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Cornish EE, Wickremasinghe S, Mehta H, Lim L, Sandhu SS, Nguyen V, Gillies MC, Fraser-Bell S. Aflibercept monotherapy versus aflibercept with targeted retinal laser to peripheral retinal ischemia for diabetic macular oedema (LADAMO). Eye (Lond) 2023; 37:3417-3422. [PMID: 37069239 PMCID: PMC10630305 DOI: 10.1038/s41433-023-02525-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 03/21/2023] [Accepted: 04/05/2023] [Indexed: 04/19/2023] Open
Abstract
OBJECTIVE We tested the hypothesis that targeted retinal laser photocoagulation (TPRP) to peripheral retinal ischaemia reduces the overall burden of aflibercept injections when treating diabetic macular oedema (DMO) over a 24-month period. METHODS Prospective, double-masked, multicentre, randomised controlled trial in Australia comparing aflibercept monotherapy, following a treat-and-extend protocol, or combination therapy of aflibercept and TPRP for DMO. The aflibercept monotherapy group received placebo laser. The primary outcome measure was the mean number of intravitreal aflibercept injections for each group at 24 months. Secondary outcome included: mean change in central macular thickness (CMT) and vision at trial completion, the proportion of eyes whose DMO resolved and the mean injection treatment interval. Ocular and systemic adverse events were recorded. RESULTS We enrolled 48 eyes of 47 patients; 27 eyes were randomised to combination therapy (aflibercept and TPRP) and 21 to aflibercept monotherapy. Thirty-two eyes (67%) completed the 2-year study. The number of intravitreal treatments given were similar for combination therapy (10.5 (SD 5.8) and monotherapy (11.8 (SD5.6)) (P = 0.44). The mean visual improvement (+4.0 (-1.8, 9.8) and +7.8 (2.6, 12.9) letters, P = 0.32), mean decrease in CMT (-154 (-222,-87) µm and -152 (-218,-86) µm, P = 0.96), proportion of eyes with CMT < 300 µm (48% and 67%; P = 0.50) and safety outcomes were similar in both the combination and monotherapy treatment groups (respectively). CONCLUSIONS Laser to areas of ischaemic peripheral retina does not reduce the burden of intravitreal aflibercept injections when treating diabetic macular oedema.
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Grants
- Consultant - Allergan, Bayer, Novartis, Roche
- Consultant - Bayer, Novartis, AbbVie, Speaker fees - Bayer, AbbVie
- Allergan (Allergan Inc.)
- Personal fees - Bayer, Consultant - Allergan, Novartis, Bayer Expert testimony - Bayer
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Affiliation(s)
- E E Cornish
- Save Sight Institute, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, Australia.
| | - S Wickremasinghe
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, VIC, Australia
| | - H Mehta
- Save Sight Institute, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, Australia
- Ophthalmology Department, Royal Free London, NHS Foundation Trust, London, United Kingdom
| | - L Lim
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, VIC, Australia
| | - S S Sandhu
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, VIC, Australia
| | - V Nguyen
- Save Sight Institute, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, Australia
| | - M C Gillies
- Save Sight Institute, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, Australia
| | - S Fraser-Bell
- Save Sight Institute, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, Australia
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Smitherman EA, Chahine RA, Beukelman T, Lewandowski LB, Rahman AKMF, Wenderfer SE, Curtis JR, Hersh AO, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar‐Smiley F, Barillas‐Arias L, Basiaga M, Baszis K, Becker M, Bell‐Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang‐Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel‐Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie‐Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui‐Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein‐Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PM, McGuire S, McHale I, McMonagle A, McMullen‐Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O'Brien B, O'Brien T, Okeke O, Oliver M, Olson J, O'Neil K, Onel K, Orandi A, Orlando M, Osei‐Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan‐Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas‐Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth‐Wojcicki E, Rouster – Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert‐Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner‐Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Childhood-Onset Lupus Nephritis in the Childhood Arthritis and Rheumatology Research Alliance Registry: Short-Term Kidney Status and Variation in Care. Arthritis Care Res (Hoboken) 2023; 75:1553-1562. [PMID: 36775844 PMCID: PMC10500561 DOI: 10.1002/acr.25002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/14/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The goal was to characterize short-term kidney status and describe variation in early care utilization in a multicenter cohort of patients with childhood-onset systemic lupus erythematosus (cSLE) and nephritis. METHODS We analyzed previously collected prospective data from North American patients with cSLE with kidney biopsy-proven nephritis enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry from March 2017 through December 2019. We determined the proportion of patients with abnormal kidney status at the most recent registry visit and applied generalized linear mixed models to identify associated factors. We also calculated frequency of medication use, both during induction and ever recorded. RESULTS We identified 222 patients with kidney biopsy-proven nephritis, with 64% class III/IV nephritis on initial biopsy. At the most recent registry visit at median (interquartile range) of 17 (8-29) months from initial kidney biopsy, 58 of 106 patients (55%) with available data had abnormal kidney status. This finding was associated with male sex (odds ratio [OR] 3.88, 95% confidence interval [95% CI] 1.21-12.46) and age at cSLE diagnosis (OR 1.23, 95% CI 1.01-1.49). Patients with class IV nephritis were more likely than class III to receive cyclophosphamide and rituximab during induction. There was substantial variation in mycophenolate, cyclophosphamide, and rituximab ever use patterns across rheumatology centers. CONCLUSION In this cohort with predominately class III/IV nephritis, male sex and older age at cSLE diagnosis were associated with abnormal short-term kidney status. We also observed substantial variation in contemporary medication use for pediatric lupus nephritis between pediatric rheumatology centers. Additional studies are needed to better understand the impact of this variation on long-term kidney outcomes.
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Lim L, Hulsebosch SE, Gilor C, Reagan KL, Kopecny L, Maggiore AD, Phillips KL, Kass PH, Vernau W, Nelson RW. Re-evaluation of the low-dose dexamethasone suppression test in dogs. J Small Anim Pract 2023; 64:12-20. [PMID: 36089334 DOI: 10.1111/jsap.13553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES This study aims to re-evaluate the low-dose dexamethasone suppression test 8-hour cortisol cut-point for the diagnosis of hypercortisolism in dogs using a solid-phase, competitive chemiluminescent enzyme immunoassay. MATERIALS AND METHODS Twenty-seven client-owned dogs with naturally occurring hypercortisolism and 30 healthy control dogs were prospectively recruited. Performance of the low-dose dexamethasone suppression test was assessed using sensitivity, specificity and a receiver operating characteristic curve compared to a clinical diagnosis of hypercortisolism including response to treatment. RESULTS Twenty-four dogs were diagnosed with pituitary-dependent hypercortisolism and three with adrenal-dependent hypercortisolism. In 30 healthy control dogs, 8-hour post-dexamethasone cortisol concentrations ranged from 5.5 to 39 nmol/L. A receiver operating characteristic curve curve constructed from the 8-hour post-dexamethasone cortisol concentrations of hypercortisolism and control dogs demonstrated that the most discriminatory cut-point was more than 39 nmol/L with sensitivity of 85.2% (95% confidence interval, 67.5% to 94.1%) and specificity of 100% (95% confidence interval, 88.7% to 100.0%) and an area under the curve of 0.963. CLINICAL SIGNIFICANCE The optimal cut-point of more than 36 nmol/L proposed by this study is similar to the currently accepted 8-hour cortisol concentration cut-point for diagnosing hypercortisolism when using a solid-phase, competitive chemiluminescent enzyme immunoassay.
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Affiliation(s)
- L Lim
- Veterinary Medical Teaching Hospital, University of California-Davis, Davis, California, USA
| | - S E Hulsebosch
- Department of Medicine & Epidemiology, University of California-Davis, Davis, California, USA
| | - C Gilor
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, Florida, USA
| | - K L Reagan
- Department of Medicine & Epidemiology, University of California-Davis, Davis, California, USA
| | - L Kopecny
- Veterinary Medical Teaching Hospital, University of California-Davis, Davis, California, USA
| | - A D Maggiore
- Department of Medicine & Epidemiology, University of California-Davis, Davis, California, USA
| | - K L Phillips
- Department of Surgical & Radiological Sciences, University of California-Davis, Davis, California, USA
| | - P H Kass
- Department of Population Health and Reproduction, University of California-Davis, Davis, California, USA
| | - W Vernau
- Department of Pathology, Microbiology & Immunology, University of California-Davis, Davis, California, USA
| | - R W Nelson
- Department of Medicine & Epidemiology, University of California-Davis, Davis, California, USA
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4
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Hahn T, Daymont C, Beukelman T, Groh B, Hays K, Bingham CA, Scalzi L, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Intraarticular steroids as DMARD-sparing agents for juvenile idiopathic arthritis flares: Analysis of the Childhood Arthritis and Rheumatology Research Alliance Registry. Pediatr Rheumatol Online J 2022; 20:107. [PMID: 36434731 PMCID: PMC9701017 DOI: 10.1186/s12969-022-00770-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Children with juvenile idiopathic arthritis (JIA) who achieve a drug free remission often experience a flare of their disease requiring either intraarticular steroids (IAS) or systemic treatment with disease modifying anti-rheumatic drugs (DMARDs). IAS offer an opportunity to recapture disease control and avoid exposure to side effects from systemic immunosuppression. We examined a cohort of patients treated with IAS after drug free remission and report the probability of restarting systemic treatment within 12 months. METHODS We analyzed a cohort of patients from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry who received IAS for a flare after a period of drug free remission. Historical factors and clinical characteristics and of the patients including data obtained at the time of treatment were analyzed. RESULTS We identified 46 patients who met the inclusion criteria. Of those with follow up data available 49% had restarted systemic treatment 6 months after IAS injection and 70% had restarted systemic treatment at 12 months. The proportion of patients with prior use of a biologic DMARD was the only factor that differed between patients who restarted systemic treatment those who did not, both at 6 months (79% vs 35%, p < 0.01) and 12 months (81% vs 33%, p < 0.05). CONCLUSION While IAS are an option for all patients who flare after drug free remission, it may not prevent the need to restart systemic treatment. Prior use of a biologic DMARD may predict lack of success for IAS. Those who previously received methotrexate only, on the other hand, are excellent candidates for IAS.
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Affiliation(s)
- Timothy Hahn
- Department of Pediatrics, Penn State Children's Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA, 17033-0855, USA.
| | - Carrie Daymont
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Timothy Beukelman
- grid.265892.20000000106344187Department of Pediatrics, University of Alabama at Birmingham, CPPN G10, 1600 7th Ave South, Birmingham, AL 35233 USA
| | - Brandt Groh
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | | | - Catherine April Bingham
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
| | - Lisabeth Scalzi
- grid.240473.60000 0004 0543 9901Department of Pediatrics, Penn State Children’s Hospital, 500 University Dr, Hershey, 90 Hope Drive, P.O. Box 855, Hershey, PA 17033-0855 USA
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Evans RA, Leavy OC, Richardson M, Elneima O, McAuley HJC, Shikotra A, Singapuri A, Sereno M, Saunders RM, Harris VC, Houchen-Wolloff L, Aul R, Beirne P, Bolton CE, Brown JS, Choudhury G, Diar-Bakerly N, Easom N, Echevarria C, Fuld J, Hart N, Hurst J, Jones MG, Parekh D, Pfeffer P, Rahman NM, Rowland-Jones SL, Shah AM, Wootton DG, Chalder T, Davies MJ, De Soyza A, Geddes JR, Greenhalf W, Greening NJ, Heaney LG, Heller S, Howard LS, Jacob J, Jenkins RG, Lord JM, Man WDC, McCann GP, Neubauer S, Openshaw PJM, Porter JC, Rowland MJ, Scott JT, Semple MG, Singh SJ, Thomas DC, Toshner M, Lewis KE, Thwaites RS, Briggs A, Docherty AB, Kerr S, Lone NI, Quint J, Sheikh A, Thorpe M, Zheng B, Chalmers JD, Ho LP, Horsley A, Marks M, Poinasamy K, Raman B, Harrison EM, Wain LV, Brightling CE, Abel K, Adamali H, Adeloye D, Adeyemi O, Adrego R, Aguilar Jimenez LA, Ahmad S, Ahmad Haider N, Ahmed R, Ahwireng N, Ainsworth M, Al-Sheklly B, Alamoudi A, Ali M, Aljaroof M, All AM, Allan L, Allen RJ, Allerton L, Allsop L, Almeida P, Altmann D, Alvarez Corral M, Amoils S, Anderson D, Antoniades C, Arbane G, Arias A, Armour C, Armstrong L, Armstrong N, Arnold D, Arnold H, Ashish A, Ashworth A, Ashworth M, Aslani S, Assefa-Kebede H, Atkin C, Atkin P, Aung H, Austin L, Avram C, Ayoub A, Babores M, Baggott R, Bagshaw J, Baguley D, Bailey L, Baillie JK, Bain S, Bakali M, Bakau M, Baldry E, Baldwin D, Ballard C, Banerjee A, Bang B, Barker RE, Barman L, Barratt S, Barrett F, Basire D, Basu N, Bates M, Bates A, Batterham R, Baxendale H, Bayes H, Beadsworth M, Beckett P, Beggs M, Begum M, Bell D, Bell R, Bennett K, Beranova E, Bermperi A, Berridge A, Berry C, Betts S, Bevan E, Bhui K, Bingham M, Birchall K, Bishop L, Bisnauthsing K, Blaikely J, Bloss A, Bolger A, Bonnington J, Botkai A, Bourne C, Bourne M, Bramham K, Brear L, Breen G, Breeze J, Bright E, Brill S, Brindle K, Broad L, Broadley A, Brookes C, Broome M, Brown A, Brown A, Brown J, Brown J, Brown M, Brown M, Brown V, Brugha T, Brunskill N, Buch M, Buckley P, Bularga A, Bullmore E, Burden L, Burdett T, Burn D, Burns G, Burns A, Busby J, Butcher R, Butt A, Byrne S, Cairns P, Calder PC, Calvelo E, Carborn H, Card B, Carr C, Carr L, Carson G, Carter P, Casey A, Cassar M, Cavanagh J, Chablani M, Chambers RC, Chan F, Channon KM, Chapman K, Charalambou A, Chaudhuri N, Checkley A, Chen J, Cheng Y, Chetham L, Childs C, Chilvers ER, Chinoy H, Chiribiri A, Chong-James K, Choudhury N, Chowienczyk P, Christie C, Chrystal M, Clark D, Clark C, Clarke J, Clohisey S, Coakley G, Coburn Z, Coetzee S, Cole J, Coleman C, Conneh F, Connell D, Connolly B, Connor L, Cook A, Cooper B, Cooper J, Cooper S, Copeland D, Cosier T, Coulding M, Coupland C, Cox E, Craig T, Crisp P, Cristiano D, Crooks MG, Cross A, Cruz I, Cullinan P, Cuthbertson D, Daines L, Dalton M, Daly P, Daniels A, Dark P, Dasgin J, David A, David C, Davies E, Davies F, Davies G, Davies GA, Davies K, Dawson J, Daynes E, Deakin B, Deans A, Deas C, Deery J, Defres S, Dell A, Dempsey K, Denneny E, Dennis J, Dewar A, Dharmagunawardena R, Dickens C, Dipper A, Diver S, Diwanji SN, Dixon M, Djukanovic R, Dobson H, Dobson SL, Donaldson A, Dong T, Dormand N, Dougherty A, Dowling R, Drain S, Draxlbauer K, Drury K, Dulawan P, Dunleavy A, Dunn S, Earley J, Edwards S, Edwardson C, El-Taweel H, Elliott A, Elliott K, Ellis Y, Elmer A, Evans D, Evans H, Evans J, Evans R, Evans RI, Evans T, Evenden C, Evison L, Fabbri L, Fairbairn S, Fairman A, Fallon K, Faluyi D, Favager C, Fayzan T, Featherstone J, Felton T, Finch J, Finney S, Finnigan J, Finnigan L, Fisher H, Fletcher S, Flockton R, Flynn M, Foot H, Foote D, Ford A, Forton D, Fraile E, Francis C, Francis R, Francis S, Frankel A, Fraser E, Free R, French N, Fu X, Furniss J, Garner L, Gautam N, George J, George P, Gibbons M, Gill M, Gilmour L, Gleeson F, Glossop J, Glover S, Goodman N, Goodwin C, Gooptu B, Gordon H, Gorsuch T, Greatorex M, Greenhaff PL, Greenhalgh A, Greenwood J, Gregory H, Gregory R, Grieve D, Griffin D, Griffiths L, Guerdette AM, Guillen Guio B, Gummadi M, Gupta A, Gurram S, Guthrie E, Guy Z, H Henson H, Hadley K, Haggar A, Hainey K, Hairsine B, Haldar P, Hall I, Hall L, Halling-Brown M, Hamil R, Hancock A, Hancock K, Hanley NA, Haq S, Hardwick HE, Hardy E, Hardy T, Hargadon B, Harrington K, Harris E, Harrison P, Harvey A, Harvey M, Harvie M, Haslam L, Havinden-Williams M, Hawkes J, Hawkings N, Haworth J, Hayday A, Haynes M, Hazeldine J, Hazelton T, Heeley C, Heeney JL, Heightman M, Henderson M, Hesselden L, Hewitt M, Highett V, Hillman T, Hiwot T, Hoare A, Hoare M, Hockridge J, Hogarth P, Holbourn A, Holden S, Holdsworth L, Holgate D, Holland M, Holloway L, Holmes K, Holmes M, Holroyd-Hind B, Holt L, Hormis A, Hosseini A, Hotopf M, Howard K, Howell A, Hufton E, Hughes AD, Hughes J, Hughes R, Humphries A, Huneke N, Hurditch E, Husain M, Hussell T, Hutchinson J, Ibrahim W, Ilyas F, Ingham J, Ingram L, Ionita D, Isaacs K, Ismail K, Jackson T, James WY, Jarman C, Jarrold I, Jarvis H, Jastrub R, Jayaraman B, Jezzard P, Jiwa K, Johnson C, Johnson S, Johnston D, Jolley CJ, Jones D, Jones G, Jones H, Jones H, Jones I, Jones L, Jones S, Jose S, Kabir T, Kaltsakas G, Kamwa V, Kanellakis N, Kaprowska S, Kausar Z, Keenan N, Kelly S, Kemp G, Kerslake H, Key AL, Khan F, Khunti K, Kilroy S, King B, King C, Kingham L, Kirk J, Kitterick P, Klenerman P, Knibbs L, Knight S, Knighton A, Kon O, Kon S, Kon SS, Koprowska S, Korszun A, Koychev I, Kurasz C, Kurupati P, Laing C, Lamlum H, Landers G, Langenberg C, Lasserson D, Lavelle-Langham L, Lawrie A, Lawson C, Lawson C, Layton A, Lea A, Lee D, Lee JH, Lee E, Leitch K, Lenagh R, Lewis D, Lewis J, Lewis V, Lewis-Burke N, Li X, Light T, Lightstone L, Lilaonitkul W, Lim L, Linford S, Lingford-Hughes A, Lipman M, Liyanage K, Lloyd A, Logan S, Lomas D, Loosley R, Lota H, Lovegrove W, Lucey A, Lukaschuk E, Lye A, Lynch C, MacDonald S, MacGowan G, Macharia I, Mackie J, Macliver L, Madathil S, Madzamba G, Magee N, Magtoto MM, Mairs N, Majeed N, Major E, Malein F, Malim M, Mallison G, Mandal S, Mangion K, Manisty C, Manley R, March K, Marciniak S, Marino P, Mariveles M, Marouzet E, Marsh S, Marshall B, Marshall M, Martin J, Martineau A, Martinez LM, Maskell N, Matila D, Matimba-Mupaya W, Matthews L, Mbuyisa A, McAdoo S, Weir McCall J, McAllister-Williams H, McArdle A, McArdle P, McAulay D, McCormick J, McCormick W, McCourt P, McGarvey L, McGee C, Mcgee K, McGinness J, McGlynn K, McGovern A, McGuinness H, McInnes IB, McIntosh J, McIvor E, McIvor K, McLeavey L, McMahon A, McMahon MJ, McMorrow L, Mcnally T, McNarry M, McNeill J, McQueen A, McShane H, Mears C, Megson C, Megson S, Mehta P, Meiring J, Melling L, Mencias M, Menzies D, Merida Morillas M, Michael A, Milligan L, Miller C, Mills C, Mills NL, Milner L, Misra S, Mitchell J, Mohamed A, Mohamed N, Mohammed S, Molyneaux PL, Monteiro W, Moriera S, Morley A, Morrison L, Morriss R, Morrow A, Moss AJ, Moss P, Motohashi K, Msimanga N, Mukaetova-Ladinska E, Munawar U, Murira J, Nanda U, Nassa H, Nasseri M, Neal A, Needham R, Neill P, Newell H, Newman T, Newton-Cox A, Nicholson T, Nicoll D, Nolan CM, Noonan MJ, Norman C, Novotny P, Nunag J, Nwafor L, Nwanguma U, Nyaboko J, O'Donnell K, O'Brien C, O'Brien L, O'Regan D, Odell N, Ogg G, Olaosebikan O, Oliver C, Omar Z, Orriss-Dib L, Osborne L, Osbourne R, Ostermann M, Overton C, Owen J, Oxton J, Pack J, Pacpaco E, Paddick S, Painter S, Pakzad A, Palmer S, Papineni P, Paques K, Paradowski K, Pareek M, Parfrey H, Pariante C, Parker S, Parkes M, Parmar J, Patale S, Patel B, Patel M, Patel S, Pattenadk D, Pavlides M, Payne S, Pearce L, Pearl JE, Peckham D, Pendlebury J, Peng Y, Pennington C, Peralta I, Perkins E, Peterkin Z, Peto T, Petousi N, Petrie J, Phipps J, Pimm J, Piper Hanley K, Pius R, Plant H, Plein S, Plekhanova T, Plowright M, Polgar O, Poll L, Porter J, Portukhay S, Powell N, Prabhu A, Pratt J, Price A, Price C, Price C, Price D, Price L, Price L, Prickett A, Propescu J, Pugmire S, Quaid S, Quigley J, Qureshi H, Qureshi IN, Radhakrishnan K, Ralser M, Ramos A, Ramos H, Rangeley J, Rangelov B, Ratcliffe L, Ravencroft P, Reddington A, Reddy R, Redfearn H, Redwood D, Reed A, Rees M, Rees T, Regan K, Reynolds W, Ribeiro C, Richards A, Richardson E, Rivera-Ortega P, Roberts K, Robertson E, Robinson E, Robinson L, Roche L, Roddis C, Rodger J, Ross A, Ross G, Rossdale J, Rostron A, Rowe A, Rowland A, Rowland J, Roy K, Roy M, Rudan I, Russell R, Russell E, Saalmink G, Sabit R, Sage EK, Samakomva T, Samani N, Sampson C, Samuel K, Samuel R, Sanderson A, Sapey E, Saralaya D, Sargant J, Sarginson C, Sass T, Sattar N, Saunders K, Saunders P, Saunders LC, Savill H, Saxon W, Sayer A, Schronce J, Schwaeble W, Scott K, Selby N, Sewell TA, Shah K, Shah P, Shankar-Hari M, Sharma M, Sharpe C, Sharpe M, Shashaa S, Shaw A, Shaw K, Shaw V, Shelton S, Shenton L, Shevket K, Short J, Siddique S, Siddiqui S, Sidebottom J, Sigfrid L, Simons G, Simpson J, Simpson N, Singh C, Singh S, Sissons D, Skeemer J, Slack K, Smith A, Smith D, Smith S, Smith J, Smith L, Soares M, Solano TS, Solly R, Solstice AR, Soulsby T, Southern D, Sowter D, Spears M, Spencer LG, Speranza F, Stadon L, Stanel S, Steele N, Steiner M, Stensel D, Stephens G, Stephenson L, Stern M, Stewart I, Stimpson R, Stockdale S, Stockley J, Stoker W, Stone R, Storrar W, Storrie A, Storton K, Stringer E, Strong-Sheldrake S, Stroud N, Subbe C, Sudlow CL, Suleiman Z, Summers C, Summersgill C, Sutherland D, Sykes DL, Sykes R, Talbot N, Tan AL, Tarusan L, Tavoukjian V, Taylor A, Taylor C, Taylor J, Te A, Tedd H, Tee CJ, Teixeira J, Tench H, Terry S, Thackray-Nocera S, Thaivalappil F, Thamu B, Thickett D, Thomas C, Thomas S, Thomas AK, Thomas-Woods T, Thompson T, Thompson AAR, Thornton T, Tilley J, Tinker N, Tiongson GF, Tobin M, Tomlinson J, Tong C, Touyz R, Tripp KA, Tunnicliffe E, Turnbull A, Turner E, Turner S, Turner V, Turner K, Turney S, Turtle L, Turton H, Ugoji J, Ugwuoke R, Upthegrove R, Valabhji J, Ventura M, Vere J, Vickers C, Vinson B, Wade E, Wade P, Wainwright T, Wajero LO, Walder S, Walker S, Walker S, Wall E, Wallis T, Walmsley S, Walsh JA, Walsh S, Warburton L, Ward TJC, Warwick K, Wassall H, Waterson S, Watson E, Watson L, Watson J, Welch C, Welch H, Welsh B, Wessely S, West S, Weston H, Wheeler H, White S, Whitehead V, Whitney J, Whittaker S, Whittam B, Whitworth V, Wight A, Wild J, Wilkins M, Wilkinson D, Williams N, Williams N, Williams J, Williams-Howard SA, Willicombe M, Willis G, Willoughby J, Wilson A, Wilson D, Wilson I, Window N, Witham M, Wolf-Roberts R, Wood C, Woodhead F, Woods J, Wormleighton J, Worsley J, Wraith D, Wrey Brown C, Wright C, Wright L, Wright S, Wyles J, Wynter I, Xu M, Yasmin N, Yasmin S, Yates T, Yip KP, Young B, Young S, Young A, Yousuf AJ, Zawia A, Zeidan L, Zhao B, Zongo O. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med 2022; 10:761-775. [PMID: 35472304 PMCID: PMC9034855 DOI: 10.1016/s2213-2600(22)00127-8] [Citation(s) in RCA: 144] [Impact Index Per Article: 72.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/23/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. METHODS The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. FINDINGS 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. INTERPRETATION The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. FUNDING UK Research and Innovation and National Institute for Health Research.
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McIntyre C, McLeod M, Tutt T, Petersen A, Lepori-Bui N, Patel S, Monterola G, Siddiqui A, Villar K, Tran C, Bainter C, Pham T, Diaz N, Lim L, Dibian Z, Wang L, Meyer E. Process Development and Manufacturing: GROWING A CELL THERAPY FACILITY TO SUPPORT SPONSORED CLINICAL TRIALS AND COMMERCIAL CELL THERAPY PRODUCTS. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00449-2] [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: 11/03/2022]
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Soulsby WD, Balmuri N, Cooley V, Gerber LM, Lawson E, Goodman S, Onel K, Mehta B, Abel N, Abulaban K, Adams A, Adams M, Agbayani R, Aiello J, Akoghlanian S, Alejandro C, Allenspach E, Alperin R, Alpizar M, Amarilyo G, Ambler W, Anderson E, Ardoin S, Armendariz S, Baker E, Balboni I, Balevic S, Ballenger L, Ballinger S, Balmuri N, Barbar-Smiley F, Barillas-Arias L, Basiaga M, Baszis K, Becker M, Bell-Brunson H, Beltz E, Benham H, Benseler S, Bernal W, Beukelman T, Bigley T, Binstadt B, Black C, Blakley M, Bohnsack J, Boland J, Boneparth A, Bowman S, Bracaglia C, Brooks E, Brothers M, Brown A, Brunner H, Buckley M, Buckley M, Bukulmez H, Bullock D, Cameron B, Canna S, Cannon L, Carper P, Cartwright V, Cassidy E, Cerracchio L, Chalom E, Chang J, Chang-Hoftman A, Chauhan V, Chira P, Chinn T, Chundru K, Clairman H, Co D, Confair A, Conlon H, Connor R, Cooper A, Cooper J, Cooper S, Correll C, Corvalan R, Costanzo D, Cron R, Curiel-Duran L, Curington T, Curry M, Dalrymple A, Davis A, Davis C, Davis C, Davis T, De Benedetti F, De Ranieri D, Dean J, Dedeoglu F, DeGuzman M, Delnay N, Dempsey V, DeSantis E, Dickson T, Dingle J, Donaldson B, Dorsey E, Dover S, Dowling J, Drew J, Driest K, Du Q, Duarte K, Durkee D, Duverger E, Dvergsten J, Eberhard A, Eckert M, Ede K, Edelheit B, Edens C, Edens C, Edgerly Y, Elder M, Ervin B, Fadrhonc S, Failing C, Fair D, Falcon M, Favier L, Federici S, Feldman B, Fennell J, Ferguson I, Ferguson P, Ferreira B, Ferrucho R, Fields K, Finkel T, Fitzgerald M, Fleming C, Flynn O, Fogel L, Fox E, Fox M, Franco L, Freeman M, Fritz K, Froese S, Fuhlbrigge R, Fuller J, George N, Gerhold K, Gerstbacher D, Gilbert M, Gillispie-Taylor M, Giverc E, Godiwala C, Goh I, Goheer H, Goldsmith D, Gotschlich E, Gotte A, Gottlieb B, Gracia C, Graham T, Grevich S, Griffin T, Griswold J, Grom A, Guevara M, Guittar P, Guzman M, Hager M, Hahn T, Halyabar O, Hammelev E, Hance M, Hanson A, Harel L, Haro S, Harris J, Harry O, Hartigan E, Hausmann J, Hay A, Hayward K, Heiart J, Hekl K, Henderson L, Henrickson M, Hersh A, Hickey K, Hill P, Hillyer S, Hiraki L, Hiskey M, Hobday P, Hoffart C, Holland M, Hollander M, Hong S, Horwitz M, Hsu J, Huber A, Huggins J, Hui-Yuen J, Hung C, Huntington J, Huttenlocher A, Ibarra M, Imundo L, Inman C, Insalaco A, Jackson A, Jackson S, James K, Janow G, Jaquith J, Jared S, Johnson N, Jones J, Jones J, Jones J, Jones K, Jones S, Joshi S, Jung L, Justice C, Justiniano A, Karan N, Kaufman K, Kemp A, Kessler E, Khalsa U, Kienzle B, Kim S, Kimura Y, Kingsbury D, Kitcharoensakkul M, Klausmeier T, Klein K, Klein-Gitelman M, Kompelien B, Kosikowski A, Kovalick L, Kracker J, Kramer S, Kremer C, Lai J, Lam J, Lang B, Lapidus S, Lapin B, Lasky A, Latham D, Lawson E, Laxer R, Lee P, Lee P, Lee T, Lentini L, Lerman M, Levy D, Li S, Lieberman S, Lim L, Lin C, Ling N, Lingis M, Lo M, Lovell D, Lowman D, Luca N, Lvovich S, Madison C, Madison J, Manzoni SM, Malla B, Maller J, Malloy M, Mannion M, Manos C, Marques L, Martyniuk A, Mason T, Mathus S, McAllister L, McCarthy K, McConnell K, McCormick E, McCurdy D, Stokes PMC, McGuire S, McHale I, McMonagle A, McMullen-Jackson C, Meidan E, Mellins E, Mendoza E, Mercado R, Merritt A, Michalowski L, Miettunen P, Miller M, Milojevic D, Mirizio E, Misajon E, Mitchell M, Modica R, Mohan S, Moore K, Moorthy L, Morgan S, Dewitt EM, Moss C, Moussa T, Mruk V, Murphy A, Muscal E, Nadler R, Nahal B, Nanda K, Nasah N, Nassi L, Nativ S, Natter M, Neely J, Nelson B, Newhall L, Ng L, Nicholas J, Nicolai R, Nigrovic P, Nocton J, Nolan B, Oberle E, Obispo B, O’Brien B, O’Brien T, Okeke O, Oliver M, Olson J, O’Neil K, Onel K, Orandi A, Orlando M, Osei-Onomah S, Oz R, Pagano E, Paller A, Pan N, Panupattanapong S, Pardeo M, Paredes J, Parsons A, Patel J, Pentakota K, Pepmueller P, Pfeiffer T, Phillippi K, Marafon DP, Phillippi K, Ponder L, Pooni R, Prahalad S, Pratt S, Protopapas S, Puplava B, Quach J, Quinlan-Waters M, Rabinovich C, Radhakrishna S, Rafko J, Raisian J, Rakestraw A, Ramirez C, Ramsay E, Ramsey S, Randell R, Reed A, Reed A, Reed A, Reid H, Remmel K, Repp A, Reyes A, Richmond A, Riebschleger M, Ringold S, Riordan M, Riskalla M, Ritter M, Rivas-Chacon R, Robinson A, Rodela E, Rodriquez M, Rojas K, Ronis T, Rosenkranz M, Rosolowski B, Rothermel H, Rothman D, Roth-Wojcicki E, Rouster-Stevens K, Rubinstein T, Ruth N, Saad N, Sabbagh S, Sacco E, Sadun R, Sandborg C, Sanni A, Santiago L, Sarkissian A, Savani S, Scalzi L, Schanberg L, Scharnhorst S, Schikler K, Schlefman A, Schmeling H, Schmidt K, Schmitt E, Schneider R, Schollaert-Fitch K, Schulert G, Seay T, Seper C, Shalen J, Sheets R, Shelly A, Shenoi S, Shergill K, Shirley J, Shishov M, Shivers C, Silverman E, Singer N, Sivaraman V, Sletten J, Smith A, Smith C, Smith J, Smith J, Smitherman E, Soep J, Son M, Spence S, Spiegel L, Spitznagle J, Sran R, Srinivasalu H, Stapp H, Steigerwald K, Rakovchik YS, Stern S, Stevens A, Stevens B, Stevenson R, Stewart K, Stingl C, Stokes J, Stoll M, Stringer E, Sule S, Sumner J, Sundel R, Sutter M, Syed R, Syverson G, Szymanski A, Taber S, Tal R, Tambralli A, Taneja A, Tanner T, Tapani S, Tarshish G, Tarvin S, Tate L, Taxter A, Taylor J, Terry M, Tesher M, Thatayatikom A, Thomas B, Tiffany K, Ting T, Tipp A, Toib D, Torok K, Toruner C, Tory H, Toth M, Tse S, Tubwell V, Twilt M, Uriguen S, Valcarcel T, Van Mater H, Vannoy L, Varghese C, Vasquez N, Vazzana K, Vehe R, Veiga K, Velez J, Verbsky J, Vilar G, Volpe N, von Scheven E, Vora S, Wagner J, Wagner-Weiner L, Wahezi D, Waite H, Walker J, Walters H, Muskardin TW, Waqar L, Waterfield M, Watson M, Watts A, Weiser P, Weiss J, Weiss P, Wershba E, White A, Williams C, Wise A, Woo J, Woolnough L, Wright T, Wu E, Yalcindag A, Yee M, Yen E, Yeung R, Yomogida K, Yu Q, Zapata R, Zartoshti A, Zeft A, Zeft R, Zhang Y, Zhao Y, Zhu A, Zic C. Social determinants of health influence disease activity and functional disability in Polyarticular Juvenile Idiopathic Arthritis. Pediatr Rheumatol Online J 2022; 20:18. [PMID: 35255941 PMCID: PMC8903717 DOI: 10.1186/s12969-022-00676-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Social determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry. METHODS In this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months. RESULTS One thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability. CONCLUSION High community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.
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Affiliation(s)
- William Daniel Soulsby
- University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA, 94158, USA.
| | - Nayimisha Balmuri
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Victoria Cooley
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Linda M. Gerber
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Erica Lawson
- grid.266102.10000 0001 2297 6811University of California, San Francisco, 550 16th Street, 4th Floor, Box #0632, San Francisco, CA 94158 USA
| | - Susan Goodman
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Karen Onel
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
| | - Bella Mehta
- grid.239915.50000 0001 2285 8823Hospital for Special Surgery, New York, NY USA ,grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA
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Aldibekova G, Abdrakhmanova S, Lim L, Panaviene V, Starosvetova Е. [ASSESSMENT OF PHYSICAL DEVELOPMENT OF PRESCHOOL CHILDREN OF THE REPUBLIC OF KAZAKHSTAN AND RETROSPECTIVE ANALYSIS OVER THE LAST 50 YEARS]. Georgian Med News 2021:45-51. [PMID: 34749322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose - study of the physical development of preschool children, taking into account gender characteristics and comparison with identical data from the study of 1968, 1972, 1986, 2000s. Object of the research: 968 children aged 3-6 years, living in the central, southern and northern regions of the country, who underwent an anthropometric study using standard instruments. Also, the results were compared with the research data from 1968, 1972, 1986, 2000s. The body weight of boys 3-5 years old significantly exceeded that of girls (р<0.05). A significant difference in body length is obvious only at the age of 4 (р<0.05). The lengths of the arms and legs did not differ in both sexes, except for the length of the arms in 5-year-old boys with a significant predominance (p<0.05). On average, boys of the studied ages had higher body length indicators than girls (p>0,05). When conducting a comparative analysis of the body length and body weight of children in Kazakhstan with the WHO standards, there were no significant differences. At the same time, the head circumference of 3-year-old boys and 3-4-year-old girls exceeds the identical indicators according to WHO (р<0.05). This fact is possibly related to the climatic, ethnic and social-everyday characteristics of the children. The latter, once again indicates the need to develop regional standards, since WHO standards are likely to be a guideline. A comparative analysis of the basic indicators of the physical development of children over the period from 1968 to 2019 demonstrates a gradual increase in somatometric indicators in most age groups. The physical development of preschool children in the Republic of Kazakhstan at the present stage is quite harmonious. A retrospective analysis of the physical development of children aged 3-6 years over the past 50 years has shown a significant increase in body length, without a significant increase in body weight in modern children, which indicates the ongoing process of acceleration with a tendency to asthenization.
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Affiliation(s)
- G Aldibekova
- 1Non-profit Joint Stock Company «Astana Medical University», Nur-Sultan; 2Corporate funddation University Medical Center «National Research Center for Maternal and Child health», Nur-Sultan, Kazakhstan
| | - S Abdrakhmanova
- 1Non-profit Joint Stock Company «Astana Medical University», Nur-Sultan; Kazakhstan
| | - L Lim
- 1Non-profit Joint Stock Company «Astana Medical University», Nur-Sultan; Kazakhstan
| | - V Panaviene
- 3Vilnius University, Faculty of Medicine, Lithuania
| | - Е Starosvetova
- 1Non-profit Joint Stock Company «Astana Medical University», Nur-Sultan; Kazakhstan
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Jalali A, Gard G, Banks S, Dunn C, Wong HL, Wong R, Lee M, Gately L, Loft M, Shapiro JD, Kosmider S, Tie J, Ananda S, Yeung JM, Jennens R, Lee B, McKendrick J, Lim L, Khattak A, Gibbs P. Initial experience of TAS-102 chemotherapy in Australian patients with Chemo-refractory metastatic colorectal cancer. Curr Probl Cancer 2021; 46:100793. [PMID: 34565601 DOI: 10.1016/j.currproblcancer.2021.100793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 11/24/2022]
Abstract
For patients with refractory metastatic colorectal cancer (mCRC) treatment with Trifluridine/Tipiracil, also known as TAS-102, improves overall survival. This study aims to investigate the efficacy and safety of TAS-102 in a real-world population from Victoria, Australia. A retrospective analysis of prospectively collected data from the Treatment of Recurrent and Advanced Colorectal Cancer (TRACC) registry was undertaken. The characteristics and outcomes of patients receiving TAS-102 were assessed and compared to those enrolled in the registration study (RECOURSE). Across 13 sites, 107 patients were treated with TAS-102. The median age was 60 years (range: 31-83), compared to 63 for RECOURSE. Comparing registry TAS-102-treated and RECOURSE patients, 75% vs 100% were ECOG performance status 0-1, 74% vs 79% had initiated treatment more than 18 months from diagnosis of metastatic disease and 36% vs 49% were RAS wild-type. Median time on treatment was 10.4 weeks (range: 1.7-32). Median progression-free survival (PFS) was 3.3 months compared to 2 months in RECOURSE, while median overall survival was the same at 7.1 months. Two patients (2.3%) had febrile neutropenia and there were no treatment-related deaths, where TAS-102 dose at treatment initiation was at clinician discretion.TRACC registry patients treated with TAS-102 were younger than those from the RECOURSE trial, with similar overall survival observed. Less strict application of RECIST criteria and less frequent imaging may have contributed to an apparently longer PFS.
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Affiliation(s)
- A Jalali
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Western Health, VIC, Australia; Department of Medical Oncology, Latrobe Regional Hospital, VIC, Australia.
| | - G Gard
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia
| | - S Banks
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia
| | - C Dunn
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia
| | - H L Wong
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, VIC, Australia
| | - R Wong
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Eastern Health, VIC, Australia; Eastern Health Clinical School, Monash University, VIC, Australia
| | - M Lee
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Western Health, VIC, Australia; Department of Medical Oncology, Eastern Health, VIC, Australia; Eastern Health Clinical School, Monash University, VIC, Australia
| | - L Gately
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia
| | - M Loft
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia
| | - J D Shapiro
- Department of Medical Oncology, Cabrini Hospital, VIC, Australia
| | - S Kosmider
- Department of Medical Oncology, Western Health, VIC, Australia
| | - J Tie
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Western Health, VIC, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, VIC, Australia
| | - S Ananda
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Western Health, VIC, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, VIC, Australia; Department of Medical Oncology, Epworth Health, VIC, Australia
| | - J M Yeung
- Department of Surgery, Western Health, University of Melbourne, VIC, Australia; Western Health Chronic Disease Alliance, Western Health, VIC, Australia
| | - R Jennens
- Department of Medical Oncology, Epworth Health, VIC, Australia
| | - B Lee
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, VIC, Australia; Department of Medical Oncology, Northern Health, VIC, Australia
| | - J McKendrick
- Department of Medical Oncology, Eastern Health, VIC, Australia; Department of Medical Oncology, Epworth Health, VIC, Australia
| | - L Lim
- Department of Medical Oncology, Eastern Health, VIC, Australia
| | - A Khattak
- Department of Medical Oncology, Fiona Stanley Hospital, WA, Australia
| | - P Gibbs
- Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, VIC, Australia; Department of Medical Oncology, Western Health, VIC, Australia
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Denning M, Goh ET, Tan B, Kanneganti A, Almonte M, Scott A, Martin G, Clarke J, Sounderajah V, Markar S, Przybylowicz J, Chan YH, Sia CH, Chua YX, Sim K, Lim L, Tan L, Tan M, Sharma V, Ooi S, Winter Beatty J, Flott K, Mason S, Chidambaram S, Yalamanchili S, Zbikowska G, Fedorowski J, Dykowska G, Wells M, Purkayastha S, Kinross J. Determinants of burnout and other aspects of psychological well-being in healthcare workers during the Covid-19 pandemic: A multinational cross-sectional study. PLoS One 2021; 16:e0238666. [PMID: 33861739 PMCID: PMC8051812 DOI: 10.1371/journal.pone.0238666] [Citation(s) in RCA: 166] [Impact Index Per Article: 55.3] [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: 09/03/2020] [Accepted: 03/21/2021] [Indexed: 01/09/2023] Open
Abstract
The Covid-19 pandemic has placed unprecedented pressure on healthcare systems and workers around the world. Such pressures may impact on working conditions, psychological wellbeing and perception of safety. In spite of this, no study has assessed the relationship between safety attitudes and psychological outcomes. Moreover, only limited studies have examined the relationship between personal characteristics and psychological outcomes during Covid-19. From 22nd March 2020 to 18th June 2020, healthcare workers from the United Kingdom, Poland, and Singapore were invited to participate using a self-administered questionnaire comprising the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory (OLBI) and Hospital Anxiety and Depression Scale (HADS) to evaluate safety culture, burnout and anxiety/depression. Multivariate logistic regression was used to determine predictors of burnout, anxiety and depression. Of 3,537 healthcare workers who participated in the study, 2,364 (67%) screened positive for burnout, 701 (20%) for anxiety, and 389 (11%) for depression. Significant predictors of burnout included patient-facing roles: doctor (OR 2.10; 95% CI 1.49-2.95), nurse (OR 1.38; 95% CI 1.04-1.84), and 'other clinical' (OR 2.02; 95% CI 1.45-2.82); being redeployed (OR 1.27; 95% CI 1.02-1.58), bottom quartile SAQ score (OR 2.43; 95% CI 1.98-2.99), anxiety (OR 4.87; 95% CI 3.92-6.06) and depression (OR 4.06; 95% CI 3.04-5.42). Significant factors inversely correlated with burnout included being tested for SARS-CoV-2 (OR 0.64; 95% CI 0.51-0.82) and top quartile SAQ score (OR 0.30; 95% CI 0.22-0.40). Significant factors associated with anxiety and depression, included burnout, gender, safety attitudes and job role. Our findings demonstrate a significant burden of burnout, anxiety, and depression amongst healthcare workers. A strong association was seen between SARS-CoV-2 testing, safety attitudes, gender, job role, redeployment and psychological state. These findings highlight the importance of targeted support services for at risk groups and proactive SARS-CoV-2 testing of healthcare workers.
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Affiliation(s)
- Max Denning
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Ee Teng Goh
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Benjamin Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Abhiram Kanneganti
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore, Singapore
| | - Melanie Almonte
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Alasdair Scott
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Guy Martin
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Jonathan Clarke
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Viknesh Sounderajah
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Sheraz Markar
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Jan Przybylowicz
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ching-Hui Sia
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Ying Xian Chua
- Pioneer Polyclinic, National University Polyclinic, National University Health System, Singapore, Singapore
| | - Kang Sim
- Institute of Mental Health, Singapore, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lucas Lim
- Department of Forensic Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Lifeng Tan
- Division of Healthy Ageing, Alexandra Hospital, Singapore, Singapore
| | - Melanie Tan
- Department of Geriatric Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Vijay Sharma
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shirley Ooi
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Emergency Medicine Department, National University Hospital, Singapore, Singapore
| | | | - Kelsey Flott
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Sam Mason
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | | | - Seema Yalamanchili
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Gabriela Zbikowska
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | | | - Grazyna Dykowska
- Department of Economics of Health and Medical Law, Medical University of Warsaw, Poland
| | - Mary Wells
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Sanjay Purkayastha
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - James Kinross
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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Lim L, Galvin S. R35 Early Experiences of Thoracoscopic Parathyroid Gland Resection in New Zealand. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.03.193] [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]
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Lim L, Nam K, Bahk J, Jeon Y. The relationship between intraoperative cerebral oximetry and postoperative delirium in patients undergoing off-pump coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 2020. [DOI: 10.1053/j.jvca.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tay YH, Lim L, Cheng A, Sim K. Disrupting the disruption: Using digital tools to support psychiatry residency training in Singapore during the COVID-19 pandemic. Psychiatry Res 2020; 289:113063. [PMID: 32413713 PMCID: PMC7204742 DOI: 10.1016/j.psychres.2020.113063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/02/2020] [Accepted: 05/02/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Yi Hang Tay
- East Region, Institute of Mental Health, Singapore
| | - Lucas Lim
- Department of Forensic Psychiatry, Institute of Mental Health, Singapore
| | - Ambrose Cheng
- Associate Program Director, National Psychiatry Residency Program and Senior Consultant, Ng Teng Fong General Hospital, Singapore
| | - Kang Sim
- Program Director, NHG National Psychiatry Residency Program and Senior Consultant, Institute of Mental Health, Singapore,Corresponding author at: Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, 539747, Singapore
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Lim L, Kozhanov V, Lim N, Abdrakhmanova S, Aldibekova G. [RETROSPECTIVE ANALYSIS OF THE STATE OF PHYSICAL DEVELOPMENT OF SCHOOLCHILDREN FOR THE LAST 60 YEARS ACCORDING TO DATA ALMATY CITY]. Georgian Med News 2020:47-55. [PMID: 32242844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The physical development of children is one of the main criteria for the health status of the child population, reflecting the influence of endogenous and exogenous factors. Dynamic study of schoolchildren's physical development allows one to determine the characteristics of the formations of their morphofunctional parameters and then influence the health of the whole population. The study of the orientation of time shifts in physical development has an important predictive preventive component and is the basis for updating regional standards every 5-10 years. Objective - to identify the main trends in the physical development of schoolchildren in Kazakhstan according to anthropometric measurements among schoolchildren of Almaty over the past 60 years (1956, 1972(2), 1983, 1989, 2005, 2017). Object of study: 13136 schoolchildren of 7-16 years old, various general education institutions (schools) of Almaty, who studied in 1956, in 1972, in 1983, in 1989, in 2005, and in 2017, which were used to carry out transverse and longitudinal studies of physical development using a standardized anthropometric method using standard tools. A comparative analysis of the basic indicators of physical development (length and body weight), conducted between 1956 and 2017, shows a pronounced tendency to increase them across all ages. The largest increase in basic body size in both boys and girls was in the period from 1956 to 1972 (p <0.05). Later, until 2005, stabilization and even slowing down of the observed processes of increasing somatometric indicators was noted. The economic crisis that swept the country in the 1990 led to a significant decrease in the mass-growth indicators in children of both sexes in 2005. The results of a 2017 study indicate a "new round of acceleration" of modern children of Kazakhstan of both sexes. A retrospective study of the physical development of schoolchildren, conducted in Kazakhstan over the past 60 years, showed a pronounced tendency to increase the basic mass and growth indicators, especially in males, and the acceleration of the period of puberty. In modern schoolchildren, there was a change in the timing of the annual "crosses" of growth curves at an earlier age period. For children of Kazakhstan in the new millennium, a decrease in the degree of correlative connections between length and body weight is characteristic, which indicates their disharmonious development.
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Affiliation(s)
- L Lim
- 1Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan
| | - V Kozhanov
- 1Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan
| | - N Lim
- 2Nazarbayev University, Nur-Sultan, Kazakhstan
| | - S Abdrakhmanova
- 1Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan
| | - G Aldibekova
- 1Scientific Center of Pediatrics and Pediatric Surgery, Almaty; 2Nazarbayev University, Nur-Sultan, Kazakhstan
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Tu H, Xu C, Tong-Li C, Offin M, Razavi P, Schapira E, Namakydoust A, Lee A, Pavlakis N, Clarke S, Diakos C, Chan D, Myers M, Makhnin A, Jain H, Martinez A, Iqbal Z, Adamski A, Li H, Hernandez J, Watford S, Hosseini A, Shaffer T, Lim L, Li M, Drilon A, Ladanyi M, Arcila M, Rusch V, Jones D, Rudin C, Rimner A, Isbell J, Li B. P1.01-122 A Clinical Utility Study of Plasma DNA Next Generation Sequencing Guided Treatment of Uncommon Drivers in Advanced Non-Small-Cell Lung Cancers. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pekker I, Lim L, Simon J, Gormley M, Li Z, Pollak J, Potts K, Watford S, Posey J, Chan P, Urtishak K, Garg K, Hosseini A, Li M. Analytical performance of the resolution-HRD plasma assay used to identify mCRPC patients with biallelic disruption of DNA repair genes for treatment with niraparib. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz257.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lim L, Cho Y, Lee HC, Choi EK, Park S, Yu J, Nam K, Kim T, Jeon Y. The attenuated effect of remote ischemic conditioning on tissue oxygen saturation and heart rate variability in the patient undergoing cardiac surgery: a pilot study. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.055] [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: 11/11/2022]
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Abstract
OBJECTIVE We aimed to evaluate the prevalence of depressive and anxiety symptoms and mental health literacy (MHL) in outpatients with or without cancer in Singapore. METHODS Oncology outpatients and outpatients without cancer (controls) were assessed for severity of anxiety and depressive symptoms (using the Hospital Anxiety and Depression Scale) and MHL regarding major depressive disorder and generalised anxiety disorder in terms of diagnosis, aetiology, treatment, and attitudes toward mental health services. RESULTS A total of 89 oncology outpatients and 61 controls were recruited. Those with primary and secondary education had significantly lower MHL scores than those with university education (p = 0.001). Oncology outpatients and controls were comparable in terms of anxiety (13.5% vs 9.8%, p = 0.5), depression (2.2% vs 1.6%, p > 0.99), and total MHL score (7.94 vs 9.13, p = 0.102). CONCLUSIONS MHL is comparable between oncology outpatients and controls and is positively associated with education level.
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Affiliation(s)
- S H Poon
- Department of Psychiatry, Singapore General Hospital, Singapore
| | - F Q Wang
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - J Goh
- Department of Psychiatry, Singapore General Hospital, Singapore
| | - Y H Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - L Lim
- Department of Psychiatry, Singapore General Hospital, Singapore
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Raffetin A, Belkacem A, Bounhiol A, Diallo K, Schemoul J, Paoletti G, Lim L, Medina F, Caraux-Paz P, Patey O. Être ou ne pas être une borréliose de Lyme ? Une approche pluridisciplinaire pour un diagnostic plus juste et un parcours de soin personnalisé. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Koh J, Lim W, Neoh J, Hescham S, Blokland A, Chan Y, Temel Y, Lim L, Wu E. Pacemaker in the aged brain: From molecular profiling to memory enhancement. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Schmid P, Pinder S, Wheatley D, Zummit C, Macaskill EJ, Hu J, Price R, Bundred N, Hadad S, Shia A, Sarker SJ, Lim L, Mousa K, O'Brien C, Wilson TR, Lackner MR, Gendreau S, Gazinska P, Korbie D, Trau M, Mainwaring P, Thompson A, Purushotham A. Abstract P2-08-02: Interaction of PIK3CA mutation subclasses with response to preoperative treatment with the PI3K inhibitor pictilisib in patients with estrogen receptor-positive breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Although preclinical data suggest that combining PI3K inhibitors with endocrine therapy may overcome resistance, results from randomized clinical trials have failed to identify a subgroup of patients that derive a substantial benefit. This preoperative window study assessed whether adding the PI3K inhibitor pictilisib can increase the anti-tumor effects of anastrozole in primary breast cancer and aimed to identify the most appropriate patient population for combination therapy.
Methods: In this randomized, open-label, phase 2 study, 167 postmenopausal women with newly diagnosed, operable, ER-positive, HER2-negative breast cancers were recruited. Participants were randomly allocated (2:1, favoring the combination) to two-weeks of preoperative treatment with anastrozole 1 mg once daily or the combination of anastrozole 1mg with pictilisib 260 mg once daily. The primary endpoint was inhibition of tumor cell proliferation, as measured by change in Ki-67 protein expression between tumor samples taken before and at the end of treatment. Secondary endpoints include induction of apoptosis (Caspase3) and safety. Comprehensive biomarkers analyses included targeted NGS of a comprehensive cancer panel of >400 genes (Ampliseq Comprehensive Cancer panel), copy number variation analyses, and pre- and post-treatment reverse-phase protein arrays (RPPA) and RNA profiling (NanoString nCounter platform).
Results:There was significantly greater geometric mean Ki67 suppression of 82.5% (90% CI, 78.3%-85.8%) for the combination vs 70.7% (61.0%-78.0%) for anastrozole [geometric mean ratio (combination/ anastrozole) 0.60 (0.58-0.85);p=0.01]. Higher baseline Ki67, Luminal B status and/or negative PR status were associated with increased benefit from adding pictilisib. A significant interaction was observed between PIK3CA mutation subtypes [helical domain mutations (HD), kinase domain mutations (KD), wildtype (WT)] and mean Ki67 suppression; the combination/anastrozole geometric mean ratio of Ki67 suppression was 0.48 (0.27-0.84; p=0.02) for patients with HD mutations and 0.63 (0.39–1.0; p=0.05) for patients with PIK3Ca WT, compared to 1.17 (0.57–2.41; p=0.64) for patients with KD mutations. This was largely due to patients with HD mutations showing a particularly poor response to anastrozole alone [mean Ki67 suppression 53.9% (9.5%-76.5%)], that was reversed by the addition of pictilisib [mean Ki-67 suppression 78.1% (71.0%-83.4%)]. On the other hand, patients with KD mutations responded well to anastrozole alone [mean Ki-67 suppression 77.7% (57.0%-88.4%)] and showed no benefit from the addition of pictilisib [mean Ki-67 suppression 73.9% (59.8%-83.0%)]. There was no significant difference in induction of apoptosis between treatment groups. Comprehensive pre- and post-treatment biomarkers analyses will be presented.
Conclusions: Adding pictilisib to anastrozole significantly increases the anti-proliferative response to preoperative treatment with anastrozole. A significant interaction was observed between PIK3CA mutation subtypes, with patients with helical domain mutations showing a particularly poor response to anastrozole alone that was reversed by the addition of pictilisib.
Citation Format: Schmid P, Pinder S, Wheatley D, Zummit C, Macaskill EJ, Hu J, Price R, Bundred N, Hadad S, Shia A, Sarker S-J, Lim L, Mousa K, O'Brien C, Wilson TR, Lackner MR, Gendreau S, Gazinska P, Korbie D, Trau M, Mainwaring P, Thompson A, Purushotham A. Interaction of PIK3CA mutation subclasses with response to preoperative treatment with the PI3K inhibitor pictilisib in patients with estrogen receptor-positive breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-02.
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Affiliation(s)
- P Schmid
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - S Pinder
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - D Wheatley
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - C Zummit
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - EJ Macaskill
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - J Hu
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - R Price
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - N Bundred
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - S Hadad
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - A Shia
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - S-J Sarker
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - L Lim
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - K Mousa
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - C O'Brien
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - TR Wilson
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - MR Lackner
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - S Gendreau
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - P Gazinska
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - D Korbie
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - M Trau
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - P Mainwaring
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - A Thompson
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
| | - A Purushotham
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom; Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Ninewells Hospital, Dundee, United Kingdom; Barts Health NHS Trust, London, United Kingdom; King's College Hospital NHS Foundation Trust, London, United Kingdom; Manchester University NHS Foundation Trust, London, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Genentech, San Francisco; Breast Cancer Now Research Unit, Cancer Centre at Guy's Hospital, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane City, Australia; Mater Research Centre, Brisbane, Australia; The University of Texas MD Anderson Cancer Centre, Houston
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Liew K, Bartolo C, O'Reilly M, Lim L. Targeting antimicrobial stewardship in hospitalised patients with community-acquired pneumonia within 24 h of admission. Infect Dis Health 2018. [DOI: 10.1016/j.idh.2018.03.002] [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: 12/01/2022]
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Lim L, Faisal W, Wuttke M, Chong G. Causes of death in a cohort of early stage colorectal cancer patients at a regional centre in Australia. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hart H, Lim L, Mehta MA, Simmons A, Mirza KAH, Rubia K. Altered fear processing in adolescents with a history of severe childhood maltreatment: an fMRI study. Psychol Med 2018; 48:1092-1101. [PMID: 29429419 PMCID: PMC6088776 DOI: 10.1017/s0033291716003585] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 12/08/2016] [Accepted: 12/15/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Children with a history of maltreatment suffer from altered emotion processing but the neural basis of this phenomenon is unknown. This pioneering functional magnetic resonance imaging (fMRI) study investigated the effects of severe childhood maltreatment on emotion processing while controlling for psychiatric conditions, medication and substance abuse. METHOD Twenty medication-naive, substance abuse-free adolescents with a history of childhood abuse, 20 psychiatric control adolescents matched on psychiatric diagnoses but with no maltreatment and 27 healthy controls underwent a fMRI emotion discrimination task comprising fearful, angry, sad happy and neutral dynamic facial expressions. RESULTS Maltreated participants responded faster to fearful expressions and demonstrated hyper-activation compared to healthy controls of classical fear-processing regions of ventromedial prefrontal cortex (vmPFC) and anterior cingulate cortex, which survived at a more lenient threshold relative to psychiatric controls. Functional connectivity analysis, furthermore, demonstrated reduced connectivity between left vmPFC and insula for fear in maltreated participants compared to both healthy and psychiatric controls. CONCLUSIONS The findings show that people who have experienced childhood maltreatment have enhanced fear perception, both at the behavioural and neurofunctional levels, associated with enhanced fear-related ventromedial fronto-cingulate activation and altered functional connectivity with associated limbic regions. Furthermore, the connectivity adaptations were specific to the maltreatment rather than to the developing psychiatric conditions, whilst the functional changes were only evident at trend level when compared to psychiatric controls, suggesting a continuum. The neurofunctional hypersensitivity of fear-processing networks may be due to childhood over-exposure to fear in people who have been abused.
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Affiliation(s)
- H. Hart
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - L. Lim
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - M. A. Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A. Simmons
- NIHR Biomedical Research Centre at South London and Maudsley Foundation NHS Trust and King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | | | - K. Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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Kurtys E, Lim L, Man F, Volpe A, Fruhwirth G. In vivo tracking of CAR-T by [ 18 f]BF 4 - PET/CT in human breast cancer xenografts reveals differences in CAR-T tumour retention. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mavaddat N, Sadler E, Lim L, Williams K, Warburton E, Kinmonth AL, Mant J, Burt J, McKevitt C. Perceptions of self-rated health among stroke survivors: a qualitative study in the United Kingdom. BMC Geriatr 2018; 18:81. [PMID: 29609550 PMCID: PMC5879795 DOI: 10.1186/s12877-018-0765-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 03/12/2018] [Indexed: 11/15/2022] Open
Abstract
Background Self-rated health predicts health outcomes independently of levels of disability or mood. Little is known about what influences the subjective health experience of stroke survivors. Our aim was to investigate stroke survivors’ perceptions of self-rated health, with the intention of informing the design of interventions that may improve their subjective health experience. Methods We conducted semi-structured interviews with a purposive sample of 28 stroke survivors recruited from a stroke unit and follow-up outpatient clinic, 4–6 months after stroke, to explore what factors are perceived to be part of self-rated health in the early stages of recovery. Qualitative data were analysed using a thematic analysis approach to identify underlying themes. Results Participants’ accounts show that stroke survivors’ perceptions of self-rated health are multifactorial, comprising physical, psychological and social components. Views on future recovery after stroke play a role in present health experience and are shaped by psychosocial resources that are influenced by past experiences of ill-health, dispositional outlook such as degree of optimism, a sense of control and views on ageing. Conclusions Severity of physical limitations alone does not influence perceptions of self-rated health among stroke survivors. Self-rated health in stroke survivors is a multidimensional construct shaped by changes in health status occurring after the stroke, individual characteristics and social context. Understanding the factors stroke survivors themselves associate with better health will inform the development of effective approaches to improve rehabilitation and recovery after stroke.
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Affiliation(s)
- N Mavaddat
- Division of General Practice, School of Medicine, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia. .,Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK.
| | - E Sadler
- Health Service & Population Research Department, King's Improvement Science and Centre for Implementation Science, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
| | - L Lim
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK
| | - K Williams
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK
| | - E Warburton
- Department of Clinical Neurosciences, University of Cambridge, Neurology Unit, R3, Box 83, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - A L Kinmonth
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK
| | - J Mant
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Laboratory, 2 Worts Causeway, Cambridge, CB1 8RN, UK
| | - J Burt
- Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Robinson Way, Cambridge, UK
| | - C McKevitt
- School of Population Health Sciences, King's College London, Addison House, London, SE1 1UL, UK
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Abstract
BACKGROUND Childhood abuse is associated with abnormalities in brain structure and function. Few studies have investigated abuse-related brain abnormalities in medication-naïve, drug-free youth that also controlled for psychiatric comorbidities by inclusion of a psychiatric control group, which is crucial to disentangle the effects of abuse from those associated with the psychiatric conditions. METHODS Cortical volume (CV), cortical thickness (CT) and surface area (SA) were measured in 22 age- and gender-matched medication-naïve youth (aged 13-20) exposed to childhood abuse, 19 psychiatric controls matched for psychiatric diagnoses and 27 healthy controls. Both region-of-interest (ROI) and whole-brain analyses were conducted. RESULTS For the ROI analysis, the childhood abuse group compared with healthy controls only, had significantly reduced CV in bilateral cerebellum and reduced CT in left insula and right lateral orbitofrontal cortex (OFC). At the whole-brain level, relative to healthy controls, the childhood abuse group showed significantly reduced CV in left lingual, pericalcarine, precuneus and superior parietal gyri, and reduced CT in left pre-/postcentral and paracentral regions, which furthermore correlated with greater abuse severity. They also had increased CV in left inferior and middle temporal gyri relative to healthy controls. Abnormalities in the precuneus, temporal and precentral regions were abuse-specific relative to psychiatric controls, albeit at a more lenient level. Groups did not differ in SA. CONCLUSIONS Childhood abuse is associated with widespread structural abnormalities in OFC-insular, cerebellar, occipital, parietal and temporal regions, which likely underlie the abnormal affective, motivational and cognitive functions typically observed in this population.
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Affiliation(s)
- L Lim
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - H Hart
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - M Mehta
- Department of Neuroimaging,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - A Worker
- Department of Neuroimaging,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - A Simmons
- Department of Neuroimaging,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - K Mirza
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
| | - K Rubia
- Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK
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Abstract
Facial Osteotomy techniques have evolved enormously over the past 20 years providing significant and often life-changing benefits to our dental patients with skeletal malocclusions. Advancements in technology and refined surgical techniques have resulted in improvements in surgical outcomes, a reduction in post-operative complications and a quicker recovery for today's patients undergoing orthognathic surgery. This paper aims to an update on the contemporary approach to the correction of skeletal malocclusions with facial osteotomies.
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Affiliation(s)
- L Lim
- Sydney University and Westmead Hospital, Westmead, New South Wales, Australia.,Sydney Oral and Facial Surgery, Chatswood, New South Wales, Australia
| | - A A Heggie
- Section of Oral & Maxillofacial Surgery, Royal Children's Hospital of Melbourne, Parkville, Melbourne, Australia
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Offen S, Bart N, Hungerford S, Lim L, Feneley M, Kathir K, Winlaw D, Jabbour A, Kotlyar E, Hayward C, Muthiah K, MacDonald P. Connecting the Dots: VF Arrest Secondary to Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Syndrome. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lim L, Liu Y, Liu W, Tjandra R, Rasenthiram L, Chen Z, Yu A. All-in-One Graphene Based Composite Fiber: Toward Wearable Supercapacitor. ACS Appl Mater Interfaces 2017; 9:39576-39583. [PMID: 29099572 DOI: 10.1021/acsami.7b10182] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Graphene fibers (GF) have aroused great interest in wearable electronics applications because of their excellent mechanical flexibility and superior electrical conductivity. Herein, an all-in-one graphene and MnO2 composite hybrid supercapacitor fiber device has been developed. The unique coaxial design of this device facilitates large-scale production while avoiding the risk of short circuiting. The core backbone of the device consists of GF that not only provides mechanical stability but also ensures fast electron transfer during charge-discharge. The introduction of a MnO2 (200 nm in length) hierarchical nanostructured film enhanced the pseudocapacitance dramatically compared to the graphene-only device in part because of the abundant number of active sites in contact with the poly(vinyl alcohol) (PVA)/H3PO4 electrolyte. The entire device exhibits outstanding mechanical strength as well as good electrocapacitive performance with a volumetric capacitance of 29.6 F cm-3 at 2 mv s-1. The capacitance of the device did not fade under bending from 0° to 150°, while the capacitance retention of 93% was observed after 1000 cycles. These unique features make this device a promising candidate for applications in wearable fabric supercapacitors.
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Affiliation(s)
- Lucas Lim
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L 3G1, Canada
| | - Yangshuai Liu
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L 3G1, Canada
| | - Wenwen Liu
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L 3G1, Canada
| | - Ricky Tjandra
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L 3G1, Canada
| | - Lathankan Rasenthiram
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L 3G1, Canada
| | - Zhongwei Chen
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L 3G1, Canada
| | - Aiping Yu
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L 3G1, Canada
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Liew K, Lim L, O'Reilly M, Bartolo C, Krishneel D, Thakkar H. Targeting antimicrobial stewardship in hospitalized patients with community-acquired pneumonia within 24 h of admission. Intern Med J 2017. [DOI: 10.1111/imj.6_13463] [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: 11/29/2022]
Affiliation(s)
- K Liew
- Eastern Health; Victoria Australia
| | - L Lim
- Eastern Health; Victoria Australia
| | - M O'Reilly
- Eastern Health; Victoria Australia
- Monash University; Victoria Australia
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Liu W, Li J, Feng K, Sy A, Liu Y, Lim L, Lui G, Tjandra R, Rasenthiram L, Chiu G, Yu A. Advanced Li-Ion Hybrid Supercapacitors Based on 3D Graphene-Foam Composites. ACS Appl Mater Interfaces 2016; 8:25941-25953. [PMID: 27627198 DOI: 10.1021/acsami.6b07365] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Li-ion hybrid supercapacitors (LIHSs) have recently attracted increasing attention as a new and promising energy storage device. However, it is still a great challenge to construct novel LIHSs with high-performance due to the majority of battery-type anodes retaining the sluggish kinetics of Li-ion storage and most capacitor-type cathodes with low specific capacitance. To solve this problem, 3D graphene-wrapped MoO3 nanobelt foam with the unique porous network structure has been designed and prepared as anode material, which delivers high capacity, improved rate performance, and enhanced cycle stability. First-principles calculation reveals that the combination of graphene dramatically reduces the diffusion energy barrier of Li+ adsorbed on the surface of MoO3 nanobelt, thus improving its electrochemical performance. Furthermore, 3D graphene-wrapped polyaniline nanotube foam derived carbon is employed as a new type of capacitor-type cathode, demonstrating high specific capacitance, good rate performance, and long cycle stability. Benefiting from these two graphene foam-enhanced materials, the constructed LIHSs show a wide operating voltage range (3.8 V), a long stable cycle life (90% capacity retention after 3000 cycles), a high energy density (128.3 Wh·kg-1), and a high power density (13.5 kW·kg-1). These encouraging performances indicate that the obtained LIHSs may have promising prospect as next-generation energy-storage devices.
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Affiliation(s)
- Wenwen Liu
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L3G1, Canada
| | - Jingde Li
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L3G1, Canada
| | - Kun Feng
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L3G1, Canada
| | - Abel Sy
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L3G1, Canada
| | - Yangshuai Liu
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L3G1, Canada
| | - Lucas Lim
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L3G1, Canada
| | - Gregory Lui
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L3G1, Canada
| | - Ricky Tjandra
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L3G1, Canada
| | - Lathankan Rasenthiram
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L3G1, Canada
| | - Gordon Chiu
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L3G1, Canada
| | - Aiping Yu
- Department of Chemical Engineering, Waterloo Institute for Nanotechnology, University of Waterloo , Waterloo, Ontario N2L3G1, Canada
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Eerkes T, Santiago-Walker AA, Loreen M, Lim L, Hernandez J, Raymond C, Henderson S, Dipasquo D, Shaffer T, Motely C, Moy C, Wallace S, Eaton K, Karkera J, Li M. Utility of a targeted NGS oncology assay for circulating tumor DNA in a multi-histology clinical setting. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw380.03] [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: 11/12/2022] Open
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34
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Horn L, Wakelee H, Blumenschein G, Reckamp K, Waqar S, Carter C, Gitlitz B, Infante J, Sanborn R, Neal J, Gockerman J, Dukart G, Harrow K, Liang C, Gibbons J, Hernandez J, Newman-Eerkes T, Lim L, Lovly C. Phase I/II trial of X-396 in patients (pts) with ALK+ non-small cell lung cancer (NSCLC): Correlation with plasma and tissue genotyping and response to therapy (tx). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Otome O, O'Reilly M, Lim L. Disseminated Mycobacterium haemophilum skeletal disease in a patient with interferon-gamma deficiency. Intern Med J 2016; 45:1073-6. [PMID: 26429217 DOI: 10.1111/imj.12875] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 03/23/2015] [Indexed: 11/29/2022]
Abstract
Disseminated non-tuberculous mycobacterial (NTM) infection is rare in immunocompetent adults. Anti-interferon-gamma (IFN-γ) autoantibodies have recently been associated with NTM infections, particularly in patients of Asian ethnicity. We describe a case of disseminated Mycobacterium haemophilum skeletal infection due to anti IFN-γ autoantibodies in a 71-year-old Cambodian man. He responded to a combination of anti-mycobacterial antibiotics without requirement for immunomodulator therapy. Testing for acquired IFN-γ deficiency due to IFN-γ autoantibodies should be considered when standard tests for immunodeficiency are negative in patients with unusual or severe opportunistic infections, including NTM.
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Affiliation(s)
- O Otome
- Department of Infectious Diseases, Box Hill Hospital, Eastern Health, Melbourne, Victoria, Australia
| | - M O'Reilly
- Department of Infectious Diseases, Box Hill Hospital, Eastern Health, Melbourne, Victoria, Australia
| | - L Lim
- Department of Infectious Diseases, Box Hill Hospital, Eastern Health, Melbourne, Victoria, Australia
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Affiliation(s)
- L Lim
- Consultant Oral and Maxillofacial Surgeon; Westmead Hospital; Westmead New South Wales Australia
| | - P Sirichai
- Department of Oral and Maxillofacial Surgery; Westmead Hospital; Westmead New South Wales Australia
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Schmid P, Pinder SE, Bundred N, Wheatley D, Macaskill J, Zammit C, Hu J, Price R, Shia A, Lim L, Parker P, Molinero L, Yu J, O'Brien C, Wilson T, Savage H, Derynck M, Lackner MR, Amler L, Purushotham A, Thompson A, Gendreau S. Abstract P5-13-01: Transcript analysis of PI3K and immune-related genes and gene signatures in the pre- and post-treatment samples from the window of opportunity study of anastrozole and anastrozole with pictilisib (GDC-0941) in patients with HR-positive early breast cancer (OPPORTUNE study). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-13-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The OPPORTUNE Study randomized postmenopausal patients (pts) to receive 2-week preoperative treatment with anastrozole (ANA) plus pictilisib ("ANA+PIC" arm) or ANA alone. Patients had newly diagnosed, operable, ER+, HER2- invasive breast cancer of ≥1 cm size. The primary outcome at interim analysis (n=70) revealed that the addition of PIC significantly increased the anti-proliferative response to ANA as measured by reduction in Ki67 immunohistochemistry (IHC). Multivariate analyses suggested benefit of PIC for patients with luminal B disease (Schmid et al. SABCS 2014).
Methods: RNA expression analysis of ∼800 breast cancer-related genes was performed on patients analyzed at the interim analysis, including 14 (ANA) and 20 (ANA+PIC) patients with matched pre- and post- treatment paired tumour samples using the nCounter platform (NanoString). Differential expression of individual genes by arm was assessed using paired and moderated t-tests and statistical significance assessed through false discovery rate (FDR). Ingenuity Pathway Analysis (IPA) of differentially expressed transcripts identified pathways of relevance. Protein expression was analyzed by reverse protein array ( RPPA) in pre- and post-treatment samples.
Results: In an unsupervised analysis, down-regulation of genes associated with ER signaling was observed in patients who received single-agent ANA and ANA+PIC, which included genes that regulate the cell cycle, cell death, survival, growth and proliferation and known ER target genes (e.g., PGR, GREB1). In addition, transcripts related to growth factor signaling pathway appeared to be specifically modulated in the ANA+PIC arm, possibly via the upregulation of the expression of RTK ligands. There were no clear changes in PI3K-related phosphoproteins (e.g., AKT, S6, 4E-BP1) in the post-treatment samples by RPPA. However, known PI3K-regulated genes, IRS2 and PIK3IP1, were upregulated in the post-treatment samples and a composite PI3K gene expression signature score (O'Brien et al. 2010) was reduced in both study arms following treatment. This PI3K signature was associated with pre-treatment luminal B status (n=27) and, consistent with this finding, the baseline PI3K gene signature score in the ANA arm, but not the ANA+PIC arm, was inversely associated with the decrease in post treatment Ki67. The tumor immune microenvironment was analyzed though the use of composite gene sets. In our initial observations, analysis of pre- and post-treatment samples showed that 2-week treatment with ANA resulted in a modest increase in transcripts associated with multiple immune signatures, which was further enhanced by the addition of PIC.
Conclusions: Gene expression analysis of pre- and post-treatment samples in the OPPORTUNE study demonstrates on-target inhibition of ER and PI3K signaling networks. The analysis of additional paired samples is in progress to further assess if 2-weeks of treatment with a regimen containing an AI in patients with early breast cancer impacts the tumor immune microenvironment.
Citation Format: Schmid P, Pinder SE, Bundred N, Wheatley D, Macaskill J, Zammit C, Hu J, Price R, Shia A, Lim L, Parker P, Molinero L, Yu J, O'Brien C, Wilson T, Savage H, Derynck M, Lackner MR, Amler L, Purushotham A, Thompson A, Gendreau S. Transcript analysis of PI3K and immune-related genes and gene signatures in the pre- and post-treatment samples from the window of opportunity study of anastrozole and anastrozole with pictilisib (GDC-0941) in patients with HR-positive early breast cancer (OPPORTUNE study). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-13-01.
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Affiliation(s)
- P Schmid
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - SE Pinder
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - N Bundred
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - D Wheatley
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - J Macaskill
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - C Zammit
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - J Hu
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - R Price
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - A Shia
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - L Lim
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - P Parker
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - L Molinero
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - J Yu
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - C O'Brien
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - T Wilson
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - H Savage
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - M Derynck
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - MR Lackner
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - L Amler
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - A Purushotham
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - A Thompson
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
| | - S Gendreau
- Barts Cancer Institute, Queen Mary University London, London, United Kingdom; Kings College London, London, United Kingdom; Guys and St Thomas NHS Trust, Kings College London, London, United Kingdom; University Hospital of South Manchester, Manchester, United Kingdom; Royal Cornwall Hospital, Truro, United Kingdom; Ninewells Hospital Dundee, Dundee, United Kingdom; Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom; Barts Health NHS Trust, London, United Kingdom; Kings College Hospital, London, United Kingdom; MD Anderson Cancer Centre, Houston, TX; Genentech, South San Francisco, California, South San Francisco, CA
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Papakostas TD, Lim L, van Zyl T, Miller JB, Modjtahedi BS, Andreoli CM, Wu D, Young LH, Kim IK, Vavvas DG, Esmaili DD, Husain D, Eliott D, Kim LA. Intravitreal aflibercept for macular oedema secondary to central retinal vein occlusion in patients with prior treatment with bevacizumab or ranibizumab. Eye (Lond) 2015; 30:79-84. [PMID: 26449196 DOI: 10.1038/eye.2015.175] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 07/12/2015] [Indexed: 11/09/2022] Open
Abstract
PurposeTo report the visual and anatomic outcomes in eyes with macular oedema (MO) secondary to central retinal vein occlusion (CRVO) that were switched from either intravitreal bevacizumab or ranibizumab to intravitreal aflibercept.MethodsTwo-center retrospective chart review. Eyes with MO secondary to CRVO that received a minimum of three intravitreal injections of bevacizumab or ranibizumab and were switched to intravitreal aflibercept for persistent or recurrent MO not responding to either bevacizumab and/or ranibizumab.ResultsIn all 42 eyes of 42 patients were included in the study. The median visual acuity before the switch was 20/126, 1 month after the first injection of aflibercept 20/89 (P=0.0191), and at the end of the follow-up 20/100 (P=0.2724). The median CRT before the switch was 536 μm, 1 month after the first injection of aflibercept 293.5 μm (P=0.0038), and at the end of the follow-up 279 μm (P=0.0013 compared to before the switch). The median number of weeks between injections before the switch was 5.6 and after the switch was 7.6 (P<0.0001).ConclusionConverting eyes with refractory MO due to CRVO to aflibercept can result in stabilization of the vision, improved macular anatomy, and extension of the injection interval.
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Affiliation(s)
- T D Papakostas
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - L Lim
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - T van Zyl
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - J B Miller
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - B S Modjtahedi
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - C M Andreoli
- Harvard Vanguard Medical Associates, Boston, MA, USA
| | - D Wu
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - L H Young
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - I K Kim
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - D G Vavvas
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - D D Esmaili
- Retina-Vitreous Associates Medical Group, Los Angeles, CA, USA
| | - D Husain
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - D Eliott
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - L A Kim
- Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
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Lim L, Pullenayegum E, Lim L, Gladman D, Feldman B, Silverman E. OP0063 From Childhood to Adulthood: Longitudinal Trajectory of Damage in Patients with Childhood-Onset Systemic Lupus Erythematosus (CSLE). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Arnold JJ, Campain A, Barthelmes D, Simpson JM, Guymer RH, Hunyor AP, McAllister IL, Essex RW, Morlet N, Gillies MC, Gillies M, Hunt A, Hunyor A, Arnold J, Young S, Clark G, Banerjee G, Phillips R, Perks M, Essex R, McAllister I, Constable I, Guymer R, Guymer R, Lim L, Harper A, Chow L, Wickremansinghe S, Wickremasinghe S, Wickremasinghe S. Two-year outcomes of "treat and extend" intravitreal therapy for neovascular age-related macular degeneration. Ophthalmology 2015; 122:1212-9. [PMID: 25846847 DOI: 10.1016/j.ophtha.2015.02.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To report 24-month outcomes of anti-vascular endothelial growth factor (VEGF) therapy for treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) using a treat and extend treatment regimen in routine clinical practice. DESIGN Database observational study. PARTICIPANTS We included treatment-naïve eyes receiving predominantly ranibizumab for nAMD in routine clinical practice treated using a treat and extend regimen that were tracked in the Fight Retinal Blindness observational registry. METHODS A cohort of eyes treated by practitioners using exclusively a treat and extend regimen was extracted from the Fight Retinal Blindness observational registry. MAIN OUTCOME MEASURES Change in visual acuity (VA) over 2 years and number of injections and visits. RESULTS Data from 1198 eyes from 1011 patients receiving anti-VEGF therapy using a treat and extend regimen for treatment-naïve nAMD between January 2007 and December 2012 and with 24-month follow-up were included in the analysis. Mean VA increased by +5.3 logarithm of the minimum angle of resolution letters from 56.5 letters (20/80+1) at initial visit to 61.8 (20/60+2) letters at 24 months. Mean VA gains improved and number of injections increased with successive years from +2.7 letters for eyes commencing in 2007 after a mean of 9.7 injections in 2 years, to +7.8 letters for eyes commencing in 2012 after a mean of 14.2 injections over 2 years. The proportion of eyes with VA >20/40 increased from 27% when starting treatment to 45% after 24 months; the proportion with vision of <20/200 remained unchanged (13% initial, 11% at 24 months). Of the included eyes, 90.5% avoided a vision loss of ≥15 letters. There was an overall mean of 13.0 injections over the 24 months, 7.5 injections in the first year and 5.5 in the second year, with a mean of 14.8 clinic visits. CONCLUSIONS These data indicate that eyes managed in routine clinical practice with a treat and extend regimen can achieve good visual outcomes while decreasing the burden of treatments and clinic visits.
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Affiliation(s)
| | - Anna Campain
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Daniel Barthelmes
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Judy M Simpson
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Robyn H Guymer
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Victoria, Australia
| | - Alex P Hunyor
- The Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Retina Associates, Chatswood, New South Wales, Australia
| | - Ian L McAllister
- Lions Eye Institute, Centre for Ophthalmology and Vision Science, University of Western Australia, Western Australia
| | - Rohan W Essex
- Academic Unit of Ophthalmology, Australian National University, Acton, Canberra, Australia
| | - Nigel Morlet
- University of Western Australia Department of Population Health, Perth, Western Australia
| | - Mark C Gillies
- Marsden Eye Specialists, Parramatta, New South Wales, Australia
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Lim L, Chantiluke K, Cubillo AI, Smith AB, Simmons A, Mehta MA, Rubia K. Disorder-specific grey matter deficits in attention deficit hyperactivity disorder relative to autism spectrum disorder. Psychol Med 2015; 45:965-76. [PMID: 25229248 PMCID: PMC4413819 DOI: 10.1017/s0033291714001974] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 07/20/2014] [Accepted: 07/21/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are two common childhood disorders that exhibit genetic and behavioural overlap and have abnormalities in similar brain systems, in particular in frontal and cerebellar regions. This study compared the two neurodevelopmental disorders to investigate shared and disorder-specific structural brain abnormalities. METHOD Forty-four predominantly medication-naïve male adolescents with ADHD, 19 medication-naïve male adolescents with ASD and 33 age-matched healthy male controls were scanned using high-resolution T1-weighted volumetric imaging in a 3-T magnetic resonance imaging (MRI) scanner. Voxel-based morphometry (VBM) was used to test for group-level differences in structural grey matter (GM) and white matter (WM) volumes. RESULTS There was a significant group difference in the GM of the right posterior cerebellum and left middle/superior temporal gyrus (MTG/STG). Post-hoc analyses revealed that this was due to ADHD boys having a significantly smaller right posterior cerebellar GM volume compared to healthy controls and ASD boys, who did not differ from each other. ASD boys had a larger left MTG/STG GM volume relative to healthy controls and at a more lenient threshold relative to ADHD boys. CONCLUSIONS The study shows for the first time that the GM reduction in the cerebellum in ADHD is disorder specific relative to ASD whereas GM enlargement in the MTG/STG in ASD may be disorder specific relative to ADHD. This study is a first step towards elucidating disorder-specific structural biomarkers for these two related childhood disorders.
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Affiliation(s)
- L. Lim
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry,
King's College London, UK
- Department of Psychological Medicine,
Yong Loo Lin School of Medicine, National
University of Singapore, Singapore
| | - K. Chantiluke
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry,
King's College London, UK
| | - A. I. Cubillo
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry,
King's College London, UK
| | - A. B. Smith
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry,
King's College London, UK
| | - A. Simmons
- Department of Neuroimaging,
Institute of Psychiatry, King's College London,
UK
- NIHR Biomedical Research Centre at South London
and Maudsley NHS Foundation Trust (SLaM), London,
UK
| | - M. A. Mehta
- Department of Neuroimaging,
Institute of Psychiatry, King's College London,
UK
| | - K. Rubia
- Department of Child and Adolescent
Psychiatry, Institute of Psychiatry,
King's College London, UK
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Zhang XQ, Even-Or O, Xu X, van Rosmalen M, Lim L, Gadde S, Farokhzad OC, Fisher EA. Nanoparticles containing a liver X receptor agonist inhibit inflammation and atherosclerosis. Adv Healthc Mater 2015; 4:228-36. [PMID: 25156796 DOI: 10.1002/adhm.201400337] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 07/28/2014] [Indexed: 01/25/2023]
Abstract
Liver X receptor (LXR) signaling pathways regulate lipid metabolism and inflammation, which has generated widespread interest in developing synthetic LXR agonists as potential therapeutics for the management of atherosclerosis. In this study, it is demonstrated that nanoparticles (NPs) containing the synthetic LXR agonist GW3965 (NP-LXR) exert anti-inflammatory effects and inhibit the development of atherosclerosis without causing hepatic steatosis. These NPs are engineered through self-assembly of a biodegradable diblock poly(lactide-co-glycolide)-b-poly(ethylene glycol) (PLGA-b-PEG) copolymer. NP-LXR is significantly more effective than free GW3965 at inducing LXR-target gene expression and suppressing inflammatory factors in macrophages in vitro and in vivo. Additionally, the NPs elicit negligible lipogenic gene stimulation in the liver. Using the Ldlr (-/-) mouse model of atherosclerosis, abundant colocalization of fluorescently labeled NPs within plaque macrophages following systemic administration is seen. Notably, six intravenous injections of NP-LXR over 2 weeks markedly reduce the CD68-positive cell (macrophage) content of plaques (by 50%) without increasing total cholesterol or triglycerides in the liver and plasma. Together, these findings identify GW3965-encapsulated PLGA-b-PEG NPs as a promising nanotherapeutic approach to combat atherosclerosis, providing the benefits of LXR agonists without their adverse effects on hepatic and plasma lipid metabolism.
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Affiliation(s)
- Xue-Qing Zhang
- Laboratory of Nanomedicine and Biomaterials; Department of Anesthesiology; Brigham and Women's Hospital; Harvard Medical School; Boston MA 02115 USA
| | - Orli Even-Or
- Leon H. Charney Division of Cardiology and the Marc and Ruti Bell Program in Vascular Biology; Department of Medicine; New York University School of Medicine; New York NY 10016 USA
| | - Xiaoyang Xu
- Laboratory of Nanomedicine and Biomaterials; Department of Anesthesiology; Brigham and Women's Hospital; Harvard Medical School; Boston MA 02115 USA
- The David H. Koch Institute for Integrative Cancer Research; Massachusetts Institute of Technology; Cambridge MA 02139 USA
| | - Mariska van Rosmalen
- Leon H. Charney Division of Cardiology and the Marc and Ruti Bell Program in Vascular Biology; Department of Medicine; New York University School of Medicine; New York NY 10016 USA
| | - Lucas Lim
- Laboratory of Nanomedicine and Biomaterials; Department of Anesthesiology; Brigham and Women's Hospital; Harvard Medical School; Boston MA 02115 USA
| | - Suresh Gadde
- Laboratory of Nanomedicine and Biomaterials; Department of Anesthesiology; Brigham and Women's Hospital; Harvard Medical School; Boston MA 02115 USA
| | - Omid C. Farokhzad
- Laboratory of Nanomedicine and Biomaterials; Department of Anesthesiology; Brigham and Women's Hospital; Harvard Medical School; Boston MA 02115 USA
- King Abdulaziz University; Jeddah 21589 Saudi Arabia
| | - Edward A. Fisher
- Leon H. Charney Division of Cardiology and the Marc and Ruti Bell Program in Vascular Biology; Department of Medicine; New York University School of Medicine; New York NY 10016 USA
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Field K, Wong HL, Shapiro J, Kosmider S, Tie J, Bae S, Yip D, McKendrick J, Nott L, Desai J, Harold M, Lipton L, Stefanou G, Lim L, Parente P, Gibbs P. Developing a national database for metastatic colorectal cancer management: perspectives and challenges. Intern Med J 2014; 43:1224-31. [PMID: 23834128 DOI: 10.1111/imj.12230] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 06/27/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND The changing treatment landscape for metastatic colorectal cancer creates multiple potential treatment strategies. An Australian-centric database capturing comprehensive information across a range of treatment locations would create a valuable resource enabling multiple important research questions to be addressed. AIMS To establish a collection of a consensus dataset capturing treatment and outcomes at multiple public and private hospitals across Australia. METHODS An electronic database was developed by a panel of clinicians, to capture an agreed dataset for patients with newly diagnosed metastatic colorectal cancer. Of particular interest were clinician decision-making, the impact of comorbidities and the frequency of major adverse events. RESULTS Since July 2009, data collection has been established at six public and eight private hospitals across three Australian states and territories. Successful linkage and analysis, with support from BioGrid Australia, of selected data on the initial 864 patients demonstrates that data can be captured from diverse sites, including public and private practice, that multiple factors impact on treatment delivered and outcomes achieved and that comprehensive data on rare but important adverse events can be captured. As a clinical research tool, the project has been highly successful, generating multiple presentations at national and international conferences related to a diverse range of research questions. CONCLUSIONS Multistate, project-specific data collection involving large numbers of patients is achievable. Providing invaluable insight into the routine clinical management of metastatic colorectal cancer in the era of targeted therapies, this also creates a significant resource for research, including many questions not being addressed by clinical trials.
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Affiliation(s)
- K Field
- Medical Oncology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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Lim L, Tanguy JY, Della Schiava L, Ghitu-Barbieux C, Godard S, Verny C, Morar-Precup AD. Un tableau radiologique atypique d’un lymphome cérébral primitif. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Aljandan B, Alharkan A, Lim L, Marei H, Guerrero J. The efficacy of biodegradable mesh as a fixation device for support of autogenous onlay bone grafts: a radiographic and histomorphometric analysis. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2013.07.600] [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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Loh C, Teo YW, Lim L. Deliberate self-harm in adolescent psychiatric outpatients in Singapore: prevalence and associated risk factors. Singapore Med J 2013; 54:491-5. [DOI: 10.11622/smedj.2013170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Powles T, Kayani I, Sharpe K, Lim L, Peters J, Stewart G, Berney D, Sahdev A, Chowdhury S, Boleti E, Shamash J, Reynolds A, Jones R, Blank C, Haanen J, Bex A. A prospective evaluation of VEGF-targeted treatment cessation in metastatic clear cell renal cancer. Ann Oncol 2013; 24:2098-103. [DOI: 10.1093/annonc/mdt130] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [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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Sinclair M, Roberts S, Kemp W, Knight V, Dev A, Gow P, Philpott H, Kronborg I, Arachchi NJ, Bell S, Lim L, Gorelik A, Nicoll A. Epidemiology of hepatitis B-associated hepatocellular carcinoma in Victoria. Intern Med J 2013; 43:501-6. [DOI: 10.1111/imj.12068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 12/16/2012] [Indexed: 12/16/2022]
Affiliation(s)
- M. Sinclair
- Department of Gastroenterology and Hepatology; Royal Melbourne Hospital; Heidelberg Victoria Australia
| | - S. Roberts
- Department of Gastroenterology; Alfred Hospital; Heidelberg Victoria Australia
| | - W. Kemp
- Department of Gastroenterology; Alfred Hospital; Heidelberg Victoria Australia
| | - V. Knight
- Department of Gastroenterology; Monash Medical Centre; Heidelberg Victoria Australia
| | - A. Dev
- Department of Gastroenterology; Monash Medical Centre; Heidelberg Victoria Australia
| | - P. Gow
- Department of Gastroenterology; Austin; Heidelberg Victoria Australia
| | - H. Philpott
- Department of Gastroenterology; Austin; Heidelberg Victoria Australia
| | - I. Kronborg
- Department of Gastroenterology; Western Hospital; Melbourne Victoria Australia
| | - N. J. Arachchi
- Department of Gastroenterology; Western Hospital; Melbourne Victoria Australia
| | - S. Bell
- Department of Gastroenterology; St Vincent's Hospital; Melbourne Victoria Australia
| | - L. Lim
- Department of Gastroenterology; St Vincent's Hospital; Melbourne Victoria Australia
| | - A. Gorelik
- Department of Clinical Epidemiology; Royal Melbourne Hospital; Heidelberg Victoria Australia
| | - A. Nicoll
- Department of Gastroenterology and Hepatology; Royal Melbourne Hospital; Heidelberg Victoria Australia
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Ding NS, De Cruz P, Lim L, Thompson A, Desmond P. Androgenic-anabolic steroid drug-induced liver injury. Intern Med J 2013; 43:215-6. [DOI: 10.1111/imj.12054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 10/28/2012] [Indexed: 11/28/2022]
Affiliation(s)
- N. S. Ding
- Gastroenterology and Hepatology department; St Vincent's Hospital; Melbourne; Victoria; Australia
| | - P. De Cruz
- Gastroenterology and Hepatology department; St Vincent's Hospital; Melbourne; Victoria; Australia
| | - L. Lim
- Gastroenterology and Hepatology department; St Vincent's Hospital; Melbourne; Victoria; Australia
| | - A. Thompson
- Gastroenterology and Hepatology department; St Vincent's Hospital; Melbourne; Victoria; Australia
| | - P. Desmond
- Gastroenterology and Hepatology department; St Vincent's Hospital; Melbourne; Victoria; Australia
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