1
|
Fukui N, Partain DK, Yeow ME, Farfour HN, Prokop L, Barwise A. Learning to collaborate with medical interpreters in health professions education: A systematic review of training programs. Med Teach 2024; 46:258-272. [PMID: 37625438 DOI: 10.1080/0142159x.2023.2249211] [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] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
BACKGROUND Working effectively with medical interpreters is an increasingly valuable skill for clinicians to provide high-quality medical care. We aimed to assess the effectiveness of existing training programs that teach optimal collaboration practices between clinicians and interpreters during patient encounters. METHODS We searched MEDLINE, EMBASE, Scopus, and Cochrane Central for studies published from 1945 through June 21, 2022. RESULTS Out of the 1689 studies screened, we identified 19 studies that met inclusion criteria. Participants were from diverse professions, medical specialities, and training levels. Interpreter involvement in the development or delivery of the program was mentioned in 63% of the evaluated studies. There was substantial variability in training design, assessment methods, and reported outcomes. Only 10 of the programs included an objective knowledge or skills assessment. Only one study conducted a longitudinal assessment of skill maintenance over time. The training programs were generally well received. CONCLUSIONS There is a critical need for structured programs to train clinicians to effectively collaborate with medical interpreters to reduce healthcare disparities. An effective training program should involve interpreters in the development and delivery of the program, practical skills development through interactive activities, structured clinical skill assessment, and both in-person and virtual components.
Collapse
Affiliation(s)
- Natsu Fukui
- Division of Palliative Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Daniel K Partain
- Division of Community Internal Medicine, Geriatrics and Palliative Care, Mayo Clinic, Rochester, MN, USA
| | - Mei-Ean Yeow
- Division of Community Internal Medicine, Geriatrics and Palliative Care, Mayo Clinic, Rochester, MN, USA
| | | | - Larry Prokop
- Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA
| | - Amelia Barwise
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
2
|
Lydon KL, Struijk C, Michielsen J, Prokop L, Krych AJ, Saris D, Verdonk P. Fresh Versus Frozen Meniscal Allograft Transplant: Revisit or Redundant? A Systematic Review. Am J Sports Med 2024:3635465231200236. [PMID: 38282584 DOI: 10.1177/03635465231200236] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
BACKGROUND Fresh-frozen allografts are the current standard in meniscal allograft transplant (MAT) surgery, due to their availability, ease of preservation, and affordability. However, fresh-frozen grafts are associated with several clinical challenges such as graft shrinkage and extrusion, among many others. PURPOSE To present the current knowledge on the use of fresh meniscal allografts, presenting whether benefits associated with fresh grafts provide sufficient evidence to support their use in clinical practice. STUDY DESIGN Systematic review; Level of evidence, 5. METHODS A comprehensive search was conducted with keywords listed below. After an initial screening on title and abstract, full-text articles were assessed with the inclusion criteria. RESULTS A total of 78 studies matched the inclusion criteria. Literature and preclinical studies indicated that fresh meniscal allografts are beneficial for maintaining mechanical properties, graft ultrastructure, and matrix metabolism due to the presence of viable cells. Therefore, fresh allografts may address common complications associated with fresh-frozen MAT. To overcome challenges associated with both fresh-frozen and fresh allografts, a group has studied treating fresh-frozen allografts with a cell-based injection therapy. CONCLUSION Fresh meniscal allografts pose several challenges including limited availability, demanding preservation procedures, and high costs. Although the role of viable cells within meniscal allografts remains controversial, these cells may be vital for maintaining tissue properties.
Collapse
Affiliation(s)
- Katherine L Lydon
- Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Caroline Struijk
- Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopedic Surgery, Antwerp University, Antwerp, Belgium
| | - Jozef Michielsen
- Department of Orthopedic Surgery, Antwerp University, Antwerp, Belgium
| | - Larry Prokop
- Library Public Services, Mayo Clinic, Rochester, Minnesota, USA
| | - Aaron J Krych
- Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Daniel Saris
- Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Orthopedic Surgery, University Medical Centre, Utrecht, the Netherlands
| | - Peter Verdonk
- Department of Orthopedic Surgery, Antwerp University, Antwerp, Belgium
- ORTHOCA, Antwerp, Belgium
| |
Collapse
|
3
|
Yang C, Prokop L, Barwise A. Strategies Used by Healthcare Systems to Communicate with Hospitalized Patients and Families with Limited English Proficiency During the COVID-19 Pandemic: A Narrative Review. J Immigr Minor Health 2023; 25:1393-1401. [PMID: 36821068 PMCID: PMC9948796 DOI: 10.1007/s10903-023-01453-w] [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] [Accepted: 01/17/2023] [Indexed: 02/24/2023]
Abstract
The COVID-19 pandemic disproportionately affected racial and ethnic minorities in the United States, including many with limited English proficiency (LEP). These patients face various communication barriers, including a shortage of available interpreters and the need for masks that exacerbated communication barriers. It is not known how hospitals responded to these unique challenges to providing language services for the large number of patients with LEP during COVID-19. This narrative review assessed literature and lay media to identify strategies utilized by hospitals to communicate with patients with LEP hospitalized during the COVID-19 pandemic. A search of APA PsychInfo, EBM Reviews, Embase, Ovid MEDLINE, Epub Ahead of Print, and Ebsco Megafile initially yielded 61 articles, 6 of which were ultimately included after reviewing abstracts and full texts. The identified interventions, which sought to increase accessibility of language-concordant care, increase accessibility of professional interpretation, and improve family communication and understanding, were described positively, though only one was tested for effectiveness.
Collapse
Affiliation(s)
- Catherine Yang
- Mayo Clinic Alix School of Medicine, 200 First St SW, Rochester, MN, 55905, USA.
| | - Larry Prokop
- Department of Library Services, Mayo Clinic, Rochester, MN, USA
| | - Amelia Barwise
- Bioethics Research Program, Mayo Clinic, Rochester, MN, USA
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
4
|
Reyes-Farias CI, Reategui-Diaz M, Romani-Romani F, Prokop L. The effect of sodium-glucose cotransporter 2 inhibitors in patients with chronic kidney disease with or without type 2 diabetes mellitus on cardiovascular and renal outcomes: A systematic review and meta-analysis. PLoS One 2023; 18:e0295059. [PMID: 38019892 PMCID: PMC10686459 DOI: 10.1371/journal.pone.0295059] [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] [Received: 05/01/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have shown a favorable effect on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus (T2DM). However, their efficacy in patients with chronic kidney disease (CKD) with or without T2DM has not yet been analyzed. OBJECTIVE To assess the cardiovascular and renal effects of SGLT-2 inhibitors in patients with CKD with and without T2DM, including all CKD patients in the current literature. METHODS We searched MEDLINE, EMBASE, CENTRAL and Scopus for randomized controlled trials of SGLT-2 inhibitors that evaluated cardiovascular and kidney outcomes in patients with CKD, or trials in which these patients were a subgroup. We defined 2 primary outcomes: a composite of cardiovascular death or hospitalization for heart failure, and a composite renal outcome. For each outcome, we obtained overall hazard ratios with 95% confidence intervals by using a random effects model. RESULTS We included 14 randomized controlled trials. SGLT-2 inhibitors decreased the hazard for the primary cardiovascular outcome (HR 0.76; [95% CI 0.72-0.79]) and the primary renal outcome (HR 0.69; [95% CI 0.61-0.79]) in patients with CKD with or without T2DM. We did not find significant differences in the subgroup analyses according to diabetes status, baseline eGFR values or the type of SGLT-2 inhibitor used. CONCLUSION In patients with CKD, treatment with SGLT-2 inhibitors in addition to standard therapy conferred protection against cardiovascular and renal outcomes. Further research on patients with non-diabetic CKD should be done to confirm the utility of these medications in this population. (PROSPERO ID: CRD42021275012).
Collapse
Affiliation(s)
| | | | | | - Larry Prokop
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota, United States of America
| |
Collapse
|
5
|
Greif T, Alsawas M, Reid AT, Liu V, Prokop L, Murad MH, Powers JG. Targeting the Angiotensin Pathway in the Treatment of Cutaneous Fibrosis: A Systematic Review. JID Innov 2023; 3:100231. [PMID: 37840767 PMCID: PMC10568560 DOI: 10.1016/j.xjidi.2023.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 08/03/2023] [Accepted: 08/22/2023] [Indexed: 10/17/2023] Open
Abstract
Acting on the renin-angiotensin-aldosterone system, angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs) are mechanisms of some of the most prescribed medications in the world. In addition to their routine use for the treatment of hypertension, such agents have gained attention for their influence on the angiotensin receptor pathway in fibrotic skin disorders, including scars and keloids. To evaluate the current level of evidence supporting the use of these agents, a systematic review related to ACE-Is/ARBs and cutaneous scarring was conducted. We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus from database inception through January 26, 2022. Two independent reviewers identified eligible studies for inclusion and extracted data. Data were insufficient for meta-analysis and are presented narratively. Of 461 citations identified, seven studies were included (199 patients). The studies included two randomized clinical trials, one comparative observation study, and four case reports. All the included studies reported statistically significant improvement in cutaneous scarring in patients using ACE-Is/ARBs compared with that in those treated with placebo/control using various outcome measures such as scar size and scar scales. However, much of the literature on this subject to date is limited by study design.
Collapse
Affiliation(s)
- Trenton Greif
- Department of Dermatology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Mouaz Alsawas
- Department of Pathology, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Alexander T. Reid
- Department of Dermatology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Vincent Liu
- Department of Dermatology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
- Department of Pathology, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
| | - Larry Prokop
- Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA
| | - M. Hassan Murad
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer G. Powers
- Department of Dermatology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| |
Collapse
|
6
|
Chen A, Alsawas M, Tan KW, Prokop L, Murad MH, Powers JG. Surgical site infection rates following Mohs micrographic surgery by body site: A systematic review and meta-analysis. J Am Acad Dermatol 2023; 89:862-864. [PMID: 37364613 DOI: 10.1016/j.jaad.2023.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/28/2023] [Accepted: 06/10/2023] [Indexed: 06/28/2023]
Affiliation(s)
- Ailynna Chen
- University of Iowa, Carver College of Medicine, Iowa City, Iowa.
| | - Mouaz Alsawas
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Kendra W Tan
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Larry Prokop
- Mayo Clinic Libraries, Mayo Clinic, Rochester, Massachusetts
| | | | - Jennifer G Powers
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| |
Collapse
|
7
|
Torres Roldan VD, Urtecho M, Nayfeh T, Firwana M, Muthusamy K, Hasan B, Abd-Rabu R, Maraboto A, Qoubaitary A, Prokop L, Lieb DC, McCall AL, Wang Z, Murad MH. A Systematic Review Supporting the Endocrine Society Guidelines: Management of Diabetes and High Risk of Hypoglycemia. J Clin Endocrinol Metab 2023; 108:592-603. [PMID: 36477885 DOI: 10.1210/clinem/dgac601] [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: 10/08/2022] [Indexed: 12/12/2022]
Abstract
CONTEXT Interventions targeting hypoglycemia in people with diabetes are important for improving quality of life and reducing morbidity and mortality. OBJECTIVE To support development of the Endocrine Society Clinical Practice Guideline for management of individuals with diabetes at high risk for hypoglycemia. METHODS We searched several databases for studies addressing 10 questions provided by a guideline panel from the Endocrine Society. Meta-analysis was conducted when feasible. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess certainty of evidence. RESULTS We included 149 studies reporting on 43 344 patients. Continuous glucose monitoring (CGM) reduced episodes of severe hypoglycemia in patients with type 1 diabetes (T1D) and reduced the proportion of patients with hypoglycemia (blood glucose [BG] levels <54 mg/dL). There were no data on use of real-time CGM with algorithm-driven insulin pumps vs multiple daily injections with BG testing in people with T1D. CGM in outpatients with type 2 diabetes taking insulin and/or sulfonylureas reduced time spent with BG levels under 70 mg/dL. Initiation of CGM in hospitalized patients at high risk for hypoglycemia reduced episodes of hypoglycemia with BG levels lower than 54 mg/dL and time spent under 54 mg/dL. The proportion of patients with hypoglycemia with BG levels lower than 70 mg/dL and lower than 54 mg/dL detected by CGM was significantly higher than point-of-care BG testing. We found no data evaluating continuation of personal CGM in the hospital. Use of an inpatient computerized glycemic management program utilizing electronic health record data was associated with fewer patients with and episodes of hypoglycemia with BG levels lower than 70 mg/dL and fewer patients with severe hypoglycemia compared with standard care. Long-acting basal insulin analogs were associated with less hypoglycemia. Rapid-acting insulin analogs were associated with reduced severe hypoglycemia, though there were more patients with mild to moderate hypoglycemia. Structured diabetes education programs reduced episodes of severe hypoglycemia and time below 54 mg/dL in outpatients taking insulin. Glucagon formulations not requiring reconstitution were associated with longer times to recovery from hypoglycemia, although the proportion of patients who recovered completely from hypoglycemia was not different between the 2 groups. CONCLUSION This systematic review summarized the best available evidence about several interventions addressing hypoglycemia in people with diabetes. This evidence base will facilitate development of clinical practice guidelines by the Endocrine Society.
Collapse
Affiliation(s)
| | - Meritxell Urtecho
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55902, USA
| | - Tarek Nayfeh
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55902, USA
| | - Mohammed Firwana
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55902, USA
| | | | - Bashar Hasan
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55902, USA
| | - Rami Abd-Rabu
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55902, USA
| | - Andrea Maraboto
- Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN 55902, USA
| | - Amjad Qoubaitary
- College of Arts and Science, University of San Francisco, San Francisco, CA 94117, USA
| | - Larry Prokop
- Department of Library Services, Mayo Clinic, Rochester, MN 55902, USA
| | - David C Lieb
- Division of Endocrine and Metabolic Disorders, Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA 23501-1980, USA
| | - Anthony L McCall
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA 22908, USA
| | - Zhen Wang
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55902, USA
| | | |
Collapse
|
8
|
Shafa A, Kailasam A, Prokop L, Hou X, Weroha SJ. 50 The role of DNA methyltransferase inhibitors (DNMTi) in the treatment of patients with recurrent epithelial ovarian cancer: a systematic review and meta-analysis. Gynecol Oncol Rep 2022. [DOI: 10.1016/s2352-5789(22)00262-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
9
|
Barron CR, Alomari A, Aypar U, Chaubey A, Deak K, Geiersbach K, Golem S, Prokop L, Sahajpal N, Wei L, Williams E, Zou Y, Kolhe R, Iqbal A. 36. Clinical utility of copy number alteration analysis in the evaluation of Melanocytic Lesions for diagnosis and prognosis. Cancer Genet 2022. [DOI: 10.1016/j.cancergen.2022.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
10
|
Alsawas M, Dundar B, Prokop L, Murad MH, Swick B. Clinicopathologic Features of Facial Dermatofibromas, a Cohort Study, and a Systematic Review of Literature. Am J Dermatopathol 2022; 44:822-827. [PMID: 35503883 DOI: 10.1097/dad.0000000000002211] [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: 11/25/2022]
Abstract
BACKGROUND Dermatofibromas are common skin tumors that typically occur on the extremities and trunk and demonstrate benign behavior, frequent recurrences, and very rare metastasis. Facial dermatofibromas are rare and not well studied . We analyzed clinicopathologic features of facial dermatofibromas. DESIGN Considering the rarity of the condition, we conducted a cohort study and a systematic review. We queried medical records of a single tertiary care center for dermatofibromas from January 1, 2000, to July 1, 2021. A systematic review of multiple databases was conducted through October 27, 2021, to include studies reporting facial dermatofibromas. Random-effects meta-analysis was used to estimate pooled odds ratio and proportions with associated 95% confidence interval (CI). RESULTS The cohort study identified 2858 cases of dermatofibromas, of which, 23 cases from 18 patients were on the face (1%). The mean age was 52.7 ± 17.8 years. Fifty-six percent of the cases were women. The most common location was the forehead (6 cases). The mean follow-up was 54 months. Forty-four percent of the cases had subcutaneous involvement, and 39% were the cellular type. Margins were positive in 89% of the cases, recurrence rate was 22%, and no metastases were observed. The systematic review included 10 studies (119 patients). Meta-analyses showed that facial dermatofibromas were 2% of all dermatofibromas (95% CI: 1%-3%). The local recurrence rate was 14% (95% CI: 6%-26%). Facial dermatofibromas with subcutaneous involvement were more likely to recur [odds ratio 4.53 (95% CI: 1.12-18.24)]. Before histopathologic examination, clinical differential diagnosis included dermatofibromas in only 9% of the cases (95% CI: 2%-19%). CONCLUSION Facial dermatofibromas are rare and are difficult to fully excise. Cellular type and subcutaneous or muscular involvement are common in these cases and tend to have higher local recurrence rate than other nonfacial dermatofibromas. Wider excisions might be necessary for complete excision.
Collapse
Affiliation(s)
- Mouaz Alsawas
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, MN
| | - Bilge Dundar
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Larry Prokop
- Mayo Clinic Libraries, Mayo Clinic, Rochester, MN; and
| | - M Hassan Murad
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, MN
| | - Brian Swick
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City, IA
| |
Collapse
|
11
|
Schoonover KL, Yadav H, Prokop L, Lapid MI. Accommodating Bereaved Parents in the Workplace: A Scoping Review. J Loss Trauma 2022; 28:348-363. [PMID: 37635848 PMCID: PMC10456992 DOI: 10.1080/15325024.2022.2122221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/02/2022] [Indexed: 10/14/2022]
Abstract
Helpful workplace support strategies and accommodations (WSSA) for bereaved parents returning to work was assessed via comprehensive search of databases from 1990-1/21/22. 11 of 45 qualitative articles met inclusion. Bereaved parents often felt returning to work provided a coping strategy for and/or distraction from grief; however, some received insensitive comments by employer/coworkers. Helpful WSSA included flexibility on date to return to work and schedule. In conclusion, due to the intensity of their grief, bereaved parents benefit from a workplace offering individualized time off for bereavement & workplace accommodations to address potential difficulty meeting prior productivity demands.
Collapse
Affiliation(s)
| | - Hemang Yadav
- Department of Pulmonary & Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
| | - Larry Prokop
- Department of Education, Mayo Clinic, Rochester, Minnesota
| | - Maria I Lapid
- Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
- Mayo Clinic Hospice, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
12
|
Veccia A, Kostine M, Tison A, Dipasquale M, Kinspergher S, Prokop L, Grandi G, Inchiostro S, Caffo O, Paolazzi G, Bortolotti R, Cornec D, Berti A. Rheumatic immune- and nonimmune-related adverse events in phase 3 clinical trials assessing PD-(L)1 checkpoint inhibitors for lung cancer: a systematic review and meta-analysis. Joint Bone Spine 2022; 89:105403. [DOI: 10.1016/j.jbspin.2022.105403] [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] [Received: 09/18/2021] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 11/28/2022]
|
13
|
Schoonover KL, Prokop L, Lapid MI. Valuable Informal Bereavement Support Strategies for Bereaved Parents of Stillborn, Young Children, and Adult Children: A Scoping Review. J Palliat Care 2022; 37:381-400. [PMID: 35354346 DOI: 10.1177/08258597211062762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Informal support of a bereaved parent is common after the loss of a child (stillborn, young or adult child); however, it is not clear which aspects of informal support were perceived to be helpful by the bereaved parent. The aim of this scoping review is to clarify from the standpoint of bereaved parents what are considered helpful and unhelpful characteristics of informal support given by the support network of bereaved parents. Methods: A comprehensive search of databases from 2000 to April 20, 2020 was conducted for clinical studies published in English on informal bereavement support of adult bereaved parents of stillborn to adult children; 52 articles met criteria for the scoping review. The databases included Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Ovid PsycINFO, and Scopus. Results: Specific supportive strategies reported by parents as helpful more frequently included talking with other supportive persons felt to be supportive, meeting another person with a similar type of loss, and a loss-specific peer support group. Other support included peer support groups in general, tangible aid, talking with the spouse about the child who died and/or accepting each other's different grieving styles, and remembrance gestures. Specific supportive strategies reported by parents as unhelpful more frequently included feeling of stigma or blame due to type of death or feeling that the type of death was not considered equal to other deaths and platitudes & insensitive comments. Other unhelpful support included talking with others felt to be unsupportive about discussing the loss, others stating a time limit to grief, others actively avoiding or stopping all communication with the bereaved parent, and one spouse not accepting the grieving style of the other or the spouse not willing to discuss the loss. Conclusion: Support focused on supportive verbal and nonverbal communication towards the bereaved parent and tangible aid were noted to be helpful informal support. Feeling stigma for or judged by others due to the type of death or the death not being considered equal (such as in deaths due to suicide and stillborn deaths) to other types of deaths as well as informational support (utilization of clichés/platitudes, advice giving, statements about the process and end point of grieving) were noted to be unhelpful informal support.
Collapse
Affiliation(s)
| | | | - Maria I Lapid
- Mayo Clinic, Rochester, MN, USA.,Mayo Clinic Hospice, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
14
|
Yoon HH, Jin Z, Kour O, Shitara K, Gibson MK, Prokop L, Kang YK, Shi Q, Ajani JA. Association of magnitude and consistency of PD-L1 expression and other variables associated with benefit from immune checkpoint inhibition (ICI): Systematic review and meta-analysis of 14 phase 3 trials in advanced gastroesophageal cancer (GEC). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.4_suppl.344] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
344 Background: ICI with anti-PD-1 therapy was approved by the US FDA as 1st/2nd-line treatment of advanced GEC regardless of PD-L1 status. It is argued that patients (pts) with PD-L1-low GEC do not benefit from ICI. To avoid spurious exclusion of pts, we systematically reviewed phase 3 trials to assess the magnitude and consistency of PD-L1 to predict benefit from ICI. We also examined other potential predictive factors to understand their magnitude and consistency in comparison with PD-L1 status. Methods: MEDLINE, Embase, Scopus, Web of Science, and Cochrane Central Register were searched for all randomized clinical trials (RCT; 2000-2021) in advanced GEC comparing ICI, alone or with chemotherapy, vs standard of care (SOC). The primary endpoint was overall survival (OS). Study screening, data abstraction, and bias assessment were done independently by two reviewers per PRISMA guidelines. The mean HR for ICI vs SOC was calculated by random effects model. The predictive value of a factor was quantified using relative magnitude and consistency (table). Results: 14 RCTs at low risk of bias were included (N = 9,210 pts; KN62, CM649, CM648, ESCORT1st, KN590, ATT4, JAV100, KN181, KN61, ATT3, ESCORT, RATIONALE302, JAV300, ATT2). 6 trials were 1st-line, 8 were after 1st-line. Treatment comparisons were ICI + chemo vs chemo (6 trials), ICI vs chemo (9 trials), and ICI vs placebo (1 trial). ICI was always anti-PD-1/-L1 (1 trial also had anti-CTLA-4). Table shows primary results. To enable head to head comparisons, subgroup analyses of trials containing both levels of a factor or having similar design were done and generally yielded consistent results. Conclusions: PD-L1 CPS is the strongest predictive biomarker, after MSI, for OS benefit from ICI-containing therapy vs SOC. Additional research on gender is warranted.[Table: see text]
Collapse
Affiliation(s)
| | - Zhaohui Jin
- Division of Medical Oncology, Mayo Clinic, Rochester, MN
| | | | - Kohei Shitara
- National Cancer Center Hospital East, Kashiwa, Japan
| | - Michael K. Gibson
- Vanderbilt Universithy Medical Center/Vanderbilt-Ingram Cancer Center, Nashville, TN
| | | | | | | | - Jaffer A. Ajani
- The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
15
|
MacDonald CS, Ried-Larsen M, Soleimani J, Alsawas M, Lieberman DE, Ismail AS, Serafim LP, Yang T, Prokop L, Joyner M, Murad MH, Barwise A. A systematic review of adherence to physical activity interventions in individuals with type 2 diabetes. Diabetes Metab Res Rev 2021; 37:e3444. [PMID: 33769660 DOI: 10.1002/dmrr.3444] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/20/2021] [Accepted: 02/09/2021] [Indexed: 02/05/2023]
Abstract
Lifestyle interventions are pivotal for successful management of type 2 diabetes (T2D), however, the proportion of people with T2D adhering to physical activity advice has not been thoroughly studied. The purpose of this systematic review was to summarise the evidence on adherence to exercise or physical activity components in lifestyle interventions in those with T2D. We searched MEDLINE EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and Scopus on 12 November 2019. Eligible studies enrolled adults with T2D and reported the proportion of adherence to lifestyle interventions as a primary or secondary outcome. We included 11 studies (nine randomised controlled trials (RCTs) enrolling 1717 patients and two nonrandomised studies enrolling 62 patients). Only one of the studies had low risk of bias. The proportion of participants adhering to physical activity varied from 32% to 100% with a median of 58%. Adherence was higher in interventions using supervised training and lowest in interventions using remote coaching and the adherence rate in observational studies was higher compared to RCTs (92% vs. 55%; p < 0.01). Study duration, risk of bias, or participants' sex, were not associated with adherence to physical activity. The proportion of those with T2D adhering to physical activity interventions for T2D varies widely and most of the included studies had a high risk of bias. These findings have important implications for planning and power analysis of future trials and when counselling patients about lifestyle interventions including physical activity or exercise components.
Collapse
Affiliation(s)
- Christopher S MacDonald
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mathias Ried-Larsen
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jalal Soleimani
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Mouaz Alsawas
- Mayo Clinic Evidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USA
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Daniel E Lieberman
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Abdalla S Ismail
- Canton Medical Education Foundation (CMEF), Aultman Hospital, Canton, Ohio, USA
| | - Laura P Serafim
- School of medicine, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil
| | - Ting Yang
- Pulmonary and Critical Care Medicine Department, West China Hospital, Si Chuan University, China
| | - Larry Prokop
- Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael Joyner
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Amelia Barwise
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
16
|
Benkhadra R, Nayfeh T, Patibandla SK, Peterson C, Prokop L, Alhalabi O, Murad MH, Mao SS. Systematic Review and Meta-Analysis of Cisplatin Based Neoadjuvant Chemotherapy in Muscle Invasive Bladder Cancer. Bladder Cancer 2021. [DOI: 10.3233/blc-201511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Cisplatin-based neoadjuvant chemotherapy is the standard of care for muscle invasive bladder cancer (MIBC). OBJECTIVE: To compare the efficacy and safety of the two most commonly used cisplatin-based regimens; gemcitabine, and cisplatin (GC) vs. accelerated (dose-dense: dd) or conventional methotrexate, vinblastine, adriamycin, and cisplatin (MVAC). METHODS: We searched MEDLINE, Embase, Scopus and other sources. Outcomes of interest included overall survival, downstaging to pT≤1, pathologic complete response (pCR), recurrence, and toxicity. Meta-analysis was conducted using the random-effects model. RESULTS: We identified 24 studies. Efficacy outcomes were comparable between MVAC and GC for MIBC. dd-MVAC was associated with favorable efficacy compared to GC in terms of downstaging (OR 1.45; 95%CI 1.15–1.82) and all-cause mortality at longest follow-up (OR 0.63; 95%CI 0.44–0.81). However, GC was associated with a better safety profile in terms of febrile neutropenia (OR 0.32; 95%CI 0.13–0.80), anemia (OR 0.32; 95%CI 0.18–0.54), nausea and vomiting (OR 0.27; 95%CI 0.12–0.65) compared to dd-MVAC. Compared to MVAC, patients receiving GC had an increased risk of developing grade 3–4 thrombocytopenia (OR 4.70; 95%CI 1.59–13.89) and a lower risk of nausea and vomiting (OR 0.05; 95%CI 0.01–0.31). Certainty in the estimates was very low for most outcomes. CONCLUSIONS: Efficacy and safety outcomes were comparable between MVAC and GC for MIBC. Including non-peer-reviewed studies showed higher efficacy with dd-MVAC. A phase III randomized trial comparing the two regimens is needed to guide clinical practice.
Collapse
Affiliation(s)
| | - Tarek Nayfeh
- Evidence-based Practice Center, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Omar Alhalabi
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M. Hassan Murad
- Evidence-based Practice Center, Mayo Clinic, Rochester, MN, USA
| | - Shifeng S. Mao
- Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA
| |
Collapse
|
17
|
Torres Roldan VD, Ponce OJ, Urtecho M, Torres GF, Belluzzo T, Montori V, Liu C, Barrera F, Diaz A, Prokop L, Guyatt G, Montori VM. Understanding treatment-subgroup effect in primary and secondary prevention of cardiovascular disease: An exploration using meta-analyses of individual patient data. J Clin Epidemiol 2021; 139:160-166. [PMID: 34400257 DOI: 10.1016/j.jclinepi.2021.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/02/2020] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVE Recommendations for preventing cardiovascular (CV) disease are currently separated into primary and secondary prevention. We hypothesize that relative effects of interventions for CV prevention are not different across primary and secondary prevention cohorts. Our aim was to test for differences in relative effects on CV events in common preventive CV interventions across primary and secondary prevention cohorts. METHODS AND RESULTS A systematic search was performed to identify individual patient data (IPD) meta-analyses that included both primary and secondary prevention populations. Eligibility assessment, data extraction, and risk of bias assessment were conducted independently and in duplicate. We extracted relative risks (RR) with 95% confidence intervals (95% CI) of the interventions over patient-important outcomes and estimated the ratio of RR for primary and secondary prevention populations. We identified five eligible IPDs representing 524,570 participants. Quality assessment resulted in overall low-to-moderate methodological quality. We found no subgroup effect across prevention categories in any of the outcomes assessed. CONCLUSION In the absence of significant treatment-subgroup interactions between primary and secondary CV prevention cohorts for common preventive interventions, clinical practice guidelines could offer recommendations tailored to individual estimates of CV risk without regard to membership to primary and secondary prevention cohorts. This would require the development of reliable ASCVD risk estimators that apply across both cohorts.
Collapse
Affiliation(s)
| | - Oscar J Ponce
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Meritxell Urtecho
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Gabriel F Torres
- School of Medicine, Cayetano Heredia Peruvian University, Lima, Peru
| | - Tereza Belluzzo
- Internal Medicine, Jablonec nad Nisou Hospital, Jablonec nad Nisou, Czech Republic
| | - Victor Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Carolina Liu
- School of Medicine, Cayetano Heredia Peruvian University, Lima, Peru
| | - Francisco Barrera
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA; Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Alejandro Diaz
- Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Larry Prokop
- Department of Library-Public Services, Mayo Clinic, Rochester, MN, USA
| | | | - Victor M Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
18
|
Dages KN, Kohlenberg JD, Young WF, Murad MH, Prokop L, Rivera M, Dy B, Foster T, Lyden M, McKenzie T, Thompson G, Bancos I. Presentation and outcomes of adrenal ganglioneuromas: A cohort study and a systematic review of literature. Clin Endocrinol (Oxf) 2021; 95:47-57. [PMID: 33721367 PMCID: PMC8178203 DOI: 10.1111/cen.14460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/20/2021] [Accepted: 03/09/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To describe the presentation and outcomes of patients with adrenal ganglioneuromas (AGNs). DESIGN Single-centre retrospective cohort study (1 January 1995 to 31 December 2019) and systematic review of literature (1 January 1980 to 19 November 2019). PATIENTS Diagnosed with histologically confirmed AGN. MEASUREMENTS Baseline clinical, imaging and biochemical characteristics, recurrence rates and mortality. Subgroup analysis was performed on tumours with histologic elements of ganglioneuroma and pheochromocytoma (ie composite tumours). RESULTS The cohort study included 45 patients with AGN, 20 (44%) of which had composite tumours. Compared to pure AGN, patients with composite tumour were older (median age, 62.5 vs. 35 years, p < .001), had smaller tumours (median size, 3.9 vs. 5.7 cm, p = .016) and were discovered incidentally less frequently (65% vs. 84%, p = .009). No recurrences or ganglioneuroma-specific mortality occurred during follow-up (range, 0-266 months). The systematic review included 14 additional studies and 421 patients. The mean age of diagnosis was 39 years, and 47% were women. AGNs were discovered incidentally in 72% of patients, were predominantly unilateral (99%) and had a mean diameter of 5.8 cm and an unenhanced computed tomography (CT) attenuation of -118 to 49 Hounsfield units (HU). On imaging, 69% of AGNs were homogenous, 41% demonstrated calcifications, and 40% were lobulated. CONCLUSIONS AGNs are rare benign tumours that present with variable imaging features including large size, unenhanced CT attenuation >20 HU, calcifications and lobulated shape. Imaging characteristics can assist in establishing a diagnosis and avoiding an unnecessary adrenalectomy. The association of pheochromocytomas with AGNs is frequent. Diagnosis should include biochemical testing.
Collapse
Affiliation(s)
- Kelley N. Dages
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jacob D. Kohlenberg
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, and Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - William F. Young
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, and Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Mohammad Hassan Murad
- Evidence-Based Practice Center, Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, Minnesota
| | - Larry Prokop
- Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael Rivera
- Department of Laboratory Medicine and Pathology, Anatomic Pathology, Mayo Clinic, Rochester, Minnesota
| | - Benzon Dy
- Division of Breast, Endocrine, Metabolic and GI Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Trenton Foster
- Division of Breast, Endocrine, Metabolic and GI Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Melanie Lyden
- Division of Breast, Endocrine, Metabolic and GI Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Travis McKenzie
- Division of Breast, Endocrine, Metabolic and GI Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Geoffrey Thompson
- Division of Breast, Endocrine, Metabolic and GI Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | - Irina Bancos
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, and Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
19
|
Benkhadra R, Nayfeh T, Patibandla NSK, Peterson C, Prokop L, Alhalabi O, Murad MH, Mao S. Methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) versus gemcitabine, and cisplatin (GC) as neoadjuvant chemotherapy in muscle-invasive bladder cancer, a systematic review and meta-analysis. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e16522] [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: 11/20/2022] Open
Abstract
e16522 Background: Cisplatin-based neoadjuvant chemotherapy is the standard of care for muscle invasive bladder cancer (MIBC) in cisplatin-eligible patients. This systematic review and meta-analysis provide an updated efficacy and safety comparison between the two most commonly used cisplatin-based regimens; dose-dense (dd) or conventional MVAC versus GC. Methods: We searched different databases for studies comparing MVAC versus GC in the neoadjuvant setting. Outcomes of interest included overall survival, downstaging to pT≤1, pathologic complete response (pCR), recurrence, and toxicity. Meta-analysis was conducted using the random-effects model. Results: We identified 24 studies from inception to March 2020; among them 17 were peer reviewed and 7 were only reported as abstracts in national or international meetings, including a phase 3, randomized-controlled clinical trial. Among peer-reviewed published studies, efficacy outcomes such as OS, downstaging and pCR were comparable between conventional MVAC and GC for MIBC. If including non-peer-reviewed studies, dd-MVAC was associated with favorable efficacy compared to GC in terms of downstaging (OR 1.45; 95% CI 1.15–1.82), and OS at longest follow-up (OR 0.63; 95% CI 0.44–0.81). However, GC was associated with a better safety profile in terms of febrile neutropenia (OR 0.32; 95% CI 0.13–0.80), anemia (OR 0.32; 95% CI 0.18–0.54), nausea and vomiting (OR 0.27; 95% CI 0.12–0.65) compared to dd-MVAC. Compared to MVAC, patients receiving GC had an increased risk of developing grade 3–4 thrombocytopenia (OR 4.70; 95% CI 1.59–13.89) and a lower risk of nausea and vomiting (OR 0.05; 95% CI 0.01-0.31). Certainty in the estimates was very low for most outcomes. Conclusions: Among peer-reviewed published studies, efficacy and safety outcomes were comparable between conventional MVAC and GC for MIBC. However, If including non-peer-reviewed studies, this analysis showed higher efficacy with dd-MVAC. A phase III randomized trial comparing the two regimens is needed to guide clinical practice
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Shifeng Mao
- Allegheny Health Network Cancer Institute, Pittsburgh, PA
| |
Collapse
|
20
|
Berti A, Bortolotti R, Dipasquale M, Kinspergher S, Prokop L, Grandi G, Inchiostro S, Paolazzi G, Caffo O, Veccia A. Meta-analysis of immune-related adverse events in phase 3 clinical trials assessing immune checkpoint inhibitors for lung cancer. Crit Rev Oncol Hematol 2021; 162:103351. [PMID: 33989769 DOI: 10.1016/j.critrevonc.2021.103351] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/06/2021] [Accepted: 05/08/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION The introduction in clinical practice of the immune checkpoint inhibitors (ICIs) radically changed the treatment algorithm of lung cancers. To characterize the toxicity of ICIs (atezolizumab, durvalumab, nivolumab, pembrolizumab) is important for personalizing treatment. PATIENTS AND METHODS We performed a systematic review and meta-analysis of phase III randomized controlled trials assessing ICIs, from inception until April 23rd, 2020. We extracted the data from the ICI arm of each trial for indirect comparisons to estimate relative risk for immune-related adverse events (irAEs), severe (grade ≥3) irAEs, drug discontinuation due to irAEs or toxic death. RESULTS Sixteen trials included a total of 6226 subjects randomized to the experimental immunotherapy arm. Immunotherapy was administered in monotherapy (8 trials), in combination with chemotherapy (6 trials) or other ICI (2 trials). Any grade irAEs and severe irAEs for ICI were 37.1% and 18.5%, respectively. Discontinuations due to any grade irAEs and severe irAEs were 13.8% and 9.2%, respectively; toxic deaths were 2.9% in the immunotherapy arm. Pooled data on any, severe and organ-specific irAEs showed that immunotherapy has a significantly lower risk of irAEs compared to immuno-chemotherapy, especially when analysis was restricted to monoimmunotherapy, like drug discontinuation and toxic death (all p < 0.05). Detailed comparisons between different ICIs provided treatment-related risk profiles for organ-specific irAEs. CONCLUSIONS Our findings contribute to clarifying frequency and features of immune-related toxicities between different ICIs in lung cancer patients, including any grade irAEs, severe irAEs, drug discontinuation and toxic deaths, and may be useful to inform the selection of treatment.
Collapse
Affiliation(s)
- Alvise Berti
- Department of Immunolgy and Rheumatology, Santa Chiara Hospital, Trento, Italy; Thoracic Disease Research Unit, Mayo Clinic, Rochester, MN, USA.
| | - Roberto Bortolotti
- Department of Immunolgy and Rheumatology, Santa Chiara Hospital, Trento, Italy.
| | | | | | - Larry Prokop
- Evidence-Based Practice Center, Mayo Clinic, Rochester, MN, USA.
| | - Guido Grandi
- Department of CIBIO, University of Trento, Italy.
| | | | - Giuseppe Paolazzi
- Internal Medicine, San Lorenzo Hospital, Borgo Valsugana, Italy; Department of Rheumatology, San Camillo Hospital, Trento, Italy.
| | - Orazio Caffo
- Medical Oncology, Santa Chiara Hospital, Trento, Italy.
| | | |
Collapse
|
21
|
Solis-Pazmino P, Baiu I, Lincango-Naranjo E, Trope W, Prokop L, Ponce OJ, Shrager JB. Impact of the Surgical Approach to Thymectomy Upon Complete Stable Remission Rates in Myasthenia Gravis: A Meta-analysis. Neurology 2021; 97:e357-e368. [PMID: 33947783 DOI: 10.1212/wnl.0000000000012153] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/11/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To determine whether the available operative techniques for thymectomy in myasthenia gravis (MG) confer variable chances for achieving complete stable remission (CSR), we performed a meta-analysis of comparative studies of surgical approaches to thymectomy. METHODS Meta-analysis was done of all studies providing comparative data on thymectomy approaches, with CSR reported and minimum 3-year mean follow-up. RESULTS Twelve cohort studies and 1 randomized clinical trial, containing 1,598 patients, met entry criteria. At 3 years, CSR from MG was similar after video-assisted thoracoscopic (VATS) extended vs both basic (relative risk [RR] 1.00, p = 1.00, 95% confidence interval [CI] 0.39-2.58) and extended (RR 0.96, p = 0.74, 95% CI 0.72-1.27) transsternal approaches. CSR at 3 years was also similar after extended transsternal vs combined transcervical-subxiphoid (RR 1.08, p = 0.62, 95% CI 0.8-1.44) approaches. VATS extended approaches remained statistically equivalent to extended transsternal approaches through 9 years of follow-up (RR 1.51, p = 0.05, 95% CI 0.99-2.30). The only significant difference in CSR rate between a traditional open and a minimally invasive approach was seen at 10 years when the now-abandoned basic (non-sternum-lifting) transcervical approach was compared to the extended transsternal approach (RR 0.4, p = 0.01, 95% CI 0.2-0.8). CONCLUSIONS A significant difference in the rate of CSR among various surgical approaches for thymectomy in MG was identified only at long-term follow-up and only between what might be considered the most aggressive approach (extended transsternal thymectomy) and the least aggressive approach (basic transcervical thymectomy). Extended minimally invasive approaches appear to have CSR rates equivalent to those of extended transsternal approaches and are therefore appropriate in the hands of experienced surgeons.
Collapse
Affiliation(s)
- Paola Solis-Pazmino
- From the Division of Thoracic Surgery (P.S.-P., J.B., W.T., J.B.S.), Department of Cardiothoracic Surgery, Stanford University School of Medicine, CA; Knowledge and Evaluation Research Unit (P.S.-P., E.L.-N., L.P., O.J.P.), Mayo Clinic, Rochester, MN; Universidad Central (E.L.-N.), Medical School, Quito, Ecuador; Unidad de Conocimiento y Evidencia (O.J.P.), Universidad Peruana Cayetano Heredia, Lima, Perú; and Department of Surgery (J.B.S.), Veterans Affair Palo Alto Health Care System, CA
| | - Ioana Baiu
- From the Division of Thoracic Surgery (P.S.-P., J.B., W.T., J.B.S.), Department of Cardiothoracic Surgery, Stanford University School of Medicine, CA; Knowledge and Evaluation Research Unit (P.S.-P., E.L.-N., L.P., O.J.P.), Mayo Clinic, Rochester, MN; Universidad Central (E.L.-N.), Medical School, Quito, Ecuador; Unidad de Conocimiento y Evidencia (O.J.P.), Universidad Peruana Cayetano Heredia, Lima, Perú; and Department of Surgery (J.B.S.), Veterans Affair Palo Alto Health Care System, CA
| | - Eddy Lincango-Naranjo
- From the Division of Thoracic Surgery (P.S.-P., J.B., W.T., J.B.S.), Department of Cardiothoracic Surgery, Stanford University School of Medicine, CA; Knowledge and Evaluation Research Unit (P.S.-P., E.L.-N., L.P., O.J.P.), Mayo Clinic, Rochester, MN; Universidad Central (E.L.-N.), Medical School, Quito, Ecuador; Unidad de Conocimiento y Evidencia (O.J.P.), Universidad Peruana Cayetano Heredia, Lima, Perú; and Department of Surgery (J.B.S.), Veterans Affair Palo Alto Health Care System, CA
| | - Winston Trope
- From the Division of Thoracic Surgery (P.S.-P., J.B., W.T., J.B.S.), Department of Cardiothoracic Surgery, Stanford University School of Medicine, CA; Knowledge and Evaluation Research Unit (P.S.-P., E.L.-N., L.P., O.J.P.), Mayo Clinic, Rochester, MN; Universidad Central (E.L.-N.), Medical School, Quito, Ecuador; Unidad de Conocimiento y Evidencia (O.J.P.), Universidad Peruana Cayetano Heredia, Lima, Perú; and Department of Surgery (J.B.S.), Veterans Affair Palo Alto Health Care System, CA
| | - Larry Prokop
- From the Division of Thoracic Surgery (P.S.-P., J.B., W.T., J.B.S.), Department of Cardiothoracic Surgery, Stanford University School of Medicine, CA; Knowledge and Evaluation Research Unit (P.S.-P., E.L.-N., L.P., O.J.P.), Mayo Clinic, Rochester, MN; Universidad Central (E.L.-N.), Medical School, Quito, Ecuador; Unidad de Conocimiento y Evidencia (O.J.P.), Universidad Peruana Cayetano Heredia, Lima, Perú; and Department of Surgery (J.B.S.), Veterans Affair Palo Alto Health Care System, CA
| | - Oscar J Ponce
- From the Division of Thoracic Surgery (P.S.-P., J.B., W.T., J.B.S.), Department of Cardiothoracic Surgery, Stanford University School of Medicine, CA; Knowledge and Evaluation Research Unit (P.S.-P., E.L.-N., L.P., O.J.P.), Mayo Clinic, Rochester, MN; Universidad Central (E.L.-N.), Medical School, Quito, Ecuador; Unidad de Conocimiento y Evidencia (O.J.P.), Universidad Peruana Cayetano Heredia, Lima, Perú; and Department of Surgery (J.B.S.), Veterans Affair Palo Alto Health Care System, CA
| | - Joseph B Shrager
- From the Division of Thoracic Surgery (P.S.-P., J.B., W.T., J.B.S.), Department of Cardiothoracic Surgery, Stanford University School of Medicine, CA; Knowledge and Evaluation Research Unit (P.S.-P., E.L.-N., L.P., O.J.P.), Mayo Clinic, Rochester, MN; Universidad Central (E.L.-N.), Medical School, Quito, Ecuador; Unidad de Conocimiento y Evidencia (O.J.P.), Universidad Peruana Cayetano Heredia, Lima, Perú; and Department of Surgery (J.B.S.), Veterans Affair Palo Alto Health Care System, CA.
| |
Collapse
|
22
|
Torres Roldan VD, Brand-McCarthy SR, Ponce OJ, Belluzzo T, Urtecho M, Espinoza Suarez NR, Toloza FJK, Thota AD, Organick PW, Barrera F, Liu-Sanchez C, Jaladi S, Prokop L, Ozanne EM, Fagerlin A, Hargraves IG, Noseworthy PA, Montori VM, Brito JP. Shared Decision Making Tools for People Facing Stroke Prevention Strategies in Atrial Fibrillation: A Systematic Review and Environmental Scan. Med Decis Making 2021; 41:540-549. [PMID: 33896270 PMCID: PMC8191170 DOI: 10.1177/0272989x211005655] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Shared decision making (SDM) tools can help implement guideline recommendations for patients with atrial fibrillation (AF) considering stroke prevention strategies. We sought to characterize all available SDM tools for this purpose and examine their quality and clinical impact. METHODS We searched through multiple bibliographic databases, social media, and an SDM tool repository from inception to May 2020 and contacted authors of identified SDM tools. Eligible tools had to offer information about warfarin and ≥1 direct oral anticoagulant. We extracted tool characteristics, assessed their adherence to the International Patient Decision Aids Standards, and obtained information about their efficacy in promoting SDM. RESULTS We found 14 SDM tools. Most tools provided up-to-date information about the options, but very few included practical considerations (e.g., out-of-pocket cost). Five of these SDM tools, all used by patients prior to the encounter, were tested in trials at high risk of bias and were found to produce small improvements in patient knowledge and reductions in decisional conflict. CONCLUSION Several SDM tools for stroke prevention in AF are available, but whether they promote high-quality SDM is yet to be known. The implementation of guidelines for SDM in this context requires user-centered development and evaluation of SDM tools that can effectively promote high-quality SDM and improve stroke prevention in patients with AF.
Collapse
Affiliation(s)
- Victor D Torres Roldan
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sarah R Brand-McCarthy
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Oscar J Ponce
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Tereza Belluzzo
- General Medicine, Charles University in Prague, Medical Faculty of Hradec Králové, Hradec Kralove, Czech Republic
| | - Meritxell Urtecho
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Nataly R Espinoza Suarez
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Freddy J K Toloza
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Anjali D Thota
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Paige W Organick
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Francisco Barrera
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | | | - Soumya Jaladi
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Larry Prokop
- Department of Library-Public Services, Mayo Clinic, Rochester MN, USA
| | - Elissa M Ozanne
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Angela Fagerlin
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.,Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation
| | - Ian G Hargraves
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Peter A Noseworthy
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Victor M Montori
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Juan P Brito
- Knowledge and Evaluation Research (KER) Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
23
|
Dave S, Park S, Murad MH, Barnard A, Prokop L, Adams LA, Singh S, Loomba R. Comparative Effectiveness of Entecavir Versus Tenofovir for Preventing Hepatocellular Carcinoma in Patients with Chronic Hepatitis B: A Systematic Review and Meta-Analysis. Hepatology 2021; 73:68-78. [PMID: 32277491 PMCID: PMC8022893 DOI: 10.1002/hep.31267] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 03/21/2020] [Accepted: 03/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Chronic hepatitis B (CHB) can lead to hepatocellular carcinoma (HCC). While both tenofovir disoproxil (TDF) and entecavir (ETV) have been shown to reduce the risk of HCC, their comparative effectiveness is unclear. We estimated the comparative effectiveness of these two agents in reducing the risk of HCC in patients with CHB, through a systematic review and meta-analysis. APPROACH AND RESULTS We searched multiple electronic databases from January 1, 1998, to October 31, 2019, for randomized controlled trials and observational comparative effectiveness studies in adults with CHB treated with ETV compared to TDF, reporting the incidence of HCC (minimum follow-up 12 months). Primary outcome was incidence of HCC, calculated as incidence rate ratio (IRR) with 95% confidence interval (CI, unadjusted analysis) and hazard ratio (HR) with 95% CI (adjusted analysis, where reported). Of 1,971 records identified, 14 studies (263,947 person-years) were included for quantitative analysis. On unadjusted meta-analysis of 14 studies, the risk of HCC was not statistically different between ETV and TDF (IRR, 1.28; 95% CI, 0.99-1.66). When using available adjusted data (multivariate or propensity-matched data), the risk of HCC among patients treated with ETV was 27% higher when compared to TDF (seven studies; 95% CI, 1.01-1.60, P = 0.04). Additional analysis of adjusted data when separately reported among patients with cirrhosis demonstrated an adjusted HR of 0.90 (95% CI, 0.66-1.23), suggesting no difference between ETV-treated and TDF-treated groups. The overall confidence in estimates was very low (observational studies, high heterogeneity). CONCLUSIONS TDF may be associated with lower risk of HCC when compared to ETV.
Collapse
Affiliation(s)
- Shravan Dave
- Division of Gastroenterology, Department of Medicine, University of California at San Diego, USA
| | - Sooyoung Park
- Division of Gastroenterology, Department of Medicine, University of California at San Diego, USA,Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kyungpook National University, South Korea
| | | | - Abbey Barnard
- Division of Gastroenterology, Department of Medicine, University of California at San Diego, USA
| | | | - Leon A Adams
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Australia
| | - Siddharth Singh
- Division of Gastroenterology, Department of Medicine, University of California at San Diego, USA
| | - Rohit Loomba
- Division of Gastroenterology, Department of Medicine, University of California at San Diego, USA
| |
Collapse
|
24
|
Solis-Pazmino P, Kim GS, Lincango-Naranjo E, Prokop L, Ponce OJ, Truong MT. Major complications after tongue-tie release: A case report and systematic review. Int J Pediatr Otorhinolaryngol 2020; 138:110356. [PMID: 32927351 DOI: 10.1016/j.ijporl.2020.110356] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 05/16/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The diagnosis of ankyloglossia, or tongue-tie, and the number of frenotomies performed has increased over 10-fold from 1997 to 2012 in the United States. The sharpest increase has been in neonates. For parents considering frenotomy for their breastfeeding newborn, there is controversy surrounding the evaluation of tongue-tie and the benefit of a frenotomy. Complications from tongue-tie procedures are thought to be low, though it is not well reported nor studied. OBJECTIVES The aim of this study is to describe a case of a sublingual mucocele after laser frenotomy in a neonate with tongue-tie and to investigate major complications reported after tongue-tie release in pediatric patients through a systematic review of the literature. CASE REPORT We present a 6-week-old female who underwent a laser frenotomy procedure performed by a dentist who presented with a new cyst under her tongue. MATERIAL AND METHODS A systematic literature search of articles published from 1965 to April 2020 was conducted in Ovid MEDLINE(R), Ovid EMBASE, and Scopus. Citations were uploaded into a systematic review software program (DistillerSR, Ottawa, ON, Canada), followed by full text screening. RESULTS 47 major complications were reported in 34 patients, including our patient. Most of the cases were located in the United States and Europe. The most frequent indications for the procedure were breastfeeding problems (n = 18) and speech impediment (n = 4). The procedure was performed by dentists (n = 6), lactation consultants (n = 5), and otolaryngologists (n = 4). The bulk of the major complications after frenotomy included poor feeding (n = 7), hypovolemic shock (n = 4), apnea (n = 4), acute airway obstruction (n = 4), and Ludwig angina (n = 2). CONCLUSIONS Reporting of complications after frenotomy is lacking. Risks to neonates may be different than risks to older children and adults. Practitioners across different specialties should be monitoring and studying this more rigorously to better guide patients and families on the risks and benefits of this procedure.
Collapse
Affiliation(s)
- Paola Solis-Pazmino
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Grace S Kim
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA
| | - Eddy Lincango-Naranjo
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA; Facultad de Ciencias Medicas, Universidad Central El Ecuador, Quito, Ecuador
| | - Larry Prokop
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Oscar J Ponce
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA; Unidad de Conocimiento y Evidencia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mai Thy Truong
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA.
| |
Collapse
|
25
|
Ding J, Hasan B, Malandris K, Farah MH, Manolopoulos A, Ginex PK, Anbari AB, Nayfeh T, Rajjoub M, Benkhadra R, Prokop L, Morgan RL, Murad MH. Prospective Surveillance and Risk Reduction of Cancer Treatment-Related Lymphedema: Systematic Review and Meta-Analysis. Oncol Nurs Forum 2020; 47:E161-E170. [PMID: 32830796 DOI: 10.1188/20.onf.e161-e170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Secondary lymphedema is a chronic condition that may result from cancer-related treatments. Evidence is emerging on prospective surveillance and risk reduction. LITERATURE SEARCH Databases were systematically searched through April 1, 2019, for comparative studies evaluating interventions aiming to prevent lymphedema in patients with cancer. DATA EVALUATION A random-effects model was used to perform meta-analysis, when appropriate. SYNTHESIS A total of 26 studies (4,095 patients) were included, with 23 providing data sufficient for meta-analysis. Surveillance programs increased the likelihood of detecting lymphedema. Physiotherapy, exercise programs, and delayed exercise reduced the incidence of lymphedema. IMPLICATIONS FOR RESEARCH Future research should standardize (a) evidence-based interventions to reduce the development of lymphedema and increase the likelihood of early detection and (b) outcome measures to build a body of evidence that leads to practice change. SUPPLEMENTAL MATERIAL CAN BE FOUND AT&NBSP;HTTPS //onf.ons.org/supplementary-material-systematic-review-cancer-treatment-related-lymphedema.
Collapse
|
26
|
Ding J, Farah MH, Nayfeh T, Malandris K, Manolopoulos A, Ginex PK, Hasan B, Dunnack H, Abd-Rabu R, Rajjoub M, Prokop L, Morgan RL, Murad MH. Targeted Therapy- and Chemotherapy-Associated Skin Toxicities: Systematic Review and Meta-Analysis. Oncol Nurs Forum 2020; 47:E149-E160. [PMID: 32830797 DOI: 10.1188/20.onf.e149-e160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Preventing and managing skin toxicities can minimize treatment disruptions and improve well-being. This systematic review aimed to evaluate the effectiveness of interventions for the prevention and management of cancer treatment-related skin toxicities. LITERATURE SEARCH The authors systematically searched for comparative studies published before April 1, 2019. Study selection and appraisal were conducted by pairs of independent reviewers. DATA EVALUATION The random-effects model was used to conduct meta-analysis when appropriate. SYNTHESIS 39 studies (6,006 patients) were included; 16 of those provided data for meta-analysis. Prophylactic minocycline reduced the development of all-grade and grade 1 acneform rash in patients who received erlotinib. Prophylaxis with pyridoxine 400 mg in capecitabine-treated patients lowered the risk of grade 2 or 3 hand-foot syndrome. Several treatments for hand-foot skin reaction suggested benefit in heterogeneous studies. Scalp cooling significantly reduced the risk for severe hair loss or total alopecia associated with chemotherapy. IMPLICATIONS FOR RESEARCH Certainty in the available evidence was limited for several interventions, suggesting the need for future research. SUPPLEMENTAL MATERIAL CAN BE FOUND AT&NBSP;HTTPS //onf.ons.org/supplementary-material-targeted-therapy-and-chemotherapy-associated-skin-toxicity-systematic-review.
Collapse
|
27
|
Murad MH, Nayfeh T, Urtecho Suarez M, Seisa MO, Abd-Rabu R, Farah MHE, Firwana M, Hasan B, Jawaid T, Shah S, Torres Roldan V, Prokop L, Wang Z, Saadi SM. A Framework for Evidence Synthesis Programs to Respond to a Pandemic. Mayo Clin Proc 2020; 95:1426-1429. [PMID: 32561147 PMCID: PMC7833794 DOI: 10.1016/j.mayocp.2020.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/01/2020] [Indexed: 12/02/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic requires making rapid decisions based on sparse and rapidly changing evidence. Evidence synthesis programs conduct systematic reviews for guideline developers, health systems clinicians, and decision-makers that usually take an average 6 to 8 months to complete. We present a framework for evidence synthesis programs to respond to pandemics that has proven feasible and practical during the COVID-19 response in a large multistate health system employing more than 78,000 people. The framework includes four components: an approach for conducting rapid reviews, a repository of rapid reviews, a registry for all original studies about COVID-19, and twice-weekly prioritized update of new evidence sent to key stakeholders. As COVID-19 will not be our last pandemic, we share the details of this framework to allow replication in other institutions and re-implementation in future pandemics.
Collapse
Affiliation(s)
- M Hassan Murad
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
| | - Tarek Nayfeh
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Meritxell Urtecho Suarez
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Mohamed O Seisa
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Rami Abd-Rabu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | | | - Mohammed Firwana
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Bashar Hasan
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Tabinda Jawaid
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Sahrish Shah
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Victor Torres Roldan
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Larry Prokop
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Zhen Wang
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Samer Mohir Saadi
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| |
Collapse
|
28
|
Benkhadra R, Nayfeh T, Bakalov V, Hilton C, Khan C, Prokop L, Shah MV, Alkhateeb H, Litzow MR, Murad MH, Al-Kali A. Intensive chemotherapy in patients with high grade myelodysplastic syndromes (MDS): A systematic review and meta-analysis. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e19530] [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: 11/20/2022] Open
Abstract
e19530 Background: Intensive chemotherapy (IC) regimens are rarely used in patients with myelodysplastic syndromes (MDS) for many reasons including advanced age at diagnosis, the frailty of these patients, the presence of several comorbidities and potentially increased mortality when such regimens are used. Additionally, very little literature exists on its safety and long-term benefit in this population. Aim: To evaluate the safety and effectiveness of IC regimens in patients with MDS. Methods: We searched MEDLINE, Embase, Scopus and Cochrane databases from each database's inception from 1990 to January 27th, 2020. Keywords include: “MDS”, “induction chemotherapy” and “remission induction”. Studies evaluating different IC regimens with MDS were included. IC studies for patients with relapsed/ refractory MDS were excluded. Studies that combined acute myeloid leukemia (AML) and MDS outcomes were excluded. The random-effects model was used to pool relative risks and incidence rates. Main endpoints were overall remission rates (ORR), 30- and 60-days mortality, 1-year, 2-year and 5-year overall survival (OS). Results: Characteristics: From 2001 records, we included 13 studies [1,164 patients, median age 60.1 years (range, 17-88), males 58.9%, 58.4% patients had abnormal cytogenetics, median bone marrow blasts 17.8% (range 4 -29%), 4 studies were randomized]. Induction outcome: IC regimes included “7+3, FLAG, s-HAM, and few other regimens. Response: ORR was 55%, including 52% CR rate. Safety: 30- and 60-days mortality were 7%, 15%, respectively. Survival outcome: median survival was 11.6 months, 1-year, 2-year and 5-year OS were 48%, 21% and 5%, respectively. Randomized studies comparison: adding growth factors to IC did not show statistically significant effects on outcomes regarding induction mortality, ORR and OS (p-value > .05). Conclusions: IC is rarely used in MDS patients and its use is associated with high mortality rates and low long-term survival. Limitations to our studies include the long span of this review over 3 decades and the difficulty of using published studies that combines MDS and AML patients’ outcome. More studies are needed in this population of interest in the future.
Collapse
Affiliation(s)
| | | | | | | | - Cyrus Khan
- Allegheny Health Network Cancer Institute, Pittsburgh, PA
| | | | | | | | | | | | | |
Collapse
|
29
|
Lee C, Rivera-Valerio M, Bangash H, Prokop L, Kullo IJ. New Case Detection by Cascade Testing in Familial Hypercholesterolemia: A Systematic Review of the Literature. Circ Genom Precis Med 2019; 12:e002723. [PMID: 31638829 PMCID: PMC9875692 DOI: 10.1161/circgen.119.002723] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The prevalence of familial hypercholesterolemia is 1 in 250, but <10% of patients are diagnosed. Cascade testing enables early detection of cases through systematic family tracing. Establishment of familial hypercholesterolemia cascade testing programs in the US could be informed by approaches used elsewhere. METHODS We conducted a systematic review of published studies in the English language of cascade testing for familial hypercholesterolemia, which reported the number of index cases and number of relatives tested and specified methods of contacting relatives and testing modalities methods utilized. For each study, we calculated yield (proportion of relatives who test positive) and new cases per index case, to facilitate comparison. RESULTS We identified 10 studies from the literature that met inclusion criteria; the mean number of probands and relatives per study was 242 and 826, respectively. The average yield was 44.76% with a range of 30% to 60.5%, and the mean new cases per index case was 1.65 with a range of 0.22 to 8.0. New cases per index case tended to be greater in studies that used direct contact versus indirect contact (2.06 versus 0.86), tested beyond first-degree relatives versus only first-degree relatives (3.65 versus 0.80), used active sample collection versus collection at clinic (4.11 versus 1.06), and utilized genetic testing versus biochemical testing (2.47 versus 0.42). CONCLUSIONS New case detection in familial hypercholesterolemia cascade testing programs tended to be higher with direct contact of relatives, testing beyond first-degree relatives, in-home-based sample collection, and genetic testing. These findings should be helpful for establishing cascade testing programs in the United States.
Collapse
Affiliation(s)
- Christopher Lee
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | | | - Hana Bangash
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Larry Prokop
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | | |
Collapse
|
30
|
Elhassan YS, Alahdab F, Prete A, Delivanis DA, Khanna A, Prokop L, Murad MH, O'Reilly MW, Arlt W, Bancos I. Natural History of Adrenal Incidentalomas With and Without Mild Autonomous Cortisol Excess: A Systematic Review and Meta-analysis. Ann Intern Med 2019; 171:107-116. [PMID: 31234202 DOI: 10.7326/m18-3630] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Adrenal incidentalomas are mostly benign nonfunctioning adrenal tumors (NFATs) or adenomas causing mild autonomous cortisol excess (MACE), but their natural history is unclear. PURPOSE To summarize the follow-up data of adults with NFAT or MACE to determine the proportions of tumor growth, malignant transformation, and incident changes in hormone function; the prevalence of incident cardiometabolic comorbid conditions; and mortality. DATA SOURCES MEDLINE, Embase, Cochrane, and Scopus (January 1990 to February 2019) and bibliographies of identified articles, without language restriction. STUDY SELECTION Studies that included 20 or more conservatively managed patients with NFAT or MACE and reported outcomes at baseline and after at least 12 months of follow-up. DATA EXTRACTION Pairs of reviewers extracted outcomes and assessed methodological quality. DATA SYNTHESIS Thirty-two studies reported outcomes of 4121 patients with NFAT or MACE, 61.5% of whom were women; the mean age was 60.2 years, and mean follow-up was 50.2 months. Mean tumor growth was 2 mm over 52.8 months. Clinically significant tumor enlargement (≥10 mm) occurred in 2.5% of patients, and none developed adrenal cancer. Clinically overt hormone excess was unlikely to develop (<0.1%) in patients with NFAT or MACE. Only 4.3% of patients with NFAT developed MACE, and preexisting MACE was unlikely to resolve (<0.1%). Hypertension, obesity, dyslipidemia, and type 2 diabetes were highly prevalent (60.0%, 42.0%, 33.7%, and 18.1% of patients, respectively) and were more likely to develop and worsen in MACE than NFAT. New cardiovascular events were more prevalent in MACE (15.5%) than NFAT (6.4%). Mortality was 11.2% and was similar between NFAT and MACE. LIMITATION Evidence was scarce, and definitions of MACE and comorbid conditions were heterogeneous. CONCLUSION During follow-up, NFAT and MACE do not show clinically relevant changes in size or hormonal function, but they may carry an increased risk for cardiometabolic comorbid conditions. PRIMARY FUNDING SOURCE None.
Collapse
Affiliation(s)
- Yasir S Elhassan
- University of Birmingham Institute of Metabolism and Systems Research and Birmingham Health Partners Centre for Endocrinology, Diabetes and Metabolism, Birmingham, United Kingdom (Y.S.E., A.P., M.W.O., W.A.)
| | - Fares Alahdab
- Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota (F.A., D.A.D., A.K., M.H.M., I.B.)
| | - Alessandro Prete
- University of Birmingham Institute of Metabolism and Systems Research and Birmingham Health Partners Centre for Endocrinology, Diabetes and Metabolism, Birmingham, United Kingdom (Y.S.E., A.P., M.W.O., W.A.)
| | - Danae A Delivanis
- Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota (F.A., D.A.D., A.K., M.H.M., I.B.)
| | - Aakanksha Khanna
- Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota (F.A., D.A.D., A.K., M.H.M., I.B.)
| | - Larry Prokop
- Mayo Clinic, Rochester, Minnesota; Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota (L.P.)
| | - Mohammad H Murad
- Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota (F.A., D.A.D., A.K., M.H.M., I.B.)
| | - Michael W O'Reilly
- University of Birmingham Institute of Metabolism and Systems Research and Birmingham Health Partners Centre for Endocrinology, Diabetes and Metabolism, Birmingham, United Kingdom (Y.S.E., A.P., M.W.O., W.A.)
| | - Wiebke Arlt
- University of Birmingham Institute of Metabolism and Systems Research and Birmingham Health Partners Centre for Endocrinology, Diabetes and Metabolism, Birmingham, United Kingdom (Y.S.E., A.P., M.W.O., W.A.)
| | - Irina Bancos
- Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota (F.A., D.A.D., A.K., M.H.M., I.B.)
| |
Collapse
|
31
|
Elhassan Y, Alahdab F, Prete A, Delivanis D, Khanna A, Prokop L, Murad M, O'Reilly M, Arlt W, Bancos I. SAT-368 Natural History Of Adrenal Incidentalomas With And Without Mild Autonomous Cortisol Excess; A Systematic Review And Meta-analysis. J Endocr Soc 2019. [PMCID: PMC6551935 DOI: 10.1210/js.2019-sat-368] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Adrenal incidentalomas are mostly non-functioning adrenal tumors (NFAT) or adenomas with mild autonomous cortisol excess (MACE), of which the natural history is unclear. We conducted a systematic review and meta-analysis to study the long-term follow-up of NFAT and MACE to determine: (i) proportion of tumor growth and malignant transformation, (ii) incident change of hormone function, and (iii) incident cardio-metabolic comorbidities and mortality. Methods: Literature search of multiple databases including MEDLINE, EMBASE, Cochrane, and Scopus (January 1990 to February 2018). We included studies of adults with NFAT or MACE (as defined by authors), with ≥20 patients undergoing conservative management, and reported outcomes of interest at baseline and after ≥12 months follow-up. Results: We included 31 studies reporting on 4138 patients with incidental NFAT and MACE; 61.9% females, mean age 60.1 years, and mean follow-up 48.9 months. Overall, the data quality was medium-high, but there was significant heterogeneity in MACE and comorbidities definitions. Mean tumor growth in NFAT and MACE was 1.8mm over 60.6 months, which was similar between both groups. Adenomas were less likely to grow when the baseline mean size was ≥2.5cm, compared to smaller adenomas (<2.5 cm); mean size difference 0.8mm and 2.3mm, respectively. While 10% of patients demonstrated tumor enlargement, growth of ≥1cm occurred in only 4.5% over 62.0 months, which was relatively higher in MACE (MACE 4.5% vs. NFAT 2.3%). None of 2690 NFAT and MACE patients developed adrenal malignancy over 42.4 months. Development of overt Cushing’s syndrome and pheochromocytoma was very rare (0.4%). None of 2690 patients developed primary hyperaldosteronism. Of 2088 NFAT patients, 5.6% developed MACE, while pre-existing MACE resolved in 1.9% of 780 patients during 50.6 months. Hypertension, obesity, dyslipidemia, and type 2 diabetes were highly prevalent, 59.8%, 46.6%, 34.2%, and 19.3% of patients, respectively, and more likely to develop and worsen in MACE compared to NFAT. Cardiovascular events were twice as common in MACE compared to NFAT, and cardiovascular mortality occurred more in MACE (6.6%) than NFAT (5.0%) during 58.7 months follow-up. Conclusions: Patients with NFAT and MACE do not require radiological or hormonal follow-up. However, they carry an increased risk of cardio-metabolic comorbidities, warranting evaluation and appropriate therapy.
Collapse
Affiliation(s)
- Yasir Elhassan
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, , United Kingdom
| | - Fares Alahdab
- Evidence-based Practice Center, Mayo Clinic, Rochester, MN, United States
| | - Alessandro Prete
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, , United Kingdom
| | - Danae Delivanis
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, United States
| | - Aakanksha Khanna
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, United States
| | - Larry Prokop
- Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, United States
| | - Muhammad Murad
- Evidence-based Practice Center, Mayo Clinic, Rochester, MN, United States
| | - Michael O'Reilly
- Centre for Endocrinology, Diabetes and Metabolism, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, , United Kingdom
| | - Wiebke Arlt
- Institute of Metabolism and Systems Research, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, , United Kingdom
| | - Irina Bancos
- Endocrinology, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Rochester, MN, United States
| |
Collapse
|
32
|
Alnahhas I, Jawish M, Alsawas M, Zukas A, Prokop L, Murad MH, Malkin M. Autologous Stem-Cell Transplantation for Primary Central Nervous System Lymphoma: Systematic Review and Meta-analysis. Clin Lymphoma Myeloma Leuk 2018; 19:e129-e141. [PMID: 30584023 DOI: 10.1016/j.clml.2018.11.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 11/11/2018] [Accepted: 11/17/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Primary central nervous system lymphoma (PCNSL) is an aggressive form of non-Hodgkin lymphoma. Methotrexate is first-line chemotherapy. Autologous stem-cell transplantation (ASCT) is increasingly used as an alternative consolidative treatment to whole-brain radiotherapy. METHODS A systematic search of several databases was conducted up through January 10, 2018. Two investigators independently assessed study eligibility and extracted the data. Studies that reported survival outcomes after ASCT were included. RESULTS We screened 1517 references and included 43 studies. ASCT was used as consolidative treatment or as salvage treatment/at relapse. Thiotepa, busulfan, and cyclophosphamide and carmustine/thiotepa were commonly used conditioning regimens. In the consolidation setting, 94% of patients experienced or maintained complete or partial response after ASCT. The rates of overall survival (OS) and progression-free survival (PFS) were 94%, 86%, 82%, and 70% and 79%, 70%, 64%, and 54% after 1, 2, 3, and 5 years, respectively. The overall risk of relapse at 5 years was 24%. In the salvage/relapse settings, 85% of patients experienced or maintained complete response or partial response after ASCT. The rates of OS and PFS were 75%, 63%, 56%, and 54% and 85%, 62%, 59%, and 54% after 1, 2, 3, and 5 years, respectively. The risk of relapse at 5 years was 29%. Subgroup analysis showed that the use of carmustine and thiotepa as a conditioning regimen carried the lowest risk of transplant-related mortality. The thiotepa, busulfan, and cyclophosphamide regimen, on the other hand, showed numerically superior OS and PFS rates. CONCLUSION This review provides estimates for response and survival to aid in decision making when considering ASCT for patients with PCNSL.
Collapse
Affiliation(s)
- Iyad Alnahhas
- Division of Neuro-oncology, The Ohio State University, Columbus, OH.
| | | | - Mouaz Alsawas
- Evidence-Based Practice Center, Mayo Clinic, Rochester, MN
| | - Alicia Zukas
- Division of Neuro-oncology, Virginia Commonwealth University, Richmond, VA
| | - Larry Prokop
- Evidence-Based Practice Center, Mayo Clinic, Rochester, MN
| | - M Hassan Murad
- Evidence-Based Practice Center, Mayo Clinic, Rochester, MN
| | - Mark Malkin
- Division of Neuro-oncology, Virginia Commonwealth University, Richmond, VA
| |
Collapse
|
33
|
Smither FC, Andrews K, Prokop L. Poster 18: Systematic Review of Sensory Feedback with Upper Extremity Prosthetics. PM R 2018. [DOI: 10.1016/j.pmrj.2018.08.057] [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: 10/28/2022]
|
34
|
Singh Ospina N, Castaneda-Guarderas A, Hamidi O, Ponce OJ, Zhen W, Prokop L, Montori VM, Brito JP. Weight Changes After Thyroid Surgery for Patients with Benign Thyroid Nodules and Thyroid Cancer: Population-Based Study and Systematic Review and Meta-Analysis. Thyroid 2018; 28:639-649. [PMID: 29631475 PMCID: PMC6117738 DOI: 10.1089/thy.2017.0216] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND A key concern among patients who undergo thyroid surgery is postoperative weight gain. Yet, the impact of thyroid surgery on weight is unclear. METHODS The population-based Rochester Epidemiology Project was used to examine weight and body mass index (BMI) changes at one, two, and three years of follow-up in (i) patients with thyroid cancer and benign thyroid nodules after thyroid surgery, and (ii) patients with thyroid nodules who did not have surgery. A comprehensive systematic review of the published literature from inception to February 2016 was also conducted. The results were pooled across studies using a random effects model. RESULTS A total of 435 patients were identified: 181 patients with thyroid cancer who underwent surgery (group A), 226 patients with benign thyroid nodules without surgery (group B), and 28 patients with benign thyroid nodules undergoing surgery (group C). Small changes in mean weight, BMI, and the number of patients whose weight increased between 5 and 10 kg were similar during each year of follow-up between patients in groups A and B. Furthermore, age >50 years, female sex, baseline BMI >25 kg/m2, and thyrotropin value at one to two years were not predictors of a 5% weight change. In the meta-analysis, 11 studies were included. One to two years after surgery for thyroid cancer or thyroid nodules, patients gained on average 0.94 kg [confidence interval (CI) 0.58-1.33] and 1.07 kg [CI 0.26-1.87], respectively. Patients with benign thyroid nodules who did not have surgery gained 1.50 kg [CI 0.60-2.4] at the longest follow-up. CONCLUSIONS On average, patients receiving care for thyroid nodules or cancer gain weight, but existing evidence suggests that surgery for these conditions does not contribute significantly to further weight gain. Clinicians and patients can use this information to discuss what to expect after thyroid surgery.
Collapse
Affiliation(s)
- Naykky Singh Ospina
- Division of Endocrinology, Diabetes, Metabolism, Department of Medicine, University of Florida, Gainesville, Florida
- Knowledge and Evaluation Research Unit (KER-ENDO), Mayo Clinic, Rochester, Minnesota
| | | | - Oksana Hamidi
- Knowledge and Evaluation Research Unit (KER-ENDO), Mayo Clinic, Rochester, Minnesota
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
| | - Oscar J. Ponce
- Knowledge Synthesis Unit, Mayo Clinic, Rochester, Minnesota
| | - Wang Zhen
- Knowledge Synthesis Unit, Mayo Clinic, Rochester, Minnesota
| | - Larry Prokop
- Mayo Medical Libraries, Mayo Clinic, Rochester, Minnesota
| | - Victor M. Montori
- Knowledge and Evaluation Research Unit (KER-ENDO), Mayo Clinic, Rochester, Minnesota
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
| | - Juan P. Brito
- Knowledge and Evaluation Research Unit (KER-ENDO), Mayo Clinic, Rochester, Minnesota
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
- Address correspondence to:Juan P. Brito, MD, MScKnowledge and Evaluation Research UnitDivision of Endocrinology, Diabetes, Metabolism, and NutritionMayo Clinic200 1st Street SWRochester, MN 55905
| |
Collapse
|
35
|
Hamidi O, Young WF, Gruber L, Smestad J, Yan Q, Ponce OJ, Prokop L, Murad MH, Bancos I. Outcomes of patients with metastatic phaeochromocytoma and paraganglioma: A systematic review and meta-analysis. Clin Endocrinol (Oxf) 2017; 87:440-450. [PMID: 28746746 PMCID: PMC5854189 DOI: 10.1111/cen.13434] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The outcomes of patients with metastatic phaeochromocytoma (PHEO) and paraganglioma (PGL) are unclear. We performed a systematic review and meta-analysis of baseline characteristics and mortality rates of patients with metastatic PHEO and PGL (PPGL). DESIGN Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Scopus, Web of Science, and references of key articles were searched from inception to 2016. PATIENTS Studies comprised ≥20 patients with metastatic PPGL and reported baseline characteristics and follow-up data. MEASUREMENTS Reviewers extracted standardized data and assessed risk of bias using a modified Newcastle-Ottawa tool. Random-effects meta-analysis was used to pool event rates across studies. RESULTS Twenty retrospective noncomparative studies reported on 1338 patients with metastatic PHEO (685/1296, 52.9%) and PGL (611/1296, 47.1%), diagnosed at a mean age of 43.9 ± 5.2 years. Mean follow-up was 6.3 ± 3.2 years. Of 532 patients with reported data, 40.4% had synchronous metastases. Five-year (7 studies, n = 738) and 10-year (2 studies, n = 55) mortality rates for patients with metastatic PPGL were 37% (95% CI, 24%-51%) and 29% (95% CI, 17%-42%), respectively. Higher mortality was associated with male sex (RR 1.50; 95% CI, 1.11-2.02) and synchronous metastases (RR 2.43; 95% CI, 1.01-5.85). CONCLUSIONS Available low-quality evidence from heterogeneous studies suggests low mortality rates of patients with metastatic PPGL. Male sex and synchronous metastases correlated with increased mortality. The outcomes of patients with metastatic PPGL have been inadequately assessed, indicating the need for carefully planned prospective studies.
Collapse
Affiliation(s)
- Oksana Hamidi
- Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - William F. Young
- Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - Lucinda Gruber
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - John Smestad
- Mayo Clinic Medical Scientist Training Program, Mayo Clinic, Rochester, MN, USA
| | - Qi Yan
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Oscar J. Ponce
- Evidence-based Practice Center, Mayo Clinic, Rochester, MN, USA
- Unidad de Conocimiento y Evidencia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Larry Prokop
- Evidence-based Practice Center, Mayo Clinic, Rochester, MN, USA
- Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA
| | - M. Hassan Murad
- Evidence-based Practice Center, Mayo Clinic, Rochester, MN, USA
- Division of Preventive Medicine, Mayo Clinic, Rochester, MN, USA
| | - Irina Bancos
- Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
36
|
Barakat S, Boehmer K, Abdelrahim M, Ahn S, Al-Khateeb AA, Villalobos NÁ, Prokop L, Erwin PJ, Fleming K, Serrano V, Spencer-Bonilla G, Murad MH. Does Health Coaching Grow Capacity in Cancer Survivors? A Systematic Review. Popul Health Manag 2017. [PMID: 28636526 DOI: 10.1089/pop.2017.0040] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Interventions that grow patient capacity to do the work of health care and life are needed to support the health of cancer survivors. Health coaching may grow capacity. This systematic review of health coaching interventions explored coaching's ability to grow capacity of cancer survivors. The authors included randomized trials or quasi-experimental studies comparing coaching to alternative interventions, and adhered to PRISMA reporting guidelines. Data were analyzed using the Theory of Patient Capacity (BREWS: Capacity is affected by factors that influence ability to reframe Biography ["B"], mobilize or recruit Resources ["R"], interact with the Environment of care ["E"], accomplish Work ["W"]), and function Socially ["S"]). The authors reviewed 2210 references and selected 12 studies (6 randomized trials and 6 pre-post). These studies included 1038 cancer survivors, mean age 57.2 years, with various type of cancers: breast, colorectal, prostate, and lung. Health coaching was associated with improved quality of life, mood, and physical activity but not self-efficacy. Classified by potential to support growth in patient capacity, 67% of included studies reported statistically significant outcomes that support "B" (quality of life, acceptance, spirituality), 75% "R" (decreased fatigue, pain), 67% "W" (increased physical activity), and 33% "S" (social deprivation index). None addressed changing the patient's environment of care. In cancer survivors, health coaching improved quality of life and supported patient capacity by several mechanisms, suggesting an important role for "Capacity Coaching." Future interventions that improve self-efficacy and patients' environments of care are needed. Capacity Coaching may improve health and quality of life of cancer survivors.
Collapse
Affiliation(s)
| | | | | | - Sangwoo Ahn
- 2 University of Minnesota , Minneapolis, Minnesota
| | | | - Neri Álvarez Villalobos
- 1 Mayo Clinic , Rochester, Minnesota.,4 Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario "Dr. José E. González," Monterrey, México
| | | | | | | | - Valentina Serrano
- 1 Mayo Clinic , Rochester, Minnesota.,5 Pontificia Universidad Católica de Chile , Escuela de Medicina, Alameda, Chile
| | - Gabriela Spencer-Bonilla
- 1 Mayo Clinic , Rochester, Minnesota.,6 University of Puerto Rico Medical Sciences Campus , San Juan, Puerto Rico
| | | |
Collapse
|
37
|
Klem F, Wadhwa A, Prokop L, Sundt W, Farrugia G, Camilleri M, Singh S, Grover M. Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis. Gastroenterology 2017; 152:1042-1054.e1. [PMID: 28069350 PMCID: PMC5367939 DOI: 10.1053/j.gastro.2016.12.039] [Citation(s) in RCA: 249] [Impact Index Per Article: 35.6] [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: 07/07/2016] [Revised: 12/29/2016] [Accepted: 12/30/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Foodborne illness affects 15% of the US population each year, and is a risk factor for irritable bowel syndrome (IBS). We evaluated risk of, risk factors for, and outcomes of IBS after infectious enteritis. METHODS We performed a systematic review of electronic databases from 1994 through August 31, 2015 to identify cohort studies of the prevalence of IBS 3 months or more after infectious enteritis. We used random-effects meta-analysis to calculate the summary point prevalence of IBS after infectious enteritis, as well as relative risk (compared with individuals without infectious enteritis) and host- and enteritis-related risk factors. RESULTS We identified 45 studies, comprising 21,421 individuals with enteritis, followed for 3 months to 10 years for development of IBS. The pooled prevalence of IBS at 12 months after infectious enteritis was 10.1% (95% confidence interval [CI], 7.2-14.1) and at more than 12 months after infectious enteritis was 14.5% (95% CI, 7.7-25.5). Risk of IBS was 4.2-fold higher in patients who had infectious enteritis in the past 12 months than in those who had not (95% CI, 3.1-5.7); risk of IBS was 2.3-fold higher in individuals who had infectious enteritis more than 12 months ago than in individuals who had not (95% CI, 1.8-3.0). Of patients with enteritis caused by protozoa or parasites, 41.9% developed IBS, and of patients with enteritis caused by bacterial infection, 13.8% developed IBS. Risk of IBS was significantly increased in women (odds ratio [OR], 2.2; 95% CI, 1.6-3.1) and individuals with antibiotic exposure (OR, 1.7; 95% CI, 1.2-2.4), anxiety (OR, 2; 95% CI, 1.3-2.9), depression (OR, 1.5; 95% CI, 1.2-1.9), somatization (OR, 4.1; 95% CI, 2.7-6.0), neuroticism (OR, 3.3; 95% CI, 1.6-6.5), and clinical indicators of enteritis severity. There was a considerable level of heterogeneity among studies. CONCLUSIONS In a systematic review and meta-analysis, we found >10% of patients with infectious enteritis develop IBS later; risk of IBS was 4-fold higher than in individuals who did not have infectious enteritis, although there was heterogeneity among studies analyzed. Women-particularly those with severe enteritis-are at increased risk for developing IBS, as are individuals with psychological distress and users of antibiotics during the enteritis.
Collapse
Affiliation(s)
- Fabiane Klem
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN,Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Akhilesh Wadhwa
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN
| | - Larry Prokop
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN
| | - Wendy Sundt
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN
| | - Gianrico Farrugia
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN
| | - Michael Camilleri
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN
| | - Siddharth Singh
- Division of Gastroenterology, University of California San Diego, San Diego, CA
| | - Madhusudan Grover
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
| |
Collapse
|
38
|
Haffar S, Bazerbachi F, Prokop L, Watt KD, Murad MH, Chari ST. Frequency and prognosis of acute pancreatitis associated with fulminant or non-fulminant acute hepatitis A: A systematic review. Pancreatology 2017; 17:166-175. [PMID: 28236520 DOI: 10.1016/j.pan.2017.02.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [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: 10/14/2016] [Revised: 02/10/2017] [Accepted: 02/13/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Acute pancreatitis (AP) in patients with fulminant viral hepatitis is well recognized and its mortality depends on the severity of hepatitis rather than pancreatitis. Acute pancreatitis associated with non-fulminant acute hepatitis A (AHA) has been rarely described, and is considered to have a benign course with good response to conservative management. OBJECTIVE To perform a systematic review of the frequency and prognosis of AP associated with fulminant or non-fulminant AHA. RATIONALE An increasing number of reports describe AP associated with AHA. Some life-threatening complications related to AP may occur, and death has been reported. In addition, it is possible that early diagnosis of these cases may help in reducing the morbidity and mortality. DATA SOURCES Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Scopus, Google Scholar, and reference lists of relevant articles. STUDY SELECTION All available studies discussing AP associated with fulminant or non-fulminant AHA. DATA EXTRACTION AND ASSESSMENT Two blinded independent observers extracted and assessed the frequency of AP associated with AHA based on large studies including all cases of AHA observed during a prolonged period of time, diagnosis of AHA based on anti-HAV IgM, diagnosis of fulminant hepatitis (FH) based on the American Association for the study of Liver Diseases (AASLD) position paper, diagnosis of AP based on the American College of Gastroenterology (ACG) guidelines, diagnosis of AP associated with AHA based on Makharia's association, and diagnosis of AP severity based on the Revision of the Atlanta Classification (RAC). We have developed a tool for risk of bias assessment of case reports and case-series and applied it to the included studies. RESULTS The frequency of reported AP associated with AHA is 0-0.1%. Thirty-eight publications with a total of 54 patients meeting the inclusion criteria have been published. Twenty-two studies had a low risk for bias, 10 had moderate risk and 6 had high risk. Patients originated from all continents but most of them were from Asia. The median age at diagnosis was 16 years (range: 2-81) with a male to female ratio of 2. The median interval between the onset of jaundice and onset of AP pain was 4 days (range: 0-30). AP was severe in 9% of patients. The median hospital stay for AP was 8 days (range: 3-35). Most cases occur in patients without FH (94%). Mortality was reported in 2 patients (3.7%). CONCLUSION Acute pancreatitis associated with AHA is rare with an estimated frequency of 0-0.1%. Fifty-four documented cases, mostly in Asian patients, have been reported. The median age of patients is 16 years with a M/F ratio of 2. Acute pancreatitis occurs less than one week after the onset of jaundice and mostly in patients without FH. Acute pancreatitis in this setting is severe in 9% of patients with a mortality rate similar to all other causes of AP.
Collapse
Affiliation(s)
- Samir Haffar
- Digestive Center for Diagnosis and Treatment, 29 Ayar Street, Damascus, Syria
| | - Fateh Bazerbachi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
| | - Larry Prokop
- Department of Library Services, Mayo Clinic, Rochester, MN, USA
| | - Kymberly D Watt
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - M Hassan Murad
- Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Suresh T Chari
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
39
|
Hilscher MB, Odell LJ, Myhre LJ, Prokop L, Talwalkar J. The pharmacotherapy of cirrhosis: concerns and proposed investigations and solutions. J Clin Pharm Ther 2016; 41:587-591. [PMID: 27576303 DOI: 10.1111/jcpt.12443] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/01/2016] [Indexed: 12/11/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE The presence of cirrhosis has a multifaceted impact on hepatic drug metabolism. An area of concern and uncertainty in the care of patients with cirrhosis is the safe use of both prescription and over-the-counter medications. COMMENT Retrospective studies indicate a high incidence of adverse drug reactions (ADRs) among patients with cirrhosis related to use of certain medication classes including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and non-steroidal anti-inflammatory drugs. Conversely, use of appropriate medications, such as statins, may be decreased in this population due to fear of precipitating hepatotoxicity. WHAT IS NEW AND CONCLUSION Pharmacotherapy in cirrhosis is an area of uncertainty and heterogeneity in clinical practice. Prescribing and dosing guidelines are needed to decrease the risk of serious ADRs in this high-risk patient population.
Collapse
Affiliation(s)
- M B Hilscher
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
| | - L J Odell
- Department of Pharmacy, Mayo Clinic, Rochester, MN, USA
| | - L J Myhre
- Department of Pharmacy, Mayo Clinic, Rochester, MN, USA
| | - L Prokop
- Department of Education Administration, Mayo Clinic, Rochester, MN, USA
| | - J Talwalkar
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
40
|
Velthuis J, Klar R, Bönig H, Rovers J, Roy D, Prokop L, Stevanovic S, Ruediger M, Krackhardt A. Leukemia-associated Antigen Reactive T-cells in ATIR101, a Recipient-specific Allodepleted T-cell Product to Reduce Relapse Rates and GVHD after Haplo-HSCT. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.218] [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: 10/21/2022]
|
41
|
Wang Z, Hasan R, Firwana B, Elraiyah T, Tsapas A, Prokop L, Mills JL, Murad MH. A systematic review and meta-analysis of tests to predict wound healing in diabetic foot. J Vasc Surg 2016; 63:29S-36S.e1-2. [DOI: 10.1016/j.jvs.2015.10.004] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/08/2015] [Indexed: 12/13/2022]
|
42
|
Greiter F, Bachl N, Prokop L, Müller M, Kreuzer W. UV conditioning: physical and physiological impact. Curr Probl Dermatol 2015; 15:282-9. [PMID: 2936574 DOI: 10.1159/000412110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
43
|
Abu Dabrh A, Asi N, Farah W, Mohammed K, Wang Z, Farah M, Prokop L, Katznelson L, Murad M. Radiotherapy vs. Radiosurgery in Treating Patients with Acromegaly: Systematic Review and Meta-Analysis. Endocr Pract 2015:1-33. [PMID: 25786558 DOI: 10.4158/ep14574.ra] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
OBJECTIVE When patients with acromegaly have residual disease following surgery, adjuvant radiation therapy is considered. Both stereotactic radiosurgery (SRS) and conventional fractionated radiotherapy (RT) are utilized. We conducted a systematic review and meta-analysis to synthesize the existing evidence to compare outcomes with SRS and RT in patients with acromegaly. METHODS We searched Medline In-Process & Other Non-Indexed Citations, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through April 2014 for studies in which SRS or RT were used in patients with acromegaly. Outcomes evaluated were serum IGF-1 and GH levels, biochemical remission, all-cause mortality, hypopituitarism, headaches and secondary malignancies. We pooled outcomes using the random-effects model. RESULTS The final search yielded 30 eligible studies enrolling 2464 patients. When compared to RT, SRS was associated with a non-significant increase in remission rate at the latest follow-up period (52% vs. 36%; p = 0.14), and a significantly lower follow-up IGF-1 level (decline of - 409.72 μg/1 vs. -102 μg/1; p = 0.002). SRS was associated with lower incidence of hypopituitarism than RT; however the difference was not statistically significant [(32% vs.51%, respectively; p = 0.05). CONCLUSIONS SRS may be associated with better biochemical remission and lower risk of hypopituitarism with at least one deficient axis when compared with RT; however, the confidence in such evidence is very low due to the non-comparative nature of the studies, high heterogeneity, and imprecision.
Collapse
Affiliation(s)
- Abd Abu Dabrh
- 1 Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Wild J, Schmiedel BJ, Maurer A, Raab S, Prokop L, Stevanović S, Dörfel D, Schneider P, Salih HR. Neutralization of (NK-cell-derived) B-cell activating factor by Belimumab restores sensitivity of chronic lymphoid leukemia cells to direct and Rituximab-induced NK lysis. Leukemia 2015; 29:1676-83. [PMID: 25710310 DOI: 10.1038/leu.2015.50] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/10/2015] [Accepted: 02/19/2015] [Indexed: 12/22/2022]
Abstract
Natural killer (NK) cells are cytotoxic lymphocytes that substantially contribute to the therapeutic benefit of antitumor antibodies like Rituximab, a crucial component in the treatment of B-cell malignancies. In chronic lymphocytic leukemia (CLL), the ability of NK cells to lyse the malignant cells and to mediate antibody-dependent cellular cytotoxicity upon Fc receptor stimulation is compromised, but the underlying mechanisms are largely unclear. We report here that NK-cells activation-dependently produce the tumor necrosis factor family member 'B-cell activating factor' (BAFF) in soluble form with no detectable surface expression, also in response to Fc receptor triggering by therapeutic CD20-antibodies. BAFF in turn enhanced the metabolic activity of primary CLL cells and impaired direct and Rituximab-induced lysis of CLL cells without affecting NK reactivity per se. The neutralizing BAFF antibody Belimumab, which is approved for treatment of systemic lupus erythematosus, prevented the effects of BAFF on the metabolism of CLL cells and restored their susceptibility to direct and Rituximab-induced NK-cell killing in allogeneic and autologous experimental systems. Our findings unravel the involvement of BAFF in the resistance of CLL cells to NK-cell antitumor immunity and Rituximab treatment and point to a benefit of combinatory approaches employing BAFF-neutralizing drugs in B-cell malignancies.
Collapse
Affiliation(s)
- J Wild
- 1] Department of Hematology and Oncology, Eberhard Karls University, Tuebingen, Germany [2] Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - B J Schmiedel
- Department of Hematology and Oncology, Eberhard Karls University, Tuebingen, Germany
| | - A Maurer
- Interfaculty Institute of Biochemistry, Eberhard Karls University, Tuebingen, Germany
| | - S Raab
- 1] Department of Hematology and Oncology, Eberhard Karls University, Tuebingen, Germany [2] Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - L Prokop
- Department of Immunology, Eberhard Karls University, Tuebingen, Germany
| | - S Stevanović
- Department of Immunology, Eberhard Karls University, Tuebingen, Germany
| | - D Dörfel
- 1] Department of Hematology and Oncology, Eberhard Karls University, Tuebingen, Germany [2] Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P Schneider
- Department of Biochemistry, University of Lausanne, Epalinges, Switzerland
| | - H R Salih
- 1] Department of Hematology and Oncology, Eberhard Karls University, Tuebingen, Germany [2] Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| |
Collapse
|
45
|
Chaudhry HM, Bruce AJ, Wolf R, Litzow MR, Hogan W, Gastineau DA, Patnaik M, Prokop L, Hashmi S. The Incidence and Outcomes of Oral Mucositis Among Allogeneic Stem Cell Transplantation Patients: A Systematic Review and Meta-Analysis. Biol Blood Marrow Transplant 2015. [DOI: 10.1016/j.bbmt.2014.11.384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
46
|
Prokop L, Kaske M, Maccari P, Lucius R, Kunz HJ, Wiedemann S. Intensive rearing of male calves during the first three weeks of life has long-term effects on number of islets of Langerhans and insulin stained area in the pancreas. J Anim Sci 2015; 93:988-98. [DOI: 10.2527/jas.2014-8144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
47
|
Elraiyah T, Sonbol MB, Wang Z, Khairalseed T, Asi N, Undavalli C, Nabhan M, Firwana B, Altayar O, Prokop L, Montori VM, Murad MH. Clinical review: The benefits and harms of systemic testosterone therapy in postmenopausal women with normal adrenal function: a systematic review and meta-analysis. J Clin Endocrinol Metab 2014; 99:3543-50. [PMID: 25279572 PMCID: PMC5393495 DOI: 10.1210/jc.2014-2262] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 07/08/2014] [Indexed: 11/19/2022]
Abstract
CONTEXT The use of T has been suggested to improve women's health during the postmenopausal period. OBJECTIVE We conducted a systematic review and meta-analysis of randomized trials to summarize the best available evidence regarding the benefits and harms of systemic T in postmenopausal women with normal adrenal function. METHODS A comprehensive search of MEDLINE, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, EBSCO CINAHL, and Scopus was conducted through January 2014. We conducted study selection, data extraction, and appraisal in duplicate. Random-effects meta-analysis was used to pool results. RESULTS We identified 35 randomized trials (n = 5053) at a moderate risk of bias. T use was associated with statistically significant improvement in various domains of sexual function and personal distress in postmenopausal women, although the majority of the trials did not have specific or contemporary diagnostic criteria for androgen deficiency in women. T use was also associated with a reduction in total cholesterol, triglyceride, and high-density lipoprotein and an increase in low-density lipoprotein and in the incidence of acne and hirsutism. No significant effect was noted on anthropometric measures and bone density. Long-term safety data were sparse, and the quality of such evidence was low. CONCLUSION Despite the improvement in sexual function associated with T use in postmenopausal women, long-term safety data are lacking.
Collapse
Affiliation(s)
- Tarig Elraiyah
- Knowledge and Evaluation Research Unit (T.E., M.B.S., Z.W., T.K., N.A., C.U., M.N., B.F., O.A., V.M.M., M.H.M.), and Center for the Science of Healthcare Delivery (T.E., Z.W., N.A., M.H.M.), Mayo Clinic, Rochester, Minnesota 55905; Internal Medicine Department (M.B.S.), Georgia Regents University, Augusta, Georgia 30901; and Mayo Clinic Libraries (L.P.), Division of Endocrinology, Diabetes, Metabolism and Nutrition (V.M.M.), and Division of Preventive, Occupational, and Aerospace Medicine (M.H.M.), Mayo Clinic, Rochester, Minnesota 55905
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Elraiyah T, Sonbol MB, Wang Z, Khairalseed T, Asi N, Undavalli C, Nabhan M, Altayar O, Prokop L, Montori VM, Murad MH. Clinical review: The benefits and harms of systemic dehydroepiandrosterone (DHEA) in postmenopausal women with normal adrenal function: a systematic review and meta-analysis. J Clin Endocrinol Metab 2014; 99:3536-42. [PMID: 25279571 PMCID: PMC5393492 DOI: 10.1210/jc.2014-2261] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
CONTEXT Exogenous dehydroepiandrosterone (DHEA) therapy has been proposed to replenish the depletion of endogenous DHEA and its sulfate form, which occurs with advancing age and is thought to be associated with loss of libido and menopausal symptoms. OBJECTIVE We conducted a systematic review and meta-analysis to summarize the evidence supporting the use of systemic DHEA in postmenopausal women with normal adrenal function. METHODS We searched MEDLINE, EMBASE, PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through January 2014. Pairs of reviewers, working independently, selected studies and extracted data from eligible randomized controlled trials (RCTs). We used the random-effects model to pool across studies and evaluated heterogeneity using the I(2) statistic. RESULTS We included 23 RCTs with moderate to high risk of bias enrolling 1188 women. DHEA use was not associated with significant improvement in libido or sexual function (standardized mean difference, 0.35; 95% confidence interval, -0.02 to 0.73; P value = .06; I(2) = 62%). There was also no significant effect of DHEA on serious adverse effects, serum lipids, serum glucose, weight, body mass index, or bone mineral density. This evidence warranted low confidence in the results, mostly due to imprecision, risk of bias, and inconsistency across RCTs. CONCLUSIONS Evidence warranting low confidence suggests that DHEA administration does not significantly impact sexual symptoms or selected metabolic markers in postmenopausal women with normal adrenal function.
Collapse
Affiliation(s)
- Tarig Elraiyah
- Knowledge and Evaluation Research Unit (T.E., M.B.S., Z.W., T.K., N.A., C.U., M.N., O.A., V.M.M., M.H.M.), and Center for the Science of Healthcare Delivery (T.E., Z.W., N.A., M.H.M.), Mayo Clinic, Rochester, Minnesota 55905; Internal Medicine Department (M.B.S.), Georgia Regents University, Augusta, Georgia 30912; and Mayo Clinic Libraries (L.P.), Division of Endocrinology, Diabetes, Metabolism, and Nutrition (V.M.M.), and Division of Preventive, Occupational and Aerospace Medicine (M.H.M.), Mayo Clinic, Rochester, Minnesota 55905
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Hazem A, Sharma S, Sharma A, Leitch C, Sharadanant R, Uriell M, Neutzling K, Barrionuevo Moreno P, LeBlanc A, Wang Z, Sorita A, Vilenski L, Prokop L, Makkuni P, Ting HH, Murad MH. Abstract 118: Right Bundle Branch Block and Clinical Outcomes in Patients with Heart Failure: A Systematic Review and Meta-analysis. Circ Cardiovasc Qual Outcomes 2014. [DOI: 10.1161/circoutcomes.7.suppl_1.118] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Importance:
Right bundle branch block (RBBB) is observed in approximately 5-14% of patients with heart failure (HF). Multiple observational studies have reported the association of RBBB with clinical outcomes in patients with HF. We performed a systematic review and meta-analysis to determine the prognostic significance of RBBB for patients with HF.
Data Sources:
We have systematically searched MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science and Scopus through January 2014.
Study Selection:
Reviewers working independently and in duplicate screened all eligible abstracts that described all cause or cardiovascular mortality in patients with RBBB and HF. We excluded studies that reported unadjusted outcome, i.e.: unadjusted event rates.
Knowledge synthesis:
We pooled reported risk ratio and hazard ratio.
Main Outcomes:
All-cause mortality and cardiovascular mortality (death).
Results:
We found 12 relevant observational studies enrolling over 38,000 patients. Risk of bias was assessed using the Newcastle-Ottawa Scale. Included studies had at least a moderate quality. Seven of those evaluated prognosis of patients with RBBB and heart failure. After a mean follow up period of 2.5 years (range: 1-5 years), RBBB was associated with a statistically significant increased risk of all-cause mortality compared to patients with heart failure but no BBB, RR 1.27, 95% CI (1.08-1.50), Figure 1. The other 5 studies evaluated CHF patients receiving cardiac resynchronization therapy (CRT), comparing outcomes of patients with RBBB to those with LBBB. After a mean f/u period of 3 years, patients with RBBB were once again found to have an increased risk of all-cause mortality, RR 1.45, 95% CI 1.12-1.89.
Conclusion and Relevance:
RBBB in patients with HF is associated with higher all-cause mortality in comparison to patients without inter-ventricular conduction defects, as well as LBBB patients in patients undergoing CRT setting.
Collapse
|
50
|
Hazem A, Sharma S, Sharma A, Leitch C, Sharadanant R, Uriell M, Neutzling K, Wang Z, Brrionuevo Moreno P, LeBlanc A, Sorita A, Vilesnki L, Prokop L, Makkuni P, Ting HH, Murad MH. Abstract 309: Is Right Bundle Branch Block Associated with Poor Outcomes in the Setting of an Acute Coronary Syndrome? A Systematic Review and Meta-analysis. Circ Cardiovasc Qual Outcomes 2014. [DOI: 10.1161/circoutcomes.7.suppl_1.309] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Importance:
Up to 10% of patients with acute myocardial infarction (AMI) have right bundle branch block (RBBB), and RBBB has been associated with a higher risk of mortality. We performed a systematic review and meta-analysis to determine the prognostic significance of RBBB for patients with AMI. Acute coronary syndrome (ACS)
Data Sources:
We have systematically searched Ovid, Scopus and Web of Science through January 2014.
Study Selection:
Reviewers working independently and in duplicate screened all eligible abstracts, selecting studies that described all-cause mortality or cardiovascular death in patients with RBBB and suspected ACS. We excluded studies that reported unadjusted outcomes.
Knowledge synthesis:
We pooled risk ratio with hazard ratio in studies reporting those outcomes. When reported, odds ratio was converted into risk ratio using reported event rate in each study’s unexposed -read: non RBBB- group.
Main Outcomes:
All-cause mortality and cardiovascular mortality (death).
Results:
Eighteen studies were found that reported eligible data. All were observational studies, involving over 89,000 patients. In short-term follow up (up to 30 days), RBBB on presentation was associated with higher all-cause mortality rate, compared to patients without RBBB (RR 2.23, 95% CI 1.76-2.82). There was a trend for higher mortality at long-term follow up (range: 6 months-16 years) that did not reach statistical significance (RR 1.45, 95% CI 0.93-2.25). Figure-1 demonstrates the forest plot. Risk of bias was assessed with the Newcastle-Ottawa scale and majority of included studied were deemed moderate to high quality.
Conclusion and Relevance:
RBBB is associated with a more than 2-fold higher risk of all-cause mortality in patients with AMI at 30 days follow up. Patients with AMI and RBBB represent a high risk group for adverse outcomes. A sentence on the differential findings for new vs. old RBBB and association with outcomes could follow here.
Collapse
|