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Azizi M, Mahfoud F, Weber MA, Sharp ASP, Schmieder RE, Lurz P, Lobo MD, Fisher NDL, Daemen J, Bloch MJ, Basile J, Sanghvi K, Saxena M, Gosse P, Jenkins JS, Levy T, Persu A, Kably B, Claude L, Reeve-Stoffer H, McClure C, Kirtane AJ, Mullin C, Thackeray L, Chertow G, Kahan T, Dauerman H, Ullery S, Abbott JD, Loening A, Zagoria R, Costello J, Krathan C, Lewis L, McElvarr A, Reilly J, Cash M, Williams S, Jarvis M, Fong P, Laffer C, Gainer J, Robbins M, Crook S, Maddel S, Hsi D, Martin S, Portnay E, Ducey M, Rose S, DelMastro E, Bangalore S, Williams S, Cabos S, Rodriguez Alvarez C, Todoran T, Powers E, Hodskins E, Paladugu V, Tecklenburg A, Devireddy C, Lea J, Wells B, Fiebach A, Merlin C, Rader F, Dohad S, Kim HM, Rashid M, Abraham J, Owan T, Abraham A, Lavasani I, Neilson H, Calhoun D, McElderry T, Maddox W, Oparil S, Kinder S, Radhakrishnan J, Batres C, Edwards S, Garasic J, Drachman D, Zusman R, Rosenfield K, Do D, Khuddus M, Zentko S, O'Meara J, Barb I, Foster A, Boyette A, Wang Y, Jay D, Skeik N, Schwartz R, Peterson R, Goldman JA, Goldman J, Ledley G, Katof N, Potluri S, Biedermann S, Ward J, White M, Mauri L, Sobieszczky P, Smith A, Aseltine L, Stouffer R, Hinderliter A, Pauley E, Wade T, Zidar D, Shishehbor M, Effron B, Costa M, Semenec T, Roongsritong C, Nelson P, Neumann B, Cohen D, Giri J, Neubauer R, Vo T, Chugh AR, Huang PH, Jose P, Flack J, Fishman R, Jones M, Adams T, Bajzer C, Mathur A, Jain A, Balawon A, Zongo O, Bent C, Beckett D, Lakeman N, Kennard S, D’Souza RJ, Statton S, Wilkes L, Anning C, Sayer J, Iyer SG, Robinson N, Sevillano A, Ocampo M, Gerber R, Faris M, Marshall AJ, Sinclair J, Pepper H, Davies J, Chapman N, Burak P, Carvelli P, Jadhav S, Quinn J, Rump LC, Stegbauer J, Schimmöller L, Potthoff S, Schmid C, Roeder S, Weil J, Hafer L, Agdirlioglu T, Köllner T, Böhm M, Ewen S, Kulenthiran S, Wachter A, Koch C, Fengler K, Rommel KP, Trautmann K, Petzold M, Ott C, Schmid A, Uder M, Heinritz U, Fröhlich-Endres K, Genth-Zotz S, Kämpfner D, Grawe A, Höhne J, Kaesberger B, von zur Mühlen C, Wolf D, Welzel M, Heinrichs G, Trabitzsch B, Cremer A, Trillaud H, Papadopoulos P, Maire F, Gaudissard J, Sapoval M, Livrozet M, Lorthioir A, Amar L, Paquet V, Pathak A, Honton B, Cottin M, Petit F, Lantelme P, Berge C, Courand PY, Langevin F, Delsart P, Longere B, Ledieu G, Pontana F, Sommeville C, Bertrand F, Feyz L, Zeijen V, Ruiter A, Huysken E, Blankestijn P, Voskuil M, Rittersma Z, Dolmans H, Kroon A, van Zwam W, Vranken J, de Haan. C, Renkin J, Maes F, Beauloye C, Lengelé JP, Huyberechts D, Bouvie A, Witkowski A, Januszewicz A, Kądziela J, Prejbisj A, Hering D, Ciecwierz D, Jaguszewski MJ, Owczuk R. Effects of Renal Denervation vs Sham in Resistant Hypertension After Medication Escalation: Prespecified Analysis at 6 Months of the RADIANCE-HTN TRIO Randomized Clinical Trial. JAMA Cardiol 2022; 7:1244-1252. [PMID: 36350593 PMCID: PMC9647563 DOI: 10.1001/jamacardio.2022.3904] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 11/10/2022]
Abstract
Importance Although early trials of endovascular renal denervation (RDN) for patients with resistant hypertension (RHTN) reported inconsistent results, ultrasound RDN (uRDN) was found to decrease blood pressure (BP) vs sham at 2 months in patients with RHTN taking stable background medications in the Study of the ReCor Medical Paradise System in Clinical Hypertension (RADIANCE-HTN TRIO) trial. Objectives To report the prespecified analysis of the persistence of the BP effects and safety of uRDN vs sham at 6 months in conjunction with escalating antihypertensive medications. Design, Setting, and Participants This randomized, sham-controlled, clinical trial with outcome assessors and patients blinded to treatment assignment, enrolled patients from March 11, 2016, to March 13, 2020. This was an international, multicenter study conducted in the US and Europe. Participants with daytime ambulatory BP of 135/85 mm Hg or higher after 4 weeks of single-pill triple-combination treatment (angiotensin-receptor blocker, calcium channel blocker, and thiazide diuretic) with estimated glomerular filtration rate (eGFR) of 40 mL/min/1.73 m2 or greater were randomly assigned to uRDN or sham with medications unchanged through 2 months. From 2 to 5 months, if monthly home BP was 135/85 mm Hg or higher, standardized stepped-care antihypertensive treatment starting with aldosterone antagonists was initiated under blinding to treatment assignment. Interventions uRDN vs sham procedure in conjunction with added medications to target BP control. Main Outcomes and Measures Six-month change in medications, change in daytime ambulatory systolic BP, change in home systolic BP adjusted for baseline BP and medications, and safety. Results A total of 65 of 69 participants in the uRDN group and 64 of 67 participants in the sham group (mean [SD] age, 52.4 [8.3] years; 104 male [80.6%]) with a mean (SD) eGFR of 81.5 (22.8) mL/min/1.73 m2 had 6-month daytime ambulatory BP measurements. Fewer medications were added in the uRDN group (mean [SD], 0.7 [1.0] medications) vs sham (mean [SD], 1.1 [1.1] medications; P = .045) and fewer patients in the uRDN group received aldosterone antagonists at 6 months (26 of 65 [40.0%] vs 39 of 64 [60.9%]; P = .02). Despite less intensive standardized stepped-care antihypertensive treatment, mean (SD) daytime ambulatory BP at 6 months was 138.3 (15.1) mm Hg with uRDN vs 139.0 (14.3) mm Hg with sham (additional decreases of -2.4 [16.6] vs -7.0 [16.7] mm Hg from month 2, respectively), whereas home SBP was lowered to a greater extent with uRDN by 4.3 mm Hg (95% CI, 0.5-8.1 mm Hg; P = .03) in a mixed model adjusting for baseline and number of medications. Adverse events were infrequent and similar between groups. Conclusions and Relevance In this study, in patients with RHTN initially randomly assigned to uRDN or a sham procedure and who had persistent elevation of BP at 2 months after the procedure, standardized stepped-care antihypertensive treatment escalation resulted in similar BP reduction in both groups at 6 months, with fewer additional medications required in the uRDN group. Trial Registration ClinicalTrials.gov Identifier: NCT02649426.
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Affiliation(s)
- Michel Azizi
- Université Paris Cité, F-75006 Paris, France,Assistance Publique–Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Hypertension Department and DMU CARTE, F-75015 Paris, France,INSERM, CIC1418, F-75015 Paris, France
| | - Felix Mahfoud
- Klinik für Innere Medizin III, Saarland University Hospital, Homburg/Saar, Germany,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge
| | - Michael A. Weber
- Division of Cardiovascular Medicine, State University of New York, Downstate Medical Center, New York
| | - Andrew S. P. Sharp
- University Hospital of Wales, Cardiff and University of Exeter, Exeter, United Kingdom
| | - Roland E. Schmieder
- Nephrology and Hypertension, University Hospital Erlangen, Friedrich Alexander University, Erlangen, Germany
| | - Philipp Lurz
- Heart Center Leipzig, University of Leipzig, Leipzig, Germany
| | - Melvin D. Lobo
- Barts NIHR Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | | | - Joost Daemen
- Erasmus MC, University Medical Center Rotterdam, Department of Cardiology, Rotterdam, the Netherlands
| | - Michael J. Bloch
- Department of Medicine, University of Nevada School of Medicine, Vascular Care, Renown Institute of Heart and Vascular Health, Reno
| | - Jan Basile
- Division of Cardiovascular Medicine, Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Charleston
| | | | - Manish Saxena
- Barts NIHR Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | | | | | - Terry Levy
- Royal Bournemouth Hospital, Dorset, United Kingdom
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Benjamin Kably
- Assistance Publique–Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Department of Pharmacology, Paris, France
| | | | | | | | - Ajay J. Kirtane
- Columbia University Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Danny Do
- for the RADIANCE-HTN Investigators
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jay Giri
- for the RADIANCE-HTN Investigators
| | | | - Thu Vo
- for the RADIANCE-HTN Investigators
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Hania A, Harnett C, Morrison J, Klemmer K, Costello J. Placenta Accreta Spectrum: A 2-year Retrospective Observational Study. Ir Med J 2022; 115:629. [PMID: 36300594] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Aims To assess the management and outcomes of Placenta Accreta Spectrum disorders and highlight the important management recommendations from international guidelines. Methods A retrospective audit of women diagnosed with Placenta Accreta Spectrum disorder from January 2018 to December 2019. Results Nine cases (0.16%) of placenta accreta from 5695 births were identified. All women received caesarean section under general anaesthesia. Caesarean hysterectomy occurred in seven cases (78%). Mean (±SD) age of women was (34.4 ± 3.9 years) and mean parity score was (3.2 ± 1.2). Mean gestational age at birth was 35.1 ± 0.8 weeks. Bilateral iliac artery balloon occlusion occurred in eight (89%) cases. Median estimated blood loss [range] was 1700 mL [1000-7000] with only 11% of patients (1/9) experiencing more than 3L of blood loss. Intraoperative red blood cell transfusion occurred in six cases (67%). Median number of units of red cell transfusion [range] was four units [0-10]. Mean hospital length of stay was (6.7 ± 1.1 days) and there were no maternal deaths. Multidisciplinary team involvement of senior anaesthetists and obstetricians was noted in all cases. Discussion Placenta accreta spectrum is increasing in incidence in obstetric practice and is associated with significant maternal morbidity and mortality. Implementing national guidelines can improve patient outcomes.
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Affiliation(s)
- A Hania
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Galway
| | - C Harnett
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Galway
| | - J Morrison
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Galway
| | - K Klemmer
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Galway
| | - J Costello
- Department of Anaesthesiology and Critical Care Medicine, University Hospital Galway
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Zubir M, Costello J, Ali A, Erwins C, Cheasty M, Judge L. COVID-19, Telemedicine and Emergency Department Referrals: Patient Presentations and Follow-up Times to a Community Mental Health Team. Eur Psychiatry 2022. [PMCID: PMC9563861 DOI: 10.1192/j.eurpsy.2022.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction The COVID-19 pandemic caused changes to how healthcare services are utilised and delivered. Objectives We examine the impact of COVID-19 on the pattern of emergency patient presentations referred on to the community mental health team and the impact of utilising telemedicine on time to follow-up. Methods We retrospectively reviewed all clinical records of patients currently attending our service. We identified presentations to the emergency department (N=119) who were subsequently referred on for mental health follow-up. Results Patients being referred to our team from emergency departments were significantly younger during, mean age 33.1 years (SD=12.3) compared to before the pandemic, mean age 40.0 years (SD=14.5), p=0.006 and a higher proportion were new patients during, 55.8%, compared to pre-pandemic period 33.3%, p=0.015. There was also a higher proportion of patients presenting with suicidal ideation and lower proportions of affective, psychosis and suicidal/self-injurious acts during the pandemic period compared to before, p=0.006. The ratio of female to male patients on the other hand were similar during both periods, p=0.853. There appeared to be no difference in median time to follow-up pre and during the pandemic (6.0 vs 5.5 days, p=0.995). Further analysis also found no significant impact on time to follow-up upon implementing telemedicine consultations, with median days to initial follow-up of 6 days pre-pandemic, 4.5 days during pandemic + prior to telemedicine and 6.5 days during pandemic + telemedicine, p=0.602. Conclusions This study provides preliminary data on the impact of COVID-19 on mental health emergency presentations and utilization of telemedicine on time to follow-up by CMHTs. Disclosure No significant relationships.
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Costello J, Smith M. The BCH message banking process™, voice banking, and double-dipping™. Augment Altern Commun 2022; 37:241-250. [PMID: 35000518 DOI: 10.1080/07434618.2021.2021554] [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: 10/19/2022] Open
Abstract
Significant advances have been made in interventions to maintain communication and personhood for individuals with neurodegenerative conditions. One innovation is Message Banking, a clinical approach first developed at Boston Children's Hospital (BCH). This paper outlines the Message Banking process as implemented at BCH, which includes the option of "Double Dipping," where banked messages are mined to develop personalized synthesized voices. More than a decade of experience has led to the evolution of six core principles underpinning the BCH process, resulting in a structured introduction of the associated concepts and practices with people with amyotrophic lateral sclerosis (ALS) and their families. These principles highlight the importance of assigning ownership and control of the process to individuals with ALS and their families, ensuring that as a tool it is empowering and offers hope. Changes have been driven by feedback from individuals who have participated in the BCH process over many years. The success of the process has recently been extended through partnerships that allow the recorded messages to be used to develop individual personalized synthetic voices to complement banked messages. While the process of banking messages is technically relatively simple, the full value of the process should be underpinned by the values and principles outlined in this tutorial.
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Affiliation(s)
- John Costello
- Augmentative Communication Program and Jay S. Fishman ALS Augmentative Communication Program, Boston Children's Hospital, Adjunct Faculty Boston University, Boston, MA, USA
| | - Martine Smith
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
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Shields R, Pyron M, Arsenault ER, Thorp JH, Minder M, Artz C, Costello J, Otgonganbat A, Mendsaikhan B, Altangerel S, Maasri A. Geomorphology variables predict fish assemblages for forested and endorheic rivers of two continents. Ecol Evol 2021; 11:16745-16762. [PMID: 34938470 PMCID: PMC8668727 DOI: 10.1002/ece3.8300] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/07/2021] [Accepted: 10/18/2021] [Indexed: 11/10/2022] Open
Abstract
Stream fishes are restricted to specific environments with appropriate habitats for feeding and reproduction. Interactions between streams and surrounding landscapes influence the availability and type of fish habitat, nutrient concentrations, suspended solids, and substrate composition. Valley width and gradient are geomorphological variables that influence the frequency and intensity that a stream interacts with the surrounding landscape. For example, in constrained valleys, canyon walls are steeply sloped and valleys are narrow, limiting the movement of water into riparian zones. Wide valleys have long, flat floodplains that are inundated with high discharge. We tested for differences in fish assemblages with geomorphology variation among stream sites. We selected rivers in similar forested and endorheic ecoregion types of the United States and Mongolia. Sites where we collected were defined as geomorphologically unique river segments (i.e., functional process zones; FPZs) using an automated ArcGIS-based tool. This tool extracts geomorphic variables at the valley and catchment scales and uses them to cluster stream segments based on their similarity. We collected a representative fish sample from replicates of FPZs. Then, we used constrained ordinations to determine whether river geomorphology could predict fish assemblage variation. Our constrained ordination approach using geomorphology to predict fish assemblages resulted in significance using fish taxonomy and traits in several watersheds. The watersheds where constrained ordinations were not successful were next analyzed with unconstrained ordinations to examine patterns among fish taxonomy and traits with geomorphology variables. Common geomorphology variables as predictors for taxonomic fish assemblages were river gradient, valley width, and valley slope. Significant geomorphology predictors of functional traits were valley width-to-floor width ratio, elevation, gradient, and channel sinuosity. These results provide evidence that fish assemblages respond similarly and strongly to geomorphic variables on two continents.
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Affiliation(s)
- Robert Shields
- Aquatic Biology and FisheriesBall State UniversityMuncieIndianaUSA
| | - Mark Pyron
- Aquatic Biology and FisheriesBall State UniversityMuncieIndianaUSA
| | - Emily R. Arsenault
- Kansas Biological Survey and the Department of Ecology and Evolutionary BiologyUniversity of KansasLawrenceKansasUSA
| | - James H. Thorp
- Kansas Biological Survey and the Department of Ecology and Evolutionary BiologyUniversity of KansasLawrenceKansasUSA
| | - Mario Minder
- Aquatic Biology and FisheriesBall State UniversityMuncieIndianaUSA
| | - Caleb Artz
- Aquatic Biology and FisheriesBall State UniversityMuncieIndianaUSA
| | - John Costello
- Department of Civil and Environmental EngineeringSouth Dakota School of Mines & TechnologyRapid CitySouth DakotaUSA
| | | | - Bud Mendsaikhan
- Institute of Geography and GeoecologyMongolian Academy of SciencesUlaanbaatarMongolia
| | | | - Alain Maasri
- Department of Ecosystem ResearchLeibniz Institute of Freshwater Ecology and Inland Fisheries (IGB)BerlinGermany
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Choudhury A, Magill S, Eaton C, Prager B, Chen W, Seo K, Lucas C, Villanueva-Meyer J, Vasudevan H, Liu S, Cady M, Zhang M, Braunstein S, Oberheim N, Perry A, Solomon D, Costello J, McDermott M, Rich J, Raleigh D. Meningioma DNA Methylation Grouping Reveals Biologic Drivers and Therapeutic Vulnerabilities. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hoffe S, Kim D, Malafa M, Costello J, Aguilera T, Beg S, Parikh P, Herman J, Terry K, Holmlund J, Moser E. GRECO-2: A Randomized, Phase 2 Study of Stereotactic Body Radiation Therapy (SBRT) in Combination with GC4711 in the Treatment of Unresectable or Borderline Resectable Nonmetastatic Pancreatic Cancer (PC). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.372] [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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McDonald J, Raghunand N, Rejniak K, Frakes J, Song E, Latifi K, Kim D, Carballido E, Denbo J, Pimiento J, Parsee A, Hodul P, Hoffe S, Costello J. Multisequence MRI With Functional Imaging May Improve Pseudoprogression vs. Viable Tumor Determination Following High Dose Adaptive MRgRT in Patients With Pancreatic Adenocarcinoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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O’Neill R, Wall T, Costello J. P.50 Factors affecting patient reported satisfaction with epidural analgesia during labour in Mayo University Hospital (MUH) and University Hospital Galway (UHG). Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103048] [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: 11/26/2022]
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Maasri A, Pyron M, Arsenault ER, Thorp JH, Mendsaikhan B, Tromboni F, Minder M, Kenner SJ, Costello J, Chandra S, Otgonganbat A, Boldgiv B. Valley-scale hydrogeomorphology drives river fish assemblage variation in Mongolia. Ecol Evol 2021; 11:6527-6535. [PMID: 34141237 PMCID: PMC8207391 DOI: 10.1002/ece3.7505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/11/2021] [Accepted: 03/15/2021] [Indexed: 11/08/2022] Open
Abstract
River hydrogeomorphology is a major driver shaping biodiversity and community composition. Here, we examine how hydrogeomorphic heterogeneity expressed by Functional Process Zones (FPZs) in river networks is associated with fish assemblage variation. We examined this association in two distinct ecoregions in Mongolia expected to display different gradients of river network hydrogeomorphic heterogeneity. We delineated FPZs by extracting valley-scale hydrogeomorphic variables at 10 km sample intervals in forest steppe (FS) and in grassland (G) river networks. We sampled fish assemblages and examined variation associated with changes in gradients of hydrogeomorphology as expressed by the FPZs. Thus, we examined assemblage variation as patterns of occurrence- and abundance-based beta diversities for the taxonomic composition of assemblages and as functional beta diversity. Overall, we delineated 5 and 6 FPZs in river networks of the FS and G, respectively. Eight fish species were found in the FS river network and seventeen in the G, four of them common to both ecoregions. Functional richness was correspondingly higher in the G river network. Variation in the taxonomic composition of assemblages was driven by species turnover and was only significant in the G river network. Abundance-based taxonomic variation was significant in river networks of both ecoregions, while the functional beta diversity results were inconclusive. We show that valley-scale hydrogeomorphology is a significant driver of variation in fish assemblages at a macrosystem scale. Both changes in the composition of fish assemblages and the carrying capacity of the river network were driven by valley-scale hydrogeomorphic variables. River network hydrogeomorphology as accounted for in the study has, therefore, the potential to inform macrosystem scale community ecology research and conservation efforts.
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Affiliation(s)
- Alain Maasri
- Department of Ecosystem ResearchLeibniz Institute of Freshwater Ecology and Inland Fisheries (IGB)BerlinGermany
- The Academy of Natural Sciences of Drexel UniversityPhiladelphiaPAUSA
| | - Mark Pyron
- Department of BiologyBall State UniversityMuncieINUSA
| | - Emily R. Arsenault
- Kansas Biological Survey and the Department of Ecology and Evolutionary BiologyUniversity of KansasLawrenceKSUSA
| | - James H. Thorp
- Kansas Biological Survey and the Department of Ecology and Evolutionary BiologyUniversity of KansasLawrenceKSUSA
| | - Bud Mendsaikhan
- Institute of Geography and GeoecologyMongolian Academy of SciencesUlaanbaatarMongolia
| | - Flavia Tromboni
- Global Water Center and Department of BiologyUniversity of NevadaRenoNVUSA
| | - Mario Minder
- Department of BiologyBall State UniversityMuncieINUSA
| | - Scott J. Kenner
- Department of Civil and Environmental EngineeringSouth Dakota School of Mines & TechnologyRapid CitySDUSA
| | - John Costello
- Department of Civil and Environmental EngineeringSouth Dakota School of Mines & TechnologyRapid CitySDUSA
| | - Sudeep Chandra
- Global Water Center and Department of BiologyUniversity of NevadaRenoNVUSA
| | | | - Bazartseren Boldgiv
- The Academy of Natural Sciences of Drexel UniversityPhiladelphiaPAUSA
- Department of BiologyNational University of MongoliaUlaanbaatarMongolia
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Romanelli K, Wells J, Patel A, Mendonca Torres M, Costello J, Jensen K, Vasko V. Clinical and molecular characterization of thyroid cancer when seen as a second malignant neoplasm. Ther Adv Endocrinol Metab 2021; 12:20420188211058327. [PMID: 35154635 PMCID: PMC8832328 DOI: 10.1177/20420188211058327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/19/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Second malignant neoplasms (SMN) are among the most serious long-term adverse health conditions in cancer survivors. The aim of this study was to characterize clinical findings of patients who developed thyroid cancers as SMN, and to examine genomic alterations in thyroid cancer tissue. METHODS Retrospective analysis of medical records from patients seen for management of thyroid cancer over 10-year period was performed. Clinical and pathologic data were retrieved from their medical charts. Tumor DNA and RNA were extracted from formalin-fixed, paraffin-embedded tissue and subjected to next-generation sequencing (NGS) using Ion Torrent Oncomine Focus Assay. Microfluidic digital polymerase chain reactions (PCRs) were performed using QIAcuity Digital PCR System to identify BRAF V600E mutations and RET/PTC fusions. RESULTS Sixteen of 620 patients operated for thyroid cancer had history of previously diagnosed malignancy. Eight patients were male and eight patients were female, with a median age at diagnosis of 58.5 years (range, 4-78). Four patients had history of pediatric malignancy (PedCa), and 12 patients had a history of prior malignancy as an adult (AdCa). The latency periods for development of SMN in PedCa and AdCa patients were 10.8 (±5.2) years and 9.5 (±5.2) years, respectively. Histopathology revealed papillary thyroid cancers in 15 cases, and follicular thyroid cancer in 1 case. All tumors were classified as T1 or T2, and there were no patients presenting with metastases at the time of surgery. Genomic alterations were detected in 13/16 (81.2%) tumors including eight gene mutations (BRAF V600E (N = 4), RAS (N = 2), PI3CA (N = 2) and five gene fusions (RET/PTC1 (N = 4) and STRN/ALK (N = 1). In patients with PedCa and AdCa, mutations were detected in 1/4 (25%) and 7/12 (58.3%), respectively, p = 0.56; and fusions were detected in 3/4 (75%) and 2/12 (16.6%), respectively, p = 0.06. In patients with and without history of therapeutic irradiation, mutations were detected with the same frequencies (5/10 (50%), and 3/6 (50%), respectively, p = 1.0). Gene fusions were detected in patients with and without history of irradiation in 5/10 (55.5%) and 0/6 (0%), respectively, p = 0.09. CONCLUSIONS Monitoring of cancer survivors for thyroid disorders allowed diagnosis of second thyroid cancers at early stages. Second thyroid cancers harbor genomic alterations that are typical for sporadic as well as for radio-induced thyroid cancers.
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Affiliation(s)
- Kristen Romanelli
- Department of Pediatric, Hematology/Oncology,
Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Justin Wells
- Department of Pathology, Walter Reed National
Military Medical Center, Bethesda, MD, USA
| | - Aneeta Patel
- Department of Pediatrics, Uniformed Services
University of Health Sciences, Bethesda, MD, USA
| | - Maria Mendonca Torres
- Department of Pediatrics, Uniformed Services
University of Health Sciences, Bethesda, MD, USA
| | - John Costello
- Department of Pediatrics, Uniformed Services
University of Health Sciences, Bethesda, MD, USA
| | - Kirk Jensen
- Department of Pediatrics, Uniformed Services
University of Health Sciences, Bethesda, MD, USA
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12
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Shehadeh M, Brar V, Costello J, Hadadi C, O'Donoghue S, Worley S. Ineffective implantable cardioverter-defibrillator shocks among patients on continuous left ventricular assist device support: Clinical characteristics and management. Heart Rhythm O2 2020; 1:336-340. [PMID: 34113891 PMCID: PMC8183971 DOI: 10.1016/j.hroo.2020.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 11/24/2022] Open
Abstract
Background Placement of a left ventricular assist device (LVAD) has been described to compromise implantable cardioverter-defibrillator (ICD) defibrillation threshold (DFT). Elevated DFT will have negative consequences and increases the risk of ineffective ICD shocks, morbidity, and mortality. DFT testing is not routinely performed in clinical practice, despite this fact. Objective We describe the clinical characteristics of 7 LVAD patients who presented with multiple ineffective ICD shocks, along with the management strategy in such patients. Methods Seven patients (5 male, mean age 52.2 ± 9 years, 85.7% nonischemic cardiomyopathy) with an ICD in situ who progressed to NYHA class IV, ACC/AHA stage D chronic systolic congestive heart failure who underwent successful LVAD implantation presented to our institution in the setting of ventricular tachyarrhythmia and ineffective ICD shocks. Six patients underwent implantation of azygos and subclavian coils with subsequent DFT testing. The remaining patient was made comfort care. Results Five patients had successful DFT testing with azygos (n = 4) and subclavian (n = 1) defibrillation coil implantation. One patient had unsuccessful DFT testing despite evaluation of multiple shock vectors. There were no major or minor vascular complications in any of the cases. There were no procedural-related deaths. Conclusion This case series highlights the need for a systematic approach to management of ICDs and DFT testing in LVAD patients. The addition of new shock vectors with azygos and subclavian coil implantation may reduce DFT, shock burden, morbidity, and mortality.
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Affiliation(s)
| | | | | | - Cyrus Hadadi
- Medstar Washington Hospital Center, Washington, DC
| | | | - Seth Worley
- Medstar Washington Hospital Center, Washington, DC
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13
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Vasudevan H, Magill S, Seo K, Villanueva-Meyer J, Choudhury A, Liu S, Pekmezci M, Findakly S, Hilz S, LaStella S, Braunstein S, Oberheim N, Aghi M, Theodosopoulos P, Sneed P, Berger M, McDermott M, Lim D, Ulian E, Costello J, Raleigh D. Multiplatform Genomic Profiling and Magnetic Resonance Imaging Identify Molecular and Radiologic Determinants of Intratumor Heterogeneity Underlying Aggressive Behavior in Meningioma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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14
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Johanson DM, Goertz JE, Marin IA, Costello J, Overall CC, Gaultier A. Experimental autoimmune encephalomyelitis is associated with changes of the microbiota composition in the gastrointestinal tract. Sci Rep 2020; 10:15183. [PMID: 32938979 PMCID: PMC7494894 DOI: 10.1038/s41598-020-72197-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 07/01/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023] Open
Abstract
The gut microbiome is known to be sensitive to changes in the immune system, especially during autoimmune diseases such as Multiple Sclerosis (MS). Our study examines the changes to the gut microbiome that occur during experimental autoimmune encephalomyelitis (EAE), an animal model for MS. We collected fecal samples at key stages of EAE progression and quantified microbial abundances with 16S V3–V4 amplicon sequencing. Our analysis of the data suggests that the abundance of commensal Lactobacillaceae decreases during EAE while other commensal populations belonging to the Clostridiaceae, Ruminococcaceae, and Peptostreptococcaceae families expand. Community analysis with microbial co-occurrence networks points to these three expanding taxa as potential mediators of gut microbiome dysbiosis. We also employed PICRUSt2 to impute MetaCyc Enzyme Consortium (EC) pathway abundances from the original microbial abundance data. From this analysis, we found that a number of imputed EC pathways responsible for the production of immunomodulatory compounds appear to be enriched in mice undergoing EAE. Our analysis and interpretation of results provides a detailed picture of the changes to the gut microbiome that are occurring throughout the course of EAE disease progression and helps to evaluate EAE as a viable model for gut dysbiosis in MS patients.
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Affiliation(s)
- David M Johanson
- Center for Brain Immunology and Glia, University of Virginia, Charlottesville, VA, 22908, USA.,Department of Neuroscience, School of Medicine, University of Virginia, Charlottesville, VA, 22908, USA
| | - Jennifer E Goertz
- Center for Brain Immunology and Glia, University of Virginia, Charlottesville, VA, 22908, USA.,Department of Neuroscience, School of Medicine, University of Virginia, Charlottesville, VA, 22908, USA.,Dept. of Neuroscience, Cornell University, Ithaca, NY, 14850, USA
| | - Ioana A Marin
- Center for Brain Immunology and Glia, University of Virginia, Charlottesville, VA, 22908, USA.,Department of Neuroscience, School of Medicine, University of Virginia, Charlottesville, VA, 22908, USA.,Dept. of Neuroscience, Stanford University, Stanford, CA, 94305, USA
| | - John Costello
- Center for Brain Immunology and Glia, University of Virginia, Charlottesville, VA, 22908, USA.,Department of Neuroscience, School of Medicine, University of Virginia, Charlottesville, VA, 22908, USA
| | - Christopher C Overall
- Center for Brain Immunology and Glia, University of Virginia, Charlottesville, VA, 22908, USA.,Department of Neuroscience, School of Medicine, University of Virginia, Charlottesville, VA, 22908, USA.,Myriad Genetics, Inc., San Francisco, CA, 94080, USA
| | - Alban Gaultier
- Center for Brain Immunology and Glia, University of Virginia, Charlottesville, VA, 22908, USA. .,Department of Neuroscience, School of Medicine, University of Virginia, Charlottesville, VA, 22908, USA.
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15
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Tiron R, Lyon G, Kilroy H, Osman A, Kelly N, O'Mahony N, Lopes C, Coffey S, McMahon S, Wren M, Conway K, Fox N, Costello J, Shouldice R, Lederer K, Fietze I, Penzel T. Screening for obstructive sleep apnea with novel hybrid acoustic smartphone app technology. J Thorac Dis 2020; 12:4476-4495. [PMID: 32944361 PMCID: PMC7475565 DOI: 10.21037/jtd-20-804] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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] [Indexed: 12/17/2022]
Abstract
Background Obstructive sleep apnea (OSA) has a high prevalence, with an estimated 425 million adults with apnea hypopnea index (AHI) of ≥15 events/hour, and is significantly underdiagnosed. This presents a significant pain point for both the sufferers, and for healthcare systems, particularly in a post COVID-19 pandemic world. As such, it presents an opportunity for new technologies that can enable screening in both developing and developed countries. In this work, the performance of a non-contact OSA screener App that can run on both Apple and Android smartphones is presented. Methods The subtle breathing patterns of a person in bed can be measured via a smartphone using the "Firefly" app technology platform [and underpinning software development kit (SDK)], which utilizes advanced digital signal processing (DSP) technology and artificial intelligence (AI) algorithms to identify detailed sleep stages, respiration rate, snoring, and OSA patterns. The smartphone is simply placed adjacent to the subject, such as on a bedside table, night stand or shelf, during the sleep session. The system was trained on a set of 128 overnights recorded at a sleep laboratory, where volunteers underwent simultaneous full polysomnography (PSG), and "Firefly" smartphone app analysis. A separate independent test set of 120 recordings was collected across a range of Apple iOS and Android smartphones, and withheld for performance evaluation by a different team. An operating point tuned for mid-sensitivity (i.e., balancing sensitivity and specificity) was chosen for the screener. Results The performance on the test set is comparable to ambulatory OSA screeners, and other smartphone screening apps, with a sensitivity of 88.3% and specificity of 80.0% [with receiver operating characteristic (ROC) area under the curve (AUC) of 0.92], for a clinical threshold for the AHI of ≥15 events/hour of detected sleep time. Conclusions The "Firefly" app based sensing technology offers the potential to significantly lower the barrier of entry to OSA screening, as no hardware (other than the user's personal smartphone) is required. Additionally, multi-night analysis is possible in the home environment, without requiring the wearing of a portable PSG or other home sleep test (HST).
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Affiliation(s)
- Roxana Tiron
- ResMed Sensor Technologies, NexusUCD, Dublin, Ireland
| | - Graeme Lyon
- ResMed Sensor Technologies, NexusUCD, Dublin, Ireland
| | - Hannah Kilroy
- ResMed Sensor Technologies, NexusUCD, Dublin, Ireland
| | - Ahmed Osman
- ResMed Sensor Technologies, NexusUCD, Dublin, Ireland
| | - Nicola Kelly
- ResMed Sensor Technologies, NexusUCD, Dublin, Ireland
| | | | - Cesar Lopes
- ResMed Sensor Technologies, NexusUCD, Dublin, Ireland
| | - Sam Coffey
- ResMed Sensor Technologies, NexusUCD, Dublin, Ireland
| | | | - Michael Wren
- ResMed Sensor Technologies, NexusUCD, Dublin, Ireland
| | - Kieran Conway
- ResMed Sensor Technologies, NexusUCD, Dublin, Ireland
| | - Niall Fox
- ResMed Sensor Technologies, NexusUCD, Dublin, Ireland
| | - John Costello
- ResMed Sensor Technologies, NexusUCD, Dublin, Ireland
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16
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Lowdon J, Costello J. P369 Annual review process at the Leeds Paediatric Cystic Fibrosis unit: how are we doing? J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30697-4] [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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17
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Ylli D, Patel A, Mendoca-Torres MC, Costello J, Bikas A, Wartofsky L, Burman KD, Jensen K, Vasko VV. MON-514 Detection of RAS Mutations and RET/PTC Fusions in Thyroid Cancer Using Microfluidic Digital PCR. J Endocr Soc 2020. [PMCID: PMC7209185 DOI: 10.1210/jendso/bvaa046.1774] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background:
The identification of somatic mutations and gene fusions is crucial for guiding therapeutic decisions in patients with thyroid cancer. Microfluidic digital PCR is currently considered as a technique of choice for highly sensitive detection of gene mutations/fusion. We recently demonstrated that dPCR is a useful tool for detection of BRAFV600E and TERT promoter mutations in thyroid tumors.
Objectives:
This study aimed to determine the analytic and clinical validity of dPCR for detection of RAS mutations and RET/PTC fusions in thyroid cancer tissue.
Material and Methods:
Thyroid tissues from 75 patients with PTCs (58 classical PTC (CPTC) and 17 follicular variant (FVPTC) were used for DNA and RNA extraction. The rare mutation SNP genotyping assays which were multiplexed for detection of mutant and wild type NRASQ61; as well as RET/PTC1 and RET/PTC3 were synthesized by Thermo Fisher Scientific. Digital PCR was performed using a QuantStudio 3D Digital PCR platform. QuantStudio Software was used for relative and quantitative data analysis.
Results:
NRASQ61 was detected in 0/58 CPTC and in 6/17 (35%) FVPTC. The ratios of mutant/total varying from 11.7% to 61.5%. Among patients with FVPTC there were no significant associations between the presence of NRASQ61 and patient’s age, sex, multifocal growth, extra-thyroidal invasion and lymph node metastases. The ratios mutant/total correlated with tumor size in patients harboring NRASQ61. In 23 cases, RET/PTC1 and RET/PTC3 transcripts were examined. RET/PTC1 and RET/PTC3 transcripts were detected in 3 and 1 case, respectively. RET/PTCs were detected in CPTC, but not in FVPTC. RET/PTC positive tumors were characterized by multi-focal patterns of growth, presence of extra-thyroidal invasion, and presence of lymph node metastases (4 of 4 cases with RET/PTC). There were not RET/PTCs positive tumors harboring simultaneously anomalies in RAS oncogene.
Conclusions:
Microfluidic digital PCR allows specific, sensitive and rapid detection of RAS mutations and RET/PTC fusions in thyroid tissue samples. Implementation of dPCR-based assays may facilitate analysis of thyroid tumors and support research in patients with thyroid cancer.
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Affiliation(s)
- Dorina Ylli
- MedStar Health Research Institute, Washington, DC, USA
| | - Aneeta Patel
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - John Costello
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | | | | | - Kirk Jensen
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Vasyl V Vasko
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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18
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Shehadeh M, Costello J, Brar V, Hadadi C. SUCCESSFUL MICRA LEADLESS PACEMAKER IMPLANTATION THROUGH AN ILIAC VEIN STENT. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)33312-x] [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: 11/17/2022]
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19
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Gatti J, Chaturvedi M, Costello J. TICK-BORNE CARDIAC ARREST: A NOVEL CASE OF LYME CARDITIS PRESENTING AS PULSELESS VENTRICULAR TACHYCARDIA. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)33871-7] [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: 10/24/2022]
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20
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Ylli D, Patel A, Jensen K, Li ZZ, Mendonca-Torres MC, Costello J, Gomes-Lima CJ, Wartofsky L, Burman KD, Vasko VV. Microfluidic Droplet Digital PCR Is a Powerful Tool for Detection of BRAF and TERT Mutations in Papillary Thyroid Carcinomas. Cancers (Basel) 2019; 11:cancers11121916. [PMID: 31810221 PMCID: PMC6966523 DOI: 10.3390/cancers11121916] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 11/11/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/15/2022] Open
Abstract
We examined the utility of microfluidic digital PCR (dPCR) for detection of BRAF and TERT mutations in thyroid tumors. DNA extracted from 100 thyroid tumors (10 follicular adenomas, 10 follicular cancers, 5 medullary cancers, and 75 papillary thyroid cancer (PTC) were used for detection of BRAF and TERT mutations. Digital PCRs were performed using rare mutation SNP genotyping assays on QuantStudio 3D platform. In PTCs, BRAFV600E was detected by dPCR and Sanger sequencing in 42/75 (56%) and in 37/75 (49%), respectively. BRAFV600E was not detected in other tumors. The ratio of mutant/total BRAF alleles varied from 4.7% to 47.5%. These ratios were higher in classical PTCs (27.1%) as compared to follicular variant PTCs (9.4%) p = 0.001. In PTCs with and without metastases, the ratios of mutant/total BRAF alleles were 27.6% and 18.4%, respectively, (p = 0.03). In metastatic lesions percentages of mutant/total BRAF alleles were similar to those detected in primary tumors. TERTC228T and TERTC250T were found in two and one cases, respectively, and these tumors concomitantly harbored BRAFV600E. These tumors exhibited gross extra-thyroidal extension, metastases to lymph nodes, and pulmonary metastases (one case). Our results showed that dPCR allows quantitative assessment of druggable targets in PTCs and could be helpful in a molecular-based stratification of prognosis in patients with thyroid cancer.
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Affiliation(s)
- Dorina Ylli
- Thyroid Cancer Research Center, MedStar Health Research Institute, 100 Irving St NW, Washington, DC 2010, USA; (D.Y.); (C.J.G.-L.); (L.W.); (K.D.B.)
- Division of Endocrinology, Department of Internal Medicine, MedStar Washington Hospital Center, 110 Irving St NW, Washington, DC 2010, USA
- Department of Imaging and Clinical Semeiotic, Faculty of Medicine, University of Medicine Tirana, 371 Dibra St, 1005 Tirana, Albania
| | - Aneeta Patel
- Department of Pediatrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge, Bethesda, MD 20814, USA; (A.P.); (K.J.); (M.C.M.-T.); (J.C.)
| | - Kirk Jensen
- Department of Pediatrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge, Bethesda, MD 20814, USA; (A.P.); (K.J.); (M.C.M.-T.); (J.C.)
| | - Zhao-Zhang Li
- Biomedical instrumentation center, Uniformed Services University of the Health Sciences, 4301 Jones Bridge, Bethesda, MD 20814, USA;
| | - Maria Cecilia Mendonca-Torres
- Department of Pediatrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge, Bethesda, MD 20814, USA; (A.P.); (K.J.); (M.C.M.-T.); (J.C.)
| | - John Costello
- Department of Pediatrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge, Bethesda, MD 20814, USA; (A.P.); (K.J.); (M.C.M.-T.); (J.C.)
| | - Cristiane Jeyce Gomes-Lima
- Thyroid Cancer Research Center, MedStar Health Research Institute, 100 Irving St NW, Washington, DC 2010, USA; (D.Y.); (C.J.G.-L.); (L.W.); (K.D.B.)
- Division of Endocrinology, Department of Internal Medicine, MedStar Washington Hospital Center, 110 Irving St NW, Washington, DC 2010, USA
| | - Leonard Wartofsky
- Thyroid Cancer Research Center, MedStar Health Research Institute, 100 Irving St NW, Washington, DC 2010, USA; (D.Y.); (C.J.G.-L.); (L.W.); (K.D.B.)
- Division of Endocrinology, Department of Internal Medicine, MedStar Washington Hospital Center, 110 Irving St NW, Washington, DC 2010, USA
| | - Kenneth Dale Burman
- Thyroid Cancer Research Center, MedStar Health Research Institute, 100 Irving St NW, Washington, DC 2010, USA; (D.Y.); (C.J.G.-L.); (L.W.); (K.D.B.)
- Division of Endocrinology, Department of Internal Medicine, MedStar Washington Hospital Center, 110 Irving St NW, Washington, DC 2010, USA
| | - Vasyl V. Vasko
- Department of Pediatrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge, Bethesda, MD 20814, USA; (A.P.); (K.J.); (M.C.M.-T.); (J.C.)
- Correspondence: ; Tel.: +1-(240)-423-1051
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Bikas A, Jensen K, Patel A, Costello J, Kaltsas G, Hoperia V, Wartofsky L, Burman K, Vasko V. Mitotane induces mitochondrial membrane depolarization and apoptosis in thyroid cancer cells. Int J Oncol 2019; 55:7-20. [PMID: 31115496 PMCID: PMC6561621 DOI: 10.3892/ijo.2019.4802] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 03/12/2019] [Indexed: 12/17/2022] Open
Abstract
Mitotane is used for the treatment of adrenocortical cancer and elicits its anticancer effects via inhibition of mitochondrial respiration. Targeting mitochondria‑dependent metabolism has emerged as a promising strategy for thyroid cancer (TC) treatment. We hypothesized that mitotane targets mitochondria and induces apoptosis in TC cells. Cell lines representative of the major histological variants of TC were chosen: Follicular (FTC‑133), poorly differentiated (BCPAP), anaplastic (SW1736 and C643) and medullary (TT) TC cells, and were treated with mitotane (0‑100 µM). Mitochondrial membrane potential, cell viability and apoptosis were examined by JC‑1 staining and by western blot analysis using an antibody against caspase‑3. The expression of mitochondrial molecules and DNA damage markers and the activation of endoplasmic reticulum (ER) stress were determined by western blotting. The expression of mitochondrial ATP synthase subunit β (ATP5B) was examined by immunostaining in 100 human TC tissue samples. Treatment with mitotane (50 µM for 24 h) decreased the viability of FTC‑133, BCPAP, SW1736, C643 and TT cells by 12, 59, 54, 31 and 66%, respectively. Morphological evidence of ER stress and overexpression of ER markers was observed in TC cells following exposure to mitotane. The treatment led to increased expression of histone γH2AX, indicating DNA damage, and to caspase‑3 cleavage. Consistent with the results of the cell viability assays, the overexpression of pro‑apoptotic genes following treatment with mitotane was more prominent in TC cells harboring mutations in the serine/threonine‑protein kinase B‑raf gene and proto‑oncogene tyrosine‑protein kinase receptor Ret. Treatment with mitotane was associated with loss of mitochondrial membrane potential and decreased expression of ATP5B, particularly in the medullary TC (MTC)‑derived TT cells. Immunohistochemical analysis of mitochondrial ATP5B in human TC specimens demonstrated its overexpression in cancer compared with normal thyroid tissue. The level of ATP5B expression was higher in MTC compared with the follicular, papillary or anaplastic types of TC. Mitotane elicited pleiotropic effects on TC cells, including induction of ER stress, inhibition of mitochondrial membrane potential and induction of apoptosis. The results of the present study suggest that mitotane could be considered as a novel agent for the treatment of aggressive types of TC.
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Affiliation(s)
- Athanasios Bikas
- Department of Pathophysiology, Laiko Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Kirk Jensen
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Aneeta Patel
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - John Costello
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Gregory Kaltsas
- Department of Pathophysiology, Laiko Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Victoria Hoperia
- Department of Fundamental Medicine, National University of Kyiv, 01033 Kyiv, Ukraine
| | - Leonard Wartofsky
- Division of Endocrinology, Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC 20010, USA
| | - Kenneth Burman
- Division of Endocrinology, Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC 20010, USA
| | - Vasyl Vasko
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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22
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Gaies M, Olive MK, Owens G, Charpie J, Zhang W, Pasquali S, Klugman D, Costello J, Hammel J, Gaynor JW, Banerjee M, Schwartz S. PEDIATRIC CARDIAC CRITICAL CARE OUTCOMES IMPROVE FOLLOWING IMPLEMENTATION OF A COMMERCIAL DATA AGGREGATION AND VISUALIZATION SOFTWARE PLATFORM. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)31170-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Pattee GL, Plowman EK, (Focht) Garand KL, Costello J, Brooks BR, Berry JD, Smith RA, Atassi N, Chapin JL, Yunusova Y, McIlduff CE, Young E, Macklin EA, Locatelli ER, Silani V, Heitzman D, Wymer J, Goutman SA, Gelinas DF, Perry B, Nalipinski P, Stipancic K, O'Brien M, Sullivan SL, Pioro EP, Gargiulo G, Green JR. Provisional best practices guidelines for the evaluation of bulbar dysfunction in amyotrophic lateral sclerosis. Muscle Nerve 2019; 59:531-536. [DOI: 10.1002/mus.26408] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/24/2018] [Accepted: 01/02/2019] [Indexed: 12/12/2022]
Affiliation(s)
| | - Emily K. Plowman
- Department of Speech, Language and Hearing SciencesUniversity of Florida Gainesville FL U.S.A
| | | | - John Costello
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Charlestown, MA, U.S.A., ALS Augmentative Communication ProgramBoston Children's Hospital Boston MA U.S.A
| | | | | | | | | | - Jennifer L. Chapin
- Department of Speech, Language and Hearing SciencesUniversity of Florida Gainesville FL U.S.A
| | - Yana Yunusova
- Department of Speech‐Language PathologyUniversity of Toronto Toronto ON CANADA
| | | | - Eufrosina Young
- State University of New YorkDepartment of Neurology Syracuse NY U.S.A
| | | | | | - Vincenzo Silani
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Laboratory of Neuroscience, Department of Pathophysiology and Transplantation, “Dino Ferrari” CenterUniversità degli studi di Milano Milan 20122 Italy
| | | | - James Wymer
- University of Florida, Rehabilitation Science Gainesville FL U.S.A
| | | | | | - Bridget Perry
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Charlestown, MA, U.S.A., ALS Augmentative Communication ProgramBoston Children's Hospital Boston MA U.S.A
| | | | - Kaila Stipancic
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Charlestown, MA, U.S.A., ALS Augmentative Communication ProgramBoston Children's Hospital Boston MA U.S.A
| | - Meghan O'Brien
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Charlestown, MA, U.S.A., ALS Augmentative Communication ProgramBoston Children's Hospital Boston MA U.S.A
| | | | - Erik P. Pioro
- Cleveland ClinicDepartment of Neurology Cleveland OH U.S.A
| | - Gisella Gargiulo
- National Scientific and Technical Research Council Buenos Aires Argentina
| | - Jordan R. Green
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Charlestown, MA, U.S.A., ALS Augmentative Communication ProgramBoston Children's Hospital Boston MA U.S.A
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24
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Borrero CG, Bertolet M, Costello J, Vyas D. Value of anterosuperior rotator cuff and labral tears at MRI for predicting long head of biceps tearing at arthroscopy. Clin Radiol 2018; 73:1058.e1-1058.e9. [PMID: 30224185 DOI: 10.1016/j.crad.2018.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/10/2018] [Indexed: 11/29/2022]
Abstract
AIM To determine whether magnetic resonance imaging (MRI) signs of subscapularis (SBT), supraspinatus (SST), or superior labral tearing predict long head of biceps (LHB) tendon tearing at arthroscopy. MATERIALS AND METHODS Subjects with MRI studies followed by arthroscopy were collected. Radiologists graded rotator cuff (RC) tendons and the superior labrum using three grade classifications and blinded to arthroscopy. Correlation between imaging variables and surgical outcome was expressed in terms of odds ratios and determined using a stepwise logistic regression model. RESULTS Selection criteria identified 89 participants. Statistically significant increase in odds of finding a partial LHB tendon tear at arthroscopy were noted for both MRI readers with any SBT tear (OR=4.1-5.6, p<0.0001 to 0.002), full-thickness SST (OR=8-20.4, p=0.002 to 0.006), and combined SST-SBT tears (OR=5.1-7.6, p<0.0001 to 0.002) and relative to grade 0 MRI scores for those categories. Statistically significant increase in the odds of finding any LHB tendon tear at arthroscopy were noted for both MRI readers with any SBT tear (OR=9.6 to 14.6, p<0.0001), full-thickness SST (OR=9.0 to 52.0, p<0.0001 to 0.0004) and combined SST-SBT tears (OR=8.2 to 15.1, p<0.0001) at MRI and relative to grade 0 MRI scores for these categories. No significant predictive effect was found for the labral categories. CONCLUSION LHB tendons should be closely scrutinised if anterosuperior rotator cuff tears, and SBT tears in particular, are found on MRI.
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Affiliation(s)
- C G Borrero
- University of Pittsburgh School of Medicine, USA.
| | - M Bertolet
- University of Pittsburgh School of Public Health, USA
| | - J Costello
- University of Pittsburgh School of Medicine, USA
| | - D Vyas
- University of Pittsburgh School of Medicine, USA
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25
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care
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Affiliation(s)
- John Costello
- Honorary Lecturer, University of Manchester School of Nursing, Midwifery and Social Work
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26
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Barthel F, Verburg N, Johnson K, Anderson K, Taylor M, Costello J, Wesseling P, De Witt Hamer P, Verhaak R. PO-390 Image-guided stereotactic molecular profiling of samples taken in- and outside conventional tumour boundaries highlight extensive infiltration of tumour cells in diffuse gliomas. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.417] [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: 11/04/2022] Open
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27
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care.
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Affiliation(s)
- John Costello
- Honorary Lecturer, University of Manchester School of Nursing, Midwifery and Social Work
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28
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care
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Affiliation(s)
- John Costello
- Honorary Lecturer, University of Manchester School of Nursing, Midwifery and Social Work
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29
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30
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care
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Affiliation(s)
- John Costello
- Honorary Lecturer, University of Manchester School of Nursing, Midwifery and Social Work
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31
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Zhou N, Costello J. A220 TIME TO DIAGNOSIS OF COLORECTAL CANCER FROM FINDING OF IRON DEFICIENCY ANEMIA. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy009.220] [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)
- N Zhou
- Gastroenterology, University of Ottawa, Ottawa, ON, Canada
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32
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Gaies M, Ghanayem N, Alten J, Costello J, Lasa J, Chanani N, Shin A, Retzloff L, Zhang W, Pasquali S, Banerjee M, Tabbutt S. MEASURING PEDIATRIC CARDIAC INTENSIVE CARE UNIT QUALITY IN MEDICAL ADMISSIONS. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31144-6] [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: 10/17/2022]
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33
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care
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Affiliation(s)
- John Costello
- Honorary Lecturer, University of Manchester School of Nursing, Midwifery and Social Work
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34
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care.
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Affiliation(s)
- John Costello
- Senior Lecturer, University of Manchester Division of Nursing, Midwifery and Social Work
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35
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care.
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Affiliation(s)
- John Costello
- Senior Lecturer, University of Manchester Division of Nursing, Midwifery and Social Work
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36
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care.
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Affiliation(s)
- John Costello
- Senior Lecturer, University of Manchester Division of Nursing, Midwifery and Social Work
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37
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care.
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Affiliation(s)
- John Costello
- Senior Lecturer, University of Manchester Division of Nursing, Midwifery and Social Work
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38
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Costello J. Palliative care for people with non-cancer conditions. Int J Palliat Nurs 2017; 23:471. [DOI: 10.12968/ijpn.2017.23.10.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- John Costello
- Senior lecturer in palliative care nursing, University of Manchester
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39
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Affiliation(s)
- John Costello
- Senior Lecturer, University of Manchester Division of Nursing, Midwifery and Social Work
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40
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Affiliation(s)
- Jacqueline Crowther
- Admiral Nurse, End of Life Care, Kirkwood Hospice; Kirklees Honorary Research Associate, University of Liverpool
| | - John Costello
- Senior Lecturer, School of Nursing, University of Manchester
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41
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Choi S, Hayes J, Shelton S, Jones L, Mazor T, Fouse S, Oldham M, Costello J. Genetic Characterization of Stromal Cells in High Grade Gliomas. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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42
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Klubo-Gwiezdzinska J, Costello J, Jensen K, Patel A, Tkavc R, Van Nostrand D, Burman KD, Wartofsky L, Vasko V. Amifostine does not protect thyroid cancer cells in DNA damaging in vitro models. Endocr Connect 2017; 6:469-478. [PMID: 28790138 PMCID: PMC5597971 DOI: 10.1530/ec-17-0138] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 08/08/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND Amifostine is a potent scavenger of reactive oxygen species that is used for the salivary gland protection during therapy with radioactive iodine for thyroid cancer. There are no data on the potential effect of amifostine on thyroid cancer cells. METHODS We investigated the effects of the active form of amifostine (WR-1065) on the response of thyroid cancer cells to treatment with DNA-damaging agents. WR-1065 was examined in human thyroid cancer cell lines (FTC133, TPC1, BCPAP and C643) and embryonic fibroblast cells NIH3T3. DNA damage was induced by exposure to H2O2 (0.1 mM), by treatment with the radiomimetic neocarzinostatin (NCS 250 ng/mL) and by γ-radiation (6 Gy). DNA damage, cell viability and apoptosis were examined. RESULTS We demonstrated the selective action of WR-1065 (0.1 mM), which prevented oxidative stress-induced DNA damage in fibroblasts, but did not protect thyroid cancer cells from DNA damage and apoptosis documented by caspase-3 and PARP cleavage after exposure to H2O2, NCS and γ-radiation. Prolonged exposure to WR-1065 (0.1 mM for 24 h) was toxic for thyroid cancer cells; this treatment decreased the number of viable cells by 8% in C643 cells, 47% in TPC cells, 92% in BCPAP cells and 82% in FTC 133 cells. The cytotoxic effects of WR-1065 were not associated with induction of apoptosis. CONCLUSIONS Our data show that amifostine has no protective effect on thyroid cancer cells against DNA-damaging agents in vitro and suggest that amifostine will not attenuate the efficacy of radioiodine treatment in patients with thyroid cancer.
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Affiliation(s)
- Joanna Klubo-Gwiezdzinska
- National Institute of HealthNIDDK, Office 10 Center Drive, Bethesda, Maryland, USA
- Division of EndocrinologyDepartment of Medicine, Medstar Washington Hospital Center, Washington Hospital Center, Northwest, Washington, District of Columbia, USA
| | - John Costello
- Department of PediatricsUniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Kirk Jensen
- Department of PediatricsUniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Aneeta Patel
- Department of PediatricsUniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Rok Tkavc
- Department of PathologyUniformed Services University of the Health Sciences, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Douglas Van Nostrand
- Division of EndocrinologyDepartment of Medicine, Medstar Washington Hospital Center, Washington Hospital Center, Northwest, Washington, District of Columbia, USA
| | - Kenneth D Burman
- Division of EndocrinologyDepartment of Medicine, Medstar Washington Hospital Center, Washington Hospital Center, Northwest, Washington, District of Columbia, USA
| | - Leonard Wartofsky
- Division of EndocrinologyDepartment of Medicine, Medstar Washington Hospital Center, Washington Hospital Center, Northwest, Washington, District of Columbia, USA
| | - Vasyl Vasko
- Department of PediatricsUniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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43
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O'Brien M, Schlosser R, Yu C, Allen A, Flynn S, Costello J, Shane H, O'Brien A. Repurposing Consumer Products as a Gateway to Just-in-Time Communication. Semin Speech Lang 2017; 38:297-312. [DOI: 10.1055/s-0037-1604277] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractThe rich feature set and flexibility of mobile technology offers a host of novel opportunities to provide specific and timely supports to individuals with communication and memory disorders. These “just-in-time” (JIT) supports can be used as prompts, reminders, rewards, strategies to increase independence, and expressive language supports for children and adults with communication and memory disorders. The purpose of this article is to examine current research on, and propose future directions for, repurposing consumer products to enhance JIT communication within the field of augmentative and alternative communication. Initially, a brief history of JIT supports will be reviewed, including a timeline and history of JIT-enabling technology. Next, the taxonomy of JIT supports will be applied to current research in both individuals with autism spectrum disorder and individuals with acquired communication disorders (e.g., acquired brain injury, amyotrophic lateral sclerosis) to illustrate current clinical implications and evaluate current limitations of JIT supports. Finally, future directions for research and expanded use of consumer products to provide JIT supports will be discussed.
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Affiliation(s)
- Meghan O'Brien
- Boston Children's Hospital, MGH Institute of Health Professions, Boston, Massachusetts
| | - Ralf Schlosser
- Northeastern University, Boston Children's Hospital, Boston, Massachusetts
| | - Christina Yu
- Boston Children's Hospital, Boston, Massachusetts
| | - Anna Allen
- Boston Children's Hospital, MGH Institute of Health Professions, Boston, Massachusetts
| | - Suzanne Flynn
- Massachusetts Institute of Technology, Boston Children's Hospital, Boston, Massachusetts
| | - John Costello
- Boston Children's Hospital, MGH Institute of Health Professions, Boston University, Boston, Massachusetts
| | - Howard Shane
- Boston Children's Hospital, Harvard Medical School, MGH Institute of Health Professions, Boston, Massachusetts
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44
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Henriksen MDL, Sharkey L, Esser M, Costello J. Clinical management of superficial complicated corneal ulcerations infected with newly identified fastidious bacteria with unknown antibiotic sensitivity in three horses. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M. d. L. Henriksen
- Department of Veterinary Sciences College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins ColoradoUSA
| | - L. Sharkey
- Department of Veterinary Clinical Sciences College of Veterinary Medicine University of Minnesota St Paul MinnesotaUSA
| | - M. Esser
- Department of Large Animal Clinical Sciences College of Veterinary Medicine Michigan State University East Lansing MichiganUSA
| | - J. Costello
- Virginia Equine Imaging The Plains Virginia USA
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45
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care.
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Affiliation(s)
- John Costello
- Senior Lecturer, University of Manchester division of Nursing, Midwifery and Social Work
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46
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care.
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Affiliation(s)
- John Costello
- Senior Lecturer, University of Manchester School of Nursing, Midwifery and Social Work
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47
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care.
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Affiliation(s)
- John Costello
- Senior Lecturer, University of Manchester School of Nursing, Midwifery and Social Work
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48
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Abstract
In the palliative phase of a person's illness, the needs of the patient and informal caregivers are paramount. Caregivers often look to palliative care practitioners for support, guidance and emotional comfort. This article reviews the role of the informal caregiver at the end of life, summarising their concerns and needs. The paper also highlights caregiver difficulties in making the coping transition when the patient's medical condition becomes advanced and they require end-of-life care. The focus of the review is placed on discussions about Advanced Care Planning (ACP). ACP is a complex legal, ethical and practical issue that can enable caregivers to consider future strategies and enable them to provide high quality care at the end of life. The paper looks at some of the ethical and legal issues associated with this sensitive end-of-life issue.
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Affiliation(s)
- John Costello
- Associate Professor, Nanyang polytechnic, Singapore SIT@NYP (University of Manchester)
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49
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Martin ASH, Costello J, Griffiths J. Communication in palliative care: the applicability of the SAGE and THYME model in Singapore. Int J Palliat Nurs 2017. [PMID: 28648130 DOI: 10.12968/ijpn.2017.23.6.288] [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: 11/11/2022]
Abstract
BACKGROUND Majority of the progress and development in palliative care in the last decade has been improvements in physical aspects of treatment, namely pain and symptom management. Psychosocial aspects of care have improved, although not enough to meet the needs of many patients and family members. This is evident in many parts of the world and notably in Singapore, where palliative care is seen as an emerging medical and nursing specialty. AIM To discuss the implementation of the SAGE and THYME communication model in a palliative care context. The article examines the use of the model and how its implementation can improve communication between patients and nurses. The model works by reviewing contemporary developments made in relation to improving communication in palliative care. These include, highlighting the importance of meeting individual needs, therapeutic relationship building, and advanced communication training within a Singaporean context. RESULTS The implementation of the SAGE and THYME model can be a useful way of enabling nurses to improve and maintain effective communication in a medically dominated health care system. The challenges and constraints in educating and training nurses with limited skills in palliative care, forms part of the review, including the cultural and attitude constraints specific to Singaporean palliative care.
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Affiliation(s)
| | - John Costello
- Associate Professor, University of Manchester, United Kingdom
| | - Jane Griffiths
- Senior Lecturer, University of Manchester, United Kingdom
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50
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Abstract
Synopses of a selection of recently published research articles of relevance to palliative care.
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Affiliation(s)
- John Costello
- Senior Lecturer, University of Manchester School of Nursing, Midwifery and Social Work
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