. We conducted two independent, NCI DCP funded, phase II placebo-controlled chemoprevention trials in patients with GPMCs (intestinal metaplasia, atrophic gastritis). The oral agents were curcumin and eflornithine (DFMO). A highly bioavailable preparation of curcumin was used. The RCTs were conducted in Puerto Rico and rural Honduras, with important characteristics: (1) representative of Caribbean and Mesoamerican populations and linked to large U.S. immigrant populations; (2) high prevalence of H. pylori infection and GPMCs; (3) absence of turmeric and curcuminoids in the local diets; (4) proven bidirectional collaboration with academic institutions in the U.S. In the curcumin trial (NCT02782949) H. pylori negative patients were randomized to study drug or placebo for 6 months. In the eflornithine study (NCT02794428), H. pylori positive and negative subjects were randomized to study drug or placebo for 18 months, with endoscopy at baseline, and 6. 18, and 24 months. The primary outcomes were based upon changes in histologic parameters at 6 months. Principal study challenges included: (1) International and bilingual regulatory environment; (2) Strengthening of the research infrastructure, particularly in Central America; (3) Participant recruitment, eg, in the curcumin RCT in Honduras wherein only 10-15% are H. pylori negative; (4) The Covid-19 pandemic; (5) Natural disasters (3 hurricanes).
In Conclusion: Eflornithine and curcumin RCTs have been successfully completed, despite important challenges in implementation and execution. No losses to follow-up were encountered related to the pandemic or natural disasters. The south-south partnership may provide a model for chemoprevention and translational studies in Latino populations with prevalent cancers such as GAC.
Citation Format: Eleazar Montalvan-Sanchez, Maria Gonzalez-Pons, Dalton Norwood, Ricardo Dominguez, Keith Wilson, Marcia Cruz-Correa, Douglas Morgan. Successful design and execution of two gastric cancer chemoprevention trials in Central America and Puerto Rico [abstract]. In: Proceedings of the Second Biennial NCI Meeting: Translational Advances in Cancer Prevention Agent Development (TACPAD); 2022 Sep 7-9. Philadelphia (PA): AACR; Can Prev Res 2022;15(12 Suppl_2): Abstract nr A016.
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Affiliation(s)
| | - Maria Gonzalez-Pons
- 2University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Dalton Norwood
- 3Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL
| | | | - Keith Wilson
- 5Vanderbilt University Division of Gastroenterology and Hepatology, Nashville, TN
| | - Marcia Cruz-Correa
- 2University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Douglas Morgan
- 6Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL
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Woo JA, Zhao X, Khan H, Penn C, Wang X, Joly-Amado A, Weeber E, Morgan D, Kang DE. Correction to: Slingshot-Cofilin activation mediates mitochondrial and synaptic dysfunction via A β ligation to β1-integrin conformers. Cell Death Differ 2022; 29:2562. [DOI: 10.1038/s41418-022-01055-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Hong C, Kamdar N, Morgan D. Prediction models for same-day discharge following benign minimally invasive hysterectomy. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.162] [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: 11/01/2022]
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DeBlanc J, Brummett C, Gunaseelan V, As-Sanie S, Morgan D. Patient recovery and opioid use after hysterectomy. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.114] [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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Singhal S, Veeratterapillay J, Locks S, Morgan D, Patil R. Magnetic Resonance Imaging-Guided Adaptive Brachytherapy for the Treatment of Cervical Cancer and its Impact on Clinical Outcome. Clin Oncol (R Coll Radiol) 2022; 34:442-451. [DOI: 10.1016/j.clon.2022.01.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/22/2021] [Accepted: 01/19/2022] [Indexed: 12/24/2022]
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Waterman J, Jayaraju U, Nadimi J, Morgan D. 940 Neck of Femur Fracture Management and Outcomes during COVID-19: Overview of the Results from a District General Hospital in Wales. Br J Surg 2021. [PMCID: PMC8524569 DOI: 10.1093/bjs/znab259.1015] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Introduction The COVID-19 pandemic has delivered significant challenges to the Orthopaedic community. Our study aims to assess the impact of COVID-19 on the management and outcomes of patient’s presenting with Hip Fractures to our DGH. Method Retrospective data analysis was performed on a cohort of hip fracture patients who presented to our DGH before the COVID-19 pandemic (23/03/2019 to 05/05/2019) and were compared to those who presented during the COVID-19 pandemic (23/03/2020 to 05/05/2020). Minimum follow up was 30 days postoperatively. Results 38 patients with hip fractures presented to our unit in the pre-COVID-19 period compared to 27 patients in the COVID-19 period. Total time from presentation to discharge, during COVID-19, demonstrated a 70.23% decrease when compared to the pre-COVID cohort. 30-day Mortality rates were higher in the COVID-19 cohort. Conclusions During the COVID-19 pandemic our time to theatre and discharge of hip fractures has seen an improvement, with time to discharge decreasing by 70.23%. Comparison of our mortality rates has seen a fourfold increase likely influenced by the detrimental effects of COVID-19. Further work and larger numbers are required to see the true impact of COVID-19 on the management and outcomes of hip fractures in our DGH.
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Affiliation(s)
- J Waterman
- Royal Glamorgan Hospital, Llantrisant, United Kingdom
| | - U Jayaraju
- Royal Glamorgan Hospital, Llantrisant, United Kingdom
| | - J Nadimi
- Royal Glamorgan Hospital, Llantrisant, United Kingdom
| | - D Morgan
- Royal Glamorgan Hospital, Llantrisant, United Kingdom
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Giovannini S, Carter CS, Leeuwenburgh C, Flex A, Biscetti F, Morgan D, Laudisio A, Coraci D, Maccauro G, Zuccalà G, Caliandro P, Bernabei R, Marzetti E. Effects of aging and life-long moderate calorie restriction on IL-15 signaling in the rat white adipose tissue. Eur Rev Med Pharmacol Sci 2021; 24:2738-2749. [PMID: 32196625 DOI: 10.26355/eurrev_202003_20547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Phosphorylation of insulin receptor substrate (IRS) 1 by tumor necrosis factor alpha (TNF-α) has been implicated as a factor contributing to insulin resistance. Administration of IL-15 reduces adipose tissue deposition in young rats and stimulates secretion of adiponectin, an insulin sensitizing hormone that inhibits the production and activity of TNF-α. We aimed at investigating the effects of age life-long moderate calorie restriction (CR) on IL-15 and TNF-α signaling in rat white adipose tissue (WAT). MATERIALS AND METHODS Thirty-six 8-month-old, 18-month-old, and 29-month-old male Fischer344´Brown Norway F1 rats (6 per group) were either fed ad libitum (AL) or calorie restricted by 40%. The serum levels of IL-15 and IL-15 receptor α-chain (IL-15Rα) were increased by CR controls regardless of age. An opposite pattern was detected in WAT. In addition, CR reduced gene expression of TNF-α and cytosolic IRS1 serine phosphorylation in WAT, independently from age. RESULTS IL-15 signaling in WAT is increased over the course of aging in AL rats compared with CR rodents. Protein levels of IL-15Rα are greater in WAT of AL than in CR rats independently from age. This adaptation was paralleled by increased IRS1 phosphorylation through TNF-α-mediated insulin resistance. Adiponectin decreased at old age in AL rats, while no changes were evident in CR rats across age groups. CONCLUSIONS IL-15 signaling could therefore represent a potential target for interventions to counteract metabolic alterations and the deterioration of body composition during aging.
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Affiliation(s)
- S Giovannini
- Department of Geriatrics, Neurosciences, and Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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Smith H, Morgan D, Berggren K, Hixon M, Shen X, Woolbright B, Taylor J, Gan G. The MAPKAPK2 Pathway Mediates Radiation-Induced Tumor Inflammation And Proliferation In Bladder Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Smith RY, Morgan D, Sharma L, Cherny VV, Tidswell N, Molo MW, DeCoursey TE. Voltage-gated proton channels exist in the plasma membrane of human oocytes. Hum Reprod 2020; 34:1974-1983. [PMID: 31633762 DOI: 10.1093/humrep/dez178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/10/2019] [Indexed: 12/25/2022] Open
Abstract
STUDY QUESTION Do human oocytes express voltage-gated proton channels? SUMMARY ANSWER Human oocytes exhibit voltage-gated proton currents. WHAT IS KNOWN ALREADY Voltage-gated proton currents have been reported in human sperm, where they contribute to capacitation and motility. No such studies of human oocytes exist. STUDY DESIGN, SIZE, DURATION Voltage-clamp studies were undertaken using entire oocytes and vesicles derived from oocytes and in excised patches of membrane from oocytes. PARTICIPANTS/MATERIALS, SETTING, METHODS Frozen, thawed human metaphase II oocytes were obtained from material donated to the gamete repository at the Rush Center for Advanced Reproductive Care. Prior to patch clamping, oocytes were warmed and equilibrated. Formation of an electrically tight seal requires exposing bare oolemma. Sections of the zona pellucida (ZP) were removed using a laser, followed by repeated pipetting, to further separate the oocyte from the ZP. Patch-clamp studies were performed using the whole-cell configuration on oocytes or vesicles derived from oocytes, and using inside-out patches of membrane, under conditions optimized to detect voltage-gated proton currents. MAIN RESULTS AND THE ROLE OF CHANCE Proton currents are present at significant levels in human oocytes where they exhibit properties similar to those reported in other human cells, as well as those in heterologous expression systems transfected with the HVCN1 gene that codes for the voltage-gated proton channel. LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION Human oocytes are large cells, which limits our ability to control the intracellular solution. Subtle effects of cryopreservation by vitrification and subsequent warming on properties of HVCN1, the HVCN1 gene product, cannot be ruled out. WIDER IMPLICATIONS OF THE FINDINGS Possible functions for voltage-gated proton channels in human oocytes may now be contemplated. STUDY FUNDING/COMPETING INTEREST(S) NIH R35GM126902 (TED), Bears Care (DM). No competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- R Ya Smith
- Rush Center for Advanced Reproductive Care, Department of Obstetrics and Gynecology, Rush University Medical Center, Chicago, IL 60612, USA
| | - D Morgan
- Department of Physiology & Biophysics, Rush University, Chicago, IL 60612, USA
| | - L Sharma
- Rush Center for Advanced Reproductive Care, Department of Obstetrics and Gynecology, Rush University Medical Center, Chicago, IL 60612, USA
| | - V V Cherny
- Department of Physiology & Biophysics, Rush University, Chicago, IL 60612, USA
| | - N Tidswell
- Rush Center for Advanced Reproductive Care, Department of Obstetrics and Gynecology, Rush University Medical Center, Chicago, IL 60612, USA
| | - M W Molo
- Rush Center for Advanced Reproductive Care, Department of Obstetrics and Gynecology, Rush University Medical Center, Chicago, IL 60612, USA
| | - T E DeCoursey
- Department of Physiology & Biophysics, Rush University, Chicago, IL 60612, USA
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Gonzalez-Pons M, Torres-Cintrón C, Soto-Salgado M, Morgan D, Cruz-Correa M. Abstract C054: Gastric cancer survival among Puerto Rican Hispanics: A ten-year population-based analysis. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp18-c054] [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] Open
Abstract
Abstract
Background: Gastric cancer (GC) is one of the top five diagnosed malignancies among U.S. Hispanics. In Puerto Rico during 2011-2015, GC was the 10th and 11th most diagnosed cancer among Puerto Rican Hispanic men and women, respectively. During the same period, GC was the 6th leading cause of cancer death in men and the 8th in women. Although the incidence of GC has decreased during the last two decades in all US racial/ethnic groups, the mortality associated with GC continues to be high and disproportionately affects Hispanics. The aim of this study was to determine and compare the overall five-year relative survival of Puerto Rican Hispanics (PRH) with GC during a ten-year period (2001-2005 and 2006-2010) to that of non-Hispanic Whites (NHW), non-Hispanic Blacks (NHB), and Hispanics living in the US.
Methods: Data were obtained from the Puerto Rico Central Cancer Registry. Primary cases with diagnostic confirmation of GC, malignancies arising primarily from the gastroesophageal junction to the pylorus, ICD-O-3 codes C16.0 to C16.9 with histologic confirmation (using ICD-O-3 codes) reported during the period of January 1, 2001 to December 31, 2010 were included in the survival analysis. Five-year relative survival rates were calculated using the incidence case files. Analyses were performed using Stata 13.0 and SEER*Stat Software version 8.3.5.
Results: For the periods of 2001-2005,2006-2010, and 2011-2015, the age-adjusted incidence rate for GC was 10.5 per 100,000 (n =1,893), 8.8 per 100,000 (n = 1,775), and 8.2 per 100,000 (n = 1,819), respectively. The overall five-year relative survival for 2001-2005 was 27.5% and 32.7% for 2006-2010. For the same study periods, when comparing overall adjusted 5-year relative survival among PRH to that of U.S. racial/ethnic groups, PRH had the lowest survival rates in localized and regional GC followed by U.S. non-Hispanic Blacks.
Conclusion: GC continues to be a common cancer among Hispanics despite the decrease in disease burden among other U.S. racial/ethnic groups. GC survival rates among PRH continue to be very low, and marked differences between racial/ethnic groups are observed in localized and regional gastric tumors, suggesting disparities in access to treatment. Studies evaluating the social, genetic, and/or environmental risk factors for GC are of utmost importance to establish health policy and to modify GC screening algorithms among Hispanic populations.
Citation Format: Maria Gonzalez-Pons, Carlos Torres-Cintrón, Marievelisse Soto-Salgado, Douglas Morgan, Marcia Cruz-Correa. Gastric cancer survival among Puerto Rican Hispanics: A ten-year population-based analysis [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C054.
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Schmidt P, Kamdar N, Swenson C, Uppal S, Morgan D. 06: Development of a preoperative prediction tool for postoperative complications after hysterectomy. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.12.029] [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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Uppal S, Tilea A, Morgan D, Pearlman M. 16: Bundled interventions and an institutional focus on infection prevention significantly reduces post-hysterectomy infectious morbidity. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.12.233] [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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Affiliation(s)
- Perica Davitkov
- Veterans Administration, Northeast Ohio Healthcare System, Celveland, OH, USA,Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Osama Altayar
- Division of Gastroenterology, Washington University School of Medicine, St Louis, MO, USA
| | - Shailja C. Shah
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andrew J. Gawron
- Salt Lake City Specialty Care Center of Innovation & Gastroenterology Section, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA,Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Reem A. Mustafa
- Division of Nephrology and Hypertension, University of Kansas Medical Center, Kansas City, KS, USA
| | - Douglas Morgan
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Douglas R Morgan
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
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Camargo MC, Kim KM, Matsuo K, Torres J, Liao LM, Morgan D, Michel A, Waterboer T, Song M, Gulley ML, Dominguez RL, Yatabe Y, Kim S, Cortes-Martinez G, Lissowska J, Zabaleta J, Pawlita M, Rabkin CS. Circulating Antibodies against Epstein-Barr Virus (EBV) and p53 in EBV-Positive and -Negative Gastric Cancer. Cancer Epidemiol Biomarkers Prev 2020; 29:414-419. [PMID: 31719065 PMCID: PMC8272980 DOI: 10.1158/1055-9965.epi-19-0790] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/01/2019] [Accepted: 11/04/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Epstein-Barr virus (EBV)-positive gastric cancers have clinicopathologic differences from EBV-negative tumors and lack TP53 mutation. Serologic profiles may inform viral contribution to carcinogenesis. METHODS We compared humoral responses of EBV-positive (n = 67) and EBV-negative (n = 137) patients with gastric cancer from the International EBV-Gastric Cancer Consortium. Serum antibodies against four EBV proteins, nuclear (EBNA), viral capsid (VCA), early-diffuse (EA-D), and Zta replication activator (ZEBRA), and to p53 were assessed by multiplex assays. OR of antibody level tertiles (T1-T3) were adjusted by logistic regression. We also conducted a meta-analysis of reported anti-p53 seropositivity in gastric cancer. RESULTS Consistent with EBV's ubiquity, 99% of patients were seropositive for anti-EBNA and 98% for anti-VCA, without difference by tumor EBV status. Seropositivity varied between patients with EBV-positive and EBV-negative tumors for anti-EA-D (97% vs. 67%, respectively, P < 0.001) and anti-ZEBRA (97% vs. 85%, respectively, P = 0.009). Adjusted ORs (vs. T1) for patients with EBV-positive versus EBV-negative tumors were significantly elevated for higher antibodies against EBNA (2.6 for T2 and 13 for T3), VCA (1.8 for T2 and 2.4 for T3), EA-D (6.0 for T2 and 44 for T3), and ZEBRA (4.6 for T2 and 12 for T3). Antibodies to p53 were inversely associated with EBV positivity (3% vs. 15%; adjusted OR = 0.16, P = 0.021). Anti-p53 prevalence from the literature was 15%. CONCLUSIONS These serologic patterns suggest viral reactivation in EBV-positive cancers and identify variation of p53 seropositivity by subtype. IMPACT Anti-EBV and anti-p53 antibodies are differentially associated with tumor EBV positivity. Serology may identify EBV-positive gastric cancer for targeted therapies.
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Affiliation(s)
- M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
| | - Kyoung-Mee Kim
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center, Nagoya, Japan
| | - Javier Torres
- Unidad de Investigación en Enfermedades Infecciosas, UMAE Pediatría, CMN SXXI, Instituto Mexicano del Seguro Social, México City, México
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Douglas Morgan
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, School of Medicine, Vanderbilt University, Nashville, Tennessee
- Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Angelika Michel
- Infections and Cancer Epidemiology, German Cancer Research Center (DFKZ), Heidelberg, Germany
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DFKZ), Heidelberg, Germany
| | - Minkyo Song
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Margaret L Gulley
- Department of Pathology and Laboratory Medicine and the Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Ricardo L Dominguez
- Department of Medicine, Western Regional Hospital, Santa Rosa de Copan, Honduras
| | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Sung Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gustavo Cortes-Martinez
- Servicio de Cirugía, Hospital de Oncología, CMN SXXI, Instituto Mexicano del Seguro Social, México City, México
| | - Jolanta Lissowska
- Division of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
| | - Jovanny Zabaleta
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Michael Pawlita
- Infections and Cancer Epidemiology, German Cancer Research Center (DFKZ), Heidelberg, Germany
| | - Charles S Rabkin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
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Altayar O, Davitkov P, Shah SC, Gawron AJ, Morgan D, Turner K, Mustafa RA. AGA Technical Review on Gastric Intestinal Metaplasia-Epidemiology and Risk Factors. Gastroenterology 2020; 158:732-744.e16. [PMID: 31816301 PMCID: PMC7425600 DOI: 10.1053/j.gastro.2019.12.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Osama Altayar
- Division of Gastroenterology, Washington University School of Medicine, St Louis, MO
| | - Perica Davitkov
- VA Northeast Ohio Healthcare System,Case Western Reserve University, Cleveland, OH, USA
| | - Shailja C. Shah
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andrew J. Gawron
- Salt Lake City Specialty Care Center of Innovation & Gastroenterology Section, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA,Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Douglas Morgan
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kevin Turner
- University of Texas Southwestern College of Medicine, Dallas, TX, USA.,Inform Diagnostics Research Institute, Irving, TX, USA
| | - Reem A. Mustafa
- Division of Nephrology and Hypertension, University of Kansas Medical Center, Kansas City, KS, USA
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19
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Affiliation(s)
- Shailja C Shah
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN
| | - Samir Gupta
- Department of Veterans Affairs San Diego Healthcare System, San Diego, CA; Division of Gastroenterology and the Moores Cancer Center, University of California San Diego, La Jolla, CA
| | - Dan Li
- Kaiser Permanente Northern California Division of Research, Oakland, CA
| | - Douglas Morgan
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN; Division of Gastroenterology and Hepatology, University of Alabama at Birmingham
| | - Reem A Mustafa
- Department of Internal Medicine, University of Kansas Medical Center, KS
| | - Andrew J Gawron
- Salt Lake City Specialty Care Center of Innovation & Gastroenterology Section, VA Salt Lake City Health Care System, Salt Lake City, UT
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20
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Winders WT, Ramos I, Sabillon W, Perez C, Estévez R, Norwood DA, Cardona JC, Dominguez RL, Morgan D. Traumatic injuries in rural Honduras: A two month pilot study. Am J Emerg Med 2019; 38:958-961. [PMID: 31839518 DOI: 10.1016/j.ajem.2019.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/03/2019] [Accepted: 12/08/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Trauma is a leading cause of morbidity and mortality worldwide, with a disproportionate burden of illness in low- and middle- income countries. This study sought to provide a proof-of-concept pilot study to evaluate the feasibility of a trauma registry in the Western Honduras Hospital. METHODS A cross-sectional, observation study was performed that included all admitted, transferred, or deceased trauma patients presenting to the Western Honduras Hospital from February 4, 2019 until April 4, 2019. Descriptive statistics were utilized to describe patient demographics and injury characteristics. RESULTS 268 patients were enrolled. The average age was 27.5 years (SD ±21.3). 10% of injuries were due to interpersonal violence. The most common mechanisms of injury were falls (33.6%) and motor vehicle collisions (MVCs) (22.4%). The mean Modified Kampala Trauma Score (M-KTS) was 12 (SD ±1.4). The mortality rate was 1.1% (N = 3). 94.5% of data points were complete. CONCLUSIONS A continuous injury surveillance system in the Western Honduras Hospital is feasible and provides valuable information. The data completeness was suboptimal, but the current data collection system may be improved via modifying and utilizing the registry form as both a clinical and data collection instrument.
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Affiliation(s)
- W Tyler Winders
- Department of Emergency Medicine, Medical University of South Carolina, United States of America.
| | - Isis Ramos
- Western Honduras Hospital, Santa Rosa de Copán, Honduras
| | | | - Celeny Perez
- Western Honduras Hospital, Santa Rosa de Copán, Honduras
| | - Rosa Estévez
- Western Honduras Hospital, Santa Rosa de Copán, Honduras
| | | | | | | | - Douglas Morgan
- Division of Gastroenterology, University of Alabama, United States of America.
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21
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Ford J, Steel N, Aasheim E, Devleesschauwer B, Gallay A, Morgan D, Schmidt J, Ziese T, Newton J. Slowing improvements in life expectancy across European Economic Area countries. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.160] [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] Open
Abstract
Abstract
Background
Life expectancy improvements have slowed down in several European countries since around 2011. The relative contributions from changes in specific conditions (e.g. cancers) and broader risk factors (e.g. smoking or austerity) remain unclear. We aimed to explore the different potential causes in 17 European Economic Area (EEA) countries.
Methods
We compared Global Burden of Disease (GBD) study estimates for life expectancy, years of life lost (YLLs) and population attributable fractions (PAFs) for risk factors, for 2005-2011 and 2011-2017 for 17 EEA countries. Three countries with the largest absolute improvements and three with the smallest were selected for analysis by gender, age, condition and risk factors.
Results
Norway, France and Belgium had the largest improvement in life expectancy (+1.5, +1.2 and +1.2 years respectively) from 2011 to 2017, and Germany, Iceland and the UK the smallest (+0.1, +0.2 and +0.2 years). Life expectancy reduced slightly for women aged over 80 in Germany and UK, men aged over 50 in Germany, and for men in all age groups up to 90 years in Iceland. Norway, France and Belgium saw faster improvements in YLLs from lung cancer and Norway and France for COPD in both men and women, and from self-harm in men, after 2011 than before. PAF for tobacco declined faster after 2011. Germany, Iceland and the UK saw slower improvements in cardiovascular disease and in Germany and the UK lung cancer. In Iceland, YLLs for cancers, self harm, respiratory disease, cirrhosis and dementia all worsened after 2011. PAF for tobacco remained high or declined less after 2011 in all 3 countries. PAFs for alcohol and drug use remained high in Iceland and UK.
Conclusions
Differential changes in major fatal diseases and risk factors help explain national changes in life expectancies, but national differences in data availability may affect results. Further research is needed into the ‘causes of the causes’, such as the 2008 economic crash in Iceland.
Key messages
Differential changes in major fatal diseases and risk factors help explain national changes in life expectancies. Norway, France and Belgium had the largest improvement in life expectancy from 2011 to 2017, and Germany, Iceland and the UK the smallest.
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Affiliation(s)
- J Ford
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - N Steel
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - E Aasheim
- Norwegian Directorate of Health, Ministry of Health and Care Services, Oslo, Norway
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - B Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - A Gallay
- Santé Publique France, Saint-Maurice, Paris, France
| | - D Morgan
- Health Statistics, OECD, Paris, France
| | - J Schmidt
- Public Health Data Science, Public Health England, London, UK
| | - T Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - J Newton
- Chief Knowledge Officer, Public Health England, London, UK
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22
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Joly-Amado A, Davtyan H, Serraneau K, Jules P, Zitnyar A, Pressman E, Zagorski K, Antonyan T, Hovakimyan A, Paek HJ, Gordon MN, Cribbs DH, Petrovsky N, Agadjanyan MG, Ghochikyan A, Morgan D. Active immunization with tau epitope in a mouse model of tauopathy induced strong antibody response together with improvement in short memory and pSer396-tau pathology. Neurobiol Dis 2019; 134:104636. [PMID: 31629891 DOI: 10.1016/j.nbd.2019.104636] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/30/2019] [Accepted: 10/07/2019] [Indexed: 12/16/2022] Open
Abstract
Abnormal tau hyperphosphorylation and its aggregation into neurofibrillary tangles are a hallmark of tauopathies, neurodegenerative disorders that include Alzheimer's disease (AD). Active and passive Tau-immunotherapy has been proposed as a therapeutic approach to AD with mixed results. One of the limitations of active immunotherapy may be associated with the mediocre immunogenicity of vaccines that are not inducing therapeutically potent titers of antibodies. The aim of this study was to test the efficacy of an anti-tau vaccine, AV-1980R/A composed of N terminal peptide of this molecule fused with an immunogenic MultiTEP platform and formulated in a strong adjuvant, AdvaxCpG in a Tg4510 mouse model of tauopathy. Experimental mice were immunized with AV-1980R/A and a control group of mice were injected with adjuvant only. Nontransgenic and tetracycline transactivator (tTA) transgenic littermates were included as baseline controls to contrast with the tau phenotype. Active immunization with AV-1980R/A induced very strong anti-tau humoral immune responses in both nontransgenic and transgenic mice with evidence of IgG in brains of AV-1980R/A vaccinated mice. These experimental animals displayed an improvement in short-term memory during a novel object recognition test. However, impairments in other behavioral tasks were not prevented by AV-1980R/A vaccinations. At the same time, high titers of anti-tau antibodies reduced hyperphosphorylated pSer396 tau but did not lower the level of other phosphorylated tau species in the brains of AV-1980R/A vaccinated mice. These data indicate that active immunotherapy with an N-terminal Tau epitope was only partially effective in improving cognition and reducing pathology in the stringent Tg4510 mouse model of tauopathy.
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Affiliation(s)
- A Joly-Amado
- USF Health Byrd Alzheimer's Institute, Tampa, FL 33613, USA.
| | - H Davtyan
- The Institute for Molecular Medicine, Huntington Beach, CA 92647, USA; Institute for Memory Impairments and Neurological Disorders, University of California Irvine, Irvine, CA 92697, USA
| | - K Serraneau
- USF Health Byrd Alzheimer's Institute, Tampa, FL 33613, USA
| | - P Jules
- USF Health Byrd Alzheimer's Institute, Tampa, FL 33613, USA
| | - A Zitnyar
- USF Health Byrd Alzheimer's Institute, Tampa, FL 33613, USA
| | - E Pressman
- USF Health Byrd Alzheimer's Institute, Tampa, FL 33613, USA
| | - K Zagorski
- The Institute for Molecular Medicine, Huntington Beach, CA 92647, USA
| | - T Antonyan
- The Institute for Molecular Medicine, Huntington Beach, CA 92647, USA
| | - A Hovakimyan
- The Institute for Molecular Medicine, Huntington Beach, CA 92647, USA
| | - H J Paek
- Molecular Pharmacology and Physiology, College of Medicine, University of South Florida, Tampa, FL, USA
| | - M N Gordon
- USF Health Byrd Alzheimer's Institute, Tampa, FL 33613, USA
| | - D H Cribbs
- Institute for Memory Impairments and Neurological Disorders, University of California Irvine, Irvine, CA 92697, USA
| | - N Petrovsky
- Flinders Med. Ctr., Bedford Park, Adelaide 5042, Australia
| | - M G Agadjanyan
- The Institute for Molecular Medicine, Huntington Beach, CA 92647, USA
| | - A Ghochikyan
- The Institute for Molecular Medicine, Huntington Beach, CA 92647, USA
| | - D Morgan
- USF Health Byrd Alzheimer's Institute, Tampa, FL 33613, USA
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23
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McLeod G, Finch C, Morgan D, Kountouris A, Fortington L. Medically treated cricket injuries in Victoria: a 15 year review of emergency department presentations and hospital admissions. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Oeser C, Aarons E, Heath P, Johnson K, Khalil A, Knight M, Lynn RM, Morgan D, Pebody R. Surveillance of congenital Zika syndrome in England and Wales: methods and results of laboratory, obstetric and paediatric surveillance. Epidemiol Infect 2019; 147:e262. [PMID: 31481135 PMCID: PMC6805733 DOI: 10.1017/s0950268819001535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 08/06/2019] [Indexed: 11/06/2022] Open
Abstract
The spread of the Zika virus (ZIKV) in the Americas led to large outbreaks across the region and most of the Southern hemisphere. Of greatest concern were complications following acute infection during pregnancy. At the beginning of the outbreak, the risk to unborn babies and their clinical presentation was unclear. This report describes the methods and results of the UK surveillance response to assess the risk of ZIKV to children born to returning travellers. Established surveillance systems operating within the UK - the paediatric and obstetric surveillance units for rare diseases, and national laboratory monitoring - enabled rapid assessment of this emerging public health threat. A combined total of 11 women experiencing adverse pregnancy outcomes after possible ZIKV exposure were reported by the three surveillance systems; five miscarriages, two intrauterine deaths and four children with clinical presentations potentially associated with ZIKV infection. Sixteen women were diagnosed with ZIKV during pregnancy in the UK. Amongst the offspring of these women, there was unequivocal laboratory evidence of infection in only one child. In the UK, the number and risk of congenital ZIKV infection for travellers returning from ZIKV-affected countries is very small.
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Affiliation(s)
- C. Oeser
- National Infection Service, Public Health England, London, UK
| | - E. Aarons
- Rare and Imported Pathogens Laboratory, Public Health England, Porton, Salisbury, UK
| | - P.T. Heath
- Institute of Infection and Immunity, St George's, University of London, London, UK
| | - K. Johnson
- Neonatal Service, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A. Khalil
- Obstetrics and Maternal-Fetal Medicine, St George's, University of London, London, UK
| | - M Knight
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - R. M. Lynn
- National Infection Service, Public Health England, London, UK
| | - D. Morgan
- National Infection Service, Public Health England, London, UK
| | - R. Pebody
- National Infection Service, Public Health England, London, UK
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25
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Abstract
PURPOSE In 1959, Maroteaux and Lamy initially designated pseudoachondroplasia as a distinct dysplasia different from achondroplasia the most common form of skeletal dysplasia. Pseudoachondroplasia is caused by a mutation in the collagen oligomeric matrix protein gene (COMP) gene on chromosome 19p13.1-p12 encoding the COMP. The COMP gene mutations result in rendering the articular and growth plate cartilages incapable of withstanding routine biomechanical loads with resultant deformity of the joints. The purpose of the study was to characterize the typical orthopaedic findings in pseudoachondroplasia. METHODS The charts and radiographs of 141 patients with pseudoachondroplasia were analyzed. This cohort, to our knowledge, represents the largest group of patients describing the typical orthopaedic manifestations of pseudoachondroplasia. RESULTS Patients with pseudoachondroplasia have normal craniofacial appearance with normal intelligence. Short stature is not present at birth and generally appears by two to four years of age. The condition is a form of spondyloepiphyseal dysplasia and the long bones are characterized by dysplastic changes in the epiphysis, metaphysis and vertebral bodies. Radiographically the long bones have altered the appearance and structure of the epiphyses with small irregularly formed or fragmented epiphyses or flattening. The metaphyseal regions of the long bones show flaring, widening or 'trumpeting'. The cervical (89%) and thoracic and lumbar vertebrae show either platyspondyly, ovoid, 'cod-fish' deformity or anterior 'beaking'. Kyphosis (28%), scoliosis (58%) and lumbar lordosis (100%) are commonly seen. The femoral head and acetabulum are severely dysplastic (100%). The knees show either genu valgum (22%), genu varum (56%) or 'windswept' deformity (22%). CONCLUSION Most commonly these distortions of the appendicular and the axial skeleton lead to premature arthritis particularly of the hips and often the knees not uncommonly in the 20- to 30-year-old age group. LEVEL OF EVIDENCE III.
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Affiliation(s)
- D. S. Weiner
- Department of Orthopaedics, Akron Children’s Hospital, Akron, Ohio, USA,Correspondence should be sent to D. S. Weiner, Department of Orthopaedics, Akron Children’s Hospital, 300 Locust Street, Ste. 250, Akron, OH 44302-1821, USA.
| | - J. Guirguis
- Department of Orthopaedics, Akron Children’s Hospital, Akron, Ohio, USA
| | - M. Makowski
- Department of Orthopaedics, Cleveland Clinic/Akron General, Akron, Ohio, USA
| | - S. Testa
- Rebecca D. Considine Research Institute/Akron Children’s Hospital, Akron, Ohio, USA
| | - L. Shauver
- Rebecca D. Considine Research Institute/Akron Children’s Hospital, Akron, Ohio, USA
| | - D. Morgan
- Rebecca D. Considine Research Institute/Akron Children’s Hospital, Akron, Ohio, USA
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26
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Shen C, Zhao YQ, Liu RB, Morgan D, Wei T. Enhancing wastewater remediation by drinking water treatment residual-augmented floating treatment wetlands. Sci Total Environ 2019; 673:230-236. [PMID: 30991314 DOI: 10.1016/j.scitotenv.2019.04.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 06/09/2023]
Abstract
In this study, the involvement of aluminum-based drinking water treatment residual (DWTR) as substrate in floating treatment wetland (FTW) to enhance its treatment performance was firstly proposed and trialed. A laboratory scale DWTR-FTW fed with synthetic wastewater containing COD, nitrogen (N), phosphorus (P) and mineral salts was operated in three stages of unplanted (1-30 days), planted (31-60 days) and aerated (61-135 days) modes. The results showed that the average removal rates of COD, total nitrogen (TN), total phosphorus (TP) in stage 3 were 88%, 85%, and 90.2%, respectively, indicating the outstanding purification performance of DWTR-FTW in comparison of traditional FTWs. The embedded DWTR enriches the biomass and robustly adsorbs P, while aeration supplies sufficient dissolved oxygen for the microorganism. The results revealed that 7.022 g P was accumulated in DWTR, which is 400 times higher than that in sediment and plants during the experimental period, reflecting that DWTR adsorption is the major P removal pathway in DWTR-FTW. Overall, DWTR-FTW could significantly remove pollutants, especially P, and provide an alternative pathway to enhance purification performance of FTW.
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Affiliation(s)
- C Shen
- UCD Dooge Centre for Water Resource Research, School of Civil Engineering, University College Dublin, Belfield, Dublin 4, Ireland; Key Laboratory of Subsurface Hydrology and Ecology in Arid Areas (Ministry of Education), School of Environmental Science and Engineering, Chang'an University, Xi'an 710064, Shaanxi, PR China
| | - Y Q Zhao
- UCD Dooge Centre for Water Resource Research, School of Civil Engineering, University College Dublin, Belfield, Dublin 4, Ireland; Key Laboratory of Subsurface Hydrology and Ecology in Arid Areas (Ministry of Education), School of Environmental Science and Engineering, Chang'an University, Xi'an 710064, Shaanxi, PR China; State Key Laboratory of Eco-Hydraulics in Northwest Arid Region of China, Xi'an University of Technology, Xi'an 710048, PR China.
| | - R B Liu
- UCD Dooge Centre for Water Resource Research, School of Civil Engineering, University College Dublin, Belfield, Dublin 4, Ireland
| | - D Morgan
- UCD Dooge Centre for Water Resource Research, School of Civil Engineering, University College Dublin, Belfield, Dublin 4, Ireland
| | - T Wei
- State Key Laboratory of Eco-Hydraulics in Northwest Arid Region of China, Xi'an University of Technology, Xi'an 710048, PR China
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27
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Almirall N, Wells PB, Ke H, Edmondson P, Morgan D, Yamamoto T, Odette GR. On the Elevated Temperature Thermal Stability of Nanoscale Mn-Ni-Si Precipitates Formed at Lower Temperature in Highly Irradiated Reactor Pressure Vessel Steels. Sci Rep 2019; 9:9587. [PMID: 31270423 PMCID: PMC6610118 DOI: 10.1038/s41598-019-45944-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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] [Received: 01/04/2019] [Accepted: 06/19/2019] [Indexed: 11/17/2022] Open
Abstract
Atom probe tomography (APT) and scanning transmission electron microscopy (STEM) techniques were used to probe the long-time thermal stability of nm-scale Mn-Ni-Si precipitates (MNSPs) formed in intermediate and high Ni reactor pressure vessel steels under high fluence neutron irradiation at ≈320 °C. Post irradiation annealing (PIA) at 425 °C for up to 57 weeks was used to determine if the MNSPs are: (a) non-equilibrium solute clusters formed and sustained by radiation induced segregation (RIS); or, (b) equilibrium G or Γ2 phases, that precipitate at accelerated rates due to radiation enhanced diffusion (RED). Note the latter is consistent with both thermodynamic models and x-ray diffraction (XRD) measurements. Both the experimental and an independently calibrated cluster dynamics (CD) model results show that the stability of the MNSPs is very sensitive to the alloy Ni and, to a lesser extent, Mn content. Thus, a small fraction of the largest MNSPs in the high Ni steel persist, and begin to coarsen at long times. These results suggest that the MNSPs remain a stable phase, even at 105 °C higher than they formed at, thus are most certainly equilibrium phases at much lower service relevant temperatures of ≈290 °C.
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Affiliation(s)
- N Almirall
- Materials Department, University of California, Santa Barbara, CA, 93106, USA
| | - P B Wells
- Materials Department, University of California, Santa Barbara, CA, 93106, USA.,Intel Corporation, Hillsboro, OR, 97124, USA
| | - H Ke
- Department of Materials Science and Engineering Department, University of Wisconsin, Madison, WI, 53706, USA.,Materials Science and Engineering Department, Ohio State University, Columbus, OH, 43210, USA
| | - P Edmondson
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - D Morgan
- Department of Materials Science and Engineering Department, University of Wisconsin, Madison, WI, 53706, USA
| | - T Yamamoto
- Materials Department, University of California, Santa Barbara, CA, 93106, USA
| | - G R Odette
- Materials Department, University of California, Santa Barbara, CA, 93106, USA.
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Akkach S, Shukla L, Morgan D. Everolimus-induced osteonecrosis of the jaw in the absence of bisphosphonates: a case report. Br J Oral Maxillofac Surg 2019; 57:688-690. [PMID: 31202510 DOI: 10.1016/j.bjoms.2019.05.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 12/11/2018] [Accepted: 05/28/2019] [Indexed: 11/19/2022]
Abstract
Osteonecrosis of the jaw (ONJ) is a rare, but severe, condition that has traditionally been associated with the use of bisphosphonates. We report what is, to our knowledge, the first case of ONJ secondary to the use of everolimus, in the absence of treatment with bisphosphonates in a 65-year-old man who was given it for immunosuppression after a renal transplant. After 18 months of treatment, he was diagnosed with severe ONJ and underwent radical debridement of the palate and complete dental clearance of the maxilla.
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Affiliation(s)
- S Akkach
- Faciomaxillary Unit, The Alfred, 55 Commercial Rd, Melbourne, Victoria, 3004, Australia.
| | - L Shukla
- Faciomaxillary Unit, The Alfred, 55 Commercial Rd, Melbourne, Victoria, 3004, Australia
| | - D Morgan
- Faciomaxillary Unit, The Alfred, 55 Commercial Rd, Melbourne, Victoria, 3004, Australia
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Diefenbach C, Hong F, Ambinder R, Cohen J, Robertson M, David K, Advani R, Fenske T, Barta S, Palmisano N, Svoboda J, Morgan D, Karmali R, Kahl B, Ansell S. EXTENDED FOLLOW-UP OF A PHASE I TRIAL OF IPILIMUMAB, NIVOLUMAB AND BRENTUXIMAB VEDOTIN IN RELAPSED HODGKIN LYMPHOMA: A TRIAL OF THE ECOG-ACRIN RESEARCH GROUP (E4412). Hematol Oncol 2019. [DOI: 10.1002/hon.83_2629] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- C.S. Diefenbach
- Hematology-Oncology; Perlmutter Cancer Center at NYU Langone Health; New York United States
| | - F. Hong
- ECOG-ACRIN Biostatistics Center; Dana Farber Cancer Institute; Boston United States
| | - R. Ambinder
- Sidney Kimmel Cancer Center; Johns Hopkins University; Baltimore MD United States
| | - J. Cohen
- Winship Cancer Institute; Emory University; Atlanta United States
| | - M. Robertson
- Hematology-Oncology; Indiana Unversity School of Medicine; Indianapolis United States
| | - K. David
- Hematology-Oncology; Rutgers Cancer Institute of New Jersey; New Brunswick United States
| | - R. Advani
- Oncology; Stanford Cancer Institute; San Francisco United States
| | - T. Fenske
- Hematology-Oncology; Froedtert and the Medical College of Wisconsin; Milwaukee United States
| | - S. Barta
- Abramson Cancer Center; University of Pennsylvania; Philadelphia United States
| | - N. Palmisano
- Hematology-Oncology; Thomas Jefferson University Hospital; Philadelphia United States
| | - J. Svoboda
- Abramson Cancer Center; University of Pennsylvania; Philadelphia United States
| | - D. Morgan
- Hematology-Oncology; Vanderbilt Ingram Henry Cancer Center; Nashville United States
| | - R. Karmali
- Feinberg School of Medicine; Northwestern University; Chicago United States
| | - B. Kahl
- Oncology; Washington University School of Medicine; St. Louis United States
| | - S. Ansell
- Hematology-Oncology; Mayo Clinic; Rochester United States
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Monakova J, Wong J, Blais I, Langan A, Ratansi N, Morgan D, Baxter NN. Establishing funding rates for colonoscopy and gastroscopy procedures in Ontario. ACTA ACUST UNITED AC 2019; 26:98-101. [PMID: 31043810 DOI: 10.3747/co.26.4405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction This paper describes the funding rates established in Ontario to reflect best practices in hospital-based care delivery for these endoscopic procedures: colonoscopy, colonoscopy biopsy, gastroscopy, gastroscopy biopsy, and colonoscopy combined with gastroscopy. Methods The funding rates are based on direct costs and were established using a micro-costing approach after receipt of inputs from 3 working groups and a review of the administrative data and literature, where applicable. The first group advised on nursing activities, time, and staffing ratios along the patient pathway for each of the procedures. The second group provided recommendations about the duration for each procedure, and the third group provided information about supplies and equipment, their use, and costs. Results The resulting funding rates are $161.18 for colonoscopy and $151.08 for gastroscopy (without accompanying interventions), $16.06 for colonoscopy biopsy and $8.22 for gastroscopy biopsy (added to the respective procedures), and $207.26 for combined colonoscopy and gastroscopy. Detailed costs for each component embedded in the rates are also provided. Conclusions The rates came into effect in April 2018. The process and outcomes described here allowed for a transparent pricing mechanism in which funding follows the patient, clinical expert consensus is the basis for practice, and providers and payers both understand the components.
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Affiliation(s)
| | - J Wong
- Cancer Care Ontario, Toronto, ON
| | - I Blais
- Cancer Care Ontario, Toronto, ON.,Ontario Medical Association, Toronto, ON.,Mastercard Foundation, Toronto, ON.,Service of Gastroenterology, St. Joseph's Hospital, and Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, ON.,Department of Surgery, Li Ka Shing Knowledge Institute, and Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - A Langan
- Ontario Medical Association, Toronto, ON
| | | | - D Morgan
- Service of Gastroenterology, St. Joseph's Hospital, and Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, ON
| | - N N Baxter
- Cancer Care Ontario, Toronto, ON.,Department of Surgery, Li Ka Shing Knowledge Institute, and Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
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Morgan D, Chorneyko K, Swain D, Bowes B, Lee V, Tinmouth J. A209 VALIDATION OF A NATURAL LANGUAGE PROCESSING ALGORITHM TO EXTRACT DATA FOR SYSTEM-LEVEL ADENOMA DETECTION RATE CALCULATION. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Morgan
- St. Joseph’s Healthcare, Hamilton, Hamilton, ON, Canada
| | - K Chorneyko
- Brantford General Hospital, Brantford, ON, Canada
| | - D Swain
- Cancer Care Ontario, Toronto, ON, Canada
| | - B Bowes
- Cancer Care Ontario, Toronto, ON, Canada
| | - V Lee
- Cancer Care Ontario, Toronto, ON, Canada
| | - J Tinmouth
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Khan K, Nehvi A, Khan M, Fergani H, Ganguli S, Jalali S, Morgan D, Spaziani R, Tsoi K, Armstrong D. A233 BASELINE BOWEL ROUTINE AND OTHER PREDICTORS OF BOWEL PREPARATION IN PATIENTS UNDERGOING OUT-PATIENT COLONOSCOPY; RESULTS FROM A PROSPECTIVE SINGLE-CENTRE STUDY. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Khan
- McMaster University, Hamilton, ON, Canada
| | - A Nehvi
- McMaster University, Hamilton, ON, Canada
| | - M Khan
- McMaster University, Hamilton, ON, Canada
| | - H Fergani
- McMaster University, Hamilton, ON, Canada
| | - S Ganguli
- McMaster University, Hamilton, ON, Canada
| | - S Jalali
- McMaster University, Hamilton, ON, Canada
| | - D Morgan
- McMaster University, Hamilton, ON, Canada
| | - R Spaziani
- McMaster University, Hamilton, ON, Canada
| | - K Tsoi
- McMaster University, Hamilton, ON, Canada
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O’connor C, Wilburn J, Walsh A, Morgan D. Epidemic intelligence activities during major international incidents involving emerging infections. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.284] [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: 10/27/2022] Open
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Danylyshen-Laycock T, Morgan D, Stewart N, O’Connell M, Goodridge D. THE IMPACT OF LEADERSHIP AND CULTURE ON SUSTAINABILITY OF A DEMENTIA TRAINING PROGRAM IN LONG-TERM CARE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2682] [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: 11/14/2022] Open
Affiliation(s)
| | - D Morgan
- Canadian Centre for Health & Safety in Agriculture
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Danylyshen-Laycock T, Morgan D, Stewart N, O’Connell M, Goodridge D. THE ROLE OF FACILITATION IN SUSTAINABILITY OF A DEMENTIA TRAINING PROGRAM IN RURAL LONG-TERM CARE HOMES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2683] [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: 11/14/2022] Open
Affiliation(s)
| | - D Morgan
- Canadian Centre for Health & Safety in Agriculture
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McLeod G, O’Conner S, Morgan D, Finch C, Fortington L. Injuries in organised community level cricket, how much do we know? A systematic review. J Sci Med Sport 2018. [DOI: 10.1016/j.jsams.2018.09.209] [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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Bacsu J, Viger M, Abonyi S, Jeffery B, Johnson S, Novik N, Morgan D. LONGER LIVES AND THE DETERMINANTS OF COGNITIVE HEALTH: RURAL OLDER ADULTS’ PERSPECTIVES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.928] [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: 11/13/2022] Open
Affiliation(s)
| | | | | | - B Jeffery
- Faculty of Social Work, University of Regina, Canada
| | - S Johnson
- Faculty of Kinesiology and Health Studies, University of Regina
| | - N Novik
- Faculty of Social Work, University of Regina
| | - D Morgan
- Canadian Centre for Health & Safety in Agriculture
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Kayamba V, Shibemba A, Zyambo K, Heimburger DC, Morgan D, Kelly P. HIV related hypochlorhydria does not appear to respond to anti-retroviral therapy in Zambian adults: a case control study. Pan Afr Med J 2018; 31:128. [PMID: 31037188 PMCID: PMC6462371 DOI: 10.11604/pamj.2018.31.128.11850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 06/16/2018] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Human Immunodeficiency Virus (HIV) infection is associated with hypochlorhydria but the mechanism is unknown. The objective of this study was to determine effects of anti-retroviral therapy (ART) on gastric physiology as measured by validated markers. METHODS We studied HIV infected individuals who were either ART-naïve or on treatment with undetectable viral loads. We measured H.pylori IgG antibodies, pepsinogen (PG) 1 and 2 levels and fasting gastrin-17 using Biohit GastroPanel®. Gastric antral biopsies and juice were obtained for histology and pH respectively. Also included were historical data from HIV negative participants (n = 72) in a previous study, for reference. RESULTS We enrolled 84 HIV positive individuals with a median age 42 years (IQR 37-40 years). 55(66%) were female, 32(38%) were ART naïve, and 52(62%) were on ART. Hypochlorhydria (pH>4) was present in 48(57%) of the HIV positive and 18(25%) of the HIV negative individuals (OR 4: 95% CI 1.9-8.5, P<0.001) with no significant effect of ART (OR 0.9: 95% CI 0.3-2.3, P = 0.82). Hypochlorhydria was not associated with the serological detection of corpus atrophy using low PG 1:2 ratio (OR 2.1: 95% CI 0.5-10.2, P = 0.37) or GastroPanel® algorithm, (OR 0.7: 95% CI 0.01-60.1, P = 1.0). ART reduced the frequency of low PG 1:2 ratio (P = 0.001), but not the histological detection in the antrum of atrophy or non-atrophic gastritis. CONCLUSION ART use is associated with reduced serological evidence of corpus atrophy but has no effect on fasting pH, supporting earlier data that suggest that the mechanism of HIV-associated hypochlorhydria is multifactorial.
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Affiliation(s)
- Violet Kayamba
- Tropical Gastroenterology & Nutrition Group, Department of Internal Medicine, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Aaron Shibemba
- Cancer Diseases Hospital, Pathology section, Nationalist Road, Lusaka, Zambia
| | - Kanekwa Zyambo
- Tropical Gastroenterology & Nutrition Group, Department of Internal Medicine, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
| | - Douglas Corbett Heimburger
- Vanderbilt Institute of Global Health, Vanderbilt Medical Center, 2525 West End Avenue, Suite 750, Nashville, 37203, Tennessee, USA
| | - Douglas Morgan
- Vanderbilt Institute of Global Health, Vanderbilt Medical Center, 2525 West End Avenue, Suite 750, Nashville, 37203, Tennessee, USA
| | - Paul Kelly
- Tropical Gastroenterology & Nutrition Group, Department of Internal Medicine, University of Zambia School of Medicine, Nationalist Road, Lusaka, Zambia
- Blizard Institute, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London E1 2AT, UK
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O’Connell M, Scerbe A, Wiley K, Gould B, Carter J, Bourassa C, Morgan D, Jacklin K, Warry W. Anticipated needs and worries about maintaining independence of rural/remote older adults: Opportunities for technology development in the context of the double digital divide. ACTA ACUST UNITED AC 2018. [DOI: 10.4017/gt.2018.17.3.001.00] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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BUBU OM, Andrade A, Hogan MM, Umasabor-Bubu OQ, Mukhtar F, Sharma RA, Miller M, Mbah A, Borenstein A, Mortimer J, Kip K, Morgan D, Jean-Louis G, Osorio R. 0737 Obstructive Sleep Apnea: A Distinct Physiological Phenotypic Risk Factor in older adults with Cognitive decline and Alzheimer’s disease. Sleep 2018. [DOI: 10.1093/sleep/zsy061.736] [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: 11/13/2022] Open
Affiliation(s)
- O M BUBU
- University of South Florida, Tampa, FL
- Wheaton College, Wheaton, IL
| | | | | | | | - F Mukhtar
- University of South Florida, Tampa, FL
| | | | - M Miller
- New York University, New York, NY
| | - A Mbah
- University of South Florida, Tampa, FL
| | | | | | - K Kip
- University of South Florida, Tampa, FL
| | - D Morgan
- University of South Florida, Tampa, FL
- Byrd Alzheimer’s Institute, Tampa, FL
- Michigan State University, East Lansing, MI
| | | | - R Osorio
- New York University, New York, NY
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BUBU OM, Umasabor-Bubu OQ, Sharma RA, Mukhtar F, Smith AH, Mbah A, Borenstein A, Mortimer J, Seixas A, Jean-Louis G, Kip K, Morgan D, Varga A, Osorio R. 1007 Obstructive Sleep Apnea (OSA) Is Associated with Longitudinal Increases in Brain Florbetapir PET Imaging, CSF TAU, PTAU, And Decrease in CSF AB42 burden, In Elderly Cognitive Normal (NL) And Mild Cognitive Impairment (MCI) Individuals. Sleep 2018. [DOI: 10.1093/sleep/zsy061.1006] [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: 11/13/2022] Open
Affiliation(s)
- O M BUBU
- University of South Florida, Tampa, FL
- Wheaton College, Wheaton, IL
| | | | | | - F Mukhtar
- University of South Florida, Tampa, FL
| | | | - A Mbah
- University of South Florida, Tampa, FL
| | | | | | - A Seixas
- New York University, New York, NY
| | | | - K Kip
- University of South Florida, Tampa, FL
| | - D Morgan
- University of South Florida, Tampa, FL
- Byrd Alzheimer’s Institute, Tampa, FL
- Michigan State University, East Lansing, MI
| | - A Varga
- New York University, New York, NY
| | - R Osorio
- New York University, New York, NY
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Khan K, Merali A, Forbes N, Fergani H, Ganguli S, Jalali S, Spaziani R, Tsoi K, Morgan D. A237 COLONOSCOPY PREPARATION OPTIMIZATION FOR INPATIENTS (COIN STUDY). A RANDOMIZED CONTROLLED TRIAL COMPARING 4L PEGLYTE TO REGULAR DOSE PICO SALAX AND SPLIT DOSE PICO SALAX FOR COLONOSCOPY BOWEL PREPARATION IN HOSPITALIZED PATIENTS. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Khan
- McMaster University, Hamilton, ON, Canada
| | - A Merali
- McMaster University, Hamilton, ON, Canada
| | - N Forbes
- McMaster University, Hamilton, ON, Canada
| | - H Fergani
- McMaster University, Hamilton, ON, Canada
| | - S Ganguli
- McMaster University, Hamilton, ON, Canada
| | - S Jalali
- McMaster University, Hamilton, ON, Canada
| | - R Spaziani
- McMaster University, Hamilton, ON, Canada
| | - K Tsoi
- McMaster University, Hamilton, ON, Canada
| | - D Morgan
- McMaster University, Hamilton, ON, Canada
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Khan K, KABIR W, Fergani H, Ganguli S, Jalali S, Spaziani R, Morgan D, Tsoi K. A235 EXPLORING PATIENT FACTORS FOR CANCELLED OR MISSED APPOINTMENTS TO AN URGENT GASTROENTEROLOGY OUTPATIENT CLINIC. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Khan
- McMaster University, Hamilton, ON, Canada
| | - W KABIR
- McMaster University, Hamilton, ON, Canada
| | - H Fergani
- McMaster University, Hamilton, ON, Canada
| | - S Ganguli
- McMaster University, Hamilton, ON, Canada
| | - S Jalali
- McMaster University, Hamilton, ON, Canada
| | - R Spaziani
- McMaster University, Hamilton, ON, Canada
| | - D Morgan
- McMaster University, Hamilton, ON, Canada
| | - K Tsoi
- McMaster University, Hamilton, ON, Canada
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Khan K, KABIR W, Fergani H, Ganguli S, Jalali S, Spaziani R, Tsoi K, Morgan D. A236 UTILIZATION OF AN URGENT GASTROENTEROLOGY CLINIC FOR PATIENTS SEEN IN THE EMERGENCY ROOM OR URGENT CARE CENTRE. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Khan
- McMaster University, Hamilton, ON, Canada
| | - W KABIR
- McMaster University, Hamilton, ON, Canada
| | - H Fergani
- McMaster University, Hamilton, ON, Canada
| | - S Ganguli
- McMaster University, Hamilton, ON, Canada
| | - S Jalali
- McMaster University, Hamilton, ON, Canada
| | - R Spaziani
- McMaster University, Hamilton, ON, Canada
| | - K Tsoi
- McMaster University, Hamilton, ON, Canada
| | - D Morgan
- McMaster University, Hamilton, ON, Canada
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Davies H, Leslie G, Morgan D, Dobb G. Fluid balance and body weight in patients requiring continuous renal replacement therapy. Aust Crit Care 2018. [DOI: 10.1016/j.aucc.2017.12.077] [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] Open
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English E, Bell S, Kamdar N, Swenson C, Wiese H, Rothman E, Morgan D. 07: Estimated blood loss as a predictor of morbidity following benign hysterectomy. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Swenson C, Seiler K, Kamdar N, Morgan D. 08: Prevalence of new persistent opioid use among opioid naive women undergoing hysterectomy. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.192] [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: 11/29/2022]
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Kucia M, Morgan D, Suresh S, Kobernik E, Swenson C. 76: Prevalence of cranberry use and compliance with recommendations for use among women undergoing urogynecologic surgery. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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González‐Pons M, Soto‐Salgado M, Sevilla J, Márquez‐Lespier JM, Morgan D, Pérez CM, Cruz‐Correa M. Seroprevalence of Helicobacter pylori in Hispanics living in Puerto Rico: A population-based study. Helicobacter 2018; 23:e12453. [PMID: 29210527 PMCID: PMC5814898 DOI: 10.1111/hel.12453] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Indexed: 12/13/2022]
Abstract
BACKGROUND Helicobacter pylori is an important etiologic factor for peptic ulcers and gastric cancer, one of the top ten leading causes of cancer death in Puerto Rico. However, the prevalence of H. pylori infections in this population was previously unknown. The aim of this study was to examine the seroprevalence of H. pylori and its associated risk factors in Puerto Rico. MATERIALS AND METHODS A cross-sectional study was designed using an existing population-based biorepository. Seropositivity was determined using the Premier™ H. pylori immunoassay. Helicobacter pylori seroprevalence was estimated with 95% confidence using marginal standardization following logistic regression. To assess the risk factors associated with H. pylori seropositivity, a multivariable log-binomial model was fitted to estimate the prevalence ratio (PR) and its 95% confidence interval (95% CI). RESULTS A total of 528 population-based serum samples were analyzed. The mean age of the study population was 41 ± 12 years, of whom 55.3% were females. The overall seroprevalence of H. pylori was 33.0% (95% CI = 28.3%-38.1%). Increasing age and having <12 years of education were significantly (P < .05) associated with H. pylori seropositivity in the multivariable model; however, residing in counties with low population density reached marginal significance (P = .085). CONCLUSIONS We report that H. pylori infection is common among Hispanics living in Puerto Rico. The H. pylori seroprevalence observed in Puerto Rico is similar to the seroprevalence reported in the overall population of the United States. The association between H. pylori seroprevalence and the risk factors analyzed offers insight into the epidemiology of gastric cancer in Puerto Rico and warrants further investigation.
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Affiliation(s)
- María González‐Pons
- University of Puerto Rico Comprehensive Cancer CenterSan JuanPuerto Rico,University of Puerto Rico Medical Sciences CampusSan JuanPuerto Rico
| | | | - Javier Sevilla
- University of Puerto Rico Rio Piedras CampusSan JuanPuerto Rico
| | | | | | - Cynthia M. Pérez
- University of Puerto Rico Medical Sciences CampusSan JuanPuerto Rico
| | - Marcia Cruz‐Correa
- University of Puerto Rico Comprehensive Cancer CenterSan JuanPuerto Rico,University of Puerto Rico Medical Sciences CampusSan JuanPuerto Rico
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Shamoon S, Kotwal R, Iorwerth A, Morgan D. Distal Biceps Tendon Rupture Imaging, A Study to Compare the Use of USS Vs. MRI Scan as First Choice of Investigation. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.443] [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: 10/18/2022]
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