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Li KR, Lava CX, Neughebauer MB, Rohrich RN, Atves J, Steinberg J, Akbari CM, Youn RC, Attinger CE, Evans KK. A Multidisciplinary Approach to End-Stage Limb Salvage in the Highly Comorbid Atraumatic Population: An Observational Study. J Clin Med 2024; 13:2406. [PMID: 38673679 PMCID: PMC11050798 DOI: 10.3390/jcm13082406] [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] [Received: 03/22/2024] [Revised: 04/09/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
Background: The use of free tissue transfer (FTT) is efficacious for chronic, non-healing lower extremity (LE) wounds. The four pillars of managing patient comorbidities, infection control, blood flow status, and biomechanical function are critical in achieving successful limb salvage. The authors present their multidisciplinary institutional experience with a review of 300 FTTs performed for the complex LE limb salvage of chronic LE wounds. Methods: A single-institution, retrospective review of atraumatic LE FTTs performed by a single surgeon from July 2011 to January 2023 was reviewed. Data on patient demographics, comorbidities, preoperative management, intraoperative details, flap outcomes, postoperative complications, and long-term outcomes were collected. Results: A total of 300 patients who underwent LE FTT were included in our retrospective review. Patients were on average 55.9 ± 13.6 years old with a median Charlson Comorbidity Index of 4 (IQR: 3). The majority of patients were male (70.7%). The overall hospital length of stay (LOS) was 27 days (IQR: 16), with a postoperative LOS of 14 days (IQR: 9.5). The most prevalent comorbidities were diabetes (54.7%), followed by peripheral vascular disease (PVD: 35%) and chronic kidney disease (CKD: 15.7%). The average operative LE FTT time was 416 ± 115 min. The majority of flaps were anterolateral thigh (ALT) flaps (52.7%), followed by vastus lateralis (VL) flaps (25.3%). The immediate flap success rate was 96.3%. The postoperative ipsilateral amputation rate was 12.7%. Conclusions: Successful limb salvage is possible in a highly comorbid patient population with a high prevalence of diabetes mellitus, peripheral vascular disease, and end-stage renal disease. In order to optimize patients prior to their LE FTT, extensive laboratory, arterial, and venous preoperative testing and diabetes management are needed preoperatively. Postoperative monitoring and long-term follow-up with a multidisciplinary team are also crucial for long-term limb salvage success.
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Affiliation(s)
- Karen R. Li
- Georgetown University School of Medicine, Washington, DC 20007, USA
| | | | | | | | - Jayson Atves
- Department of Podiatry, MedStar Georgetown University Hospital, Washington, DC 20007, USA
| | - John Steinberg
- Department of Podiatry, MedStar Georgetown University Hospital, Washington, DC 20007, USA
| | - Cameron M. Akbari
- Department of Vascular Surgery, MedStar Georgetown University Hospital, Washington, DC 20007, USA
| | - Richard C. Youn
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC 20007, USA
| | - Christopher E. Attinger
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC 20007, USA
| | - Karen K. Evans
- Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC 20007, USA
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2
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Verdin C, Zarick C, Steinberg J. Unique Challenges in Diabetic Foot Science. Clin Podiatr Med Surg 2024; 41:323-331. [PMID: 38388128 DOI: 10.1016/j.cpm.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
In the past 30 years, there has been a rapid influx of information pertaining to the diabetic foot (DF) coming from numerous directions and sources. This article discusses the current state of the DF literature and challenges it presents to clinicians with its associated increase in knowledge on their derivations, complications, and interventions. Further, we attempt to provide tips on how to navigate and criticize the current literature to encourage and maximize positive outcomes in this challenging patient population.
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Affiliation(s)
- Craig Verdin
- Department of Plastic Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road NW, Washington DC 20007, USA
| | - Caitlin Zarick
- Department of Plastic Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road NW, Washington DC 20007, USA
| | - John Steinberg
- Department of Plastic Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road NW, Washington DC 20007, USA.
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Chen P, Vilorio NC, Dhatariya K, Jeffcoate W, Lobmann R, McIntosh C, Piaggesi A, Steinberg J, Vas P, Viswanathan V, Wu S, Game F. Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: A systematic review. Diabetes Metab Res Rev 2024; 40:e3786. [PMID: 38507616 DOI: 10.1002/dmrr.3786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND It is critical that interventions used to enhance the healing of chronic foot ulcers in diabetes are backed by high-quality evidence and cost-effectiveness. In previous years, the systematic review accompanying guidelines published by the International Working Group of the Diabetic Foot performed 4-yearly updates of previous searches, including trials of prospective, cross-sectional and case-control design. AIMS Due to a need to re-evaluate older studies against newer standards of reporting and assessment of risk of bias, we performed a whole new search from conception, but limiting studies to randomised control trials only. MATERIALS AND METHODS For this systematic review, we searched PubMed, Scopus and Web of Science databases for published studies on randomised control trials of interventions to enhance healing of diabetes-related foot ulcers. We only included trials comparing interventions to standard of care. Two independent reviewers selected articles for inclusion and assessed relevant outcomes as well as methodological quality. RESULTS The literature search identified 22,250 articles, of which 262 were selected for full text review across 10 categories of interventions. Overall, the certainty of evidence for a majority of wound healing interventions was low or very low, with moderate evidence existing for two interventions (sucrose-octasulfate and leucocyte, platelet and fibrin patch) and low quality evidence for a further four (hyperbaric oxygen, topical oxygen, placental derived products and negative pressure wound therapy). The majority of interventions had insufficient evidence. CONCLUSION Overall, the evidence to support any other intervention to enhance wound healing is lacking and further high-quality randomised control trials are encouraged.
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Affiliation(s)
- Pam Chen
- Joondalup Health Campus, Ramsay Healthcare Australia, Joondalup, Western Australia, Australia
- Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia
| | - Nalini Campillo Vilorio
- Department of Diabetology, Diabetic Foot Unit, Plaza de la Salud General Hospital, Santo Domingo, Dominican Republic
| | - Ketan Dhatariya
- Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Ralf Lobmann
- Clinic for Endocrinology, Diabetology and Geriatrics, Klinikum Stuttgart, Stuttgart, Germany
| | | | - Alberto Piaggesi
- Diabetic Foot Section, Department of Medicine, University of Pisa, Pisa, Italy
| | - John Steinberg
- Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Prash Vas
- King's College Hospital NHS Foundation Trust, London, UK
| | - Vijay Viswanathan
- MV Hospital for Diabetes and Prof M Viswanathan Diabetes Research Center, Chennai, India
| | - Stephanie Wu
- Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Fran Game
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
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4
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Chen P, Vilorio NC, Dhatariya K, Jeffcoate W, Lobmann R, McIntosh C, Piaggesi A, Steinberg J, Vas P, Viswanathan V, Wu S, Game F. Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update). Diabetes Metab Res Rev 2024; 40:e3644. [PMID: 37232034 DOI: 10.1002/dmrr.3644] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 05/27/2023]
Abstract
AIMS Principles of wound management, including debridement, wound bed preparation, and newer technologies involving alternation of wound physiology to facilitate healing, are of utmost importance when attempting to heal a chronic diabetes-related foot ulcer. However, the rising incidence and costs of diabetes-related foot ulcer management necessitate that interventions to enhance wound healing of chronic diabetes-related foot ulcers are supported by high-quality evidence of efficacy and cost effectiveness when used in conjunction with established aspects of gold-standard multidisciplinary care. This is the 2023 International Working Group on the Diabetic Foot (IWGDF) evidence-based guideline on wound healing interventions to promote healing of foot ulcers in persons with diabetes. It serves as an update of the 2019 IWGDF guideline. MATERIALS AND METHODS We followed the GRADE approach by devising clinical questions and important outcomes in the Patient-Intervention-Control-Outcome (PICO) format, undertaking a systematic review, developing summary of judgements tables, and writing recommendations and rationale for each question. Each recommendation is based on the evidence found in the systematic review and, using the GRADE summary of judgement items, including desirable and undesirable effects, certainty of evidence, patient values, resources required, cost effectiveness, equity, feasibility, and acceptability, we formulated recommendations that were agreed by the authors and reviewed by independent experts and stakeholders. RESULTS From the results of the systematic review and evidence-to-decision making process, we were able to make 29 separate recommendations. We made a number of conditional supportive recommendations for the use of interventions to improve healing of foot ulcers in people with diabetes. These include the use of sucrose octasulfate dressings, the use of negative pressure wound therapies for post-operative wounds, the use of placental-derived products, the use of the autologous leucocyte/platelet/fibrin patch, the use of topical oxygen therapy, and the use of hyperbaric oxygen. Although in all cases it was stressed that these should be used where best standard of care was not able to heal the wound alone and where resources were available for the interventions. CONCLUSIONS These wound healing recommendations should support improved outcomes for people with diabetes and ulcers of the foot, and we hope that widescale implementation will follow. However, although the certainty of much of the evidence on which to base the recommendations is improving, it remains poor overall. We encourage not more, but better quality trials including those with a health economic analysis, into this area.
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Affiliation(s)
- Pam Chen
- Joondalup Health Campus, Ramsay Healthcare Australia, Joondalup, Western Australia, Australia
- Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia
| | - Nalini Campillo Vilorio
- Department of Diabetology, Diabetic Foot Unit, Plaza de la Salud General Hospital, Santo Domingo, Dominican Republic
| | - Ketan Dhatariya
- Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Ralf Lobmann
- Clinic for Endocrinology, Diabetology and Geriatrics, Klinikum Stuttgart, Stuttgart, Germany
| | - Caroline McIntosh
- Podiatric Medicine, School of Health Sciences, University of Galway, Galway, Ireland
| | - Alberto Piaggesi
- Diabetic Foot Section, Department of Medicine, University of Pisa, Pisa, Italy
| | - John Steinberg
- Georgetown University School of Medicine, Georgetown, Washington DC, USA
| | - Prash Vas
- King's College Hospital NHS Foundation Trust, London, UK
| | - Vijay Viswanathan
- MV Hospital for Diabetes and Prof M Viswanathan Diabetes Research Center, Chennai, India
| | - Stephanie Wu
- Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Fran Game
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
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5
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Früh T, Linke SJ, Steinberg J. [Uncommon treatment options for epithelial ingrowth after laser lenticule extraction]. Ophthalmologie 2024; 121:75-78. [PMID: 37814157 DOI: 10.1007/s00347-023-01922-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/11/2023]
Affiliation(s)
- T Früh
- Medizinische Fakultät, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland.
| | - S J Linke
- Augenklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Augenarztpraxis zentrumsehstaerke, Hamburg, Deutschland
| | - J Steinberg
- Augenklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Augenarztpraxis zentrumsehstaerke, Hamburg, Deutschland
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Plate RC, Jones C, Zhao S, Flum MW, Steinberg J, Daley G, Corbett N, Neumann C, Waller R. "But not the music": psychopathic traits and difficulties recognising and resonating with the emotion in music. Cogn Emot 2023; 37:748-762. [PMID: 37104122 DOI: 10.1080/02699931.2023.2205105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 12/23/2022] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
Recognising and responding appropriately to emotions is critical to adaptive psychological functioning. Psychopathic traits (e.g. callous, manipulative, impulsive, antisocial) are related to differences in recognition and response when emotion is conveyed through facial expressions and language. Use of emotional music stimuli represents a promising approach to improve our understanding of the specific emotion processing difficulties underlying psychopathic traits because it decouples recognition of emotion from cues directly conveyed by other people (e.g. facial signals). In Experiment 1, participants listened to clips of emotional music and identified the emotional content (Sample 1, N = 196) or reported on their feelings elicited by the music (Sample 2, N = 197). Participants accurately recognised (t(195) = 32.78, p < .001, d = 4.69) and reported feelings consistent with (t(196) = 7.84, p < .001, d = 1.12) the emotion conveyed in the music. However, psychopathic traits were associated with reduced emotion recognition accuracy (F(1, 191) = 19.39, p < .001) and reduced likelihood of feeling the emotion (F(1, 193) = 35.45, p < .001), particularly for fearful music. In Experiment 2, we replicated findings for broad difficulties with emotion recognition (Sample 3, N = 179) and emotional resonance (Sample 4, N = 199) associated with psychopathic traits. Results offer new insight into emotion recognition and response difficulties that are associated with psychopathic traits.
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Affiliation(s)
- R C Plate
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - C Jones
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - S Zhao
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - M W Flum
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - J Steinberg
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - G Daley
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - N Corbett
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - C Neumann
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - R Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
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Wu S, Carter M, Cole W, Crombie R, Kapp DL, Kim P, Milne C, Molnar J, Niezgoda J, Woo K, Zabel D, Hamm R, Armstrong D, Bock AJ, Dheansa B, Driver V, Glat P, Lantis J, Ferreira LM, Melin M, Patel K, Ricci E, Simman R, Steinberg J, Tettelbach W, Weir D. Best practice for wound repair and regeneration use of cellular, acellular and matrix-like products (CAMPs). J Wound Care 2023; 32:S1-S31. [PMID: 37079485 DOI: 10.12968/jowc.2023.32.sup4b.s1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
There are currently over 80 biomaterials derived from autologous, allogeneic, synthetic and xenogeneic sources, or a combination of any or all these types of materials, available for soft-tissue coverage to effect wound closure. Often generically referred to as cellular and/or tissue-based products (CTPs), they are manufactured under various trade names and marketed for a variety of indications.
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Affiliation(s)
- Stephanie Wu
- Dr William M Scholl College of Podiatric Medicine; Professor, Department of Podiatric Surgery and Applied Biomechanics, Center for Stem Cell and Regenerative Medicine, Rosalind Franklin University of Medicine and Science, Illinois, US
| | | | - Windy Cole
- Wound Care Research, Kent State University, Ohio, US
| | - Roselle Crombie
- Department of Surgery, Yale New Haven Health System, Connecticut, US
| | - Daniel L Kapp
- Chief of Plastic Surgery, Palm Beach Gardens Medical Center, Florida, US
| | - Paul Kim
- Department of Plastic Surgery, University of Texas Southwestern, Texas, US
| | | | - Joseph Molnar
- Professor of Plastic and Reconstructive Surgery and Regenerative Medicine, Wake Forest University School of Medicine, North Carolina, US
| | - Jeffrey Niezgoda
- Founder and President Emeritus, AZH Wound and Hyperbaric Center, Wisconsin, US
| | - Kevin Woo
- Professor, Queen's University, Ontario, Canada
| | - David Zabel
- Chief of Plastic and Reconstructive Surgery, Christiana Care Health System, Affiliated Faculty Department of Biomedical Engineering, University of Delaware, Delaware, US
| | - Rose Hamm
- Medical Writer, Adjunct Associate Professor of Clinical Physical Therapy, University of Southern California, California, US
| | - David Armstrong
- Professor of Surgery; Director, USC Limb Preservation Program, California, US
| | - Alan J Bock
- Palmetto State Surgical Podiatry Associates, South Carolina, US
| | - Baljit Dheansa
- Consultant Burns and Plastic Surgeon and Honorary Senior Lecturer, Queen Victoria Hospital, East Grinstead, UK
| | - Vickie Driver
- System Chief, Wound Care and Hyperbaric Medicine, Inova Heart and Vascular Institute, Virginia, US
| | - Paul Glat
- Chief of Plastic Surgery, St Christopher's Hospital for Children, Philadelphia, Pennsylvania, US
| | - John Lantis
- Chief and Professor of Surgery, Mount Sinai West Hospital and the Icahn School of Medicine, New York, US
| | | | - Mark Melin
- M Health Fairview Wound Healing Institute, Edina, Minnesota, US
| | - Keyur Patel
- Medical Director and Principal Investigator, Three Rivers Wound and Research Center, Florida, US
| | - Elia Ricci
- Difficult Wound Healing Unit, St Luca's Clinic, Turin, Italy
| | - Richard Simman
- Professor of Surgery, University of Toledo, College of Medicine and Life Sciences, Ohio, US
| | - John Steinberg
- Department of Plastic Surgery, Georgetown University School of Medicine, Washington DC, US
| | - William Tettelbach
- Adjunct Assistant Professor, Duke University School of Medicine, Undersea and Hyperbaric Medicine; Adjunct Professor, Western University of Health Sciences, Podiatric Medicine and Surgery, Salt Lake City, Utah, US
| | - Dot Weir
- Clinician and Educator, Saratoga Hospital Center for Wound Healing and Hyperbaric Medicine, New York, US
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Gottlieb L, Asrani RP, Overton E, Holdsworth J, Feistritzer N, Jacob J, Steinberg J. Implementing an electronic hand hygiene monitoring system across a large healthcare system during the COVID-19 pandemic. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00666-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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9
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Melero I, Grande Pulido E, De Miguel Luken M, Johnson M, Bauman J, Moreno Garcia V, Walter A, Adams H, Türeci Ö, Russo G, Sahin U, Steinberg J, Ahmadi T, Felip E. 175P Safety and preliminary efficacy of GEN1042 (DuoBody-CD40x4-1BB) combination therapy in patients with advanced solid tumors. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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10
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Bark HS, Linke SJ, Steinberg J. [Successful refractive surgical treatment of a patient with keratoconus using phakic intraocular lenses]. Ophthalmologie 2022; 119:748-751. [PMID: 34228204 DOI: 10.1007/s00347-021-01442-0] [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] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/16/2021] [Accepted: 06/05/2021] [Indexed: 01/26/2023]
Affiliation(s)
- H-S Bark
- Augenarztpraxis zentrumsehstärke, Martinistr. 64, 20251, Hamburg, Deutschland.
| | - S J Linke
- Augenarztpraxis zentrumsehstärke, Martinistr. 64, 20251, Hamburg, Deutschland.,Augenklinik des UKE Hamburg, Martinistr. 52, 20246, Hamburg, Deutschland
| | - J Steinberg
- Augenarztpraxis zentrumsehstärke, Martinistr. 64, 20251, Hamburg, Deutschland.,Augenklinik des UKE Hamburg, Martinistr. 52, 20246, Hamburg, Deutschland
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11
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Cook H, Kennedy C, Delijani K, Popovsky D, Elmarsafi T, Zarick C, Attinger C, Steinberg J. Early Clinical, Functional, and Mortality Outcomes for Heel Ulcers Treated With a Vertical Contour Calcanectomy. J Foot Ankle Surg 2022; 61:117-122. [PMID: 34330617 DOI: 10.1053/j.jfas.2021.06.015] [Citation(s) in RCA: 1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/15/2021] [Accepted: 06/26/2021] [Indexed: 02/03/2023]
Abstract
Heel ulcerations are common complications seen in patients suffering from chronic conditions such as diabetes mellitus, peripheral vascular disease, and in bed ridden patients. When these systemic pathologies lead to heel ulcers, an increased risk of calcaneal osteomyelitis often significantly limits the benefits of conventional therapeutic interventions and increases risk of major lower extremity amputation. The Vertical Contour Calcanectomy (VCC) is a novel surgical procedure specific for the surgical management of these complex and often recalcitrant heel ulcerations. The VCC was described as a reproducible procedure in which wide excision of both the soft tissue ulceration as well as defined bone cuts of the calcaneus allows for decreased bioburden and in many cases, for primary soft tissue closure. The present study describes the outcomes related to the VCC and provides guidance based on the objective findings detailed herein. This study, at the time of publication, represents the largest collection of patients that have undergone the VCC (N = 51) and their outcomes at 1 year. Those who remained healed without recurrence, amputation, or mortality at 1-year follow-up were 31.4%. Post-VCC total limb salvage rate is 68.6% at one year, mean follow-up 663.9 ± 464.7 days. One-year all-cause mortality post-VCC was 9.8%. Post-VCC function at 1-year follow-up reflects 79.3% of patients having the same or better function that their perioperative state.
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Affiliation(s)
- Helene Cook
- Resident Physician, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington DC
| | - Christopher Kennedy
- MedStar Georgetown University Hospital Diabetic Limb Salvage Fellow, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington DC
| | - Kevin Delijani
- Medical Student, Georgetown University Medical School, Washington DC
| | - Daniel Popovsky
- Medical Student, Georgetown University Medical School, Washington DC
| | - Tammer Elmarsafi
- Attending Physician, Potomac Podiatry Group PLLC, Woodbridge, VA
| | - Caitlin Zarick
- Attending Physician, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington DC
| | - Christopher Attinger
- Attending Physician, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington DC
| | - John Steinberg
- Attending Physician, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington DC.
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12
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Lisdahl KM, Tapert S, Sher KJ, Gonzalez R, Nixon SJ, Ewing SWF, Conway KP, Wallace A, Sullivan R, Hatcher K, Kaiver C, Thompson W, Reuter C, Bartsch H, Wade NE, Jacobus J, Albaugh MD, Allgaier N, Anokhin AP, Bagot K, Baker FC, Banich MT, Barch DM, Baskin-Sommers A, Breslin FJ, Brown SA, Calhoun V, Casey BJ, Chaarani B, Chang L, Clark DB, Cloak C, Constable RT, Cottler LB, Dagher RK, Dapretto M, Dick A, Do EK, Dosenbach NUF, Dowling GJ, Fair DA, Florsheim P, Foxe JJ, Freedman EG, Friedman NP, Garavan HP, Gee DG, Glantz MD, Glaser P, Gonzalez MR, Gray KM, Grant S, Haist F, Hawes S, Heeringa SG, Hermosillo R, Herting MM, Hettema JM, Hewitt JK, Heyser C, Hoffman EA, Howlett KD, Huber RS, Huestis MA, Hyde LW, Iacono WG, Isaiah A, Ivanova MY, James RS, Jernigan TL, Karcher NR, Kuperman JM, Laird AR, Larson CL, LeBlanc KH, Lopez MF, Luciana M, Luna B, Maes HH, Marshall AT, Mason MJ, McGlade E, Morris AS, Mulford C, Nagel BJ, Neigh G, Palmer CE, Paulus MP, Pecheva D, Prouty D, Potter A, Puttler LI, Rajapakse N, Ross JM, Sanchez M, Schirda C, Schulenberg J, Sheth C, Shilling PD, Sowell ER, Speer N, Squeglia L, Sripada C, Steinberg J, Sutherland MT, Tomko R, Uban K, Vrieze S, Weiss SRB, Wing D, Yurgelun-Todd DA, Zucker RA, Heitzeg MM. Substance use patterns in 9-10 year olds: Baseline findings from the adolescent brain cognitive development (ABCD) study. Drug Alcohol Depend 2021; 227:108946. [PMID: 34392051 PMCID: PMC8833837 DOI: 10.1016/j.drugalcdep.2021.108946] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND The Adolescent Brain Cognitive Development ™ Study (ABCD Study®) is an open-science, multi-site, prospective, longitudinal study following over 11,800 9- and 10-year-old youth into early adulthood. The ABCD Study aims to prospectively examine the impact of substance use (SU) on neurocognitive and health outcomes. Although SU initiation typically occurs during teen years, relatively little is known about patterns of SU in children younger than 12. METHODS This study aims to report the detailed ABCD Study® SU patterns at baseline (n = 11,875) in order to inform the greater scientific community about cohort's early SU. Along with a detailed description of SU, we ran mixed effects regression models to examine the association between early caffeine and alcohol sipping with demographic factors, externalizing symptoms and parental history of alcohol and substance use disorders (AUD/SUD). PRIMARY RESULTS At baseline, the majority of youth had used caffeine (67.6 %) and 22.5 % reported sipping alcohol (22.5 %). There was little to no reported use of other drug categories (0.2 % full alcohol drink, 0.7 % used nicotine, <0.1 % used any other drug of abuse). Analyses revealed that total caffeine use and early alcohol sipping were associated with demographic variables (p's<.05), externalizing symptoms (caffeine p = 0002; sipping p = .0003), and parental history of AUD (sipping p = .03). CONCLUSIONS ABCD Study participants aged 9-10 years old reported caffeine use and alcohol sipping experimentation, but very rare other SU. Variables linked with early childhood alcohol sipping and caffeine use should be examined as contributing factors in future longitudinal analyses examining escalating trajectories of SU in the ABCD Study cohort.
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Affiliation(s)
- Krista M Lisdahl
- University of Wisconsin, Milwaukee, WI, United States; Medical College of Wisconsin, Milwaukee, WI, United States.
| | - Susan Tapert
- University of California, San Diego, CA, United States
| | | | - Raul Gonzalez
- Florida International University, Miami, FL, United States
| | - Sara Jo Nixon
- University of Florida, Gainesville, FL, United States
| | | | - Kevin P Conway
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - Alex Wallace
- University of Wisconsin, Milwaukee, WI, United States
| | - Ryan Sullivan
- University of Wisconsin, Milwaukee, WI, United States
| | - Kelah Hatcher
- University of Wisconsin, Milwaukee, WI, United States
| | | | - Wes Thompson
- University of California, San Diego, CA, United States
| | - Chase Reuter
- University of California, San Diego, CA, United States
| | - Hauke Bartsch
- University of California, San Diego, CA, United States
| | | | | | - M D Albaugh
- University of Vermont, Burlington, VT, United States
| | - N Allgaier
- University of Vermont, Burlington, VT, United States
| | - A P Anokhin
- Washington University, St. Louis, MO, United States
| | - K Bagot
- University of California, San Diego, CA, United States; Icahn School of Medicine at Mount Sinai, United States
| | - F C Baker
- SRI International, Menlo Park, CA, United States
| | - M T Banich
- University of Colorado Boulder, CO, United States
| | - D M Barch
- Washington University, St. Louis, MO, United States
| | | | - F J Breslin
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - S A Brown
- University of California, San Diego, CA, United States
| | - V Calhoun
- Georgia State University, Atlanta, GA, United States
| | - B J Casey
- Yale University, New Haven, CT, United States
| | - B Chaarani
- University of Vermont, Burlington, VT, United States
| | - L Chang
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - D B Clark
- University of Pittsburgh, Pittsburgh, PA, United States
| | - C Cloak
- University of Maryland School of Medicine, Baltimore, MD, United States
| | | | - L B Cottler
- University of Florida, Gainesville, FL, United States
| | - R K Dagher
- National Institute of Minority Health and Health Disparities, Bethesda, MD, United States
| | - M Dapretto
- University of California, Los Angeles, CA, United States
| | - A Dick
- Florida International University, Miami, FL, United States
| | - E K Do
- Virginia Commonwealth University, Richmond, VA, United States
| | | | - G J Dowling
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - D A Fair
- University of Minnesota, Minneapolis, MN, United States
| | - P Florsheim
- University of Wisconsin, Milwaukee, WI, United States
| | - J J Foxe
- University of Rochester, Rochester, NY, United States
| | - E G Freedman
- University of Rochester, Rochester, NY, United States
| | - N P Friedman
- University of Colorado Boulder, CO, United States
| | - H P Garavan
- University of Vermont, Burlington, VT, United States
| | - D G Gee
- Yale University, New Haven, CT, United States
| | - M D Glantz
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - P Glaser
- Washington University, St. Louis, MO, United States
| | - M R Gonzalez
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - K M Gray
- Medical University of South Carolina, Charleston, SC, United States
| | - S Grant
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - F Haist
- University of California, San Diego, CA, United States
| | - S Hawes
- Florida International University, Miami, FL, United States
| | - S G Heeringa
- University of Michigan, Ann Arbor, MI, United States
| | - R Hermosillo
- Oregon Health & Science University, Portland, OR, United States
| | - M M Herting
- University of Southern California, Los Angeles, CA, United States
| | - J M Hettema
- Virginia Commonwealth University, Richmond, VA, United States
| | - J K Hewitt
- University of Colorado Boulder, CO, United States
| | - C Heyser
- University of California, San Diego, CA, United States
| | - E A Hoffman
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - K D Howlett
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - R S Huber
- University of Utah, Salt Lake City, UT, United States
| | - M A Huestis
- University of California, San Diego, CA, United States; Thomas Jefferson University, Philadelphia, PA, United States
| | - L W Hyde
- University of Michigan, Ann Arbor, MI, United States
| | - W G Iacono
- University of Minnesota, Minneapolis, MN, United States
| | - A Isaiah
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - M Y Ivanova
- University of Vermont, Burlington, VT, United States
| | - R S James
- American Psychistric Association, United States
| | - T L Jernigan
- University of California, San Diego, CA, United States
| | - N R Karcher
- Washington University, St. Louis, MO, United States
| | - J M Kuperman
- University of California, San Diego, CA, United States
| | - A R Laird
- Florida International University, Miami, FL, United States
| | - C L Larson
- University of Wisconsin, Milwaukee, WI, United States
| | - K H LeBlanc
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - M F Lopez
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - M Luciana
- University of Minnesota, Minneapolis, MN, United States
| | - B Luna
- University of Pittsburgh, Pittsburgh, PA, United States
| | - H H Maes
- Virginia Commonwealth University, Richmond, VA, United States
| | - A T Marshall
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - M J Mason
- University of Tennessee, Knoxville, TN, United States
| | - E McGlade
- University of Utah, Salt Lake City, UT, United States
| | - A S Morris
- Laureate Institute for Brain Research, Tulsa, OK, United States; Oklahoma State University, Stillwater, OK, United States
| | - C Mulford
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - B J Nagel
- Oregon Health & Science University, Portland, OR, United States
| | - G Neigh
- Virginia Commonwealth University, Richmond, VA, United States
| | - C E Palmer
- University of California, San Diego, CA, United States
| | - M P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - D Pecheva
- University of California, San Diego, CA, United States
| | - D Prouty
- SRI International, Menlo Park, CA, United States
| | - A Potter
- University of Vermont, Burlington, VT, United States
| | - L I Puttler
- University of Michigan, Ann Arbor, MI, United States
| | - N Rajapakse
- National Institute of Minority Health and Health Disparities, Bethesda, MD, United States
| | - J M Ross
- University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - M Sanchez
- Florida International University, Miami, FL, United States
| | - C Schirda
- University of Pittsburgh, Pittsburgh, PA, United States
| | - J Schulenberg
- University of Michigan, Ann Arbor, MI, United States
| | - C Sheth
- University of Utah, Salt Lake City, UT, United States
| | - P D Shilling
- University of California, San Diego, CA, United States
| | - E R Sowell
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - N Speer
- University of Colorado Boulder, CO, United States
| | - L Squeglia
- Medical University of South Carolina, Charleston, SC, United States
| | - C Sripada
- University of Michigan, Ann Arbor, MI, United States
| | - J Steinberg
- Virginia Commonwealth University, Richmond, VA, United States
| | - M T Sutherland
- Florida International University, Miami, FL, United States
| | - R Tomko
- Medical University of South Carolina, Charleston, SC, United States
| | - K Uban
- University of California, Irvine, CA, United States
| | - S Vrieze
- University of Minnesota, Minneapolis, MN, United States
| | - S R B Weiss
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - D Wing
- University of California, San Diego, CA, United States
| | | | - R A Zucker
- University of Michigan, Ann Arbor, MI, United States
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Chaarani B, Hahn S, Allgaier N, Adise S, Owens MM, Juliano AC, Yuan DK, Loso H, Ivanciu A, Albaugh MD, Dumas J, Mackey S, Laurent J, Ivanova M, Hagler DJ, Cornejo MD, Hatton S, Agrawal A, Aguinaldo L, Ahonen L, Aklin W, Anokhin AP, Arroyo J, Avenevoli S, Babcock D, Bagot K, Baker FC, Banich MT, Barch DM, Bartsch H, Baskin-Sommers A, Bjork JM, Blachman-Demner D, Bloch M, Bogdan R, Bookheimer SY, Breslin F, Brown S, Calabro FJ, Calhoun V, Casey BJ, Chang L, Clark DB, Cloak C, Constable RT, Constable K, Corley R, Cottler LB, Coxe S, Dagher RK, Dale AM, Dapretto M, Delcarmen-Wiggins R, Dick AS, Do EK, Dosenbach NUF, Dowling GJ, Edwards S, Ernst TM, Fair DA, Fan CC, Feczko E, Feldstein-Ewing SW, Florsheim P, Foxe JJ, Freedman EG, Friedman NP, Friedman-Hill S, Fuemmeler BF, Galvan A, Gee DG, Giedd J, Glantz M, Glaser P, Godino J, Gonzalez M, Gonzalez R, Grant S, Gray KM, Haist F, Harms MP, Hawes S, Heath AC, Heeringa S, Heitzeg MM, Hermosillo R, Herting MM, Hettema JM, Hewitt JK, Heyser C, Hoffman E, Howlett K, Huber RS, Huestis MA, Hyde LW, Iacono WG, Infante MA, Irfanoglu O, Isaiah A, Iyengar S, Jacobus J, James R, Jean-Francois B, Jernigan T, Karcher NR, Kaufman A, Kelley B, Kit B, Ksinan A, Kuperman J, Laird AR, Larson C, LeBlanc K, Lessov-Schlagger C, Lever N, Lewis DA, Lisdahl K, Little AR, Lopez M, Luciana M, Luna B, Madden PA, Maes HH, Makowski C, Marshall AT, Mason MJ, Matochik J, McCandliss BD, McGlade E, Montoya I, Morgan G, Morris A, Mulford C, Murray P, Nagel BJ, Neale MC, Neigh G, Nencka A, Noronha A, Nixon SJ, Palmer CE, Pariyadath V, Paulus MP, Pelham WE, Pfefferbaum D, Pierpaoli C, Prescot A, Prouty D, Puttler LI, Rajapaske N, Rapuano KM, Reeves G, Renshaw PF, Riedel MC, Rojas P, de la Rosa M, Rosenberg MD, Ross MJ, Sanchez M, Schirda C, Schloesser D, Schulenberg J, Sher KJ, Sheth C, Shilling PD, Simmons WK, Sowell ER, Speer N, Spittel M, Squeglia LM, Sripada C, Steinberg J, Striley C, Sutherland MT, Tanabe J, Tapert SF, Thompson W, Tomko RL, Uban KA, Vrieze S, Wade NE, Watts R, Weiss S, Wiens BA, Williams OD, Wilbur A, Wing D, Wolff-Hughes D, Yang R, Yurgelun-Todd DA, Zucker RA, Potter A, Garavan HP. Baseline brain function in the preadolescents of the ABCD Study. Nat Neurosci 2021; 24:1176-1186. [PMID: 34099922 PMCID: PMC8947197 DOI: 10.1038/s41593-021-00867-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/30/2021] [Indexed: 02/05/2023]
Abstract
The Adolescent Brain Cognitive Development (ABCD) Study® is a 10-year longitudinal study of children recruited at ages 9 and 10. A battery of neuroimaging tasks are administered biennially to track neurodevelopment and identify individual differences in brain function. This study reports activation patterns from functional MRI (fMRI) tasks completed at baseline, which were designed to measure cognitive impulse control with a stop signal task (SST; N = 5,547), reward anticipation and receipt with a monetary incentive delay (MID) task (N = 6,657) and working memory and emotion reactivity with an emotional N-back (EN-back) task (N = 6,009). Further, we report the spatial reproducibility of activation patterns by assessing between-group vertex/voxelwise correlations of blood oxygen level-dependent (BOLD) activation. Analyses reveal robust brain activations that are consistent with the published literature, vary across fMRI tasks/contrasts and slightly correlate with individual behavioral performance on the tasks. These results establish the preadolescent brain function baseline, guide interpretation of cross-sectional analyses and will enable the investigation of longitudinal changes during adolescent development.
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Affiliation(s)
- B Chaarani
- Department of Psychiatry, University of Vermont, Burlington, VT, USA.
| | - S Hahn
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - N Allgaier
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - S Adise
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M M Owens
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - A C Juliano
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - D K Yuan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - H Loso
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - A Ivanciu
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M D Albaugh
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - J Dumas
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - S Mackey
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - J Laurent
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - M Ivanova
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - D J Hagler
- University of California, San Diego, La Jolla, CA, USA
| | - M D Cornejo
- Institute of Physics UC, Pontificia Universidad Catolica de Chile, Pontificia, Chile
| | - S Hatton
- University of California, San Diego, La Jolla, CA, USA
| | - A Agrawal
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - L Aguinaldo
- University of California, San Diego, La Jolla, CA, USA
| | - L Ahonen
- University of Pittsburgh, Pittsburgh, PA, USA
| | - W Aklin
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - A P Anokhin
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - J Arroyo
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - S Avenevoli
- National Institute of Mental Health, Bethesda, MD, USA
| | - D Babcock
- National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - K Bagot
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - F C Baker
- SRI International, Menlo Park, CA, USA
| | - M T Banich
- University of Colorado, Boulder, CO, USA
| | - D M Barch
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - H Bartsch
- Haukeland University Hospital, Bergen, Norway
| | | | - J M Bjork
- Virginia Commonwealth University, Richmond, VA, USA
| | - D Blachman-Demner
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - M Bloch
- National Cancer Institute, Bethesda, MD, USA
| | - R Bogdan
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | | | - F Breslin
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - S Brown
- University of California, San Diego, La Jolla, CA, USA
| | - F J Calabro
- University of Pittsburgh, Pittsburgh, PA, USA
| | - V Calhoun
- University of Colorado, Boulder, CO, USA
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, USA
| | | | - L Chang
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D B Clark
- University of Pittsburgh, Pittsburgh, PA, USA
| | - C Cloak
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - K Constable
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - R Corley
- University of Colorado, Boulder, CO, USA
| | | | - S Coxe
- Florida International University, Miami, FL, USA
| | - R K Dagher
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - A M Dale
- University of California, San Diego, La Jolla, CA, USA
| | - M Dapretto
- University of California, Los Angeles, CA, USA
| | | | - A S Dick
- Florida International University, Miami, FL, USA
| | - E K Do
- Virginia Commonwealth University, Richmond, VA, USA
| | - N U F Dosenbach
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - G J Dowling
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - S Edwards
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - T M Ernst
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D A Fair
- Oregon Health & Science University, Portland, OR, USA
| | - C C Fan
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - E Feczko
- Oregon Health & Science University, Portland, OR, USA
| | | | | | - J J Foxe
- University of Rochester, Rochester, NY, USA
| | | | | | | | | | - A Galvan
- University of California, Los Angeles, CA, USA
| | - D G Gee
- Yale University, New Haven, CT, USA
| | - J Giedd
- University of California, San Diego, La Jolla, CA, USA
| | - M Glantz
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - P Glaser
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - J Godino
- University of California, San Diego, La Jolla, CA, USA
| | - M Gonzalez
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - R Gonzalez
- Florida International University, Miami, FL, USA
| | - S Grant
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - K M Gray
- Medical University of South Carolina, Charleston, SC, USA
| | - F Haist
- University of California, San Diego, La Jolla, CA, USA
| | - M P Harms
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - S Hawes
- Florida International University, Miami, FL, USA
| | - A C Heath
- University of California, San Diego, La Jolla, CA, USA
| | - S Heeringa
- University of Michigan, Ann Arbor, MI, USA
| | | | - R Hermosillo
- Oregon Health & Science University, Portland, OR, USA
| | - M M Herting
- University of Southern California, Los Angeles, CA, USA
| | - J M Hettema
- Virginia Commonwealth University, Richmond, VA, USA
| | - J K Hewitt
- University of Colorado, Boulder, CO, USA
| | - C Heyser
- University of California, San Diego, La Jolla, CA, USA
| | - E Hoffman
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - K Howlett
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - R S Huber
- University of Utah, Salt Lake City, UT, USA
| | - M A Huestis
- Thomas Jefferson University, Philadelphia, PA, USA
| | - L W Hyde
- University of Michigan, Ann Arbor, MI, USA
| | - W G Iacono
- University of Minnesota, Minneapolis, MN, USA
| | - M A Infante
- University of California, San Diego, La Jolla, CA, USA
| | - O Irfanoglu
- National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - A Isaiah
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - S Iyengar
- National Endowment for the Arts, Washington DC, USA
| | - J Jacobus
- University of California, San Diego, La Jolla, CA, USA
| | - R James
- Virginia Commonwealth University, Richmond, VA, USA
| | - B Jean-Francois
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - T Jernigan
- University of California, San Diego, La Jolla, CA, USA
| | - N R Karcher
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - A Kaufman
- National Cancer Institute, Bethesda, MD, USA
| | - B Kelley
- National Institute of Justice, Washington DC, USA
| | - B Kit
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - A Ksinan
- Virginia Commonwealth University, Richmond, VA, USA
| | - J Kuperman
- University of California, San Diego, La Jolla, CA, USA
| | - A R Laird
- Florida International University, Miami, FL, USA
| | - C Larson
- University of Wisconsin, Milwaukee, WI, USA
| | - K LeBlanc
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - C Lessov-Schlagger
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - N Lever
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - D A Lewis
- University of Pittsburgh, Pittsburgh, PA, USA
| | - K Lisdahl
- University of Wisconsin, Milwaukee, WI, USA
| | - A R Little
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M Lopez
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M Luciana
- University of Minnesota, Minneapolis, MN, USA
| | - B Luna
- University of Pittsburgh, Pittsburgh, PA, USA
| | - P A Madden
- Department of Psychiatry, Washington University in Saint Louis, St. Louis, MO, USA
| | - H H Maes
- Virginia Commonwealth University, Richmond, VA, USA
| | - C Makowski
- University of California, San Diego, La Jolla, CA, USA
| | - A T Marshall
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - M J Mason
- University of Tennessee, Knoxville, TN, USA
| | - J Matochik
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | | | - E McGlade
- University of Utah, Salt Lake City, UT, USA
| | - I Montoya
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - G Morgan
- National Cancer Institute, Bethesda, MD, USA
| | - A Morris
- Oklahoma State University, Stillwater, OK, USA
| | - C Mulford
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - P Murray
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - B J Nagel
- Oregon Health & Science University, Portland, OR, USA
| | - M C Neale
- Virginia Commonwealth University, Richmond, VA, USA
| | - G Neigh
- Virginia Commonwealth University, Richmond, VA, USA
| | - A Nencka
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Noronha
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - S J Nixon
- University of Florida, Gainesville, FL, USA
| | - C E Palmer
- University of California, San Diego, La Jolla, CA, USA
| | - V Pariyadath
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - M P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - W E Pelham
- Florida International University, Miami, FL, USA
| | | | - C Pierpaoli
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
| | - A Prescot
- University of Utah, Salt Lake City, UT, USA
| | - D Prouty
- SRI International, Menlo Park, CA, USA
| | | | - N Rajapaske
- National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | | | - G Reeves
- University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - M C Riedel
- Florida International University, Miami, FL, USA
| | - P Rojas
- Florida International University, Miami, FL, USA
| | - M de la Rosa
- Florida International University, Miami, FL, USA
| | | | - M J Ross
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - M Sanchez
- Florida International University, Miami, FL, USA
| | - C Schirda
- University of Pittsburgh, Pittsburgh, PA, USA
| | - D Schloesser
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | | | - K J Sher
- University of Missouri, Columbia, MO, USA
| | - C Sheth
- University of Utah, Salt Lake City, UT, USA
| | - P D Shilling
- University of California, San Diego, La Jolla, CA, USA
| | - W K Simmons
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - E R Sowell
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - N Speer
- University of Colorado, Boulder, CO, USA
| | - M Spittel
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - L M Squeglia
- Medical University of South Carolina, Charleston, SC, USA
| | - C Sripada
- University of Michigan, Ann Arbor, MI, USA
| | - J Steinberg
- Virginia Commonwealth University, Richmond, VA, USA
| | - C Striley
- University of Florida, Gainesville, FL, USA
| | | | - J Tanabe
- University of Colorado, Boulder, CO, USA
| | - S F Tapert
- University of California, San Diego, La Jolla, CA, USA
| | - W Thompson
- University of California, San Diego, La Jolla, CA, USA
| | - R L Tomko
- Medical University of South Carolina, Charleston, SC, USA
| | - K A Uban
- University of California, Irvine, CA, USA
| | - S Vrieze
- University of Minnesota, Minneapolis, MN, USA
| | - N E Wade
- University of California, San Diego, La Jolla, CA, USA
| | - R Watts
- Yale University, New Haven, CT, USA
| | - S Weiss
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - B A Wiens
- University of Florida, Gainesville, FL, USA
| | - O D Williams
- Florida International University, Miami, FL, USA
| | - A Wilbur
- SRI International, Menlo Park, CA, USA
| | - D Wing
- University of California, San Diego, La Jolla, CA, USA
| | - D Wolff-Hughes
- NIH Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - R Yang
- University of California, San Diego, La Jolla, CA, USA
| | | | - R A Zucker
- University of Michigan, Ann Arbor, MI, USA
| | - A Potter
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - H P Garavan
- Department of Psychiatry, University of Vermont, Burlington, VT, USA.
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14
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Bekeny JC, Kennedy C, Turissini JD, Naz I, Walters ET, Kim PJ, Evans KK, Steinberg J, Elmarsafi T, Attinger CE. Utility of Porcine-Derived Xenograft as an Adjunct to Split-Thickness Skin Grafting in Lower-Extremity Wounds. J Am Podiatr Med Assoc 2021; 111:466719. [PMID: 34144594 DOI: 10.7547/20-058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Porcine-derived xenograft biological dressings (PXBDs) are occasionally used to prepare chronic wound beds for definitive closure before split-thickness skin grafts (STSGs). We sought to determine whether PXBD influences rate of STSG take in lower-extremity wounds. METHODS Lower-extremity wounds treated with STSGs were retrospectively reviewed. Patients were included in one of two groups: wound bed preparation with PXBD before STSG or no preparation. Patients were excluded if they received wound bed preparation via another method. Patient demographics, comorbidities, wound history, wound bed preparation, and 30- and 60-day outcomes were collected. RESULTS There was no difference in healing outcomes between the PXBD (n = 27) and no preparation (n = 39) groups. At 30- and 60-day follow-up, percentage of STSG take was not significantly different between groups (77.9% versus 79.0%, P30 = .818; 82.2% versus 80.9%, P60 = .422). Mean wound sizes at these follow-up periods were not different (4.4 cm2 versus 5.1 cm2, P30 = .902; 1.2 cm2 versus 1.1 cm2, P60 = .689). The PXBD group had a higher mean ± SD hemoglobin A1c level (8.3 ± 3.5 versus 6.9 ± 1.6; P = .074) and age (64.9 ± 12.8 years versus 56.3 ± 11.9 years; P = .007) versus the no preparation group. CONCLUSIONS Application of PXBDs for wound bed preparation had no effect on wound healing compared with no wound bed preparation. The two groups varied only by mean age and hemoglobin A1c level. The PXBD may be beneficial, but these results call for randomized controlled trials to determine the true impact of PXBDs on wound healing. In addition, PXBDs may have utility outside of clinically oriented outcomes, and future work should address patient-reported outcomes and pain scores with this adjunct.
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15
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Mudarisov B, Linke SJ, Steinberg J. [Refractive surgical treatment of a keratoconus patient using combined excimer laser ablation and corneal cross-linking (Athens protocol)]. Ophthalmologe 2021; 119:77-82. [PMID: 33420518 PMCID: PMC8763768 DOI: 10.1007/s00347-020-01312-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/30/2020] [Accepted: 12/17/2020] [Indexed: 01/22/2023]
Affiliation(s)
- B Mudarisov
- Augenklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland.
| | - S J Linke
- Augenklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland.,Augenarztpraxis zentrumsehstärke, Martinistr. 64, 20251, Hamburg, Deutschland
| | - J Steinberg
- Augenklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Deutschland.,Augenarztpraxis zentrumsehstärke, Martinistr. 64, 20251, Hamburg, Deutschland
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16
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Skracic I, Lewin A, Steinberg J. P77 Examining the association between experiences of reproductive coercion and current contraceptive use. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Liu A, Garg R, Steinberg J, Odono L, Hammoudeh J. Microvascular Mandibular Reconstruction with an Endoprosthesis: Optimizing Bone Height and Border Contour. J Oral Maxillofac Surg 2020. [DOI: 10.1016/j.joms.2020.07.189] [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]
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18
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van der Heijden M, Gupta S, Galsky M, Derleth C, Steinberg J, Kataria R, Powles T. 798TiP Study EV-302: A 3-arm, open-label, randomized phase III study of enfortumab vedotin plus pembrolizumab and/or chemotherapy, versus chemotherapy alone, in untreated locally advanced or metastatic urothelial cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2069] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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19
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Young Harrison E, Steinberg J. Factors associated with postpartum contraceptive method use after an unintended pregnancy ending in a birth. Contraception 2018. [DOI: 10.1016/j.contraception.2018.07.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Walters E, Mehra S, Naz I, Elmarsafi T, Evans K, Steinberg J, Attinger CE, Kim PJ. Chronic Anti-Platelet or Anti-Coagulant Therapy Does Not Increase Graft Failure after Split Thickness Skin Grafting. J Am Coll Surg 2018. [DOI: 10.1016/j.jamcollsurg.2018.08.671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fizazi K, Hussain M, Saad F, Shore N, De Giorgi U, Efstathiou E, Ferreira U, Ivashchenko P, Madziarska K, Al-Adhami M, Modelska K, Phung D, Steinberg J, Sternberg C. A phase III, randomized, double-blind, placebo (PBO)-controlled study of enzalutamide (ENZA) in men with nonmetastatic (M0) castration-resistant prostate cancer (CRPC): Results of PROSPER by age and region. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Eick J, Burbelko M, Plotkin M, Steinberg J, Ring W, Schwertner C. SIRT therapy with Yttrium-90 resin microspheres in patients with liver cirrhosis Child Pugh B7-9 and unresectable nonmetastatic hepatocellular cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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23
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Huckins LM, Hatzikotoulas K, Southam L, Thornton LM, Steinberg J, Aguilera-McKay F, Treasure J, Schmidt U, Gunasinghe C, Romero A, Curtis C, Rhodes D, Moens J, Kalsi G, Dempster D, Leung R, Keohane A, Burghardt R, Ehrlich S, Hebebrand J, Hinney A, Ludolph A, Walton E, Deloukas P, Hofman A, Palotie A, Palta P, van Rooij FJA, Stirrups K, Adan R, Boni C, Cone R, Dedoussis G, van Furth E, Gonidakis F, Gorwood P, Hudson J, Kaprio J, Kas M, Keski-Rahonen A, Kiezebrink K, Knudsen GP, Slof-Op 't Landt MCT, Maj M, Monteleone AM, Monteleone P, Raevuori AH, Reichborn-Kjennerud T, Tozzi F, Tsitsika A, van Elburg A, Collier DA, Sullivan PF, Breen G, Bulik CM, Zeggini E. Investigation of common, low-frequency and rare genome-wide variation in anorexia nervosa. Mol Psychiatry 2018; 23:1169-1180. [PMID: 29155802 PMCID: PMC5828108 DOI: 10.1038/mp.2017.88] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 02/16/2017] [Accepted: 02/17/2017] [Indexed: 12/12/2022]
Abstract
Anorexia nervosa (AN) is a complex neuropsychiatric disorder presenting with dangerously low body weight, and a deep and persistent fear of gaining weight. To date, only one genome-wide significant locus associated with AN has been identified. We performed an exome-chip based genome-wide association studies (GWAS) in 2158 cases from nine populations of European origin and 15 485 ancestrally matched controls. Unlike previous studies, this GWAS also probed association in low-frequency and rare variants. Sixteen independent variants were taken forward for in silico and de novo replication (11 common and 5 rare). No findings reached genome-wide significance. Two notable common variants were identified: rs10791286, an intronic variant in OPCML (P=9.89 × 10-6), and rs7700147, an intergenic variant (P=2.93 × 10-5). No low-frequency variant associations were identified at genome-wide significance, although the study was well-powered to detect low-frequency variants with large effect sizes, suggesting that there may be no AN loci in this genomic search space with large effect sizes.
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Affiliation(s)
- L M Huckins
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - K Hatzikotoulas
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - L Southam
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - L M Thornton
- Department of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J Steinberg
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - F Aguilera-McKay
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - J Treasure
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - U Schmidt
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C Gunasinghe
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Romero
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C Curtis
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D Rhodes
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J Moens
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - G Kalsi
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D Dempster
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - R Leung
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Keohane
- Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC SLaM BioResource for Mental Health, SGDP Centre & Centre for Neuroimaging Sciences, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - R Burghardt
- Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik Klinikum Frankfurt, Frankfurt, Germany
| | - S Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - J Hebebrand
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - A Hinney
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - A Ludolph
- Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany
| | - E Walton
- Division of Psychological & Social Medicine and Developmental Neurosciences, Technische Universität Dresden, Faculty of Medicine, University Hospital C.G. Carus, Dresden, Germany
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - P Deloukas
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - A Hofman
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A Palotie
- Center for Human Genome Research at the Massachusetts General Hospital, Boston, MA, USA
- Department of Public Health & Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - P Palta
- Department of Public Health & Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - F J A van Rooij
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - K Stirrups
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - R Adan
- Brain Center Rudolf Magnus, Department of Neuroscience and Pharmacology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C Boni
- INSERM U984, Centre of Psychiatry and Neuroscience, Paris, France
| | - R Cone
- Mary Sue Coleman Director, Life Sciences Institute, Professor of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - G Dedoussis
- Department of Dietetics-Nutrition, Harokopio University, Athens, Greece
| | - E van Furth
- Rivierduinen Eating Disorders Ursula, Leiden, Zuid-Holland, The Netherlands
| | - F Gonidakis
- Eating Disorders Unit, 1st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - P Gorwood
- INSERM U984, Centre of Psychiatry and Neuroscience, Paris, France
| | - J Hudson
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - J Kaprio
- Department of Public Health & Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - M Kas
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands
| | - A Keski-Rahonen
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | - K Kiezebrink
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - G-P Knudsen
- Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway
| | | | - M Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - A M Monteleone
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - P Monteleone
- Department of Medicine and Surgery, Section of Neurosciences, University of Salerno, Salerno, Italy
| | - A H Raevuori
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | - T Reichborn-Kjennerud
- Department of Genetics, Environment and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - F Tozzi
- eHealth Lab-Computer Science Department, University of Cyprus, Nicosia, Cyprus
| | - A Tsitsika
- Adolescent Health Unit (A.H.U.), 2nd Department of Pediatrics – Medical School, University of Athens "P. & A. Kyriakou" Children's Hospital, Athens, Greece
| | - A van Elburg
- Center for Eating Disorders Rintveld, University of Utrecht, Utrecht, The Netherlands
| | - D A Collier
- Eli Lilly and Company, Erl Wood Manor, Windlesham, UK
| | - P F Sullivan
- Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinksa Institutet, Stockholm, Sweden
| | - G Breen
- Social Genetic and Developmental Psychiatry, King's College London, London, UK
| | - C M Bulik
- Department of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinksa Institutet, Stockholm, Sweden
| | - E Zeggini
- Department of Human Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
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Lu J, Elmarsafi T, Steinberg J, Kim P, Attinger C, Cooper P, Evans K. Free Flap Reconstruction after Complications of Total Ankle Arthroplasty: Case Series and Review of the Literature. J Reconstr Microsurg Open 2018. [DOI: 10.1055/s-0038-1641733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Background Postoperative complications of total ankle arthroplasty (TAA) include anterior surgical site dehiscence, hardware failure, infection, and amputation. Early intervention with free flap may provide TAA salvage. We report the largest series of failed TAA require microsurgical free tissue transfer, identify risk factors, and examine the long-term post-free flap outcomes.
Materials and Methods This is a case series of consecutive patients from a single institution dedicated to limb salvage. Inclusion criteria included patients who underwent TAA with complications related to the index surgery and underwent microsurgical free tissue transfer. Nine patients were identified within the inclusion parameters.
Results Patients presented with osteomyelitis 4 (44%), soft tissue infections 4 (44%), and wound dehiscence 1 (11%) following TAA. Three (33%) radial forearm free flaps and six (67%) anterolateral thigh flaps were used, with a 100% microsurgical success rate. Preoperative angiography revealed six (67%) patients with anterior tibial artery occlusion at the level of the ankle or below. Patients required an average of 2.7 ± 1 (range 1–4) operative débridements prior to free flap, with successful flap outcome and return to full weight bearing status in nine (100%) patients. The mean long-term lower extremity functional scale score was 62 out of 80 points.
Conclusion Microsurgical free tissue transfer is an effective and favorable strategy to attain a stable soft tissue envelope for patients presenting with surgical site complications following TAA. We recommend early involvement with plastic surgery and endovascular angiography to evaluate the integrity of the anterior tibial artery.
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Affiliation(s)
- Jocelyn Lu
- Department of Plastic Surgery, Georgetown University School of Medicine, Washington, District of Columbia
| | - Tammer Elmarsafi
- Diabetic Limb Salvage, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - John Steinberg
- Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Paul Kim
- Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Christopher Attinger
- Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Paul Cooper
- Department of Orthopedic Surgery, MedStar Georgetown University Hospital, Washington, Districy of Columbia
| | - Karen Evans
- Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia
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Falola R, Lakhiani C, Green J, Patil S, Jackson B, Bratescu R, Anghel E, Steinberg J, Kim P, Attinger C, Evans K. Assessment of Function after Free Tissue Transfer to the Lower Extremity for Chronic Wounds Using the Lower Extremity Functional Scale. J Reconstr Microsurg 2018; 34:327-333. [DOI: 10.1055/s-0037-1621736] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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
Background Free tissue transfer is one option for preservation of form and function in the native limb, in the setting of soft tissue paucity. However, the data on patient functionality after microvascular intervention is inconsistently reported. The Lower Extremity Function Scale (LEFS) measures patient-reported difficulty in carrying out 20 physical activities, on a Likert scale, the sum of which correlates with descriptive functional stages of 1–5. We assess limb functionality in this cohort of microvascular patients using the LEFS survey.
Methods A retrospective chart review was conducted at a single academic medical center of 101 consecutive free flaps, from 2011 to 2016. Of the flaps that met inclusion criteria, 39 had completed LEFS surveys. Mean LEFS scores were calculated, and the effects of risk factors such as diabetes, age, and smoking status were analyzed.
Results The mean LEFS score after free tissue transfer was 50.3 (SD ± 21.1), with a mean follow up survey time of 3.0 years (SD ± 1.3). The score correlated with Stage 4 function, or "independent community ambulation,” and age was the only demographic factor associated with decreased functionality in this group. This is compared with mean LEFS score of 43.1 (SD ± 18.4) in cohort of 55 below knee amputations (BKAs), and 38.3 (SD ± 14.9) in 28 above knee amputations (AKAs), both correlating with Stage 3 function: “limited community ambulation.”
Conclusions Functional outcomes scores such as the LEFS demonstrate that patients can obtain an adequate level of functionality for independent community activity after free tissue transfer, although functional improvement diminishes with age.
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Affiliation(s)
- Reuben Falola
- Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Chrisovalantis Lakhiani
- Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Jocelyn Green
- Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Siya Patil
- Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Brandon Jackson
- Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Rachel Bratescu
- Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Ersilia Anghel
- Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - John Steinberg
- Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Paul Kim
- Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Christopher Attinger
- Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, District of Columbia
| | - Karen Evans
- Department of Plastic Surgery, Center for Wound Healing, MedStar Georgetown University Hospital, Washington, District of Columbia
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Steinberg J, Li S, Mattson H, Ziegler P. P4583Varying the definition of the minimal duration of atrial fibrillation has a substantial impact on the incidence of atrial fibrillation: results from a large device registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4583] [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: 11/12/2022] Open
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Romanov A, Pokushalov E, Bayramova S, Shabanov V, Losik D, Ponomarev D, Stenin I, Elesin D, Mikheenko I, Steinberg J. 57Prophylactic pulmonary vein isolation during isthmus ablation for atrial flutter: three-year outcomes of the prevent af I study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.57] [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: 11/14/2022] Open
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Krop I, Abramson V, Colleoni M, Holmes FA, Estevez L, Hart L, Awada A, Zamagni C, Morris P, Schwartzberg L, Chan S, Wheatley D, Guculp A, Biganzoli L, Steinberg J, Gianni L, Trudeau M, Kelly CM, Uppal H, Tudor IC, Peterson A, Winer E, Yardley DA. Abstract P2-08-01: Results from a randomized placebo-controlled phase 2 trial evaluating exemestane ± enzalutamide in patients with hormone receptor–positive breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-08-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- I Krop
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - V Abramson
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - M Colleoni
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - FA Holmes
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - L Estevez
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - L Hart
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - A Awada
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - C Zamagni
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - P Morris
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - L Schwartzberg
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - S Chan
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - D Wheatley
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - A Guculp
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - L Biganzoli
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - J Steinberg
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - L Gianni
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - M Trudeau
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - CM Kelly
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - H Uppal
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - IC Tudor
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - A Peterson
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - E Winer
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
| | - DA Yardley
- Dana Farber Cancer Institute, Boston, MA; Vanderbilt University, Nashville, TN; Istituto Europeo di Oncologia, Milan, Italy; Texas Oncology-Houston Memorial City, Houston, TX; Centro Integral Oncológico Clara Campal, Hospital de Madrid Norte-Sanchinarro, Madrid, Spain; Florida Cancer Specialists, Ft. Myers, FL; Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Azienda Ospedaliera Universitaria di Bologna Policlinico S. Orsola Malpighi, Bologna, Italy; Beaumont Hospital, Dublin, Ireland; The University of Tennessee, West Cancer Center, Memphis, TN; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Royal Cornwall Hospitals NHS Trust-Sunrise Centre, Cornwall, United Kingdom; Memorial Sloan Kettering Cancer Center, New York, NY; Weill Cornell College of Medicine, New York, NY; Nuovo Ospedale di Prato, Italy; Astellas Pharma, Inc., Northbrook, IL; Ospedale San Raffaele, Milan, Italy; Sunnybrook Health Sciences Centre, Toronto, Canada; All Ireland Collaborative Oncoology
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Krop I, Cortes J, Miller K, Huizing MT, Provencher L, Gianni L, Chan S, Trudeau M, Steinberg J, Sugg J, Liosatos M, Paton VE, Peterson A, Wardley A. Abstract P4-22-08: A single-arm phase 2 study to assess clinical activity, efficacy and safety of enzalutamide with trastuzumab in HER2+ AR+ metastatic or locally advanced breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-22-08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:Androgen receptor (AR) expression has been observed in up to 77% of human epidermal growth factor receptor 2–positive (HER2+) breast cancer (BC).References:1 Enzalutamide (ENZA) is a potent AR inhibitor approved for patients (pts) with metastatic castration-resistant prostate cancer. In vitro, ENZA enhances antitumor activity of trastuzumab in HER2+ AR+ cell lines and inhibits proliferation in trastuzumab-resistant HER2+ cell lines.2
Methods:Pts with metastatic or locally advanced BC that was HER2+ AR+ by local or central laboratory assessment were enrolled in a single-arm, Simon 2-stage phase 2 study (NCT02091960). Key eligibility criteria included availability of a tissue sample, presence of measurable or evaluable disease per RECIST v1.1, progression on prior trastuzumab and ≥1 prior line of anti-HER2 therapy as the most recent regimen. Brain metastases and history of seizure were exclusionary. Evaluable pts were those with centrally confirmed nuclear AR expression≥10% by immunohistochemistry who received ≥1 dose of ENZA and had ≥1 postbaseline tumor assessment. Pts received ENZA 160 mg daily and trastuzumab 6 mg/kg every 21 days until disease progression. The primary objective was clinical benefit rate at 24 weeks (CBR24), defined as complete or partial response (CR or PR) or stable disease (SD) for ≥24 weeks in evaluable pts. Additional endpoints included safety and progression-free survival (PFS). CBR24 in ≥3 of 21 evaluable pts was required to continue to stage 2 and enrollment of up to 66 evaluable pts total. This design yields a 1-sided type 1 error of 5% and 90% power when the true response is 25%.
Results:Here we present results from stage 1 (data cutoff: Mar 23, 2016), with 22 evaluable pts enrolled (pts 21 and 22 enrolled simultaneously); 18 had received ≥4 prior lines of therapy. Median duration of ENZA exposure was 144 days (range, 22-495), mean number of complete trastuzumab infusions was 6.5. CBR24 was 27.3% (95% confidence interval [CI], 10.7-50.2); 2 confirmed PR and 4 SD ≥24 weeks. Median PFS was 108 days (95% CI, 56-144). All pts experienced ≥1 adverse event (AE) any grade; 5 pts experienced AEs grade ≥3. ENZA-related AEs were reported in 16 pts (72.7%), the most common (in ≥10% of pts) were fatigue (22.7%), nausea (18.2%), diarrhea (13.6%) and arthralgia (13.6%). Serious AEs were reported in 6 pts (27.3%; 2 each of infection and back pain, 1 each of abdominal pain, nausea, vomiting, pyrexia, urinary retention and pulmonary edema). Two pts discontinued due to drug-related AEs: 1 related to both drugs, 1 related to trastuzumab. One on-study death from pulmonary edema was reported, which was not considered related to either drug.
Conclusion:Stage 1 met its primary objective. No new safety signals were identified, and the safety profile in this study was similar to that in men with prostate cancer and women with other BC subtypes treated with ENZA. These results are encouraging for a heavily pretreated population with advanced HER2+ AR+ BC. Enrollment in stage 2 continues with the combination of ENZA and trastuzumab.
1. Micello D et al. Virchows Arch. 2010;457:467-476.
2. Richer J. Presented at AACR Advances in Breast Cancer, San Diego, CA, 2013.
Citation Format: Krop I, Cortes J, Miller K, Huizing MT, Provencher L, Gianni L, Chan S, Trudeau M, Steinberg J, Sugg J, Liosatos M, Paton VE, Peterson A, Wardley A. A single-arm phase 2 study to assess clinical activity, efficacy and safety of enzalutamide with trastuzumab in HER2+ AR+ metastatic or locally advanced breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-22-08.
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Affiliation(s)
- I Krop
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - J Cortes
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - K Miller
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - MT Huizing
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - L Provencher
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - L Gianni
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - S Chan
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - M Trudeau
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - J Steinberg
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - J Sugg
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - M Liosatos
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - VE Paton
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - A Peterson
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
| | - A Wardley
- Dana-Farber Cancer Institute, Boston, MA; Vall D'Hebron Institute of Oncology, Barcelona, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Indiana University Simon Cancer Center, Indianapolis, IN; Antwerp University Hospital Edegem, Antwerp, Belgium; Hôpital du Saint-Sacrement du CHU de Quebec, QC, Canada; Ospedale San Raffaele, Milan, Italy; Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Sunnybrook Health Sciences Centre, Toronto, Canada; Astellas Pharma, Inc., Northbrook, IL; Medivation, Inc., San Francisco, CA; The Christie NIHR/CRUK Clinical Research Facility, Manchester, United Kingdom
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Rojas JI, Patrucco L, MIguez J, Sinay V, Cassara FP, Cáceres F, Liguori NF, Saladino ML, Deri N, Jaacks G, Marcilla MP, Arrigoni MI, Correale J, Fiol M, Ysrraelit MC, Carrá A, Curbelo MC, Martinez A, Steinberg J, Bestoso S, Hryb JP, Di Pace JL, Perassolo MB, Contentti EC, Caride A, Lopez PA, Martinez C, Reich E, Giunta D, Cristiano E. Gender ratio trends over time in multiple sclerosis patients from Argentina. J Clin Neurosci 2017; 38:84-86. [PMID: 28087187 DOI: 10.1016/j.jocn.2016.12.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 12/26/2016] [Indexed: 11/19/2022]
Abstract
Several studies in multiple sclerosis (MS) suggest a trend of increasing disease frequency in women during the last decades. A direct comparison of gender ratio trends among MS populations from Argentina remains to be carried out. The objective of the study was to compare gender ratio trends, over a 50-year span in MS populations from Argentina. METHODS multicenter study that included patients from 14 MS Centers of Argentina. Patients with definite MS with birth years ranging from 1940 to 1989 were included. Gender ratios were calculated by five decades based on year of birth and were adjusted for the F/M born-alive ratio derived from the Argentinean national registry of births. The F/M ratios were calculated using a multivariate logistic regression per five decades by the year of birth approach. Analyses were performed using Stata 10.1. RESULTS 1069 patients were included. Gender ratios showed a significant increase from the first to the last decade in the whole MS sample (from 1.8 to 2.7; p value for trend=0.023). The Gender ratio did not show differences considering MS subtype. CONCLUSION our study showed a modest increase of the F/M ratio (from 1.8 to 2.7) over time among patients affected by MS in Argentina.
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Affiliation(s)
- J I Rojas
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina.
| | - L Patrucco
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - J MIguez
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - V Sinay
- Instituto de Neurociencias Fundación Favaloro (INCyT), Argentina
| | - F Pagani Cassara
- Instituto de Neurociencias Fundación Favaloro (INCyT), Argentina
| | - F Cáceres
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina
| | | | - M L Saladino
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina
| | - N Deri
- Centro de Investigación DIABAID, Argentina
| | - G Jaacks
- Centro de Investigación DIABAID, Argentina
| | | | | | - J Correale
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M Fiol
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M C Ysrraelit
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - A Carrá
- Hospital Británico Buenos Aires, Argentina
| | | | - A Martinez
- Hospital Británico Buenos Aires, Argentina
| | | | - S Bestoso
- Hospital Escuela "José F. De San Martín", Corrientes, Argentina
| | - J P Hryb
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - J L Di Pace
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - M B Perassolo
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | | | - A Caride
- Hospital Alemán, Buenos Aires, Argentina
| | - P A Lopez
- Hospital Alemán, Buenos Aires, Argentina
| | | | - E Reich
- Hospital Julio Mendez, Buenos Aires, Argentina
| | - D Giunta
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
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Frings A, Steinberg J, Linke SJ, Druchkiv V, Katz T. [Multifocal intraocular lens (MIOL) surgery in young non-presbyopic ametropes : Reasonable and safe?]. Ophthalmologe 2016; 114:722-727. [PMID: 27913863 DOI: 10.1007/s00347-016-0401-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/24/2022]
Abstract
BACKGROUND Refractive lens exchange and implantation of a multifocal intraocular lens (MIOL) is mainly advised for ametropes with presbyopia. Non-presbyopic young ametropes who wish spectacle-independence are usually treated with corneal refractive surgery or phakic lenses. OBJECTIVES This retrospective case series aimed to analyse the refractive and subjective satisfaction outcome after MIOL surgery in both eyes of non-presbyopic ametropes where other treatment options were not possible. MATERIALS AND METHODS This retrospective case series comprised consecutively treated 32 eyes of 16 patients (5 myopic, 11 hyperopic patients; mean age 31 ± 6 years) who wished spectacle-independence and thus received an aspheric bifocal biconvex refractive-diffractive single-piece MIOL (Acri.Lisa 366/809, Carl Zeiss Meditec AG). Refractive data prior to and after surgery as well as subjective satisfaction at the 1‑year follow-up examination were assessed. RESULTS Related to distance corrected near visual acuity myopic eyes had a median efficacy index (EI) of 0.92 (±0.20) and hyperopes of 0.91 (±0.12) (P = 0.415). For intermediate vision, in both groups a lower EI (<0.5; P = 0.188) resulted in lower subjective satisfaction, which was higher for near and distance vision. Some of hyperopic patients reported limitations in near and distance vision, only one hyperopic patient would not have chosen this surgery again. None had a related complication during the follow-up. CONCLUSIONS When neither laser refractive surgery nor implantation of a phakic lens is possible, young non-presbyopic ametropes do profit from MIOL surgery with an aspheric bifocal biconvex refractive-diffractive MIOL.
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Affiliation(s)
- A Frings
- Univ.-Klinik für Augenheilkunde, Universitätsklinik Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - J Steinberg
- Univ.-Klinik für Augenheilkunde, Universitätsklinik Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.,Care Vision GmbH, Hamburg, Deutschland.,zentrumsehstärke, Augenarztpraxis am UKE, Hamburg, Deutschland
| | - S J Linke
- Univ.-Klinik für Augenheilkunde, Universitätsklinik Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.,Care Vision GmbH, Hamburg, Deutschland.,zentrumsehstärke, Augenarztpraxis am UKE, Hamburg, Deutschland
| | - V Druchkiv
- Univ.-Klinik für Augenheilkunde, Universitätsklinik Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - T Katz
- Univ.-Klinik für Augenheilkunde, Universitätsklinik Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland. .,Care Vision GmbH, Hamburg, Deutschland.
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Syed M, Co D, North P, Steinberg J. P172 Eosinophilic granulomatous polyangiitis presenting with acute hypotension. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.183] [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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Cristiano E, Patrucco L, Miguez J, Giunta D, Correale J, Fiol M, Ysrraelit M, Cáceres F, Liguori NF, Saladino M, Garcea O, Silva B, Alonso R, Carrá A, Curbelo M, Martinez A, Steinberg J, Giachello S, Melcom M, Rojas J. Increasing prevalence of multiple sclerosis in Buenos Aires, Argentina. Mult Scler Relat Disord 2016; 9:91-4. [DOI: 10.1016/j.msard.2016.07.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/05/2016] [Accepted: 07/08/2016] [Indexed: 12/23/2022]
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Mehlan J, Steinberg J, Traber L, Katz T, Linke SJ. Recurrence rate and subjective symptoms after standardized (Hamburg protocol) phototherapeutic keratectomy on recurrent corneal erosions. Graefes Arch Clin Exp Ophthalmol 2016; 254:2005-2009. [DOI: 10.1007/s00417-016-3470-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 06/21/2016] [Accepted: 08/09/2016] [Indexed: 11/29/2022] Open
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Abstract
A 43-year-old male patient with unilateral metamorphosia presented after gazing at an eclipse with only one eye. Damage of the macula was demonstrated funduscopically, with OCT and angiography. Six weeks after initial presentation and oral methylprednisolone therapy (40 mg/d for 10 days), the symptoms and the morphological changes decreased. Solar retinopathy is a photochemical alteration of the retina, usually seen after sun gazing. In younger patients, it mostly presents as bilateral solar maculopathy. Some patients exhibit partial or total recovery.
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Affiliation(s)
- J Mehlan
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE)
| | - S J Linke
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE)
| | - L Wagenfeld
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE)
| | - J Steinberg
- Augenarztpraxis am UKE, zentrumsehstärke, Hamburg
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Abstract
Clinically detected neuroendocrine neoplasms of the rectum have increased 10- to 30-fold in frequency over the past 45 years in Germany. Endoscopic ultrasonography is the method of choice for exact determination of the size of the tumor, depth of infiltration and detection of local lymph node metastases. Well-differentiated neuroendocrine tumors ≤ 10.0 mm in size that do not infiltrate the muscularis propria can be endoscopically resected. In the case of lymphatic or blood vessel invasion or spread to lymph nodes, surgical lymph node dissection is indicated. The management of well-differentiated, neuroendocrine rectal tumors 10.1-20 mm in size is still a matter of debate. Old age and multimorbidity favor a conservative endoscopic approach; however, in the case of fit young patients, surgical management has to be considered. For neuroendocrine rectal neoplasms ≥ 20 mm in size, the risk of metastatic spread increases to 60-80 % indicating that an endoscopic resection is not adequate. Due to the introduction of screening colonoscopy, neuroendocrine rectal tumors are nowadays diagnosed mostly at a prognostically favorable early stage.
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Affiliation(s)
- J Eick
- Klinik für Innere Medizin - Gastroenterologie, Gastrointestinale Onkologie und Infektiologie, Klinikum Am Urban, Vivantes Netzwerk für Gesundheit, Dieffenbachstrasse 1, 10967, Berlin, Deutschland
| | - J Steinberg
- Klinik für Innere Medizin - Gastroenterologie, Gastrointestinale Onkologie und Infektiologie, Klinikum Am Urban, Vivantes Netzwerk für Gesundheit, Dieffenbachstrasse 1, 10967, Berlin, Deutschland
| | - C Schwertner
- Klinik für Innere Medizin - Gastroenterologie, Gastrointestinale Onkologie und Infektiologie, Klinikum Am Urban, Vivantes Netzwerk für Gesundheit, Dieffenbachstrasse 1, 10967, Berlin, Deutschland
| | - W Ring
- Klinik für Innere Medizin - Gastroenterologie, Gastrointestinale Onkologie und Infektiologie, Klinikum Am Urban, Vivantes Netzwerk für Gesundheit, Dieffenbachstrasse 1, 10967, Berlin, Deutschland
| | - H Scherübl
- Klinik für Innere Medizin - Gastroenterologie, Gastrointestinale Onkologie und Infektiologie, Klinikum Am Urban, Vivantes Netzwerk für Gesundheit, Dieffenbachstrasse 1, 10967, Berlin, Deutschland.
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Rojas JI, Patrucco L, MIguez J, Sinay V, Cassara FP, Cáceres F, Liguori NF, Saladino ML, Deri N, Jaacks G, Marcilla MP, Arrigoni MI, Correale J, Fiol M, Ysrraelit MC, Carrá A, Curbelo MC, Martinez A, Steinberg J, Bestoso S, Hryb JP, Di Pace JL, Perassolo MB, Carnero Contentti E, Caride A, Lopez PA, Martinez C, Reich E, Cristiano E. Disease onset in familial and sporadic multiple sclerosis in Argentina. Mult Scler Relat Disord 2016; 6:54-56. [PMID: 27063623 DOI: 10.1016/j.msard.2016.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 12/28/2015] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
Abstract
UNLABELLED The present study was carried out to assess if there is an anticipation of age at onset in younger generations of familial multiple sclerosis (FMS) vs. sporadic MS (SMS) in Argentina. METHODS multicenter study that included patients from 14 MS Centers of Argentina. Patients were considered as FMS if they had in their family at least one relative of first or second degree diagnosed with MS; otherwise, patients were considered to have SMS. We compared the age at onset between familial and sporadic cases as well as the age at onset between relatives from different generations in FMS vs. SMS. RESULTS 1333 patients were included, 97 of them were FMS (7.3%). A lower age at onset in the younger generations of FMS cases was found compared with older generations of FMS as well as. SMS cases (24.1±3.7 years vs. 30.3±5.7 years, and 32.4±9.4 respectively; p<0.001). No differences were observed between older generations of FMS vs. SMS cases (p=0.12). CONCLUSION we observed an anticipation of age at onset of MS in younger generations of patients with FMS vs. older generations of FMS and SMS.
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Affiliation(s)
- J I Rojas
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina.
| | - L Patrucco
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - J MIguez
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
| | - V Sinay
- Instituto de Neurociencias, Fundación Favaloro, Argentina
| | | | - F Cáceres
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina
| | - N Fernandez Liguori
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina; Multiple Sclerosis Section Hospital E.Tornú, Buenos Aires, Argentina
| | - M L Saladino
- Neurosciences Institute of Buenos Aires (INEBA), Buenos Aires, Argentina; Multiple Sclerosis Section Hospital E.Tornú, Buenos Aires, Argentina
| | - N Deri
- Centro de Investigación DIABAID, Argentina
| | - G Jaacks
- Centro de Investigación DIABAID, Argentina
| | | | | | - J Correale
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M Fiol
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - M C Ysrraelit
- Department of Neurology, Institute for Neurological Research Dr. Raúl Carrea, FLENI, Argentina
| | - A Carrá
- Hospital Británico Buenos Aires, Argentina
| | | | - A Martinez
- Hospital Británico Buenos Aires, Argentina
| | | | - S Bestoso
- Hospital Escuela "José F. De San Martín", Corrientes, Argentina
| | - J P Hryb
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - J L Di Pace
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | - M B Perassolo
- Hospital General de Agudos Carlos G Durand, Buenos Aires, Argentina
| | | | - A Caride
- Hospital Alemán, Buenos Aires, Argentina
| | - P A Lopez
- Hospital Alemán, Buenos Aires, Argentina
| | - C Martinez
- Private Office, Private Office, Argentina
| | - E Reich
- Hospital Julio Mendez, Buenos Aires, Argentina
| | - E Cristiano
- Centro de Esclerosis Múltiple de Buenos Aires, Hospital Italiano de Buenos Aires, Argentina
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Steinberg J, Adler N, Thompson K, Furgerson D, Harper C. Current and past depressive symptoms as predictors of effectiveness level of contraceptive method selected among women at reproductive health visits. Contraception 2015. [DOI: 10.1016/j.contraception.2015.06.207] [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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Steinberg J, Tschann J, Harper C. The relationship between psychosocial factors and preabortion psychological health: the significance of stigma. Contraception 2015. [DOI: 10.1016/j.contraception.2015.06.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Linke SJ, Ren L, Frings A, Steinberg J, Wöllmer W, Katz T, Reimer R, Hansen NO, Jowett N, Richard G, Dwayne Miller RJ. [Perspectives of laser-assisted keratoplasty: current overview and first preliminary results with the picosecond infrared laser (λ = 3 µm)]. Ophthalmologe 2015; 111:523-30. [PMID: 24942118 DOI: 10.1007/s00347-013-2995-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND This article provides a review of the current state of laser-assisted keratoplasty and describes a first proof of concept study to test the feasibility of a new mid-infrared (MIR) picosecond laser to perform applanation-free corneal trephination. METHODS The procedure is based on a specially adapted laser system (PIRL-HP2-1064 OPA-3000, Attodyne, Canada) which works with a wavelength of 3,000 ± 90 nm, a pulse duration of 300 ps and a repetition rate of 1 kHz. The picosecond infrared laser (PIRL) beam is delivered to the sample by a custom-made optics system with an implemented scanning mechanism. Corneal specimens were mounted on an artificial anterior chamber and subsequent trephination was performed with the PIRL under stable intraocular pressure conditions. RESULTS A defined corneal ablation pattern, e.g. circular, linear, rectangular or disc-shaped, can be selected and its specific dimensions are defined by the user. Circular and linear ablation patterns were employed for the incisions in this study. Linear and circular penetrating PIRL incisions were examined by macroscopic inspection, histology, confocal microscopy and environmental scanning electron microscopy (ESEM) for characterization of the incisional quality. Using PIRL reproducible and stable incisions could be made in human and porcine corneal samples with minimal damage to the surrounding tissue. CONCLUSION The PIRL laser radiation in the mid-infrared spectrum with a wavelength of 3 µm is exactly tuned to one of the dominant vibrational excitation bands of the water molecule, serves as an effective tool for applanation-free corneal incision and might broaden the armamentarium of corneal transplant surgery.
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Affiliation(s)
- S J Linke
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland,
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Faure A, Bruzzese L, Steinberg J, Torrents J, Fenouillet E, Berdah S, Guieu R, Lechevallier E. Argon : une technique innovante de conservations des transplants rénaux. Prog Urol 2014; 24:800-1. [DOI: 10.1016/j.purol.2014.08.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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DeFazio M, Han K, Iorio M, Attinger C, Steinberg J, Kim P, Nemets L, Evans K. Combined Free Tissue Transfer for the Management of Composite Achilles Defects: Functional Outcomes and Patient Satisfaction following Thigh-Based Vascularized Reconstruction with a Neotendon Construct. J Reconstr Microsurg 2014; 30:431-40. [DOI: 10.1055/s-0034-1370339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Michael DeFazio
- Department of Plastic Surgery, Center for Wound Healing, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Kevin Han
- Department of Plastic Surgery, Center for Wound Healing, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Matthew Iorio
- Department of Plastic Surgery, Center for Wound Healing, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Christopher Attinger
- Department of Plastic Surgery, Center for Wound Healing, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - John Steinberg
- Department of Plastic Surgery, Center for Wound Healing, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Paul Kim
- Department of Plastic Surgery, Center for Wound Healing, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Laura Nemets
- Medstar NRH Rehabilitation Network, Arlington, Virginia
| | - Karen Evans
- Department of Plastic Surgery, Center for Wound Healing, Medstar Georgetown University Hospital, Washington, District of Columbia
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Nelson F, Steinberg J. Feasibility and Findings from a Novel Working Memory fMRI Paradigm in Multiple Sclerosis. J Neurol Disord Stroke 2013; 1:1011. [PMID: 24772453 PMCID: PMC3996842] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Functional MRI (fMRI) basic cognitive paradigms such as the n-back have been shown to detect cognitive impairment (CI) in Multiple Sclerosis (MS). The immediate memory task/delayed memory task (IMT/DMT) detects varying degrees of working memory (WM) by alternating three levels of complexity and two levels of WM delay. This paradigm has not been evaluated in MS nor validated against standard neuropsychological (NP) testing. OBJECTIVE To evaluate the correlation between WM function and blood oxygen level dependent (BOLD) activation on fMRI in MS patients undergoing the IMT/DMT. To compare IMT/DMT behavioral scores to NP scores. METHODS 10 MS patients with no history of CI underwent the Minimal Assessment of Cognitive Function in MS (MACFIMS) and an fMRI session where they performed the IMT/DMT. Working-memory ("wmem") activation was defined as the BOLD signal during DMT blocks for a particular condition (3, 5, or 7 digits per stimuli) minus the BOLD signal during IMT blocks for that condition. Areas of statistically significant Family Wise Error (FWE) -corrected cluster-level BOLD activation were identified using SPM8 Random Effects t-test. IMT/DMT behavioral data and MACFIMS scores were compared. RESULTS The 3-digit as well as the 5-digit wmem showed significant fMRI BOLD activation. The 3-digit wmem, activation was found in portions of the bilateral superior and mid frontal cortex, supplementary motor area, pre and post central gyrus, bilateral superior and inferior parietal lobule, inferolateral pre-frontal cortex, cuneus, insula and cingulate regions. The 5 digit wmen activation was seen in the inferior medial frontal and medial orbitofrontal cortex. IMT/DMT behavioral scores were within normal range and consistent with MACFIMS. CONCLUSION IMT/DMT, a novel fMRI working memory paradigm, is associated with BOLD activation in areas of the brain related to cognitive function in patients with MS. Both MACFIMS and IMT/DMT scores were in agreement and supported intact cognitive function.
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Affiliation(s)
- F Nelson
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J Steinberg
- Virginia Commonwealth University Richmond, VA, USA
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Steinberg J, Kohl C, Katz T, Richard G, Linke SJ. [Difference and distance between the central and thinnest points of the cornea: impact of refractive state, age and ocular side]. Ophthalmologe 2013; 111:339-47. [PMID: 23921813 DOI: 10.1007/s00347-013-2892-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of the study was to quantify the difference in corneal thickness between the central and thinnest points (∆PachyZ-PachyD), the distance between the center of the cornea and its thinnest point (vector length PachyD) and to explore the impact of refractive state, age and ocular side. PATIENTS AND METHODS This was a multicenter, retrospective, cross-sectional study and medical records of 16,872 eyes were reviewed. The Orbscan® (Bausch and Lomb) procedure was used for pachymetry and keratometry. RESULTS The results showed that ∆PachyZ-PachyD and vector length PachyD were higher in hyperopic eyes (∆PachyZ-PachyD: 11.99 ± 12.08 µm, vector length PachyD: 0.85 ± 0.44 mm) compared to myopic eyes (∆PachyZ-PachyD: 9.2 ± 7.86 µm, vector length PachyD: 0.7 ± 0.37 mm; p < 0.001). Refractive state, age and ocular side demonstrated an independent, statistically significant impact on ∆PachyZ-PachyD and vector length PachyD. CONCLUSIONS As a result of the significant impact of refractive state, age and ocular side on ∆PachyZ-PachyD and vector length PachyD, these variables should be considered in a normative data collection.
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Affiliation(s)
- J Steinberg
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland,
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Linke SJ, Steinberg J, Katz T. [Therapeutic excimer laser treatment of the cornea]. Klin Monbl Augenheilkd 2013; 230:595-603. [PMID: 23794429 DOI: 10.1055/s-0032-1328507] [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: 10/26/2022]
Abstract
Concomitant with new innovations in the field of refractive surgery, therapeutic excimer laser applications like phototherapeutic keratectomy (PTK) and topography-guided customised ablation treatment are gaining high importance and undergoing rapid evolution. Nowadays, PTK is an effective treatment modality for superficial corneal pathologies. Primary indications are decreased epithelial adherence, superficial opacifications and an irregular corneal surface. For the right indication and successful treatment of corneal pathologies with PTK, a knowledge of the size, depth and nature of the pathology, as well as the refractive status of both eyes is important. Next to slit-lamp examination, objective measuring systems like the topography, confocal microscopy and the anterior segment OCT facilitate presurgical planning. Regarding the treatment procedure the surgeon can choose between a variety of methods. PTK can be combined with manual epithelial debridement or done by only using the excimer laser. In the case of an irregular corneal surface, depending on the pathology, masking fluids or topography-guided custom ablation protocols can increase the visual outcome. To avoid recurrence of the underlying pathology (e.g., corneal dystrophy, haze), the topical application of 0.02% mitomycin C for 20-60 seconds has proved to be a safe and effective procedure. If the surgeon considers all the patient-related factors carefully and manages to combine the available treatment options correctly, PTK embodies an effective and minimally invasive alternative to lamellar or penetrating keratoplasty.
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Affiliation(s)
- S J Linke
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg.
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Abstract
OBJECTIVES The major objective of our paper was to test and validate the nutritional literacy scale (NLS) in a pre-dominantly African-American geriatric population. DESIGN Completion of the 2 literacy scales Short Test of Functional Health Literacy in Adults (STOHFLA) and nutritional literacy scale (NLS) during a 5-month period from September 2008 to January 2009. SETTING The Rosa Parks Geriatric Center at Detroit Medical Center/Wayne State University. PARTICIPANTS The study cohort consisted of elderly (>65 years old) 150 patients that had presented to the geriatric clinic. MEASUREMENTS NLS and STOHFLA were simultaneously given to the patients. The NLS consists of 28 questions regarding organic foods; calorie intake etc. and questions in each section were arranged from easier to more difficult ones. The baseline characteristics were stratified according to the NLS (< 25 and ≥ 25) and STOHFLA (< 35 and ≥ 35) scores. Additionally we also collected data on demographic information, educational experience, blood pressure recordings from 3 consecutive clinic visits. RESULTS The patients with a higher NLS score were younger (72 ± 9) as compared to those with lower NLS score (76 ± 9) (p = 0.005), and also had more years of education (16 ± 3 years v/s 13 ± 3 years; p <0.001). A higher proportion of patients with lower score on NLS had hypertension (95.10 % for NLS < 25 v/s 77.08 % for NLS > 25; p =0.001). CONCLUSION We validated a potentially useful nutritional literacy tool that might prove to be useful intervention aimed at identifying individuals with lower levels of education and insight regarding their nutritional behaviors.
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Affiliation(s)
- P Patel
- Pragnesh Patel M.D., 5C, University Health Center, 4201 St Antonie Rd, Detroit, MI, 48201
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Abstract
A 23-year-old man presented with severe contact lens-associated keratitis and descemetocele with pre-existing drug therapy. After 1 week of intensive antibiotic treatment Aspergillus fumigatus was identified. Despite adjusted antimycotic treatment a corneal perforation occurred. Due to peripheral scleral infiltration the cornea was primarily closed with a double layer amniotic membrane in order to avoid a sclerokeratoplasty with a bad prognosis. After 2 weeks the peripheral corneal situation stabilized and a simple keratoplasty á chaud could be performed. After surgery and adjusted drug therapy, no adequate signs of recovery occured. In repeated microbiological testing an additional Candida albicans infection was diagnosed and therapy was readjusted. This resulted in a cure of the corneal infection. After 5 years and a re-keratoplasty the patient presented with a clear corneal transplant and a corrected visual acuity of 20/25.
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Affiliation(s)
- M-T Eddy
- Augenklinik, Universitätsklinikum Hamburg Eppendorf, Gebäude W40, Martinistr. 52, 20246, Hamburg, Deutschland.
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Steinberg J. Extraordinary dedication: family, profession, country. Mo Med 2012; 109:365. [PMID: 23097938 PMCID: PMC6179767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Scherübl H, Faiss S, Jahn HU, Knoefel WT, Liehr RM, Schwertner C, Steinberg J, Stölzel U, Weinke T, Zimmer T, Wardelmann E. [Early asymptomatic GIST of the stomach]. Dtsch Med Wochenschr 2012; 137:1650-3. [PMID: 22875693 DOI: 10.1055/s-0032-1305210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- H Scherübl
- Klinik für Gastroenterologie, GI Onkologie und Infektiologie, Vivantes Klinikum Am Urban, Berlin.
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Abstract
BACKGROUND Canaloplasty provides a new option in non-penetrating glaucoma surgery. The aim of this study is to examine its early postsurgical safety and efficacy. PATIENTS AND METHODS This was a retrospective study of canaloplasties performed at our institution in 2009 (n=46, 13 of which were combined with cataract surgery). The mean follow-up was 6.0±3.4 months. The most important parameters examined were intraocular pressure (IOP), number of topical medications, postoperative complications, and required additional surgery. RESULTS Mean presurgical IOP: 18.2±5.8 mmHg on a mean of 2.3±1.2 applied topical medications. Mean postsurgical IOP: 12.3±5.1 mmHg at 3 months, 11.7±3.0 mmHg at 6 months, and 12.6±2.4 mmHg at 12 months. Number of postsurgical medications: 0.8±1.1 at 3 months, 1.2±1.3 at 6 months, and 1.0±1.1 at 12 months. The most frequent postoperative complications were transient hypotension (32.6%), bleb leakage (26.1%), and microhyphema (23.9%). Revision surgery was required in 8.7% of all patients. CONCLUSIONS Canaloplasty showed a good IOP-reducing effect. Complications occurred mostly temporarily and were of a controllable nature.
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Affiliation(s)
- M Matthaei
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
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