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Ong WL, Stewart J, Sahgal A, Soliman H, Tseng CL, Detsky J, Ho L, Das S, Maralani P, Lipsman N, Stanisz G, Perry J, Chen H, Atenafu E, Lau A, Ruschin ME, Myrehaug SD. Predictors of Tumor Dynamics during a 6-Week Course of Chemoradiotherapy for Glioblastoma. Int J Radiat Oncol Biol Phys 2023; 117:e142. [PMID: 37784716 DOI: 10.1016/j.ijrobp.2023.06.953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Our prior imaging studies have shown geometrically meaningful inter-fraction tumor dynamics specific to glioblastoma (GBM). We aim to identify predictors associated with tumor dynamics during a 6-week course of concurrent chemoradiotherapy (CRT) for GBM. MATERIALS/METHODS Patients enrolled in a prospective serial magnetic resonance imaging (MRI) study were reviewed. All patients were treated with 54-60 Gy in 30 fractions. The gross tumor volume (GTV) included the surgical cavity and T1c enhanced residual tumor; clinical tumor volume (CTV) included GTV with a 15mm isotropic expansion, respecting anatomical boundaries; planning target volume (PTV) was 4mm expansion. MRIs were obtained at RT planning (F0), fraction 10 (F10), and fraction 20 (F20). Tumor dynamic metrics (relative to F0) assessed included the GTV volume (Vrel), Hausdorff distance (dH) and migration distance (dM). dH is the average distance between two datasets in metric space. dM is the maximum linear displacement of the GTV in any direction. Factors to be determined associated with tumor dynamics included: age, sex, corpus callosum (CC) involvement, extent of surgery (gross total resection (GTR), subtotal resection (STR) or biopsy alone (Bx)), MGMT methylation and IDH mutation status. RESULTS A total of 129 patients were reviewed. Median GTV was 20.9cc at F0, 17.6cc at F10 (Vrel 0.85), and 16.1cc at F20 (Vrel 0.78). Patients without CC involvement had more marked GTV volume reduction: Vrel 0.82 vs 1.02 with CC involvement at F10 (P = 0.05), and Vrel 0.77 vs 0.88 with CC involvement at F20 (P = 0.03). Patients with GTR (vs STR vs Bx) had more marked GTV volume reduction across all time points: Vrel 0.78, 0.85 and 1.07 respectively at F10 (P = 0.001), and Vrel 0.69, 0.80, 1.04 respectively at F20 (P = 0.001). The median dH was 8.1mm at F10 and 9.2mm at F20. Patients with CC involvement (vs without CC involvement) had a larger dH: 54% vs 25% had dH>10mm respectively at F10 (P = 0.03), and 73% vs 28% had dH>10mm respectively at F20 (P<0.005). Patients with a GTR had smaller dH at both F10 (P = 0.02) and F20 (P = 0.006). At F20, 20%, 47% and 37% of patients with GTR, STR and Bx had dH>10mm (P = 0.04). The median dM were 4.7mm at F10 and 4.7mm at F20. Patients with CC involvement (vs without CC involvement) had larger dM: 41% vs 12% had dM >10mm respectively at F10 (P = 0.01), and 45% vs 9% had dM >10mm respectively at F20 (P<0.001). Patients with GTR had smaller dM at F10 (P = 0.03) and F20 (P0.002). At F20, 0%, 25% and 19% of patients with GTR, STR and Bx had dM>10mm (P = 0.002). Age, sex, MGMT methylation and IDH mutation status were not associated with Vrel, dH and dM at F10 and F20. CONCLUSION We identified CC involvement and extent of surgery to be associated with tumor dynamics at F10 and F20 over the course of CRT for GBM. This offers opportunities to better select patients who may benefit from earlier/ more frequent RT replan/ adaptation to ensure adequate tumor coverage, or to reduce RT toxicities.
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Affiliation(s)
- W L Ong
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Alfred Health Radiation Oncology, Monash University Central Clinical School, Melbourne, Australia
| | - J Stewart
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - A Sahgal
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - H Soliman
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - C L Tseng
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - J Detsky
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - L Ho
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - S Das
- Division of Neurosurgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, ON, Canada
| | - P Maralani
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - N Lipsman
- Division of Neurosurgery, University of Toronto, Toronto, ON, Canada
| | - G Stanisz
- Department of Physical Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada; Department of Neurosurgery and Pediatric Neurosurgery, Medical University, Lublin, Poland
| | - J Perry
- Department of Neurooncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - H Chen
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - E Atenafu
- Department of Biostatistics, University Health Network, University of Toronto, Toronto, ON, Canada
| | - A Lau
- Department of Physical Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - M E Ruschin
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - S D Myrehaug
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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Palhares DM, Dasgupta A, Saifuddin M, Ho L, Lu L, Prasla S, Pena MLA, Karam I, Soliman H, Szumacher E, Chow E, Chen H, Vesprini D, Sahgal A, Czarnota GJ. A Novel Strategy to Enhance Radiotherapy Efficacy: Results from the Prospective Phase I Clinical Trial of MR-Guided Focused Ultrasound-Stimulated Microbubbles (MRgFUS+MB) Treatment for Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e197. [PMID: 37784840 DOI: 10.1016/j.ijrobp.2023.06.1068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Preclinical in vitro and in vivo studies have demonstrated that tumor cell death can be enhanced 10- to 40-fold when radiotherapy (RT) is combined with focused-ultrasound (FUS)-stimulated microbubbles (MB) treatment. MBs are gas microspheres used as intravascular contrast agents. The acoustic exposure of MBs within the target volume causes bubbles cavitation that induces perturbation of tumor vasculature. This activates apoptotic pathways responsible for the ablative effect of stereotactic body radiotherapy, which would otherwise require high-dose radiotherapy (>8-10 Gy/fraction) to be activated. Subsequent irradiation of an MB-sensitized tumor causes increased anoxic tumor killing, which occurs in addition to canonical RT-induced DNA damage. Given the compelling results of preclinical data, we conducted a phase I clinical trial of magnetic resonance (MR)-guided FUS-stimulated MBs (MRgFUS+MB) treatment for breast cancer patients (pts). We report the safety and efficacy results of this new radio enhancement treatment. MATERIALS/METHODS This is a single-center, single-arm, investigator-initiated phase 1 clinical trial (NCT04431674). We included pts with stage I-IV breast cancer with tumor in situ for whom breast or chest wall RT was deemed adequate by a multidisciplinary team. Pts were excluded if they had contraindications for contrast-enhanced MR or MB administration. Pts underwent 2-3 MRgFUS+MB treatments throughout the RT course. We used an MR-coupled FUS-device operating at 500 KHz and 540 kPa peak negative pressure to deliver the treatment. The FUS sonicated intravenously administrated MB within the MR-guided target volume. Pts were monitored for 30-min post-procedure and subsequently treated with RT. The primary outcome was acute toxicity per Common Terminology for Adverse Events V5.0. Secondary outcomes were radiological response at 3 months and local control (LC) at 1 year. Kaplan-Meier method was used to estimate local control. All pts signed a written consent form before study participation. RESULTS We enrolled 18 females with 20 primary breast cancer treated with MRgFUS+MB therapy. The median age was 60 years (range, 44-90). The molecular subtypes consisted of basal-like (n = 3/20), luminal (n = 11/20), and HER2-enriched (n = 6/20). The prescribed dose was 20 Gy/5 fractions (n = 8/20), 30-35 Gy/5 fractions (n = 7/20), 30-40 Gy/10 fractions (n = 3/20), and 66 Gy/33 fractions (n = 2/20). The median follow-up was 9 months (range, 0.3-29). All pts completed the planned MRgFUS+MB treatments. The only MRgFUS+MB treatment-related toxicity consisted of Grade 1 allergic reaction (mild cough) 30 minutes after the last MB injection. All worst acute toxicities were radiation dermatitis (Grade 3 = 2/20, Grade 2 = 2/20, Grade 1 = 14/20). At 3 months, 75% had partial (n = 6/20) or complete (n = 9/20) response, with a single progression. The LC rate at 1 year was 86%. CONCLUSION MRgFUS+MB was a safe and efficient treatment that provided durable responses.
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Affiliation(s)
- D M Palhares
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - A Dasgupta
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - M Saifuddin
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - L Ho
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - L Lu
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - S Prasla
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - M L A Pena
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - I Karam
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - H Soliman
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - E Szumacher
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - E Chow
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - H Chen
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - D Vesprini
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - A Sahgal
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - G J Czarnota
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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Nathan SD, Medarov B, Ho L, Kingrey J, Hong T, Rao Y, Shen E, Smith P, Deng C, Waxman A. A Novel Approach to Clinical Change Endpoints: A Win Ratio Analysis of the INCREASE Trial. Ann Am Thorac Soc 2023; 20:1537-1540. [PMID: 37413676 PMCID: PMC10559141 DOI: 10.1513/annalsats.202303-229rl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/06/2023] [Indexed: 07/08/2023] Open
Affiliation(s)
| | | | - Lawrence Ho
- University of Washington Medical CenterSeattle, Washington
| | | | - Taekwon Hong
- North Carolina State UniversityRaleigh, North Carolina
| | - Youlan Rao
- United Therapeutics CorporationResearch Triangle Park, North Carolina
| | - Eric Shen
- United Therapeutics CorporationResearch Triangle Park, North Carolina
| | - Peter Smith
- United Therapeutics CorporationResearch Triangle Park, North Carolina
| | - Chunqin Deng
- United Therapeutics CorporationResearch Triangle Park, North Carolina
| | - Aaron Waxman
- Brigham and Women’s HospitalBoston, Massachusetts
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Farrell J, Ho L. Management of Patients with Systemic Sclerosis-Associated Interstitial Lung Disease: A Focus on the Role of the Pharmacist. Integr Pharm Res Pract 2023; 12:101-112. [PMID: 37163188 PMCID: PMC10164394 DOI: 10.2147/iprp.s399518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/23/2023] [Indexed: 05/11/2023] Open
Abstract
Interstitial lung disease (ILD) is a common manifestation of systemic sclerosis (SSc), which becomes fibrosing and progressive in some patients. Regular monitoring of patients with SSc-ILD is important to assess progression and inform treatment decisions. Therapy for SSc-ILD may include immunomodulatory and antifibrotic therapies. Therapeutic decisions should be made on a case-by-case basis, ideally following multidisciplinary discussion. Most patients with SSc-ILD have several organ manifestations of SSc or comorbidities and are taking a complex medication regimen. Patients with SSc are particularly susceptible to gastrointestinal side-effects of medications due to the gastrointestinal manifestations of the disease. Pharmacists play an important role in the management of patients with SSc-ILD by assisting patients with access to medications, optimizing medication regimens, and advising on alternative dosage forms. Pharmacists can also contribute to patient education to help patients better understand their treatment and how to prevent and manage potential side effects.
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Affiliation(s)
- Jessica Farrell
- Albany College of Pharmacy and Health Sciences and Albany Medical Center Division of Rheumatology, Albany, NY, USA
- Correspondence: Jessica Farrell, Albany College of Pharmacy and Health Sciences and Albany Medical Center Division of Rheumatology, Albany, NY, USA, Email
| | - Lawrence Ho
- Center for Interstitial Lung Disease, University of Washington, Seattle, WA, USA
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Shih JY, Lin S, Nagar S, Jimenez M, Davis K, Kahangire D, Servidio L, Ho L, Veluswamy R. 302P Treatment patterns in resectable early-stage NSCLC in Taiwan: Subgroup analysis of a global real-world study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.330] [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: 12/05/2022] Open
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Denton CP, Goh NS, Humphries SM, Maher TM, Spiera R, Devaraj A, Ho L, Stock C, Erhardt E, Alves M, Wells AU. Extent of fibrosis and lung function decline in patients with systemic sclerosis and interstitial lung disease: data from the SENSCIS trial. Rheumatology (Oxford) 2022; 62:1870-1876. [PMID: 36111858 PMCID: PMC10152288 DOI: 10.1093/rheumatology/keac535] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/01/2022] [Accepted: 09/11/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
To assess associations between the extent of fibrotic interstitial lung disease (ILD) and forced vital capacity (FVC) at baseline and change in FVC over 52 weeks in patients with systemic sclerosis-associated ILD (SSc-ILD) in the SENSCIS trial.
Methods
We used generalised additive models, which involve few assumptions and allow for interaction between non-linear effects, to assess associations between the extent of fibrotic ILD on high-resolution computed tomography (HRCT), and the interplay of extent of fibrotic ILD on HRCT and FVC % predicted, at baseline and FVC decline over 52 weeks.
Results
In the placebo group (n = 288), there was weak evidence of a modest association between a greater extent of fibrotic ILD at baseline and a greater decline in FVC % predicted at week 52 (r: -0.09 [95% CI -0.2, 0.03]). Higher values of both the extent of fibrotic ILD and FVC % predicted at baseline tended to be associated with greater decline in FVC % predicted at week 52. In the nintedanib group (n = 288), there was no evidence of an association between the extent of fibrotic ILD at baseline and decline in FVC % predicted at week 52 (r: 0.01 [95% CI: -0.11, 0.12]) or between the interplay of extent of fibrotic ILD and FVC % predicted at baseline and decline in FVC % predicted at week 52.
Conclusion
Data from the SENSCIS trial suggest that patients with SSc-ILD are at risk of ILD progression and benefit from nintedanib largely irrespective of their extent of fibrotic ILD at baseline.
Trial registration
ClinicalTrials.gov, https://clinicaltrials.gov, NCT02597933.
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Affiliation(s)
- Christopher P Denton
- University College London Division of Medicine Centre for Rheumatology and Connective Tissue Diseases, , London, UK
| | - Nicole S Goh
- Austin Health, and Institute for Breathing and Sleep Respiratory and Sleep Medicine, , Melbourne, Victoria, Australia
| | | | - Toby M Maher
- National Heart and Lung Institute, Imperial College London , London, UK, and Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Robert Spiera
- Hospital for Special Surgery Division of Rheumatology, , New York, New York, USA
| | - Anand Devaraj
- Royal Brompton Hospital and National Heart and Lung Institute, Imperial College Department of Radiology, , London, UK
| | - Lawrence Ho
- University of Washington Center for Interstitial Lung Diseases, , Seattle, Washington, USA
| | - Christian Stock
- Boehringer Ingelheim Pharma GmbH & Co. KG , Ingelheim am Rhein
| | | | - Margarida Alves
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein , Germany
| | - Athol U Wells
- National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, and National Heart and Lung Institute, Imperial College , London, UK
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Kelly ML, Lynch Y, Child C, Wise A, Kim P, Garvin M, Guilliams J, Sizelove H, Cai H, Ho L, Brown MB. A Mobile-Health Exercise Intervention Improves Exercise Tolerance, Quality Of Life, And Fatigue In Lymphangioleiomyomatosis. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000878820.57641.42] [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: 11/21/2022]
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Emura F, Chandrasekar VT, Hassan C, Armstrong D, Messmann H, Arantes V, Araya R, Barrera-Leon O, Bergman JJGHM, Bandhari P, Bourke MJ, Cerisoli C, Chiu PWY, Desai M, Dinis-Ribeiro M, Falk GW, Fujishiro M, Gaddam S, Goda K, Gross S, Haidry R, Ho L, Iyer PG, Kashin S, Kothari S, Lee YY, Matsuda K, Neuhaus H, Oyama T, Ragunath K, Repici A, Shaheen N, Singh R, Sobrino-Cossio S, Wang KK, Waxman I, Sharma P. Rio de Janeiro Global Consensus on Landmarks, Definitions, and Classifications in Barrett's Esophagus: World Endoscopy Organization Delphi Study. Gastroenterology 2022; 163:84-96.e2. [PMID: 35339464 DOI: 10.1053/j.gastro.2022.03.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS Despite the significant advances made in the diagnosis and treatment of Barrett's esophagus (BE), there is still a need for standardized definitions, appropriate recognition of endoscopic landmarks, and consistent use of classification systems. Current controversies in basic definitions of BE and the relative lack of anatomic knowledge are significant barriers to uniform documentation. We aimed to provide consensus-driven recommendations for uniform reporting and global application. METHODS The World Endoscopy Organization Barrett's Esophagus Committee appointed leaders to develop an evidence-based Delphi study. A working group of 6 members identified and formulated 23 statements, and 30 internationally recognized experts from 18 countries participated in 3 rounds of voting. We defined consensus as agreement by ≥80% of experts for each statement and used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool to assess the quality of evidence and the strength of recommendations. RESULTS After 3 rounds of voting, experts achieved consensus on 6 endoscopic landmarks (palisade vessels, gastroesophageal junction, squamocolumnar junction, lesion location, extraluminal compressions, and quadrant orientation), 13 definitions (BE, hiatus hernia, squamous islands, columnar islands, Barrett's endoscopic therapy, endoscopic resection, endoscopic ablation, systematic inspection, complete eradication of intestinal metaplasia, complete eradication of dysplasia, residual disease, recurrent disease, and failure of endoscopic therapy), and 4 classification systems (Prague, Los Angeles, Paris, and Barrett's International NBI Group). In round 1, 18 statements (78%) reached consensus, with 12 (67%) receiving strong agreement from more than half of the experts. In round 2, 4 of the remaining statements (80%) reached consensus, with 1 statement receiving strong agreement from 50% of the experts. In the third round, a consensus was reached on the remaining statement. CONCLUSIONS We developed evidence-based, consensus-driven statements on endoscopic landmarks, definitions, and classifications of BE. These recommendations may facilitate global uniform reporting in BE.
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Affiliation(s)
- Fabian Emura
- Gastroenterology Division, Universidad de La Sabana, Chía, Colombia; Advanced GI Endoscopy, EmuraCenter LatinoAmerica, Bogotá DC, Colombia.
| | | | - Cesare Hassan
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy; Endoscopy Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
| | - David Armstrong
- Division of Gastroenterology & Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Helmut Messmann
- Department of Gastroenterology, Klinikum Augsburg, Augsburg, Germany
| | - Vitor Arantes
- Endoscopy Division, Hospital das Clınicas e Mater Dei Contorno, Belo Horizonte, Brazil; Alfa Institute of Gastroenterology, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Raul Araya
- Clinic Los Andes University, Division of Gastroenterology and Endoscopy, Army Hospital of Santiago, Santiago, Chile
| | - Oscar Barrera-Leon
- Gastroenterology Division, Universidad de La Sabana, Chía, Colombia; Advanced GI Endoscopy, EmuraCenter LatinoAmerica, Bogotá DC, Colombia
| | - Jacques J G H M Bergman
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
| | - Pradeep Bandhari
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, UK
| | - Michael J Bourke
- Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia
| | - Cecilio Cerisoli
- Gastroenterology and Diagnostic and Therapeutic Endoscopy (GEDYT), Buenos Aires, Argentina
| | | | - Madhav Desai
- Division of Gastroenterology, VA Medical Center and University of Kansas School of Medicine, Kansas City, Missouri
| | - Mário Dinis-Ribeiro
- MEDCIDS-Department of Community Medicine, Information and Decision in Health, Faculty of Porto, University of Medicine, Porto, Portugal
| | - Gary W Falk
- Division of Gastroenterology, Hospital of the University of Pennsylvania, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Srinivas Gaddam
- Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California
| | - Kenichi Goda
- Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Seth Gross
- Division of Gastroenterology, NYU Langone Medical Center, New York, New York
| | - Rehan Haidry
- Department of Gastrointestinal and Endoscopy, University College London Hospital, London, UK
| | - Lawrence Ho
- Division of Gastroenterology, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Prasad G Iyer
- Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Sergey Kashin
- Department of Gastroenterology, Yaroslavl Oncology Hospital, Yaroslavl, Russian Federation
| | - Shivangi Kothari
- Division of Gastroenterology and Hepatology, University of Rochester Medical Center and Strong Memorial Hospital, Rochester, New York; Developmental Endoscopy, Lab at University of Rochester (DELUR), University of Rochester Medical, Rochester, New York
| | - Yeong Yeh Lee
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Koji Matsuda
- Department of Gastroenterology and Hepatology, School of Medicine, St. Marianna University, Kawasaki, Japan
| | - Horst Neuhaus
- Department of Internal Medicine, Gastroenterology and Interventional Endoscopy, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany
| | - Tsuneo Oyama
- Department of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan
| | - Krish Ragunath
- Department of Gastroenterology, Curtin University Medical School, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Alessandro Repici
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy; Endoscopy Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
| | - Nicholas Shaheen
- Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Rajvinder Singh
- Department of Gastroenterology, The Lyell McEwin Hospital, Adelaide, South Australia, Australia
| | - Sergio Sobrino-Cossio
- Unidad de Endoscopia y Fisiología Digestiva, Hospital Ángeles del Pedregal, México DF, México
| | - Kenneth K Wang
- Barrett's Esophagus Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Irving Waxman
- Division of Gastroenterology, University of Chicago Medical Center, Chicago, Illinois
| | - Prateek Sharma
- Division of Gastroenterology, VA Medical Center and University of Kansas School of Medicine, Kansas City, Missouri
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Griffin L, Ho L, Akhurst RJ, Arron ST, Boggs JME, Conlon P, O'Kelly P, Toland AE, Epstein EH, Balmain A, Bastian BC, Moloney FJ, Murphy GM, Laing ME. Genetic polymorphism in Methylenetetrahydrofolate Reductase chloride transport protein 6 ( MTHFR CLCN6) gene is associated with keratinocyte skin cancer in a cohort of renal transplant recipients. Skin Health Dis 2022; 2:e95. [PMID: 35677930 PMCID: PMC9168012 DOI: 10.1002/ski2.95] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 12/18/2022]
Abstract
Background Renal transplant recipients (RTRs) are at increased risk of keratinocyte cancer (KC), especially cutaneous squamous cell carcinoma (cSCC). Previous studies identified a genetic variant of the Methylenetetrahydrofolate Reductase (MTHFR) gene, C677T, which conferred a risk for diagnosis of cSCC in Irish RTRs. Objective We sought to find further genetic variation in MTHFR and overlap genes that may be associated with a diagnosis of KC in RTRs. Methods Genotyping of a combined RTR population (n = 821) from two centres, Ireland (n = 546) and the USA (n = 275), was performed. This included 290 RTRs with KC and 444 without. Eleven single nucleotide polymorphisms (SNPs) in the MTHFR gene and seven in the overlap gene MTHFR Chloride transport protein 6 (CLCN6) were evaluated and association explored by time to event analysis (from transplant to first KC) using Cox proportional hazards model. Results Polymorphism at MTHFR CLCN6 (rs9651118) was significantly associated with KC in RTRs (HR 1.50, 95% CI 1.17–1.91, p < 0.00061) and cSCC (HR 1.63, 95% CI 1.14–2.34, p = 0.007). A separate SNP, MTHFR C677T, was also significantly associated with KC in the Irish population (HR 1.31, 95% CI 1.05–1.63, p = 0.016), but not American RTRs. Conclusions We report the association of a SNP in the MTHFR overlap gene, CLCN6 and KC in a combined RTR population. While the exact function of CLCN6 is not known, it is proposed to be involved in folate availability. Future applications could include incorporation in a polygenic risk score for KC in RTRs to help identify those at increased risk beyond traditional risk factor assessment.
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Affiliation(s)
- L Griffin
- Department of Dermatology University Hospital Galway Galway Ireland
| | - L Ho
- Department of Dermatology Beaumont Hospital Dublin 9 Ireland
| | - R J Akhurst
- Helen Diller Family Comprehensive Cancer Center University of California San Francisco California USA
| | - S T Arron
- Helen Diller Family Comprehensive Cancer Center University of California San Francisco California USA
| | - J M E Boggs
- Department of Dermatology University Hospital Galway Galway Ireland
| | - P Conlon
- Department of Nephrology Beaumont Hospital Dublin 9 Ireland
| | - P O'Kelly
- Department of Nephrology Beaumont Hospital Dublin 9 Ireland
| | - A E Toland
- Department of Molecular Virology, Immunology and Medical Genetics Comprehensive Cancer Centre Ohio State University Columbus Ohio USA
| | - E H Epstein
- Helen Diller Family Comprehensive Cancer Center University of California San Francisco California USA
| | - A Balmain
- Helen Diller Family Comprehensive Cancer Center University of California San Francisco California USA
| | - B C Bastian
- Helen Diller Family Comprehensive Cancer Center University of California San Francisco California USA
| | - F J Moloney
- Department of Dermatology Beaumont Hospital Dublin 9 Ireland
| | - G M Murphy
- Department of Dermatology Beaumont Hospital Dublin 9 Ireland
| | - M E Laing
- Department of Dermatology University Hospital Galway Galway Ireland.,Department of Dermatology Beaumont Hospital Dublin 9 Ireland.,Department of Medicine National University of Ireland Galway Ireland
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Raghu G, Remy-Jardin M, Richeldi L, Thomson CC, Inoue Y, Johkoh T, Kreuter M, Lynch DA, Maher TM, Martinez FJ, Molina-Molina M, Myers JL, Nicholson AG, Ryerson CJ, Strek ME, Troy LK, Wijsenbeek M, Mammen MJ, Hossain T, Bissell BD, Herman DD, Hon SM, Kheir F, Khor YH, Macrea M, Antoniou KM, Bouros D, Buendia-Roldan I, Caro F, Crestani B, Ho L, Morisset J, Olson AL, Podolanczuk A, Poletti V, Selman M, Ewing T, Jones S, Knight SL, Ghazipura M, Wilson KC. Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med 2022; 205:e18-e47. [PMID: 35486072 PMCID: PMC9851481 DOI: 10.1164/rccm.202202-0399st] [Citation(s) in RCA: 683] [Impact Index Per Article: 341.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: This American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Asociación Latinoamericana de Tórax guideline updates prior idiopathic pulmonary fibrosis (IPF) guidelines and addresses the progression of pulmonary fibrosis in patients with interstitial lung diseases (ILDs) other than IPF. Methods: A committee was composed of multidisciplinary experts in ILD, methodologists, and patient representatives. 1) Update of IPF: Radiological and histopathological criteria for IPF were updated by consensus. Questions about transbronchial lung cryobiopsy, genomic classifier testing, antacid medication, and antireflux surgery were informed by systematic reviews and answered with evidence-based recommendations using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. 2) Progressive pulmonary fibrosis (PPF): PPF was defined, and then radiological and physiological criteria for PPF were determined by consensus. Questions about pirfenidone and nintedanib were informed by systematic reviews and answered with evidence-based recommendations using the GRADE approach. Results:1) Update of IPF: A conditional recommendation was made to regard transbronchial lung cryobiopsy as an acceptable alternative to surgical lung biopsy in centers with appropriate expertise. No recommendation was made for or against genomic classifier testing. Conditional recommendations were made against antacid medication and antireflux surgery for the treatment of IPF. 2) PPF: PPF was defined as at least two of three criteria (worsening symptoms, radiological progression, and physiological progression) occurring within the past year with no alternative explanation in a patient with an ILD other than IPF. A conditional recommendation was made for nintedanib, and additional research into pirfenidone was recommended. Conclusions: The conditional recommendations in this guideline are intended to provide the basis for rational, informed decisions by clinicians.
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Glicksman R, Liu S, Cheung P, Vesprini D, Chu W, Chung H, Morton G, Deabreu A, Davidson M, Ravi A, Musunuru H, Helou J, Ho L, Zhang L, Loblaw D. Elective Nodal Ultra Hypofractionated Radiation for Prostate Cancer: Safety and Efficacy From Four Prospective Clinical Trials. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Scallan C, Strand L, Hayes J, Kadura S, Collins B, Ho L, Spada C, Canestaro W, Kolb M, Raghu G. R-Scale for Pulmonary Fibrosis (PF): a simple, visual tool for the assessment of health-related quality of life. Eur Respir J 2021; 59:13993003.00917-2021. [PMID: 34112729 DOI: 10.1183/13993003.00917-2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/26/2021] [Indexed: 11/05/2022]
Abstract
RATIONALE Patients with Idiopathic Pulmonary Fibrosis (IPF) experience impaired health related quality of life (HRQoL). Several tools have been developed to objectively assess HRQoL in this patient population, but none are in use in routine clinical practice. OBJECTIVES To develop a rapid, specific tool that can be used for patients with IPF during routine clinic visits. METHODS A novel and simple 5-item numerical rating scale (NRS) was developed and compared with two other previously validated tools. 100 consecutive patients with IPF managed at the center for ILD, were recruited to complete the R-Scale-PF, the Kings Brief Interstitial Lung Disease Questionnaire (K-BILD), and the EuroQol 5-Dimensional 5-Level Questionnaire (EQ-5D-5 L) in addition to pulmonary function and 6-min walk tests. MEASUREMENTS AND MAIN RESULTS All 100 patients successfully completed the three HRQoL tools with 53 completing them again at follow up visits. Internal consistency was high (Cronbach's α 0.825) with minimal floor/ceiling effect. Concurrent validity of the R-Scale-PF was moderate to high compared with the K-BILD (r=-0.713) and the EQ-5D-5 L (r=-0.665). Concurrent validity was moderate with physiologic measures (forced vital capacity, r=-0.307, 6-min walk distance, r=-0.383). The R-Scale-PF demonstrated good known-groups validity when comparing scores across stages of disease severity. CONCLUSIONS The R-Scale-PF correlates well with the K-BILD and EQ-5D-5 L. It is hoped that this novel simple NRS tool subject to validation in patients from other centers will provide the opportunity to objectively measure HRQoL in routine clinical practice for patients with IPF.
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Affiliation(s)
- Ciaran Scallan
- Center for Interstitial Lung Disease, University of Washington, Seattle, WA, USA.,Firestone Institute for Respiratory Health, McMaster University, Hamilton, ON, USA
| | - Lauren Strand
- School of Pharmacy, University of Washington, Seattle, WA, USA
| | - Jennifer Hayes
- Center for Interstitial Lung Disease, University of Washington, Seattle, WA, USA
| | - Suha Kadura
- Center for Interstitial Lung Disease, University of Washington, Seattle, WA, USA
| | - Bridget Collins
- Center for Interstitial Lung Disease, University of Washington, Seattle, WA, USA
| | - Lawrence Ho
- Center for Interstitial Lung Disease, University of Washington, Seattle, WA, USA
| | - Carolyn Spada
- Center for Interstitial Lung Disease, University of Washington, Seattle, WA, USA
| | - Will Canestaro
- School of Pharmacy, University of Washington, Seattle, WA, USA.,Washington Research Foundation, Seattle, WA, USA
| | - Martin Kolb
- Firestone Institute for Respiratory Health, McMaster University, Hamilton, ON, USA
| | - Ganesh Raghu
- Center for Interstitial Lung Disease, University of Washington, Seattle, WA, USA
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Flinn I, Friedman JD, Ho L, Lee HJ. BRENTUXIMAB VEDOTIN IN COMBINATION WITH NIVOLUMAB, DOXORUBICIN, AND DACARBAZINE IN NEWLY DIAGNOSED PATIENTS WITH ADVANCED HODGKIN LYMPHOMA (SGN35‐027, TRIAL IN PROGRESS). Hematol Oncol 2021. [DOI: 10.1002/hon.160_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- I. Flinn
- Sarah Cannon Research Institute and Tennessee Oncology Medical Oncology Nashville Tennessee USA
| | - J. D. Friedman
- University Hospitals Seidman Cancer Center Cleveland Ohio USA
| | - L. Ho
- Seagen Inc. Clinical Development Bothell Washington USA
| | - H. J. Lee
- MD Anderson Cancer Center Department of Lymphoma & Myeloma Houston Texas USA
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Wan D, Halim A, Ho L, Lu T, Lim K. MYOCARDIAL CYTOSKELETAL DYSFUNCTION IN KIDNEY FAILURE: THE CAIN STUDY. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.173] [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: 12/01/2022] Open
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15
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Weiss Y, Chin L, Lau A, Husain Z, Higgins K, Enepekides D, Eskander A, Ho L, Poon I, Karam I. Cine MRI-based Analysis of Intrafractional Motion in Radiation Treatment Planning of Head and Neck Cancer Patients. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Richards C, Gandhi R, Botelho F, Ho L, Paolini J. 637 Oncostatin M induction of monocyte chemoattractant protein 1 (MCP-1) in human epidermal keratinocytes is inhibited by anti-oncostatin M receptor β monoclonal antibody KPL-716. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Singh S, Collins BF, Sharma BB, Joshi JM, Talwar D, Katiyar S, Singh N, Ho L, Samaria JK, Bhattacharya P, Chaudhari S, Singh T, Pilania K, Pipavath S, Ahuja J, Chetambath R, Ghoshal AG, Jain NK, Gayathri Devi HJ, Kant S, Koul P, Dhar R, Swarnakar R, Katiyar SK, Jindal A, Mangal DK, Singh V, Raghu G. Hypersensitivity pneumonitis: Clinical manifestations - Prospective data from the interstitial lung disease-India registry. Lung India 2019; 36:476-482. [PMID: 31670294 DOI: 10.4103/lungindia.lungindia_263_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Multiple environmental factors are associated with development of hypersensitivity pneumonitis (HP), and diagnostic algorithms for the diagnosis of HP have been proposed in recent perspectives. Aims We analyzed the data of patients with HP from interstitial lung disease (ILD)-India registry. The analysis was performed to (1) find the prevalence of HP, (2) reclassify HP as per a recently proposed classification criterion to assess the level of diagnostic certainty, and (3) identify the causative agents for HP. Setting and Designs This was a prospective multicenter study of consecutive, consenting adult patients with new-onset ILD from 27 centers across India (March 2012-April 2015). Materials and Methods The diagnoses were based on prespecified working clinical criteria and multidisciplinary discussions. To assess strength of diagnosis based on available clinical information, patients with HP were subclassified into definite HP, HP with high level of confidence, and HP with low level of confidence using a recent classification scheme. Results Five hundred and thirteen of 1084 patients with new-onset ILD were clinically diagnosed with HP and subclassified as HP with high level of confidence (380, 74.1%), HP with low level of confidence (106, 20.7%), and definite HP (27, 5.3%). Exposures among patients with HP were birds (odds ratios [OR]: 3.52, P < 0.001), air-conditioners (OR: 2.23, P < 0.001), molds (OR: 1.79, P < 0.001), rural residence (OR: 1.64, P < 0.05), and air-coolers (OR: 1.45, P < 0.05). Conclusions About 47.3% of patients with new-onset ILD in India were diagnosed with HP, the majority of whom were diagnosed as HP with a high level of confidence. The most common exposures were birds, cooling devices, and visible molds.
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Affiliation(s)
- Sheetu Singh
- Department Chest and Tuberculosis, SMS Medical College, Jaipur, Rajasthan, India
| | - Bridget F Collins
- Department of Medicine, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA 98195, USA
| | - Bharat B Sharma
- Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India
| | - Jyotsana M Joshi
- Department of Pulmonary Medicine, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India
| | - Deepak Talwar
- Department of Pulmonary and Sleep Care Medicine, Metro Multispeciality Hospital, Noida, Uttar Pradesh, India
| | - Sandeep Katiyar
- Department of Respiratory Medicine, Chest Care Centre, Kanpur, Uttar Pradesh, India
| | - Nishtha Singh
- Department of Pulmonary Medicine, Asthma Bhawan, Jaipur, Rajasthan, India
| | - Lawrence Ho
- Department of Medicine, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA 98195, USA
| | - Jai K Samaria
- Department of Chest Disease, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Parthasarthi Bhattacharya
- Department of Respiratory Medicine, Institute of Pulmocare and Research, Kolkata, West Bengal, India
| | - Sudhir Chaudhari
- Department of Tuberculosis and Respiratory Diseases, GSVM Medical College, Kanpur, Uttar Pradesh, India
| | - Tejraj Singh
- Research Division, Asthma Bhawan, Jaipur, Rajasthan, India
| | - Khushboo Pilania
- Department of Radiodiagnosis, Jankharia Imaging, Mumbai, Maharashtra, India
| | - Sudhakar Pipavath
- Department of Radiology, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA 98195, USA
| | - Jitesh Ahuja
- Department of Radiology, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA 98195, USA
| | - Ravindran Chetambath
- Department of Pulmonary Medicine, Calicut Medical College, Kozhikode, Kerala, India
| | - Aloke G Ghoshal
- National Allergy Asthma Bronchitis Institute, Kolkata, West Bengal, India
| | - Nirmal K Jain
- Department of Respiratory Medicine, Jain Chest Care Center, Jaipur, Rajasthan, India
| | - H J Gayathri Devi
- Department of Respiratory Medicine, MS Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Surya Kant
- Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Parvaiz Koul
- Department of Internal and Pulmonary Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Raja Dhar
- Department of Pulmonology and Critical Care, Fortis Hospital, Kolkata, West Bengal, India
| | - Rajesh Swarnakar
- Department of Pulmonology and Respiratory Medicine, Getwell Hospital and Research Institute, Nagpur, Maharashtra, India
| | - Subodh K Katiyar
- Department of Respiratory Medicine, Chest Care Centre, Kanpur, Uttar Pradesh, India
| | - Arpita Jindal
- Department of Pathology, SMS Medical College, Jaipur, Rajasthan, India
| | | | - Virendra Singh
- Department of Pulmonary Medicine, Asthma Bhawan, Jaipur, Rajasthan, India
| | - Ganesh Raghu
- Department of Medicine, Center for Interstitial Lung Diseases, University of Washington, Seattle, WA 98195, USA
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Lim Y, Low E, Ho L, Uthirapathy J, Tan H, Teo W, Lim C, Kong E, Baldevarona J, Tan T. SUN-P293: Making a Difference in Nutrition Care for Hospitalised Patients: An Inter-Professional Collaborative Model. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30338-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sato T, Sato C, Kadowaki A, Watanabe H, Ho L, Ishida J, Yamaguchi T, Kimura A, Fukamizu A, Penninger J, Reversade B, Ito H, Imai Y, Kuba K. 5922A novel APJ ligand, ELABELA/Apela/Toddler, protects from pressure overload- and Angiotensin II-induced cardiac hypertrophy and fibrosis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.5922] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Singh S, Collins BF, Sharma BB, Joshi JM, Talwar D, Katiyar S, Singh N, Ho L, Samaria JK, Bhattacharya P, Gupta R, Chaudhari S, Singh T, Moond V, Pipavath S, Ahuja J, Chetambath R, Ghoshal AG, Jain NK, Devi HJG, Kant S, Koul P, Dhar R, Swarnakar R, Sharma SK, Roy DJ, Sarmah KR, Jankharia B, Schmidt R, Katiyar SK, Jindal A, Mangal DK, Singh V, Raghu G. Interstitial Lung Disease in India. Results of a Prospective Registry. Am J Respir Crit Care Med 2017; 195:801-813. [PMID: 27684041 DOI: 10.1164/rccm.201607-1484oc] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
RATIONALE Interstitial lung disease (ILD) is a heterogeneous group of acute and chronic inflammatory and fibrotic lung diseases. Existing ILD registries have had variable findings. Little is known about the clinical profile of ILDs in India. OBJECTIVES To characterize new-onset ILDs in India by creating a prospective ILD using multidisciplinary discussion (MDD) to validate diagnoses. METHODS Adult patients of Indian origin living in India with new-onset ILD (27 centers, 19 Indian cities, March 2012-June 2015) without malignancy or infection were included. All had connective tissue disease (CTD) serologies, spirometry, and high-resolution computed tomography chest. ILD pattern was defined by high-resolution computed tomography images. Three groups independently made diagnoses after review of clinical data including that from prompted case report forms: local site investigators, ILD experts at the National Data Coordinating Center (NDCC; Jaipur, India) with MDD, and experienced ILD experts at the Center for ILD (CILD; Seattle, WA) with MDD. Cohen's κ was used to assess reliability of interobserver agreement. MEASUREMENTS AND MAIN RESULTS A total of 1,084 patients were recruited. Final diagnosis: hypersensitivity pneumonitis in 47.3% (n = 513; exposure, 48.1% air coolers), CTD-ILD in 13.9%, and idiopathic pulmonary fibrosis in 13.7%. Cohen's κ: 0.351 site investigator/CILD, 0.519 site investigator/NDCC, and 0.618 NDCC/CILD. CONCLUSIONS Hypersensitivity pneumonitis was the most common new-onset ILD in India, followed by CTD-ILD and idiopathic pulmonary fibrosis; diagnoses varied between site investigators and CILD experts, emphasizing the value of MDD in ILD diagnosis. Prompted case report forms including environmental exposures in prospective registries will likely provide further insight into the etiology and management of ILD worldwide.
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Affiliation(s)
| | | | | | - Jyotsna M Joshi
- 4 Department of Pulmonary Medicine, Topiwala National Medical College & BYL Nair Hospital, Mumbai, India
| | - Deepak Talwar
- 5 Department of Pulmonary and Sleep Care Medicine, Metro Multispeciality Hospital, Noida, India
| | - Sandeep Katiyar
- 6 Department of Respiratory Medicine, Chest Care Centre, Kanpur, India
| | | | | | - Jai Kumar Samaria
- 8 Department of Chest Disease, Banaras Hindu University, Varanasi, India
| | | | - Rakesh Gupta
- 10 Department of Respiratory Medicine, JLN Medical College & Hospital, Ajmer, India
| | - Sudhir Chaudhari
- 11 Department of Chest and Tuberculosis, GSVM Medical College, Kanpur, India
| | - Tejraj Singh
- 12 Research Division, Asthma Bhawan, Jaipur, India
| | | | | | | | - Ravindran Chetambath
- 15 Department of Pulmonary Medicine, Government Medical College, Kozhikode, India
| | - Aloke G Ghoshal
- 16 National Allergy Asthma Bronchitis Institute, Kolkata, India
| | - Nirmal K Jain
- 17 Department of Respiratory Medicine, SoniManipal Hospital, Jaipur, India
| | - H J Gayathri Devi
- 18 Department of Chest Medicine, MS Ramaiah Medical College, Bangalore, India
| | - Surya Kant
- 19 Department of Pulmonary Medicine, King George's Medical University, Lucknow, India
| | - Parvaiz Koul
- 20 Department of Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Raja Dhar
- 21 Department of Pulmonology & Critical Care, Fortis Hospital, Kolkata, India
| | - Rajesh Swarnakar
- 22 Department of Pulmonology and Respiratory Medicine, Getwell Hospital and Research Institute, Nagpur, India
| | - Surendra K Sharma
- 23 Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Dhrubajyoti J Roy
- 24 Department of Respiratory Medicine, Pulmonary and Sleep Clinic, Kolkata, India
| | - Kripesh R Sarmah
- 25 Department of Pulmonary Medicine, Gauhati Medical College, Guwahati, India
| | - Bhavin Jankharia
- 26 Department of Radiology, Jankharia Imaging, Mumbai, India; and
| | - Rodney Schmidt
- 27 Department of Pathology, Center for Interstitial Lung Diseases, University of Washington, Seattle, Washington
| | - Santosh K Katiyar
- 6 Department of Respiratory Medicine, Chest Care Centre, Kanpur, India
| | - Arpita Jindal
- 28 Department of Pathology, SMS Medical College, Jaipur, India
| | - Daya K Mangal
- 29 Department of Research, IIHMR University, Jaipur, India
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Musunuru H, Deabreu A, Davidson M, Ravi A, Hlou J, Ho L, Cheung P, Vesprini D, Liu S, Chu W, Chung H, Zhang L, Loblaw A. EP-1341: Pelvic SABR with HDR boost in intermediate and high risk prostate cancer (spare): early results. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31776-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Canestaro WJ, Forrester SH, Raghu G, Ho L, Devine BE. Drug Treatment of Idiopathic Pulmonary Fibrosis: Systematic Review and Network Meta-Analysis. Chest 2016; 149:756-66. [PMID: 26836914 DOI: 10.1016/j.chest.2015.11.013] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/16/2015] [Accepted: 11/02/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a form of chronic progressive fibrosing interstitial lung disease of unknown origin. Recently, nintedanib and pirfenidone demonstrated efficacy in slowing disease progression and were approved by the US Food and Drug Administration. Although numerous treatments have been evaluated in IPF, none have shown significant decreases in mortality. The objective of this study was to identify all pharmacologic treatments evaluated for IPF and analyze their efficacy via Bayesian network meta-analysis and pairwise indirect treatment comparisons. This review did not evaluate the effect of steroid therapy. METHODS We searched MEDLINE, Embase, and the Cochrane Library for studies published on or before August 2014. Studies were required to contain a randomized evaluation of nonsteroidal drug therapy for treatment of IPF and be published in English. Key outcomes of interest for this analysis were pulmonary function as measured by FVC as well as all-cause and respiratory-specific death. All outcomes were analyzed via a Bayesian framework. RESULTS Our review identified 30 eligible studies that evaluated 16 unique treatments. Under both the fixed-effect and random-effect models for respiratory-specific mortality, no treatments performed better than placebo. For all-cause mortality, pirfenidone and nintedanib had effects approaching significance with credible intervals slightly crossing the null under a fixed-effect model. Notably, for respiratory-specific mortality, all-cause mortality, and decline in percent predicted FVC, nintedanib and pirfenidone were virtually indistinguishable and no clear advantage was detected. CONCLUSIONS Although two treatments have been approved for IPF on the basis of reduced decline in pulmonary function, neither one has a clear advantage on mortality outcomes.
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Affiliation(s)
- William J Canestaro
- Pharmaceutical Outcomes Research and Policy Program, University of Washington School of Pharmacy, Seattle, WA
| | | | - Ganesh Raghu
- Division of Pulmonary and Critical Care Medicine, Center for Interstitial Lung Disease, University of Washington School of Medicine, Seattle, WA
| | - Lawrence Ho
- Division of Pulmonary and Critical Care Medicine, Center for Interstitial Lung Disease, University of Washington School of Medicine, Seattle, WA
| | - Beth E Devine
- Pharmaceutical Outcomes Research and Policy Program, University of Washington School of Pharmacy, Seattle, WA.
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Cubuk PO, Ho L, Reversade B, Perçin EF. MATTHEW-WOOD SYNDROME: A CASE WITH DEXTROCARDIA AND STREAK GONADS. Genet Couns 2016; 27:405-410. [PMID: 30204971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Matthew-Wood syndrome (MWS), also termed Microphthalmia, syndrome 9 (MCOPS9, MIM 601186), Spear syndrome, or pulmonary hypoplasia, diaphragmatic hernia, anophthalmia and cardiac defects syndrome (PDAC syndrome), is an autosomal recessive disorder characterised by ocular, respiratory and cardiac abnormalities. Mutations in retinoic acid 6 gene (STRA6) have been reported in clinically diagnosed patients with MWS. Here we presented a case with MWS, who has characteristic findings of the syndrome as well as dextrocardia as an undescribed feature, and bilateral streak gonads which was described only in one patient previously. Molecular analysis showed a homozygous exonic missense mutation in the STRA6 gene.
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Ho L. Psychological inflexiblity as a potential explanation of the neuroticism–insomnia link. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.1518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Harris L, Ho L, Rae P, O'Donnell D, Warrillow SJ, Moten S, Weinberg L. Pacemaker-induced R-on-T phenomenon leading to ventricular fibrillation post cardiac surgery. Anaesth Intensive Care 2015; 43:795-797. [PMID: 26603815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Ng HJ, Lam J, Koh PL, Ho L, Lim CY, Akhbar Ali M, Mya D, Than H, Ho LP, Tan AM, Lee LH, Tien SL. A comprehensive study of current haemophilia care and outcomes in Singapore. Haemophilia 2015; 21:e428-31. [PMID: 26058545 DOI: 10.1111/hae.12729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2015] [Indexed: 12/01/2022]
Affiliation(s)
- H J Ng
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - J Lam
- Department of Paediatrics, Kandang Kerbau Women's and Children's Hospital, Singapore, Singapore
| | - P L Koh
- Department of Paediatrics, National University Hospital, Singapore, Singapore
| | - L Ho
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - C Y Lim
- Department of Paediatrics, Kandang Kerbau Women's and Children's Hospital, Singapore, Singapore
| | - M Akhbar Ali
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - D Mya
- Department of Paediatrics, Kandang Kerbau Women's and Children's Hospital, Singapore, Singapore
| | - H Than
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - L P Ho
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - A M Tan
- Department of Paediatrics, Kandang Kerbau Women's and Children's Hospital, Singapore, Singapore
| | - L H Lee
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | - S L Tien
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
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Lin S, Zhang N, Godby J, Wang J, Marsh G, Liao Z, Komaki R, Ho L, Hofstetter W, Swisher S, Mehran R, Buchholz T, Elting L, Giordano S. OC-0124: IMRT or 3DCRT and cardiopulmonary mortality risk in the elderly with Eeophageal cancer. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40122-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
We report a case of an infusion of intra-aortic propofol after the missed inadvertent placement of a centra venous catheter into the right common carotid artery. Radiological imaging revealed bilateral ischaemic infarct in the posterior fossa and right cerebral artery territories consistent with an embolic source. The potential cause of the neurological injuries sustained in this case are explored. Discussion focuses on the sequelae, managemen and prevention of an iatrogenic carotid artery injury from a central venous catheter insertion. Finally, we propose an algorithm for management of iatrogenic carotid artery cannulation.
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Affiliation(s)
- L. Ho
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria
| | - M. Spanger
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria
- Department of Radiology, Box Hill Hospital, Box Hill, Victoria
| | - P. Hayward
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria
- Department of Cardiac Surgery, Austin Health, Heidelberg, Victoria
| | - L. Mcnicol
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria
| | - L. Weinberg
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria
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Ramnath VR, Ho L, Maggio LA, Khazeni N. Centralized monitoring and virtual consultant models of tele-ICU care: a systematic review. Telemed J E Health 2014; 20:936-61. [PMID: 25226571 DOI: 10.1089/tmj.2013.0352] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Increasing intensivist shortages and demand coupled with the escalating cost of care have created enthusiasm for intensive care unit (ICU)-based telemedicine ("tele-ICU"). This systematic literature review compares the Centralized Monitoring and Virtual Consultant tele-ICU Models. MATERIALS AND METHODS With an experienced medical reference librarian, we identified all language publications addressing the employment and efficacy of the centralized monitoring and virtual consultant tele-ICU systems through PubMed, CINAHL, and Web of Science. We performed quantitative and qualitative reviews of documents regarding financial sustainability, clinical outcomes, and ICU staff workflow and acceptance. RESULTS Of 1,468 documents identified, 1,371 documents were excluded, with the remaining 91 documents addressing clinical outcomes (46 documents [enhanced guideline compliance, 5; mortality and length of stay, 28; and feasibility, 13]), financial sustainability (9 documents), and ICU staff workflow and acceptance (36 documents). Quantitative review showed that studies evaluating the Centralized Monitoring Model were twice as frequent, with a mean of 4,891 patients in an average of six ICUs; Virtual Consultant Model studies enrolled a mean of 372 patients in an average of one ICU. Ninety-two percent of feasibility studies evaluated the Virtual Consultant Model, of which 50% were in the last 3 years. Qualitative review largely confirmed findings in previous studies of centralized monitoring systems. Both the Centralized Monitoring and Virtual Consultant Models showed clinical practice adherence improvement. Although definitive evaluation was not possible given lack of data, the Virtual Consultant Model generally indicated lean absolute cost profile in contrast to centralized monitoring systems. CONCLUSIONS Compared with the Virtual Consultant tele-ICU Model, studies addressing the Centralized Monitoring Model of tele-ICU care were greater in quantity and sample size, with qualitative conclusions of clinical outcomes, staff satisfaction and workload, and financial sustainability largely consistent with past systematic reviews. Attention should be focused on performing more high-quality studies to allow for equitable comparisons between both models.
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Affiliation(s)
- Venktesh R Ramnath
- 1 Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center , Stanford, California
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Park K, Kim J, Schuler M, Planchard D, De Marinis F, Chen Y, Zhou C, Bennouna J, Xiaoqing L, Feng J, Bidoli P, Strausz J, Chouaid C, Huang M, Ho L, Wang B, Chand V, Yang J. Afatinib (A) Followed By a + Paclitaxel (P) or Investigator'S Choice of Single-Agent Chemotherapy (Ic) in Patients (Pts) with Advanced Squamous Cell Carcinoma (Scc) of the Lung: Subgroup Analysis of Lux-Lung 5 (Ll5). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.42] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chang W, Wei K, Ho L, Berry GJ, Jacobs SS, Chang CH, Rosen GD. A critical role for the mTORC2 pathway in lung fibrosis. PLoS One 2014; 9:e106155. [PMID: 25162417 PMCID: PMC4146613 DOI: 10.1371/journal.pone.0106155] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 08/01/2014] [Indexed: 12/11/2022] Open
Abstract
A characteristic of dysregulated wound healing in IPF is fibroblastic-mediated damage to lung epithelial cells within fibroblastic foci. In these foci, TGF-β and other growth factors activate fibroblasts that secrete growth factors and matrix regulatory proteins, which activate a fibrotic cascade. Our studies and those of others have revealed that Akt is activated in IPF fibroblasts and it mediates the activation by TGF-β of pro-fibrotic pathways. Recent studies show that mTORC2, a component of the mTOR pathway, mediates the activation of Akt. In this study we set out to determine if blocking mTORC2 with MLN0128, an active site dual mTOR inhibitor, which blocks both mTORC1 and mTORC2, inhibits lung fibrosis. We examined the effect of MLN0128 on TGF-β-mediated induction of stromal proteins in IPF lung fibroblasts; also, we looked at its effect on TGF-β-mediated epithelial injury using a Transwell co-culture system. Additionally, we assessed MLN0128 in the murine bleomycin lung model. We found that TGF-β induces the Rictor component of mTORC2 in IPF lung fibroblasts, which led to Akt activation, and that MLN0128 exhibited potent anti-fibrotic activity in vitro and in vivo. Also, we observed that Rictor induction is Akt-mediated. MLN0128 displays multiple anti-fibrotic and lung epithelial-protective activities; it (1) inhibited the expression of pro-fibrotic matrix-regulatory proteins in TGF-β-stimulated IPF fibroblasts; (2) inhibited fibrosis in a murine bleomycin lung model; and (3) protected lung epithelial cells from injury caused by TGF-β-stimulated IPF fibroblasts. Our findings support a role for mTORC2 in the pathogenesis of lung fibrosis and for the potential of active site mTOR inhibitors in the treatment of IPF and other fibrotic lung diseases.
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Affiliation(s)
- Wenteh Chang
- Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Ke Wei
- Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Lawrence Ho
- Division of Pulmonary and Critical Care Medicine, University of Washington School of Medicine, Seattle, Washington, United States of America
| | - Gerald J. Berry
- Department of Pathology, Stanford University School of Medicine, Stanford, California, United States of America
| | - Susan S. Jacobs
- Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Cheryl H. Chang
- Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Glenn D. Rosen
- Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, California, United States of America
- * E-mail:
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Nance T, Smith KS, Anaya V, Richardson R, Ho L, Pala M, Mostafavi S, Battle A, Feghali-Bostwick C, Rosen G, Montgomery SB. Transcriptome analysis reveals differential splicing events in IPF lung tissue. PLoS One 2014; 9:e97550. [PMID: 24805851 PMCID: PMC4013141 DOI: 10.1371/journal.pone.0097550] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Nance T, Smith KS, Anaya V, Richardson R, Ho L, Pala M, Mostafavi S, Battle A, Feghali-Bostwick C, Rosen G, Montgomery SB. Transcriptome analysis reveals differential splicing events in IPF lung tissue. PLoS One 2014; 9:e92111. [PMID: 24647608 PMCID: PMC3960165 DOI: 10.1371/journal.pone.0092111] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 02/18/2014] [Indexed: 12/22/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a complex disease in which a multitude of proteins and networks are disrupted. Interrogation of the transcriptome through RNA sequencing (RNA-Seq) enables the determination of genes whose differential expression is most significant in IPF, as well as the detection of alternative splicing events which are not easily observed with traditional microarray experiments. We sequenced messenger RNA from 8 IPF lung samples and 7 healthy controls on an Illumina HiSeq 2000, and found evidence for substantial differential gene expression and differential splicing. 873 genes were differentially expressed in IPF (FDR<5%), and 440 unique genes had significant differential splicing events in at least one exonic region (FDR<5%). We used qPCR to validate the differential exon usage in the second and third most significant exonic regions, in the genes COL6A3 (RNA-Seq adjusted pval = 7.18e-10) and POSTN (RNA-Seq adjusted pval = 2.06e-09), which encode the extracellular matrix proteins collagen alpha-3(VI) and periostin. The increased gene-level expression of periostin has been associated with IPF and its clinical progression, but its differential splicing has not been studied in the context of this disease. Our results suggest that alternative splicing of these and other genes may be involved in the pathogenesis of IPF. We have developed an interactive web application which allows users to explore the results of our RNA-Seq experiment, as well as those of two previously published microarray experiments, and we hope that this will serve as a resource for future investigations of gene regulation in IPF.
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Affiliation(s)
- Tracy Nance
- Department of Pathology, Stanford University, Stanford, California, United States of America
- * E-mail: (TN); (GR); (SBM)
| | - Kevin S. Smith
- Department of Pathology, Stanford University, Stanford, California, United States of America
| | - Vanessa Anaya
- Department of Pathology, Stanford University, Stanford, California, United States of America
| | - Rhea Richardson
- Department of Pathology, Stanford University, Stanford, California, United States of America
| | - Lawrence Ho
- Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington, United States of America
| | - Mauro Pala
- Department of Pathology, Stanford University, Stanford, California, United States of America
| | - Sara Mostafavi
- Department of Computer Science, Stanford University, Stanford, California, United States of America
| | - Alexis Battle
- Department of Computer Science, Stanford University, Stanford, California, United States of America
| | - Carol Feghali-Bostwick
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | - Glenn Rosen
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, California, United States of America
- * E-mail: (TN); (GR); (SBM)
| | - Stephen B. Montgomery
- Department of Pathology, Stanford University, Stanford, California, United States of America
- * E-mail: (TN); (GR); (SBM)
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Braun K, Cruaux L, Fabris R, Morran J, Ho L, Drikas M. Comparison of coagulation and MIEX pre-treatment processes for bacterial and turbidity removal, utilizing real-time optical monitoring techniques. Environ Technol 2014; 35:1038-1045. [PMID: 24645488 DOI: 10.1080/09593330.2013.859737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Jar testing and flow cytometry were used in conjunction with photometric dispersion analysis (PDA) to assess conventional alum coagulation with and without magnetic ion exchange (MIEX) pre-treatment for turbidity and bacterial removal capacity. Treatment assessment included powdered activated carbon (PAC) and pre-chlorination of the MIEX-treated raw water. Floc particles were subjected to shear forces after settling and re-suspended to gauge bacterial release potential, floc breakage and re-aggregation. MIEX in conjunction with alum coagulation achieved improved coagulation as measured by PDA but did not increase bacterial log removal value (LRV) in comparison with conventional coagulation. Pre-chlorination and PAC addition were seen to improve bacterial removal and coagulation, respectively, but were less effective for bacterial LRVs when they were used in conjunction during coagulation.
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Tsai H, Miyai T, Ho L, Upadhyay D. Unique Presentation of Silicone Embolism Syndrome. Chest 2013. [DOI: 10.1378/chest.1704096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Bottineau MC, Bichet M, Martinez D, Ho L, Pittet A. Prise en charge des formes graves du paludisme du jeune enfant en zone défavorisée : expérience en RDC et les propositions de MSF Suisse. Arch Pediatr 2013. [DOI: 10.1016/s0929-693x(13)71342-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ho L, Ho G. Mitigating ammonia inhibition of thermophilic anaerobic treatment of digested piggery wastewater: use of pH reduction, zeolite, biomass and humic acid. Water Res 2012; 46:4339-4350. [PMID: 22739499 DOI: 10.1016/j.watres.2012.05.016] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 04/29/2012] [Accepted: 05/08/2012] [Indexed: 06/01/2023]
Abstract
High free ammonia released during anaerobic digestion of livestock wastes is widely known to inhibit methanogenic microorganisms and result in low methane production. This was encountered during our earlier thermophilic semi-continuously fed continuously-stirred tank reactor (CSTR) treatment of piggery wastewater. This study explored chemical and biological means to mitigate ammonia inhibition on thermophilic anaerobic treatment of piggery wastewater with the aim to increase organic volatile carbon reduction and methane production. A series of thermophilic anaerobic batch experiments were conducted on the digested piggery effluent to investigate the effects of pH reduction (pH 8.3 to 7.5, 7.0 and 6.5) and additions of biomass (10% v/v and 19% v/v anaerobic digested piggery biomass and aerobic-anaerobic digested municipal biomass), natural zeolite (10, 15 and 20 g/L) and humic acid (1, 5 and 10 g/L) on methane production at 55 °C for 9-11 days. Reduction of the wastewater pH from its initial pH of 8.3 to 6.5 produced the greatest stimulation of methane production (3.4 fold) coupled with reductions in free ammonia (38 fold) and total volatile fatty acids (58% TVFA), particularly acetate and propionate. Addition of 10-20 g/L zeolite to piggery wastewater with and without pH reduction to 6.5 further enhanced total VFA reduction and methane production over their respective controls, with 20 g/L zeolite producing the highest enhancement effect despite the ammonia-nitrogen concentrations of the treated wastewaters remaining high. Without pH reduction, zeolite concentration up to 20 g/L was required to achieve comparable methane enhancement as the pH-reduced wastewater at pH 6.5. Although biomass (10% v/v piggery and municipal wastes) and low humic acid (1 and 5 g/L) additions enhanced total VFA reduction and methane production, they elevated the residual effluent total COD concentrations over the control wastewaters (pH-unadjusted and pH-reduced) unlike zeolite treatment. The outcomes from these batch experiments support the use of pH reduction to 6.5 and zeolite treatment (10-20 g/L) as effective strategies to mitigate ammonia inhibition of the thermophilic anaerobic treatment of piggery wastewater.
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Affiliation(s)
- L Ho
- School of Environmental Science, Murdoch University, 90 South Street, Murdoch, Perth WA 6163, Australia.
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Ho L, Rudenko D, Kuliszewski M, Stone S, Yuen N, House J, Leong-poi H, Keith M. 169 B Vitamin Supplementation Reduces the Endogenous Upregulation of Pro-Angiogenic Genes eNOS and VEGF in Response to Acute Hindlimb Ischemia. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Yuen N, Stone S, Liao C, Kuliszewski M, Ho L, Luck H, Shani K, Perri P, Tadic I, Granatstein J, House J, Leong-Poi H, Keith M. 533 B6 Deficiency Enhances Early Angiogenic Response to Ischemia in Vivo and in Vitro. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ho S, Ho L. Effects of facilitated swaddling for controlling procedural pain in premature neonates: a randomized controlled trial. The Journal of Pain 2012. [DOI: 10.1016/j.jpain.2012.01.246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shalini S, Dorstyn L, Wilson C, Puccini J, Ho L, Kumar S. Impaired antioxidant defence and accumulation of oxidative stress in caspase-2-deficient mice. Cell Death Differ 2012; 19:1370-80. [PMID: 22343713 DOI: 10.1038/cdd.2012.13] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Caspase-2 has been implicated in apoptosis and in non-apoptotic processes such as cell cycle regulation, tumor suppression and ageing. Using caspase-2 knockout (casp2(-/-)) mice, we show here that the putative anti-ageing role of this caspase is due in part to its involvement in the stress response pathway. The old casp2(-/-) mice show increased cellular levels of oxidized proteins, lipid peroxides and DNA damage, suggesting enhanced oxidative stress. Furthermore, murine embryonic fibroblasts from casp2(-/-) mice showed increased reactive oxygen species generation when challenged with pro-oxidants. Reduced activities of antioxidant enzymes glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were observed in the old casp2(-/-) mice. Interestingly, in the old casp2(-/-) animals expression of FoxO1 and FoxO3a was significantly reduced, whereas p21 levels and the number of senescent hepatocytes were elevated. In contrast to young wild-type mice, the casp2(-/-) animals fed an on ethanol-based diet failed to show enhanced GSH-Px and SOD activities. Thus, caspase-2, most likely via FoxO transcription factors, regulates the oxidative stress response in vivo.
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Affiliation(s)
- S Shalini
- Centre for Cancer Biology, SA Pathology, Adelaide, Australia
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Havermeyer F, Ho L, Moser C. Compact single mode tunable laser using a digital micromirror device. Opt Express 2011; 19:14642-14652. [PMID: 21934826 DOI: 10.1364/oe.19.014642] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The wavelength tuning properties of a tunable external cavity laser based on multiplexed volume holographic gratings and a commercial micromirror device are reported. The 3x3x3 cm(3) laser exhibits single mode operation in single or multi colors between 776 nm and 783 nm with less than 7.5 MHz linewidth, 37 mW output power, 50 μs rise/fall time constant and a maximum switching rate of 0.66 KHz per wavelength. The unique discrete-wavelength-switching features of this laser are also well suited as a source for continuous wave Terahertz generation and three-dimensional metrology.
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Guo Y, Palmer J, Forman A, Ho L, Tummala S, Fisch M. OP1 Adherence to 6-month oral alpha lipoic acid for prevention of platinum-induced polyneuropathy. EJC Suppl 2011. [DOI: 10.1016/j.ejcsup.2011.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Chandrappa P, Ho L. Case report of treatment resistant schizophreniaresponding to high dose quetiapine following clozapine withdrawal due to neutropenia. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)73064-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
IntroductionPatients suffering from treatment-resistant schizophrenia pose a difficult therapeutic challenge. Although Clozapine is a well-established treatment in such cases, there is a significant proportion of patients who have to discontinue Clozapine due to life-threatening side-effects, despite achieving good therapeutic response. There is very limited literature on the therapeutic alternatives to Clozapine in the treatment of resistant schizophrenia.ObjectiveTo report a case of resistant schizophrenia responding to high dose Quetiapine, following discontinuation of Clozapine due to neutropenia.Clinical details of the case: We are presenting a case of a forty-two year old female patient with treatment resistant schizophrenia who achieved remission following treatment with Clozapine, but had to discontinue treatment due to neutropenia, which occurred on two occasions. Clozapine discontinuation resulted in rapid and severe relapse in her condition and re-admission to hospital. Quetiapine was initiated as this stage, but only partial improvement was noted at the manufacturer's stated maximum daily dose of 800 mg/day. Since the drug was being well tolerated the dose was gradually further increased.ResultsThe dose of Quetiapine was eventually increased up to 1400 mg/day, which produced significant response and the patient was discharged from hospital. Quetiapine at this dose was well tolerated with minimal side effects.ConclusionThe above report indicates that high-dose Quetiapine is a viable alternative to Clozapine in treating refractory schizophrenia. The findings from this report support further investigation of this approach in the form of larger scale clinical trials.
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Dixon MB, Richard Y, Ho L, Chow CWK, O'Neill BK, Newcombe G. Integrated membrane systems incorporating coagulation, activated carbon and ultrafiltration for the removal of toxic cyanobacterial metabolites from Anabaena circinalis. Water Sci Technol 2011; 63:1405-1411. [PMID: 21508543 DOI: 10.2166/wst.2011.318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The use of integrated membrane systems (a train of treatment processes incorporating one or more membranes) is increasing globally as the technology is very effective for the production of high quality drinking water. In this investigation a laboratory scale integrated membrane system (IMS) featuring coagulation, powdered activated carbon (PAC) and ultrafiltration (UF) was investigated for the removal of an Australian strain of the cyanobacteria Anabaena circinalis and the cyanotoxin it produced. Three coagulants were compared, aluminium chlorohydrate (ACH), aluminium sulphate (alum) and an engineered aluminium coagulant referred to as high performance aluminium chlorohydrate (HPAC). PAC (Acticarb PS1000) was tested to determine adsorption of extracellular saxitoxin. Removal of A. circinalis cells was 100% by UF alone and the removal of cells prior to the membrane by coagulation reduced fouling attributed to algogenic organic material. Alum was the least efficient coagulant for removal of cells while ACH and HPAC were similar. Saxitoxin removal reached a maximum of 80% using ACH and PAC. The UF-IMS was challenged using a natural bloom of A. circinalis that occurred in the Myponga Reservoir in South Australia.
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Affiliation(s)
- M B Dixon
- Australian Water Quality Centre, SA Water Corporation, Adelaide, Australia.
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Ho L, Wassef H, Seto J. FDG PET/CT imaging in granulomatous changes secondary to breast silicone injection. Clin Radiol 2010; 65:659-61. [PMID: 20599069 DOI: 10.1016/j.crad.2010.02.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Revised: 02/11/2010] [Accepted: 02/16/2010] [Indexed: 11/19/2022]
Affiliation(s)
- L Ho
- PET Imaging Science Center, Division of Nuclear Medicine, Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
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Dixon MB, Falconet C, Ho L, Chow CWK, O'Neill BK, Newcombe G. Nanofiltration for the removal of algal metabolites and the effects of fouling. Water Sci Technol 2010; 61:1189-1199. [PMID: 20220241 DOI: 10.2166/wst.2010.903] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Nanofiltration (NF) has been shown to be an effective way of removing organic micropollutants from drinking water due to its size exclusion properties. A rapid bench scale membrane test unit was utilised to trial six NF membranes to remove the algal metabolites, microcystin, cylindrospermopsin, 2-methylisoborneol (MIB) and geosmin (GSM). Membrane fouling due to the algal metabolites was observed for both charged and neutral metabolites. MIB and GSM were removed effectively by low molecular weight cut-off (MWCO) membranes but less effectively by a higher MWCO membrane. Removal of MIB and GSM by the higher MWCO membrane was improved as the membrane fouled. Microcystin was initially removed to above 90% by tight NF membranes but fouling of several membranes caused decreased percent removals over time. Tight NF membranes afforded removals of 90-100% for cylindrospermopsin, while removal by the higher MWCO membrane was lower but improved with time due to fouling.
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Affiliation(s)
- M B Dixon
- Australian Water Quality Centre, SA Water Corporation, Adelaide, SA 5001, Australia.
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Lomanto D, Chua HC, Myat MM, So J, Shabbir A, Ho L. Microbiological contamination during transgastric and transvaginal endoscopic techniques. J Laparoendosc Adv Surg Tech A 2009; 19:465-9. [PMID: 19575634 DOI: 10.1089/lap.2009.0007] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Natural orifice transluminal endoscopic surgery (NOTES) has gained widespread interest as a potentially alternative to laparoscopic surgery, but concerns over peritoneal contaminations are unsolved. The aim of our study was to assess the safety of transluminal surgery by investigating the intraperitoneal bacterial load and contamination during transgastric and transvaginal surgeries. Twelve female pigs underwent transgastric (n = 7; tubal ligation and oophorectomy) and transvaginal procedures (n = 5; cholecystectomy). All animals were sacrificed after 2 weeks. The procedures were performed by using a double-channel endoscope (GIF-2T160; Olympus, Tokyo, Japan) under general anesthesia. Peritoneal fluid sampling was taken immediately after entry into the abdomen, at the end of the surgical procedure and during the autopsy, and sent for microbiologic assessment. In the transgastric group, 6 animals completed the surgical procedures and survived. Three pigs experienced signs of postoperative peritonitis with abscesses and adhesions visible and Escherichia Coli isolated at autopsy. In the transvaginal group, a cholecystectomy was performed without technical problems in all animals. No signs of postoperative sepsis nor growth in the microbiologic samples were recorded. In conclusion, the transvaginal approach seemed to be safer and produced less intra-abdominal contamination and sepsis, compared to the transgastric approach. Although both transgastric tubal ligation and oophorectomy and transvaginal cholecystectomy were feasible using equipment and accessories currently available for conventional endoscopy, new procedure-specific instruments and equipment should be developed to allow the operator safer access into the peritoneum.
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Affiliation(s)
- Davide Lomanto
- Department of Surgery, Minimally Invasive Surgical Center, National University Health System, 5 Lower Kent Ridge Road, Singapore.
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Skillman LC, Bajsa O, Ho L, Santhanam B, Kumar M, Ho G. Influence of high gas production during thermophilic anaerobic digestion in pilot-scale and lab-scale reactors on survival of the thermotolerant pathogens Clostridium perfringens and Campylobacter jejuni in piggery wastewater. Water Res 2009; 43:3281-3291. [PMID: 19500814 DOI: 10.1016/j.watres.2009.04.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 03/09/2009] [Accepted: 04/20/2009] [Indexed: 05/27/2023]
Abstract
Safe reuse of animal wastes to capture energy and nutrients, through anaerobic digestion processes, is becoming an increasingly desirable solution to environmental pollution. Pathogen decay is the most important safety consideration and is in general, improved at elevated temperatures and longer hydraulic residence times. During routine sampling to assess pathogen decay in thermophilic digestion, an inversely proportional relationship between levels of Clostridium perfringens and gas production was observed. Further samples were collected from pilot-scale, bench-scale thermophilic reactors and batch scale vials to assess whether gas production (predominantly methane) could be a useful indicator of decay of the thermotolerant pathogens C. perfringens and Campylobacter jejuni. Pathogen levels did appear to be lower where gas production and levels of methanogens were higher. This was evident at each operating temperature (50, 57, 65 degrees C) in the pilot-scale thermophilic digesters, although higher temperatures also reduced the numbers of pathogens detected. When methane production was higher, either when feed rate was increased, or pH was lowered from 8.2 (piggery wastewater) to 6.5, lower numbers of pathogens were detected. Although a number of related factors are known to influence the amount and rate of methane production, it may be a useful indicator of the removal of the pathogens C. perfringens and C. jejuni.
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Affiliation(s)
- L C Skillman
- Western Australian State Agricultural Biotechnology Centre, Lonergan Building, Murdoch University, Perth, WA 6150, Australia.
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