1
|
Michalski JM, Moughan J, Purdy JA, Bruner DW, Amin M, Bahary JP, Lau H, Duclos M, Yee D, Morton G, Dess RT, Doncals DE, Lock MI, Lukka H, Baumann BC, Vigneault E, Kwok Y, Robertson J, Schwartz DL, Sandler HM. Long-Term Outcomes of NRG/RTOG 0126, a Randomized Trial of High Dose (79.2 Gy) vs. Standard Dose (70.2 Gy) Radiation Therapy (RT) for Men with Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:S4-S5. [PMID: 37784491 DOI: 10.1016/j.ijrobp.2023.06.210] [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) NRG/RTOG 0126, a phase III trial for men with localized prostate cancer testing whether dose escalation to 79.2 Gy with 3DCRT/IMRT improved overall survival (OS). Long-term results of this trial are presented. MATERIALS/METHODS Patients with clinical stage T1b-T2b and either Gleason Score (GS) 2-6 and 10 ≤ PSA < 20 or GS 7 and PSA < 15 were eligible and randomized to receive 79.2 Gy or 70.2 Gy. No previous or concurrent androgen withdrawal therapy was administered. Treatment was delivered with 3DCRT/IMRT to a dose of 79.2 Gy in 44 fractions or 70.2 Gy in 39 fractions to the PTV encompassing the prostate and seminal vesicles. Image guidance was not required. ASTRO and Phoenix definitions were used for biochemical failure (ABF and PBF, respectively). OS was estimated by the Kaplan-Meier method and arms compared with the log-rank test. ABF, PBF, local progression (LP), distant metastases (DM) and time to late GI/GU toxicities were estimated by the cumulative incidence method and arms compared with Gray's test. RESULTS One thousand five hundred thirty-two men were randomized, 763 to 79.2 Gy and 769 to 70.2 Gy. 1499 were eligible, 748 and 751 in the 79.2 Gy and 70.2 Gy arms respectively. Median age was 71, 70% had PSA < 10 ng/ml, 84% with GS 7, 57% had T1 disease, and 66% treated with 3D-CRT. Outcomes are shown in the TABLE: . With a median follow up of 12 years, there was no significant difference in OS. There was a statistically significant decrease in the cumulative incidence of ABF, PBF, DM, LP, and salvage therapies in the 79.2 Gy arm. There were significantly higher rates of grade 2+ GI and GU toxicity in the 79.2 Gy arm. There were no statistically significant differences in the rates of grade 3+ GU or GI toxicity between either arm. CONCLUSION Long term follow up confirms no improvement in OS with dose escalation in this study population. However, there are significant improvements in ABF, PBF, DM, LP, and need for salvage therapy. Despite the use of more salvage therapy in the low dose arm, dose escalated RT resulted in lower rates of DM, a clinically relevant endpoint. Patients receiving dose escalation do experience a higher rate of grade 2+ GU and GI toxicity but no worse grade 3+ toxicities.
Collapse
Affiliation(s)
- J M Michalski
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO
| | - J Moughan
- NRG Oncology Statistics and Data Management Center/ACR, Philadelphia, PA
| | | | | | - M Amin
- University of Tennessee Health Science Center, Memphis, TN
| | - J P Bahary
- Centre Hospitalier de l'Université de Montreal, Montreal, QC, Canada
| | - H Lau
- University of Calgary, Calgary, AB, Canada
| | - M Duclos
- McGill University Health Centre, Division of Radiation Oncology, Montreal, QC, Canada
| | - D Yee
- Cross Cancer Institute, Edmonton, AB, Canada
| | - G Morton
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - R T Dess
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | | | - M I Lock
- London Health Sciences Centre, London, ON, Canada
| | - H Lukka
- Juravinski Cancer Centre, Hamilton, ON, Canada
| | - B C Baumann
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - E Vigneault
- CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ), Québec, QC, Canada
| | - Y Kwok
- Department of Radiation Oncology, University of Maryland Proton Treatment Center, Baltimore, MD
| | - J Robertson
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI
| | | | - H M Sandler
- Cedars-Sinai Medical Center, Los Angeles, CA
| |
Collapse
|
2
|
Wu CHD, Wierzbicki M, Parpia S, Kundapur V, Bujold A, Filion EJ, Lau H, Faria S, Ahmed N, Leong N, Okawara G, Hirmiz KJ, Owen TE, Louie AV, Wright J, Whelan TJ, Swaminath A. Long-Term Toxicity in Patients Receiving Radiotherapy for Ultracentral Stage I Non-Small Cell Lung Cancer - A Secondary Analysis of the LUSTRE Randomized Trial. Int J Radiat Oncol Biol Phys 2023; 117:S171. [PMID: 37784427 DOI: 10.1016/j.ijrobp.2023.06.636] [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) Hypofractionated and stereotactic body radiotherapy (SBRT) are increasingly used in the treatment of centrally located, early-stage non-small cell lung cancer (NSCLC), though there are concerns of increased morbidity and mortality in patients with ultracentral tumors (UC). We report on the long-term toxicity of patients with UC lung cancer treated on a prospective randomized clinical trial of SBRT versus conventionally hypofractionated radiotherapy (CRT) for stage I NSCLC (NCT01968941). MATERIALS/METHODS Patients with UC tumors, defined as those where the planning target volume directly overlaps with the proximal bronchial tree (PBT), were identified from the larger cohort of patients treated on the trial. These patients received either SBRT with 60 Gy in 8 fractions or CRT with 60 Gy in 15 fractions. The primary endpoint of this secondary analysis was development of any grade 3 or higher toxicity defined using CTCAE version 3.0. Secondary endpoints included local control, as well as dosimetric analysis of the PBT, using EQD2 with α/β ratio of 3 to assess the relationship between dose to the PBT and toxicity. RESULTS Twenty-nine patients were identified with UC tumors; 21 received SBRT and 8 received CRT. Median age was 72 years (range 55-88 years) and 59% were female. Median FEV1 was 1.46L (range 0.64-2.37L). Patients had either T1 (59%) or T2 (41%) lesions, with median tumor size 2.5cm (range 1.1-4.9cm). Most patients had histologically confirmed disease (squamous cell, n = 10; adenocarcinoma, n = 8; radiographically suspicious, n = 11). The median follow-up was 2.9 years (range 0.7-5.2 years). The 3-year local control rate of all patients was 88.3% (95% confidence interval: 75.7-100%). There were 3 patients with late (>3 months) grade 3 toxicity (bronchial stricture, chest pain, and atelectasis) and 1 patient with late grade 5 toxicity (bleeding/hemorrhage), all treated in the SBRT arm. Median EQD2 dose to PBT in patients with grade ≥3 late toxicity compared to the rest of the cohort was: Dmax, 132 vs 129 Gy; D0.1cc, 129 vs 119 Gy; D1cc, 124 vs 80 Gy; and D5cc, 83 vs 41 Gy. Median EQD2 volumetric doses in grade ≥3 patients (compared to the rest) to PBT were: V65 Gy, 9.7 vs 2.2cc; V80 Gy, 7.9 vs 1.1cc; V90 Gy, 6.2 vs 0.4cc; and V100 Gy, 4.8 vs 0.3cc. The single patient with grade 5 toxicity had the highest D5cc (116 Gy) and V100 Gy (7cc) among all patients. CONCLUSION Stereotactic radiation with 60 Gy in 8 fractions for UC lung cancer provides good local control but carries an approximately 15-20% rate of late grade ≥3 toxicity. There appears to be a dosimetric association between toxicity and dose to the PBT. It may be more important to minimize volumetric PBT dose rather than maximum point dose to reduce risk of severe late toxicity.
Collapse
Affiliation(s)
- C H D Wu
- BC Cancer Agency, Victoria, BC, Canada
| | - M Wierzbicki
- Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada
| | - S Parpia
- Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada
| | - V Kundapur
- Saskatoon Cancer Centre, Saskatoon, SK, Canada
| | - A Bujold
- Hopital Maisonneuve-Rosemont, Universite de Montreal, Montreal, QC, Canada
| | - E J Filion
- Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - H Lau
- University of Calgary, Calgary, AB, Canada
| | - S Faria
- McGill University Health Center, Montreal, QC, Canada
| | - N Ahmed
- Department of Radiation Oncology, Cancer Care Manitoba, Winnipeg, MB, Canada
| | - N Leong
- Allan Blair Cancer Centre, Regina, SK, Canada
| | - G Okawara
- Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada
| | - K J Hirmiz
- Windsor Regional Hospital Cancer Program, Windsor, ON, Canada
| | - T E Owen
- Cancer Centre of Southeastern Ontario, Kingston, ON, Canada
| | - A V Louie
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - J Wright
- Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada
| | - T J Whelan
- Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada
| | - A Swaminath
- Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
3
|
Fuchs M, Viel C, Lehto A, Lau H, Klein J. Oxidative stress in rat brain during experimental status epilepticus: effect of antioxidants. Front Pharmacol 2023; 14:1233184. [PMID: 37767398 PMCID: PMC10520702 DOI: 10.3389/fphar.2023.1233184] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Antioxidants have been proposed as a treatment for diseases of the central nervous system. However, few studies actually studied their effects in the brain. To test central actions of antioxidants, we used the lithium-pilocarpine (Li-Pilo) model of status epilepticus (SE) in the rat in which seizures are accompanied by significant oxidative stress. We used in vivo microdialysis to determine isoprostane levels during SE in real time and brain homogenates for other measures of oxidative stress. Six different antioxidants were tested in acute and preventive experiments (vitamin C, vitamin E, ebselen, resveratrol, n-tert-butyl-α-phenylnitrone and coenzyme Q10). None of the antioxidants had an effect when given acutely during SE. In contrast, when antioxidants were given for 3 days prior to seizure induction, vitamins C and E reduced isoprostane formation by 58% and 65%, respectively. Pretreatment with the other antioxidants was ineffective. In brain homogenates prepared after 90 min of seizures, SE decreased the ratio of reduced vs. oxidized glutathione (GSH/GSSG ratio) from 60.8 to 7.50 and caused a twofold increase of 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels and protein carbonyls. Pretreatment with vitamin C or vitamin E mitigated these effects and increased the GSH/GSSG ratio to 23.9 and 28.3, respectively. Again, the other antioxidants were not effective. We conclude that preventive treatment with vitamin C or vitamin E ameliorates seizure-induced oxidative damage in the brain. Several well-studied antioxidants were inactive, possibly due to limited brain permeability or a lack of chain-breaking antioxidant activity in hydrophilic compounds.
Collapse
Affiliation(s)
| | | | | | | | - Jochen Klein
- Institute of Pharmacology and Clinical Pharmacy, College of Pharmacy, Goethe University, Frankfurt am Main, Germany
| |
Collapse
|
4
|
Swaminath A, Parpia S, Wierzbicki M, Kundapur V, Faria S, Okawara G, Tsakiridis T, Ahmed N, Bujold A, Hirmiz K, Owen T, Leong N, Ramchandar K, Filion E, Lau H, Louie A, Quan K, Levine M, Wright J, Whelan T. LUSTRE: A Phase III Randomized Trial of Stereotactic Body Radiotherapy (SBRT) vs. Conventionally Hypofractionated Radiotherapy (CRT) for Medically Inoperable Stage I Non-Small Cell Lung Cancer (NSCLC). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.09.009] [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: 11/16/2022]
|
5
|
McDonald A, DeMora L, Lenzie A, Hoyle J, Yang E, Michalski J, Parliament M, Bahary J, Hurwitz M, III M, Spratt D, Mishra M, Valicenti R, Lau H, Souhami L, Mendez L, Chen Y, Doncals D, Feng F, Sandler H. Body Composition and Risk of All-Cause Mortality in Men Treated With Radiation Therapy for Prostate Cancer: A Pooled Analysis of NRG/RTOG 9406 and NRG/RTOG 0126. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.911] [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]
|
6
|
Garden A, Harris J, Eisbruch A, Chao K, Morrison W, Harari P, Swanson T, Jones C, Yom S, Spencer S, Scrimger R, Shenouda G, Shukla M, Lau H, Mierzwa M, Torres-Saavedra P, Le Q. Final Report of NRG Oncology RTOG 0022: A Phase I/II Study of Conformal and Intensity Modulated Radiation for Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.322] [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: 10/20/2022]
|
7
|
Thinnes A, Westenberger M, Piechotta C, Lehto A, Wirth F, Lau H, Klein J. Cholinergic and metabolic effects of metformin in mouse brain. Brain Res Bull 2021; 170:211-217. [PMID: 33617923 DOI: 10.1016/j.brainresbull.2021.02.018] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/05/2021] [Accepted: 02/16/2021] [Indexed: 01/11/2023]
Abstract
Metformin is widely used as a first-line treatment for type 2 diabetes, but central effects of metformin have received little attention. When metformin (200 mg/kg i.p.) was administered to C57Bl6 mice, metformin concentration in cerebrospinal fluid peaked at 29 μM after 30 min but dropped quickly and was low at 90 min. In mouse hypothalamus sampled by microdialysis, systemically administered metformin caused minor and transient increases of acetylcholine, glucose and lactate while choline levels decreased. When metformin (0.2-10 mM) was locally infused via retrodialysis, there was a short-lasting increase of acetylcholine in the hypothalamus. Extracellular lactate levels in hypothalamus showed a massive increase upon metformin infusion while glucose levels decreased. In isolated mitochondria of mouse brain, metformin inhibited oxygen consumption and the activity of complex I. Inhibition of mitochondrial respiration likely explains lactate formation in the brain during metformin infusion which may cause lactic acidosis during metformin intoxication. The changes of cholinergic activity in the hypothalamus may be associated with appetite suppression observed during metformin treatment.
Collapse
Affiliation(s)
- Anna Thinnes
- Department of Pharmacology and Clinical Pharmacy, College of Pharmacy, Goethe University of Frankfurt, 60438, Frankfurt, Germany
| | - Mara Westenberger
- Department of Pharmacology and Clinical Pharmacy, College of Pharmacy, Goethe University of Frankfurt, 60438, Frankfurt, Germany
| | - Christian Piechotta
- Bundesanstalt für Materialforschung und -prüfung (BAM), 12200, Berlin, Germany
| | - Alina Lehto
- Department of Pharmacology and Clinical Pharmacy, College of Pharmacy, Goethe University of Frankfurt, 60438, Frankfurt, Germany
| | - Franziska Wirth
- Department of Pharmacology and Clinical Pharmacy, College of Pharmacy, Goethe University of Frankfurt, 60438, Frankfurt, Germany
| | - Helene Lau
- Department of Pharmacology and Clinical Pharmacy, College of Pharmacy, Goethe University of Frankfurt, 60438, Frankfurt, Germany
| | - Jochen Klein
- Department of Pharmacology and Clinical Pharmacy, College of Pharmacy, Goethe University of Frankfurt, 60438, Frankfurt, Germany.
| |
Collapse
|
8
|
Lau H, Khosrawipour T, Kocbach P, Ichii H, Bania J, Khosrawipour V. Evaluating the massive underreporting and undertesting of COVID-19 cases in multiple global epicenters. Pulmonology 2020; 27:110-115. [PMID: 32540223 PMCID: PMC7275155 DOI: 10.1016/j.pulmoe.2020.05.015] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/16/2020] [Accepted: 05/25/2020] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND With continuous global COVID-19 outbreak, differing case numbers and mortality rates are observed. While actual case numbers appear vague, mortality numbers related to COVID-19 seem more precise. In this study, we used the mortality rate as the main indicator to evaluate the extent of underreporting and underdetection of COVID-19 cases. METHODS We have analyzed all available data provided by the World Health Organization on the development of international COVID-19 cases and mortality numbers on March 17th, 2020. A crude case-fatality risk (cCFR) and adjusted case-fatality risk (aCFR) was calculated for China, South Korea, Japan, Italy, France, Spain, Germany, Iran and the United States. Additionally, a fold-change (FC) was derived for each country. RESULTS The highest aCFR and FC were detected for Spain. Based on their FC values, an extremely high number of undetected COVID-19 cases was displayed in France, the United States, Italy and Spain. For these countries, our findings indicate a detection rate of only 1-2% of total actual COVID-19 cases. CONCLUSIONS Due to limited testing capacities, mortality numbers may serve as a better indicator for COVID-19 case spread in many countries. Our data indicate that countries like France, Italy, the United States, Iran and Spain have extremely high numbers of undetected and underreported cases. Differences in testing availability and capacity, containment as well as overall health care and medical infrastructure result in significantly different mortality rates and COVID-19 case numbers for each respective country.
Collapse
Affiliation(s)
- H Lau
- Department of Surgery, University of California Irvine, Orange, CA 92868, USA
| | - T Khosrawipour
- Department of Surgery, University of California Irvine, Orange, CA 92868, USA; Department of Surgery (A), University-Hospital Düsseldorf, Heinrich-Heine University, 40225 Düsseldorf, Germany.
| | - P Kocbach
- Division of Infectious diseases, University of Warmia and Mazury, 10-561 Olszytn, Poland
| | - H Ichii
- Department of Surgery, University of California Irvine, Orange, CA 92868, USA
| | - J Bania
- Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
| | - V Khosrawipour
- Department of Surgery, University of California Irvine, Orange, CA 92868, USA; Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
| |
Collapse
|
9
|
Stolyarova A, Rakhshan M, Hart EE, O'Dell TJ, Peters MAK, Lau H, Soltani A, Izquierdo A. Contributions of anterior cingulate cortex and basolateral amygdala to decision confidence and learning under uncertainty. Nat Commun 2019; 10:4704. [PMID: 31624264 PMCID: PMC6797780 DOI: 10.1038/s41467-019-12725-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 09/23/2019] [Indexed: 12/20/2022] Open
Abstract
The subjective sense of certainty, or confidence, in ambiguous sensory cues can alter the interpretation of reward feedback and facilitate learning. We trained rats to report the orientation of ambiguous visual stimuli according to a spatial stimulus-response rule that must be learned. Following choice, rats could wait a self-timed delay for reward or initiate a new trial. Waiting times increase with discrimination accuracy, demonstrating that this measure can be used as a proxy for confidence. Chemogenetic silencing of BLA shortens waiting times overall whereas ACC inhibition renders waiting times insensitive to confidence-modulating attributes of visual stimuli, suggesting contribution of ACC but not BLA to confidence computations. Subsequent reversal learning is enhanced by confidence. Both ACC and BLA inhibition block this enhancement but via differential adjustments in learning strategies and consistent use of learned rules. Altogether, we demonstrate dissociable roles for ACC and BLA in transmitting confidence and learning under uncertainty.
Collapse
Affiliation(s)
- A Stolyarova
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - M Rakhshan
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, 03755, USA
| | - E E Hart
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - T J O'Dell
- Department of Physiology, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- The Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - M A K Peters
- Department of Bioengineering, University of California, Riverside, Riverside, CA, 92521, USA
- Department of Psychology, University of California, Riverside, Riverside, CA, 92521, USA
- Interdepartmental Graduate Program in Neuroscience, University of California, Riverside, Riverside, CA, 92521, USA
| | - H Lau
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- The Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Psychology, The University of Hong Kong, Pok Fu Lam, Hong Kong
- State Key Laboratory for Brain and Cognitive Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - A Soltani
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, 03755, USA.
| | - A Izquierdo
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
- The Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
| |
Collapse
|
10
|
Imran I, Koch K, Schöfer H, Lau H, Klein J. Effects of Three Anti-Seizure Drugs on Cholinergic and Metabolic Activity in Experimental Status Epilepticus. J Pharm Pharm Sci 2019; 22:340-351. [PMID: 31356760 DOI: 10.18433/jpps30439] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE Status epilepticus (SE) is characterized by recurrent seizure activity and can be drug- resistant. Knowledge of neuronal and metabolic activity of the brain during SE may be helpful to improve medical care. We here report the effects of three anti-seizure drugs on changes of acetylcholine energy metabolites and oxidative stress during SE. METHODS We used the lithium-pilocarpine model in rats to induce SE and in vivo- microdialysis to monitor cholinergic and metabolic activity in the hippocampus. We measured extracellular concentrations of acetylcholine, glucose, lactate, pyruvate, glycerol and isoprostanes before and during SE, and after acute treatment with pregabalin, valproic acid, and levetiracteam. RESULTS Upon onset of SE, acetylcholine (ACh) release increased six- to eightfold. Glucose was increased only transiently by 30% but lactate levels rose four-fold, and extracellular concentrations of glycerol ten-fold. Isoprostanes are markers of oxidative stress and increased more than 20-fold. Two hours after pilocarpine adminstration, rats were treated with pregabalin (100 mg/kg), levetiracetam (200 mg/kg) or valproic acid (400 mg/kg) by i.p. injection. All three drugs stopped seizure activity in a delayed fashion, but at the doses indicated, only animals that received levetiracetam reached consciousness. All drugs reduced ACh release within 60-120 minutes. Lactate/pyruvate ratios, glycerol and isoprostanne levels were also reduced significantly after drug administration. CONCLUSIONS Hippocampal ACh release closely follows seizure activity in SE and is attenuated when SE subsides. Pregabalin, valproic acid and levetiracetam all terminate seizures in the rat SE model and attenuate cholinergic and metabolic changes within two hours.
Collapse
Affiliation(s)
- Imran Imran
- Department of Pharmacology and Clinical Pharmacy, College of Pharmacy, Goethe University Frankfurt, Max-von-Laue-Str. 9, 60438 Frankfurt, Germany. Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, 60800 Multan, Pakistan
| | | | | | | | | |
Collapse
|
11
|
Griffiths JD, Nguyen M, Lau H, Grant S, Williams DL. A Prospective Randomised Comparison of the LMA ProSeal™ versus Endotracheal tube on the Severity of Postoperative Pain following Gynaecological Laparoscopy. Anaesth Intensive Care 2019; 41:46-50. [DOI: 10.1177/0310057x1304100109] [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: 11/17/2022]
Affiliation(s)
- J. D. Griffiths
- Department of Anaesthesia, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - M. Nguyen
- Department of Anaesthesia, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - H. Lau
- Department of Anaesthesia, Royal Women's Hospital, Melbourne, Victoria, Australia
- Medical Student, University of Melbourne
| | - S. Grant
- Department of Anaesthesia, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - D. L. Williams
- Department of Anaesthesia, Royal Women's Hospital, Melbourne, Victoria, Australia
- Department of Anaesthesia and Pain Management, Royal Melbourne Hospital
| |
Collapse
|
12
|
Tan S, Chew H, Lau H, Mok K. 0541 Drug Induced Sleep Endoscopy: Is There a Difference in the Degree of Collapsibility at Different Sedation Levels? Sleep 2018. [DOI: 10.1093/sleep/zsy061.540] [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)
- S Tan
- Khoo Teck Puat Hospital, Singapore, SINGAPORE
| | - H Chew
- Tan Tock Seng Hospital, Singapore, SINGAPORE
| | - H Lau
- Khoo Teck Puat Hospital, Singapore, SINGAPORE
| | - K Mok
- My ENT Specialist, Singapore, SINGAPORE
| |
Collapse
|
13
|
Giese-Davis J, Sisler J, Zhong L, Brandelli Y, McCormick JL, Railton C, Shirt L, Lau H, Hao D, Chobanuk J, Walley B, Joy AA, Taylor A, Carlson L. Alberta CancerBridges development of a care plan evaluation measure. ACTA ACUST UNITED AC 2018; 25:e59-e72. [PMID: 29507497 DOI: 10.3747/co.25.3766] [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
Background No standardized measures specifically assess cancer survivors' and healthcare providers' experience of Survivor Care Plans (scps). We sought to develop two care plan evaluation (cpe) measures, one for survivors (cpe-s) and one for healthcare providers (cpe-p), examine initial psychometric qualities in Alberta, and assess generalizability in Manitoba, Canada. Methods We developed the initial measures using convenience samples of breast (n = 35) and head and neck (n = 18) survivors who received scps at the end of active cancer-centre treatment. After assessing Alberta's scp concordance with Institute of Medicine (iom) recommendations using a published coding scheme, we examined psychometric qualities for the cpe-s and cpe-p. We examined generalizability in Manitoba, Canada, with colorectal survivors discharged to primary care providers for follow-up (n = 75). Results We demonstrated acceptable internal consistency for the cpe-s and cpe-p subscales and total score after eliminating one item per subscale for cpe-s, two for cpe-p, resulting in revised scales with four 7-item and 6-item subscales, respectively. Subscale scores correlated highly indicating that for each measure the total score may be the most reliable and valid. We provide initial cpe-s discriminant, convergent, and predictive validity using the total score. Using the Manitoba sample, initial psychometrics similarly indicated good generalizability across differences in tumour groups, scp, and location. Conclusions We recommend the revised cpe-s and cpe-p for further use and development. Studies documenting the creation and standardization of scp evaluations are few, and we recommend further development of patient experience measures to improve both clinical practice and the specificity of research questions.
Collapse
Affiliation(s)
- J Giese-Davis
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - J Sisler
- Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba
| | - L Zhong
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - Y Brandelli
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - J L McCormick
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - C Railton
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta
| | - L Shirt
- Palliative Consult Service-Calgary Zone Urban, Alberta Health Services, Calgary, Alberta
| | - H Lau
- Department of Radiation Oncology, Head and Neck Tumour Group, Tom Baker Cancer Center, Calgary
| | - D Hao
- Department of Radiation Oncology, Head and Neck Tumour Group, Tom Baker Cancer Center, Calgary
| | - J Chobanuk
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta
| | - B Walley
- Comprehensive Breast Care Program (cbcp), Community Oncology, Alberta Health Services-Cancer Care, Edmonton, Alberta
| | - A A Joy
- Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta; and
| | - A Taylor
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta.,Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta; and
| | - L Carlson
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| |
Collapse
|
14
|
Riboldi G, Anstett K, Lau H, Swope D. Two new mutations of CP gene associated with Aceruloplasminemia and basal ganglia cavitation. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.213] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
15
|
Judd A, Zangerle R, Touloumi G, Warszawski J, Meyer L, Dabis F, Mary Krause M, Ghosn J, Leport C, Wittkop L, Reiss P, Wit F, Prins M, Bucher H, Gibb D, Fätkenheuer G, Julia DA, Obel N, Thorne C, Mocroft A, Kirk O, Stephan C, Pérez-Hoyos S, Hamouda O, Bartmeyer B, Chkhartishvili N, Noguera-Julian A, Antinori A, d’Arminio Monforte A, Brockmeyer N, Prieto L, Rojo Conejo P, Soriano-Arandes A, Battegay M, Kouyos R, Mussini C, Tookey P, Casabona J, Miró JM, Castagna A, Konopnick D, Goetghebuer T, Sönnerborg A, Quiros-Roldan E, Sabin C, Teira R, Garrido M, Haerry D, de Wit S, Miró JM, Costagliola D, d’Arminio-Monforte A, Castagna A, del Amo J, Mocroft A, Raben D, Chêne G, Judd A, Pablo Rojo C, Barger D, Schwimmer C, Termote M, Wittkop L, Campbell M, Frederiksen CM, Friis-Møller N, Kjaer J, Raben D, Salbøl Brandt R, Berenguer J, Bohlius J, Bouteloup V, Bucher H, Cozzi-Lepri A, Dabis F, d’Arminio Monforte A, Davies MA, del Amo J, Dorrucci M, Dunn D, Egger M, Furrer H, Grabar S, Guiguet M, Judd A, Kirk O, Lambotte O, Leroy V, Lodi S, Matheron S, Meyer L, Miro JM, Mocroft A, Monge S, Nakagawa F, Paredes R, Phillips A, Puoti M, Rohner E, Schomaker M, Smit C, Sterne J, Thiebaut R, Thorne C, Torti C, van der Valk M, Wittkop L, Tanser F, Vinikoor M, Macete E, Wood R, Stinson K, Garone D, Fatti G, Giddy J, Malisita K, Eley B, Fritz C, Hobbins M, Kamenova K, Fox M, Prozesky H, Technau K, Sawry S, Benson CA, Bosch RJ, Kirk GD, Boswell S, Mayer KH, Grasso C, Hogg RS, Richard Harrigan P, Montaner JSG, Yip B, Zhu J, Salters K, Gabler K, Buchacz K, Brooks JT, Gebo KA, Moore RD, Moore RD, Rodriguez B, Horberg MA, Silverberg MJ, Thorne JE, Rabkin C, Margolick JB, Jacobson LP, D’Souza G, Klein MB, Rourke SB, Rachlis AR, Cupido P, Hunter-Mellado RF, Mayor AM, John Gill M, Deeks SG, Martin JN, Patel P, Brooks JT, Saag MS, Mugavero MJ, Willig J, Eron JJ, Napravnik S, Kitahata MM, Crane HM, Drozd DR, Sterling TR, Haas D, Rebeiro P, Turner M, Bebawy S, Rogers B, Justice AC, Dubrow R, Fiellin D, Gange SJ, Anastos K, Moore RD, Saag MS, Gange SJ, Kitahata MM, Althoff KN, Horberg MA, Klein MB, McKaig RG, Freeman AM, Moore RD, Freeman AM, Lent C, Kitahata MM, Van Rompaey SE, Crane HM, Drozd DR, Morton L, McReynolds J, Lober WB, Gange SJ, Althoff KN, Abraham AG, Lau B, Zhang J, Jing J, Modur S, Wong C, Hogan B, Desir F, Liu B, You B, Cahn P, Cesar C, Fink V, Sued O, Dell’Isola E, Perez H, Valiente J, Yamamoto C, Grinsztejn B, Veloso V, Luz P, de Boni R, Cardoso Wagner S, Friedman R, Moreira R, Pinto J, Ferreira F, Maia M, Célia de Menezes Succi R, Maria Machado D, de Fátima Barbosa Gouvêa A, Wolff M, Cortes C, Fernanda Rodriguez M, Allendes G, William Pape J, Rouzier V, Marcelin A, Perodin C, Tulio Luque M, Padgett D, Sierra Madero J, Crabtree Ramirez B, Belaunzaran P, Caro Vega Y, Gotuzzo E, Mejia F, Carriquiry G, McGowan CC, Shepherd BE, Sterling T, Jayathilake K, Person AK, Rebeiro PF, Giganti M, Castilho J, Duda SN, Maruri F, Vansell H, Ly PS, Khol V, Zhang FJ, Zhao HX, Han N, Lee MP, Li PCK, Lam W, Chan YT, Kumarasamy N, Saghayam S, Ezhilarasi C, Pujari S, Joshi K, Gaikwad S, Chitalikar A, Merati TP, Wirawan DN, Yuliana F, Yunihastuti E, Imran D, Widhani A, Tanuma J, Oka S, Nishijima T, Na S, Choi JY, Kim JM, Sim BLH, Gani YM, David R, Kamarulzaman A, Syed Omar SF, Ponnampalavanar S, Azwa I, Ditangco R, Uy E, Bantique R, Wong WW, Ku WW, Wu PC, Ng OT, Lim PL, Lee LS, Ohnmar PS, Avihingsanon A, Gatechompol S, Phanuphak P, Phadungphon C, Kiertiburanakul S, Sungkanuparph S, Chumla L, Sanmeema N, Chaiwarith R, Sirisanthana T, Kotarathititum W, Praparattanapan J, Kantipong P, Kambua P, Ratanasuwan W, Sriondee R, Nguyen KV, Bui HV, Nguyen DTH, Nguyen DT, Cuong DD, An NV, Luan NT, Sohn AH, Ross JL, Petersen B, Cooper DA, Law MG, Jiamsakul A, Boettiger DC, Ellis D, Bloch M, Agrawal S, Vincent T, Allen D, Smith D, Rankin A, Baker D, Templeton DJ, O’Connor CC, Thackeray O, Jackson E, McCallum K, Ryder N, Sweeney G, Cooper D, Carr A, Macrae K, Hesse K, Finlayson R, Gupta S, Langton-Lockton J, Shakeshaft J, Brown K, Idle S, Arvela N, Varma R, Lu H, Couldwell D, Eswarappa S, Smith DE, Furner V, Smith D, Cabrera G, Fernando S, Cogle A, Lawrence C, Mulhall B, Boyd M, Law M, Petoumenos K, Puhr R, Huang R, Han A, Gunathilake M, Payne R, O’Sullivan M, Croydon A, Russell D, Cashman C, Roberts C, Sowden D, Taing K, Marshall P, Orth D, Youds D, Rowling D, Latch N, Warzywoda E, Dickson B, Donohue W, Moore R, Edwards S, Boyd S, Roth NJ, Lau H, Read T, Silvers J, Zeng W, Hoy J, Watson K, Bryant M, Price S, Woolley I, Giles M, Korman T, Williams J, Nolan D, Allen A, Guelfi G, Mills G, Wharry C, Raymond N, Bargh K, Templeton D, Giles M, Brown K, Hoy J. Comparison of Kaposi Sarcoma Risk in Human Immunodeficiency Virus-Positive Adults Across 5 Continents: A Multiregional Multicohort Study. Clin Infect Dis 2017; 65:1316-1326. [PMID: 28531260 PMCID: PMC5850623 DOI: 10.1093/cid/cix480] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/19/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We compared Kaposi sarcoma (KS) risk in adults who started antiretroviral therapy (ART) across the Asia-Pacific, South Africa, Europe, Latin, and North America. METHODS We included cohort data of human immunodeficiency virus (HIV)-positive adults who started ART after 1995 within the framework of 2 large collaborations of observational HIV cohorts. We present incidence rates and adjusted hazard ratios (aHRs). RESULTS We included 208140 patients from 57 countries. Over a period of 1066572 person-years, 2046 KS cases were diagnosed. KS incidence rates per 100000 person-years were 52 in the Asia-Pacific and ranged between 180 and 280 in the other regions. KS risk was 5 times higher in South African women (aHR, 4.56; 95% confidence intervals [CI], 2.73-7.62) than in their European counterparts, and 2 times higher in South African men (2.21; 1.34-3.63). In Europe, Latin, and North America KS risk was 6 times higher in men who have sex with men (aHR, 5.95; 95% CI, 5.09-6.96) than in women. Comparing patients with current CD4 cell counts ≥700 cells/µL with those whose counts were <50 cells/µL, the KS risk was halved in South Africa (aHR, 0.53; 95% CI, .17-1.63) but reduced by ≥95% in other regions. CONCLUSIONS Despite important ART-related declines in KS incidence, men and women in South Africa and men who have sex with men remain at increased KS risk, likely due to high human herpesvirus 8 coinfection rates. Early ART initiation and maintenance of high CD4 cell counts are essential to further reducing KS incidence worldwide, but additional measures might be needed, especially in Southern Africa.
Collapse
|
16
|
Lochmüller H, Behin A, Caraco Y, Lau H, Mirabella M, Tournev I, Tarnopolsky M, Pogoryelova O, Shah J, Koutsoubos T, Skrinar A, Mansbach H, Kakkis E, Mozaffar T. A phase 3 randomized, double blind, placebo-controlled study to evaluate the efficacy and safety of sialic acid extended-release tablets in patients with GNE myopathy (GNEM). Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.208] [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]
|
17
|
Deegan P, Fernandez-Sasso D, Giraldo P, Lau H, Panahloo Z, Zimran A. Treatment patterns from 647 patients with Gaucher disease: An analysis from the Gaucher Outcome Survey. Blood Cells Mol Dis 2016; 68:218-225. [PMID: 27829541 DOI: 10.1016/j.bcmd.2016.10.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 09/30/2016] [Accepted: 10/19/2016] [Indexed: 11/27/2022]
Abstract
The Gaucher Outcome Survey (GOS) is an international disease-specific registry established in 2010 for patients with a confirmed diagnosis of Gaucher disease (GD), regardless of GD type or treatment status. For insight into how GD management varies among countries, we analyzed treatment patterns in GOS. As of October 30, 2015, data on GD-specific treatment (enzyme replacement therapy, substrate reduction therapy, or chemical chaperone therapy) received at any time were available for 647 patients. At analysis, velaglucerase alfa (316/573, 55.1%) and imiglucerase (184/573, 32.1%) were the treatments most widely used. Of the 647 treated patients, 446 (68.9%) had been treated for >5years and 368 (56.9%) had received only one GD-specific drug therapy. There were 377 patients who received velaglucerase alfa. Velaglucerase alfa was most widely used at 60U/kg every other week (134/492 dose entries, 27.2%), but there were differences in dosing between the three highest-enrolling countries (defined as >100 GOS patients enrolled in each), with most patients in Israel receiving <20U/kg, most patients in the United Kingdom receiving 20 to <40U/kg, and most in the United States receiving 60U/kg. This analysis provides a foundation upon which to examine real-life outcomes data from different treatment regimens globally.
Collapse
Affiliation(s)
- P Deegan
- Addenbrooke's Hospital, Cambridge, United Kingdom.
| | | | - P Giraldo
- Translational Research Unit, IIS Aragon, Zaragoza, Spain; CIBER de Enfermedades Raras, IIS Aragon, Zaragoza, Spain.
| | - H Lau
- Division of Neurogenetics, New York University School of Medicine, New York, NY, United States.
| | | | - A Zimran
- Gaucher Clinic, Shaare Zedek Medical Center, The Hebrew University-Hadassah Medical School, Jerusalem, Israel.
| |
Collapse
|
18
|
D'Silva A, Lau H, Otsuka S, Tudor R, Bebb D. Reaching the pinnacle of stage III NSCLC treatment. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw382.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
19
|
Stein C, Hopfeld J, Lau H, Klein J. Effects of Ginkgo biloba Extract EGb 761, Donepezil and their Combination on Central Cholinergic Function in Aged Rats. J Pharm Pharm Sci 2016; 18:634-46. [PMID: 26626253 DOI: 10.18433/j3wc8v] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE Ginkgo extract EGb 761 and cholinesterase inhibitors have been shown to be effective in the treatment of dementia patients. In addition to neuroprotective effects, Ginkgo extract EGb 761 has been reported to elevate brain levels of certain neurotransmitters such as dopamine, noradrenaline, and acetylcholine. In the present study, we investigated the impact of EGb 761, donepezil and the combination of both drugs on the central cholinergic system in aged rats. METHODS 24 month old rats received EGb 761 (100 mg/kg/day), donepezil (1.5 mg/kg/day), the combination of both drugs or vehicle control by oral gavage for 14 days. We used microdialysis in rat hippocampus to monitor extracellular concentrations of acetylcholine (ACh), choline, glucose and lactate. Brain homogenates were prepared to measure activities of acetylcholinesterase (AChE), choline acetyltransferase (ChAT) and high affinity choline uptake (HACU). RESULTS While EGb 761 alone had no effect, donepezil and the combination of donepezil and EGb 761 increased basal ACh levels by 2- to 3-fold. Concomitantly, significant reductions of AChE and HACU were measured in both groups. No differences were seen between donepezil and the combination in these parameters. Treatment with EGb 761 decreased extracellular choline release and showed a tendency to moderately elevate ChAT activity. CONCLUSIONS We found that donepezil and EGb 761 do not display a pharmacological interaction when given together. Adding EGb 761 did not modify the effects of donepezil on the hippocampal cholinergic system. Reduced choline levels indicate neuroprotective properties of EGb 761. Therefore, the combination of EGb 761 and donepezil may be beneficial in the treatment of Alzheimer's disease (AD). This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.
Collapse
Affiliation(s)
- Christoph Stein
- Department of Pharmacology, College of Pharmacy, Goethe University Frankfurt, Germany
| | | | | | | |
Collapse
|
20
|
Banerjee R, Debenham B, Martell K, Scrimger R, Jha N, Lau H, Parliament M. A Comparison of Primary Chemoradiation Therapy Versus Primary Surgery for Stage III-IV Squamous Cell Carcinoma of the Oropharynx. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.187] [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]
|
21
|
Bruner DW, Deshmukh S, Michalski J, Purdy J, Bosch W, Bahary J, Patel M, Parliament M, Lock M, Lau H, Hamstra D, Fisher S, Souhami L, Kwok Y, Seider M, Vigneault E, Gay H, Rosenthal S, Sandler H, Movsas B. Bowel and Bladder Function of Men on a Phase 3 Randomized Study of High Versus Standard Dose of 3D-CRT/IMRT in Patients Treated for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.478] [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]
|
22
|
Harris JR, Lau H, Surgeoner BV, Chua N, Dobrovolsky W, Dort JC, Kalaydjian E, Nesbitt M, Scrimger RA, Seikaly H, Skarsgard D, Webster MA. Health care delivery for head-and-neck cancer patients in Alberta: a practice guideline. ACTA ACUST UNITED AC 2014; 21:e704-14. [PMID: 25302041 DOI: 10.3747/co.21.1980] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 02/06/2023]
Abstract
BACKGROUND The treatment of head-and-neck cancer is complex and requires the involvement of various health care professionals with a wide range of expertise. We describe the process of developing a practice guideline with recommendations about the organization and delivery of health care services for head-and-neck cancer patients in Alberta. METHODS Outcomes of interest included composition of the health care team, qualification requirements for team members, cancer centre and team member volumes, infrastructure needs, and wait times. A search for existing practice guidelines and a systematic review of the literature addressing the organization and delivery of health care services for head-and-neck cancer patients were conducted. The search included the Standards and Guidelines Evidence (sage) directory of cancer guidelines and PubMed. RESULTS One practice guideline was identified for adaptation. Three additional practice guidelines provided supplementary evidence to inform guideline recommendations. Members of the Alberta Provincial Head and Neck Tumour Team (consisting of various health professionals from across the province) provided expert feedback on the adapted recommendations through an online and in-person review process. Selected experts in head-and-neck cancer from outside the province participated in an external online review. SUMMARY The recommendations outlined in this practice guideline are based on existing guidelines that have been modified to fit the Alberta context. Although specific to Alberta, the recommendations lend credence to similar published guidelines and could be considered for use by groups lacking the resources of appointed guideline panels. The recommendations are meant to be a guide rather than a fixed protocol. The implementation of this practice guideline will depend on many factors, including but not limited to availability of trained personnel, adequate funding of infrastructure, and collaboration with other associations of health care professionals in the province.
Collapse
Affiliation(s)
- J R Harris
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, AB
| | - H Lau
- Department of Oncology, Division of Radiation Oncology, University of Calgary, Calgary, AB
| | - B V Surgeoner
- Guideline Utilization Resource Unit, CancerControl Alberta, Alberta Health Services, Calgary, AB
| | - N Chua
- Department of Oncology, University of Alberta, Edmonton, AB
| | - W Dobrovolsky
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB
| | - J C Dort
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, AB
| | - E Kalaydjian
- Department of Surgery, Section of Dentistry and Oral Health, Alberta Health Services, Calgary, AB
| | - M Nesbitt
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, AB
| | - R A Scrimger
- Department of Oncology, Division of Radiation Oncology, University of Alberta, Edmonton, AB
| | - H Seikaly
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, AB
| | - D Skarsgard
- Department of Oncology, Division of Radiation Oncology, University of Calgary, Calgary, AB
| | - M A Webster
- Department of Oncology, University of Calgary, Calgary, AB
| | | |
Collapse
|
23
|
|
24
|
Taggar A, Lau H, Lim G, Nordal R, Khan R, Breitman K, Hudson A, Spencer D, Voroney J. Outcomes From First 3 Years of Frameless Stereotactic Radiosurgery in Treating Brain Metastases. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1068] [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]
|
25
|
Scalf P, St. John-Salltink E, Barth M, Lau H, De Lange F. Serial allocation of visual attention in extrastriate cortex during simultaneous monitoring of multiple locations: a time-resolved fMRI study. J Vis 2014. [DOI: 10.1167/14.10.705] [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] Open
|
26
|
Conroy L, Liu HW, Lau H, Smith WL. Poster - Thur Eve - 65: A dosimetric comparison of isocentric and non-isocentric coplanar SBRT VMAT plans for peripheral lung tumours. Med Phys 2014. [DOI: 10.1118/1.4894925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
27
|
Hillert MH, Imran I, Zimmermann M, Lau H, Weinfurter S, Klein J. Dynamics of hippocampal acetylcholine release during lithium-pilocarpine-induced status epilepticus in rats. J Neurochem 2014; 131:42-52. [PMID: 24909269 DOI: 10.1111/jnc.12787] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [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: 02/25/2014] [Revised: 05/23/2014] [Accepted: 05/27/2014] [Indexed: 01/30/2023]
Abstract
The lithium-pilocarpine model is a rat model of epilepsy that mimics status epilepticus in humans. Here, we report changes of acetylcholine (ACh) release in the hippocampus before, during and after status epilepticus as monitored by microdialysis in unanesthetized rats. Administration of pilocarpine (30 mg/kg s.c.) to rats pretreated with lithium chloride (127 mg/kg i.p.) caused a massive, six-fold increase of hippocampal ACh release, paralleling the development of tonic seizures. When seizures were stopped by administration of diazepam (10 mg/kg i.p.) or ketamine (75 mg/kg i.p.), ACh levels returned to normal. Extracellular concentrations of glutamate remained unchanged during this procedure. Administration of atropine (1 mg/kg i.p.) 2 h after pilocarpine caused a further increase of ACh but did not affect seizures, whereas injection of mecamylamine (5 mg/kg i.p.) reduced ACh levels and seizures in a delayed fashion. Local infusion of tetrodotoxin, 1 μM locally) or hemicholinium (10 μM locally) strongly reduced ACh release and had delayed effects on seizures. Administration of glucose or inositol (250 mg/kg each i.p.) had no visible consequences. In parallel experiments, lithium-pilocarpine-induced status epilepticus also enhanced striatal ACh release, and hippocampal ACh levels equally increased when status epilepticus was induced by kainate (30 mg/kg i.p.). Taken together, our results demonstrate that seizure development in status epilepticus models is accompanied by massive increases of extracellular ACh, but not glutamate, levels. Treatments that reduce seizure activity also reliably reduce extracellular ACh levels.
Collapse
Affiliation(s)
- Markus H Hillert
- Department of Pharmacology, School of Pharmacy, Biocenter N260, Goethe University Frankfurt, Frankfurt am Main, Germany
| | | | | | | | | | | |
Collapse
|
28
|
Collie K, McCormick J, Waller A, Railton C, Shirt L, Chobanuk J, Taylor A, Lau H, Hao D, Walley B, Kapusta B, Joy AA, Carlson LE, Giese-Davis J. Qualitative evaluation of care plans for Canadian breast and head-and-neck cancer survivors. ACTA ACUST UNITED AC 2014; 21:e18-28. [PMID: 24523618 DOI: 10.3747/co.21.1698] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Survivorship care plans (scps) have been recommended as a way to ease the transition from active cancer treatment to follow-up care, to reduce uncertainty for survivors in the management of their ongoing health, and to improve continuity of care. The objective of the demonstration project reported here was to assess the value of scps for cancer survivors in western Canada. METHODS The Alberta CancerBridges team developed, implemented, and evaluated scps for 36 breast and 21 head-and-neck cancer survivors. For the evaluation, we interviewed 12 of the survivors, 9 nurses who delivered the scps, and 3 family physicians who received the scps (n = 24 in total). We asked about satisfaction, usefulness, emotional impact, and communication value. We collected written feedback from the three groups about positive aspects of the scps and possible improvements (n = 85). We analyzed the combined data using qualitative thematic analysis. RESULTS Survivors, nurses, and family physicians agreed that scps could ease the transition to survivorship partly by enhancing communication between survivors and care providers. Survivors appreciated the individualized attention and the comprehensiveness of the plans. They described positive emotional impacts, but wanted a way to ensure that their physicians received the scps. Nurses and physicians responded positively, but expressed concern about the time required to implement the plans. Suggestions for streamlining the process included providing survivors with scp templates in advance, auto-populating the templates for the nurses, and creating summary pages for physicians. CONCLUSIONS The results suggest ways in which scps could help to improve the transition to cancer survivorship and provide starting points for larger feasibility studies.
Collapse
Affiliation(s)
- K Collie
- Department of Psychosocial and Spiritual Resources, Cross Cancer Institute, Edmonton, AB. ; Department of Oncology, Palliative Care Division, University of Alberta, Edmonton, AB
| | - J McCormick
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB. ; Psychosocial Resources, Tom Baker Cancer Centre, Calgary, AB
| | - A Waller
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB. ; Psychosocial Resources, Tom Baker Cancer Centre, Calgary, AB
| | - C Railton
- Department of Oncology, Calgary Region Breast Health Program, Tom Baker Cancer Centre, Calgary, AB
| | - L Shirt
- Department of Radiation Oncology, Head-and-Neck Tumour Group, Tom Baker Cancer Centre, Calgary, AB
| | - J Chobanuk
- Comprehensive Breast Care Program, Community Oncology, Alberta Health Services-Cancer Care, Edmonton, AB
| | - A Taylor
- Breast Cancer Supportive Care Foundation, Calgary, AB
| | - H Lau
- Department of Radiation Oncology, Head-and-Neck Tumour Group, Tom Baker Cancer Centre, Calgary, AB
| | - D Hao
- Department of Radiation Oncology, Head-and-Neck Tumour Group, Tom Baker Cancer Centre, Calgary, AB
| | - B Walley
- Department of Oncology, Calgary Region Breast Health Program, Tom Baker Cancer Centre, Calgary, AB
| | | | - A A Joy
- Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB
| | - L E Carlson
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB. ; Psychosocial Resources, Tom Baker Cancer Centre, Calgary, AB
| | - J Giese-Davis
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, AB. ; Psychosocial Resources, Tom Baker Cancer Centre, Calgary, AB
| |
Collapse
|
29
|
Skrinar A, Argov Z, Caraco Y, Kolodny E, Lau H, Pestronk A, Shieh P, Bronstein F, Esposito A, Feinsod-Meiri Y, Florence J, Fowler E, Greenberg M, Malkus E, Rebibo O, Siener C, Mayhew J. P.3.1 GNE myopathy functional activity scale (GNEM-FAS): Development of a disease-specific instrument for measuring function and independence. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.426] [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: 10/26/2022]
|
30
|
Clayton R, Liu H, Lau H, Dunscombe P, Nugent Z, Khan R. Clinical Impact and Utility of Acuros XB Dose Calculation Algorithm in Lung Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1916] [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: 10/26/2022]
|
31
|
Maniscalco B, Lau H. Dissociations and suboptimalities in metacognitive performance due to unbalanced weighting of perceptual evidence can be partially remediated by task instruction and performance feedback. J Vis 2013. [DOI: 10.1167/13.9.428] [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] Open
|
32
|
Solovey G, Maniscalco B, Rahnev D, Lau H. Inflation of subjective perception in peripheral vision. J Vis 2013. [DOI: 10.1167/13.9.621] [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] Open
|
33
|
Lau H, Maniscalco B. Short-term fatigue of perceptual decision making and metacognition. J Vis 2013. [DOI: 10.1167/13.9.647] [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] Open
|
34
|
Koizumi A, Maniscalco B, Apple A, Yan X, Lau H. The effects of metacognitive awareness on top-down cognitive control. J Vis 2013. [DOI: 10.1167/13.9.429] [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] Open
|
35
|
Hourigan SK, Anders RA, Mitchell SE, Schwarz KB, Lau H, Karnsakul W. Chronic diarrhea, ascites, and protein-losing enteropathy in an infant with hepatic venous outflow obstruction after liver transplantation. Pediatr Transplant 2012; 16:E328-31. [PMID: 22489846 PMCID: PMC3568531 DOI: 10.1111/j.1399-3046.2012.01686.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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] [Indexed: 01/10/2023]
Abstract
An 18-month-old female status post-orthotopic liver transplant for biliary atresia presented nine months after transplant with severe diarrhea and intolerance of feeds. She was found to have a PLE as evidenced by a low serum albumin and a persistent elevation of fecal A1AT. Investigation eventually revealed that the cause of the PLE was a stricture at the anastomosis site between the hepatic vein and inferior cava, supported by resolution of the PLE after venoplasty of the stricture. The patient has subsequently required several repeat venoplasties for recurrence of her symptoms correlating with recurrence of the stricture. This is a very rare presentation of hepatic venous outflow obstruction. Moreover, normal duplex ultrasound imaging of liver vasculature and her unusual presentation led to a delay in her diagnosis highlighting the need for an increased index of suspicion.
Collapse
Affiliation(s)
- S. K. Hourigan
- Division of Pediatric Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - R. A. Anders
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - S. E. Mitchell
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - K. B. Schwarz
- Division of Pediatric Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - H. Lau
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - W. Karnsakul
- Division of Pediatric Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
36
|
Chen N, Kasserra C, Reyes J, Liu L, Lau H. Single-dose pharmacokinetics of lenalidomide in healthy volunteers: dose proportionality, food effect, and racial sensitivity. Cancer Chemother Pharmacol 2012; 70:717-25. [PMID: 22955172 DOI: 10.1007/s00280-012-1966-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 08/12/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE Lenalidomide is an immunomodulatory drug with efficacy in various hematological malignancies. The purpose of these studies was to evaluate the single-dose pharmacokinetics of lenalidomide, including dose proportionality, food effect, and racial sensitivity. METHODS Three studies were conducted including a total of 58 healthy subjects: a randomized, single-blind, alternating group, single-ascending dose study; a randomized, two-way crossover food effect study; and a randomized, double-blind, two-group, within-subject, single-ascending dose study. RESULTS Oral absorption of lenalidomide was rapid and the maximum plasma concentration (C (max)) was observed approximately 1 h post-dose. Co-administration with a high-fat meal reduced the area under the concentration-time curve (AUC) and C (max) by approximately 20 and 50 %, respectively, and delayed time to C (max) (t (max)) by 1.63 h. However, phase III trials were dosed without regard to food; therefore, clinical relevance of the food effect was minimal. The terminal elimination half-life (t (½)) was 3-4 h at doses up to 50 mg and was not affected by food. The AUC and C (max) were proportional to lenalidomide single doses (5-400 mg), and total and renal clearance were dose-independent. The R- to S-lenalidomide ratio in plasma was stable over time, approximately 45-55 % of total drug. There were no differences in pharmacokinetic parameters, dose-exposure relationship, or enantiomeric ratio, between Japanese and Caucasian subjects. CONCLUSION Lenalidomide displayed linear pharmacokinetics from doses 5-400 mg in healthy subjects. Although food reduced bioavailability, this was not considered clinically relevant. Lenalidomide was generally well tolerated in both ethnic groups.
Collapse
Affiliation(s)
- N Chen
- Department of Clinical Pharmacology, Translational Development, Celgene Corporation, Summit, NJ, USA.
| | | | | | | | | |
Collapse
|
37
|
Rahnev D, Maniscalco B, Lau H. Direct injection of neural noise leads to double dissociation between accuracy and confidence. J Vis 2012. [DOI: 10.1167/12.9.617] [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] Open
|
38
|
Lau H, Morales J, Rahnev D. Violation of Bayesian Cue Integration Principle Under Attentional Cuing. J Vis 2012. [DOI: 10.1167/12.9.127] [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] Open
|
39
|
Karnsakul W, Intihar P, Konewko R, Roy A, Colombani PM, Lau H, Schwarz KB. Living donor liver transplantation in children: a single North American center experience over two decades. Pediatr Transplant 2012; 16:486-95. [PMID: 22672018 DOI: 10.1111/j.1399-3046.2012.01725.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Little data concerning hospital charges and long-term outcomes of LDLT in North American children according to transplant indications have been published. To compare outcomes of patient and graft survival and healthcare charges for LDLT for those with BA vs. other diagnoses (non-BA). A retrospective review of 52 children receiving 53 LDLT (38 BA and 14 non-BA) from 1992 to 2010 at our institution was performed. One-, five-, and 10-yr patient and graft survival data were comparable to national figures reported to UNOS. Average one-yr charges for recipients and donors were $242 849 for BA patients and $183 614 for non-BA (p = 0.074). BA patients were 1.23 ± 1.20 yr of age vs. 4.25 ± 5.02 for non-BA, p = 0.045. Examination of the total population of patients who were alive in 2010 in five chronological groupings showed that the crude five-yr survival rates were 1992-1995: 9/11 (82%); 1995-1997: 6/10 (60%); 1997-1999: 8/10 (80%); 1999-2001: 9/10 (90%); and 2001-2003: 7/7 (100%). Thus, examination of the clinical and financial data together over the entire period of the transplant program suggests that the dramatic improvement in patient survival was accomplished without a dramatic increase in indexed charges. All 53 donors survived, and only 10% had complications requiring hospitalization. LDLT in children results in excellent outcomes for patients and donors. Ways to lower costs and maximize graft outcome should be investigated.
Collapse
Affiliation(s)
- W Karnsakul
- Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
| | | | | | | | | | | | | |
Collapse
|
40
|
Cervantes-Arslanian AM, Lau H, Romero J, Nguyen T, Babikian V, Kase C, Pikula A. Risk Factor Profile of HIV Patients with Ischemic Stroke (P01.244). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.244] [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: 11/15/2022] Open
|
41
|
Lau H, Rahnev D. The paradoxical negative relationship between attention-related spontaneous neural activity and perceptual decisions. J Vis 2011. [DOI: 10.1167/11.11.20] [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: 11/24/2022] Open
|
42
|
|
43
|
Davidson M, Felsovalyi O, Trongnetrpunya A, Wang X, Lau H, Thesen T. Different physiological correlates for perceptual decisions and confidence ratings support multi-stage theories. J Vis 2011. [DOI: 10.1167/11.11.879] [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: 11/24/2022] Open
|
44
|
|
45
|
Schirmer SU, Eckhardt I, Lau H, Klein J, DeGraaf YC, Lips KS, Pineau C, Gibbins IL, Kummer W, Meinhardt A, Haberberger RV. The cholinergic system in rat testis is of non-neuronal origin. Reproduction 2011; 142:157-66. [DOI: 10.1530/rep-10-0302] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The cholinergic system consists of acetylcholine (ACh), its synthesising enzyme, choline acetyltransferase (CHAT), transporters such as the high-affinity choline transporter (SLC5A7; also known as ChT1), vesicular ACh transporter (SLC18A3; also known as VAChT), organic cation transporters (SLC22s; also known as OCTs), the nicotinic ACh receptors (CHRN; also known as nAChR) and muscarinic ACh receptors. The cholinergic system is not restricted to neurons but plays an important role in the structure and function of non-neuronal tissues such as epithelia and the immune system. Using molecular and immunohistochemical techniques, we show in this study that non-neuronal cells in the parenchyma of rat testis express mRNAs forChat,Slc18a3,Slc5a7andSlc22a2as well as for the CHRN subunits in locations completely lacking any form of innervation, as demonstrated by the absence of protein gene product 9.5 labelling. We found differentially expressed mRNAs for eight α and three β subunits of CHRN in testis. Expression of the α7-subunit of CHRN was widespread in spermatogonia, spermatocytes within seminiferous tubules as well as within Sertoli cells. Spermatogonia and spermatocytes also expressed the α4-subunit of CHRN. The presence of ACh in testicular parenchyma (TP), capsule and isolated germ cells could be demonstrated by HPLC. Taken together, our results reveal the presence of a non-neuronal cholinergic system in rat TP suggesting a potentially important role for non-neuronal ACh and its receptors in germ cell differentiation.
Collapse
|
46
|
Jagdis A, Phan T, Klimowicz AC, Laskin JJ, Lau H, Petrillo SK, Siever JE, Thomson TA, Magliocco AM, Hao D. ERCC1 and XPF protein expression in patients with nasopharyngeal carcinoma (NPC) undergoing curative intent radiation with or without platinum chemotherapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
47
|
El Ouagari K, Migliaccio-Walle K, Lau H, Bozkaya D. 343 Cost-effectiveness of deferasirox in lower-risk myelodysplastic syndrome (MDS) in Canada. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70345-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
48
|
Al-Barrak J, Santos JL, Tinker A, Hoskins P, Gilks CB, Lau H, Swenerton KD. Exploring palliative treatment outcomes in women with advanced or recurrent ovarian clear cell carcinoma. Gynecol Oncol 2011; 122:107-10. [PMID: 21463887 DOI: 10.1016/j.ygyno.2011.03.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 03/09/2011] [Accepted: 03/11/2011] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Clear cell carcinoma (CCC) of the ovary is increasingly recognized as responding poorly to chemotherapy (CT). This review examines the outcomes achieved with a variety of CT regimens, looking for evidence of activity that might guide the development of more effective treatments. METHODS A retrospective chart review of all cases of CCC referred to the BC Cancer Agency (BCCA) between 2000 and 2008 was conducted. Data were collected from those with primarily advanced disease and from those who recurred after adjuvant treatment. Outcomes were measured using broad definitions of treatment benefit (any objective or subjective evidence of disease control) in order to reflect the real-life use of palliative therapy. RESULTS There were 158 women with pure CCC. First-line therapy for advanced disease was delivered to 33 patients. Second- and third-line treatment was delivered to 47 and 25 patients, respectively. The total number of treatment courses was 105: 88 CT-alone courses, 14 radiation therapy (RT)-alone and 3 combined modality. Treatment benefit was recorded in 24% of patients receiving CT, 64% of patients receiving RT, and each who received combined modality treatment. There was no CT drug class identified as obviously efficacious. CONCLUSION Most patients with advanced or recurrent CCC have a low benefit-to-failure ratio from palliative CT. The role of RT and targeted agents must be explored to improve clinical outcomes for such patients.
Collapse
Affiliation(s)
- J Al-Barrak
- Department of Medical Oncology, Vancouver BC, V5Z-4E6, Canada.
| | | | | | | | | | | | | |
Collapse
|
49
|
Vupputuri S, Nichols GA, Lau H, Joski P, Thorp ML. Risk of progression of nephropathy in a population-based sample with type 2 diabetes. Diabetes Res Clin Pract 2011; 91:246-52. [PMID: 21156326 DOI: 10.1016/j.diabres.2010.11.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Revised: 10/14/2010] [Accepted: 11/16/2010] [Indexed: 10/18/2022]
Abstract
AIMS Progression through stages of nephropathy has not been well described in a large, well-characterized, population-based study. Our aims were to describe the progression of nephropathy and identify characteristics associated with progression in a U.S. population-based sample. METHODS We identified 10,290 members of a managed care organization who had hypertension and type 2 diabetes, a urine albumin-to-creatinine ratio (UACR) measurement in 2001-2003, and at least 2 follow-up UACRs. Progression of nephropathy was defined as progression to a higher stage of nephropathy than was present at baseline. RESULTS At baseline, 57% had normoalbuminuria, 31% had microalbuminuria, and 12% had macroalbuminuria. The incidence of nephropathy progression (per 1000 person-years) was 94.7, 35.1, and 6.5 for normo-, micro-, and macro-albuminuria, respectively. ACEi/ARB use ranged from 61-67%, except among patients with macroalbuminuria at follow-up. Age, diabetes duration, and A1C were significant predictors of progression. CONCLUSIONS Our study, one of the first to examine the progression of nephropathy in a U.S. population-based sample, showed that among adults with diabetes and hypertension, the burden of nephropathy and its progression may be greater than previously reported. Further, the use of ACEi/ARBs was not optimal.
Collapse
Affiliation(s)
- S Vupputuri
- The Center for Health Research/Southeast, Kaiser Permanente Georgia, Atlanta, GA 30305, United States.
| | | | | | | | | |
Collapse
|
50
|
Brunet B, Newcomb C, Lau H, Craighead P, Danielson B. Patterns of Referral for Stereotactic Radiosurgery for Patients with Brain Metastases in Alberta, Canada. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|