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O'Driscoll JM, Edwards JJ, Greenhough E, Smith E, May M, Gupta S, Marciniak A, Sharma R. The value of cardiopulmonary exercise testing and stress echocardiography in the prediction of all-cause mortality in adults with end-stage renal disease. Eur J Sport Sci 2023:1-10. [PMID: 36815759 DOI: 10.1080/17461391.2023.2184727] [Citation(s) in RCA: 1] [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] [Indexed: 02/24/2023]
Abstract
We aimed to assess the prognostic utility of different parameters routinely assessed from cardiopulmonary exercise testing (CPET) and exercise echocardiography in adults with end-stage renal disease (ESRD). Forty-two ESRD (37 male) individuals (age: 58 ± 13 years, height: 169.30 ± 8.30 cm, weight: 81 ± 15 kg, body surface area: 1.92 ± 0.20 m2) underwent a maximal/symptom limited CPET, with a full cross-sectional echocardiogram performed at baseline and peak exercise. All participants were prospectively followed over a 10-year period, with all-cause mortality as the primary endpoint. After the follow-up period, a total of 19 participants (45%) died. Left atrial size (4.70 ± 0.70 vs. 3.65 ± 0.50 cm, P < 0.001) and anteroseptal wall thickness (1.28 ± 0.40 vs. 1.06 ± 0.02 cm, P = 0.002) were significantly greater in those that died, while peak heart rate was significantly lower (108 ± 12 vs. 128 ± 14 bpm, P < 0.001). The prevalence of myocardial ischaemia (13 vs. 8 participants, P = 0.03) was significantly greater, while peak VO2 (9.80 ± 2.10 vs. 15.90 ± 4.30 ml·kg-1·min-1, P < 0.001) was significantly lower in those that died. Following multivariate cox regression, myocardial ischaemia (Hazard Ratio 3.08; 95% Confidence Interval 1.09-8.70; P = 0.03) and peak VO2 (HR 0.73; 95% CI 0.64-0.84; P < 0.001) were significant independent predictors of 10-year all-cause mortality. This is the first study to establish peak VO2 as powerful marker of all-cause mortality when assessed with clinical, resting and stress echocardiography parameters in people with ESRD over a 10-year follow up period. This observation indicates that, in clinical practice, CPET and exercise echocardiography may serve as valuable tools for the risk stratification of individuals with ESRD. HIGHLIGHTSWe aimed to assess the prognostic utility of cardiopulmonary exercise testing (CPET) and exercise echocardiography in end-stage renal disease (ESRD) with 10-year mortality.Peak aerobic capacity and the presence of ischaemic heart disease were independently associated with all-cause mortality.This observation indicates that, in clinical practice, CPET and exercise echocardiography may serve as valuable tools for the risk stratification of individuals with end-stage renal disease.
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Affiliation(s)
- J M O'Driscoll
- Department of Cardiology, St George's Healthcare NHS Trust, London, UK.,School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, UK
| | - J J Edwards
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, UK
| | - E Greenhough
- Department of Cardiology, St George's Healthcare NHS Trust, London, UK
| | - E Smith
- Department of Cardiology, St George's Healthcare NHS Trust, London, UK
| | - M May
- Department of Cardiology, St George's Healthcare NHS Trust, London, UK
| | - S Gupta
- York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | - A Marciniak
- Department of Cardiology, St George's Healthcare NHS Trust, London, UK
| | - R Sharma
- Department of Cardiology, St George's Healthcare NHS Trust, London, UK
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Badrick T, Shirley K, Quagliotto G, May M, Meumann E, Leonard N, Simos P, MacDougall R, Bursle E. Paracoccidioidomycosis: an Australian case. Pathology 2023. [DOI: 10.1016/j.pathol.2022.12.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Daniel S, May M, Uder M, Kopp M, Taubmann O. Automatisierte Textanalyse für die personalisierte Protokollauswahl der thorakalen Computertomographie. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749776] [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: 11/05/2022]
Affiliation(s)
- S Daniel
- Universitätsklinikum Erlangen, nstitut für diagnostische und interventionelle Radiologie,, Erlangen
| | - M May
- Institut für diagnostische und interventionelle Radiologie, Universitätsklinikum, Erlangen
| | - M Uder
- Institut für diagnostische und interventionelle Radiologie, Universitätsklinikum, Erlangen
| | - M Kopp
- Institut für diagnostische und interventionelle Radiologie, Universitätsklinikum, Erlangen
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Green E, Chase A, Robinson M, Callagy S, Lundstedt C, Dykstra L, Van Andel D, Noyes C, Rostama B, Miller W, May M. Molecular Methodology for Tick Speciation and Tickborne Pathogen Surveillance. Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Cutting R, May M. Pandemic Parallels: Common Threads between the emergence of SARS-CoV-2 and HIV. Int J Infect Dis 2022. [PMCID: PMC8884813 DOI: 10.1016/j.ijid.2021.12.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose This analysis explored the parallels between the emergence of human immunodeficiency virus (HIV) and its associated disease (acquired immune deficiency syndrome [AIDS]), and SARS-CoV-2 and its associated disease (Coronavirus disease 2019 [COVID-19]) in order to highlight common patterns that enabled the epidemics of novel pathogens. Methods & Materials Our laboratory developed a core set of ten questions that focused on common features found in major disease epidemics, including the affected populations, the response parameters and dynamics of governments, the natural source of the infectious agent, and the impacts of epidemics on societies as a whole. We utilized contemporary accounts including news coverage, written descriptions, documentary accounts, and primary literatures to determine full answers to the core questions. Results Eight of the ten questions identified commonalities between the AIDS and COVID-19 pandemics. These include slow government policy responses that negatively impacted the timing and the epidemic trajectory, involvement of marginalized populations of societies who were disproportionately affected by the diseases, discovery of existence of persistent economic and social inequalities, and introduction of lifelong morbidities in patients. Most importantly, this analysis found the importance of collaborative, scientifically driven political leadership as evidenced by the improved pace of disease control measures and research for therapeutic and vaccine discovery following adoption of evidence-based policy. Conclusion This analysis identifies multiple factors that paralleled the trajectory of the HIV/AIDS epidemic and SARS-CoV-2/COVID-19 pandemic. In order to prepare for potential pandemics or large-scale outbreaks in the future, policies mindful of these lessons outlined will help provide guidance for future responses to emerging pathogens.
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Schellong S, Kretzschmar A, Heinken A, May M, Kolbe K, Schreiber S, Riess H. Anticoagulation treatment of cancer patients with deep or superficial leg vein thrombosis - a retrospective observational study of German statutory health insurance claims data (the CERTIFICAT initiative). VASA 2020; 49:403-409. [PMID: 32520658 DOI: 10.1024/0301-1526/a000878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Thrombosis is a common complication of cancer with a negative impact on quality of life and overall prognosis. Guidelines recommend low-molecular-weight heparin (LMWH) as initial and prolonged anticoagulation treatment. Little is known about current treatment patterns of these patients in ambulatory care. Patients and methods: The current retrospective observational study interrogates a large German statutory health insurance claims database in order to understand which kind of data can be extracted and analysed. An age- and sex-adjusted sample of about 4.1 million insured people from 2011 to 2016 could be used. Cancer patients with incident deep and superficial leg vein thrombosis were identified. Patients with preexisting cancer were allocated to a normal risk group; those who suffered from simultaneously diagnosed cancer and thrombosis were classified as high-risk group. Results: We identified 322,600 patients with inpatient or outpatient documented cancer diagnosis in at least two different quarters within one year. 87,755 patients were identified with an incident deep or superficial vein thrombosis. 8,201 patients suffered from both cancer and incident thrombosis. 56.9% of the patients received an anticoagulation regimen with predominant LMWH prescription, 24.2% vitamin K antagonists, 17.2% direct oral anticoagulants; in 1.7% of patients, no predominant anticoagulant drug/regime could be identified. On average, patients were prescribed anticoagulants for 4.5 months. An estimate of clinically relevant gastrointestinal bleeding could be derived (1.8% of patients). Conclusions: The dataset allows assigning detailed information of anticoagulant prescriptions in ambulatory care to well-defined groups of cancer patients. A first analysis suggests that in Germany current medical care of patients with cancer-related deep or superficial vein thrombosis does not entirely comply with guideline recommendations regarding type and duration of anticoagulation.
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Affiliation(s)
- S Schellong
- Medical Clinic Department for Cardiovascular Disease, Städtisches Klinikum Dresden, Germany
| | - A Kretzschmar
- Department for Haematology and Internist Oncology, Klinikum St. Georg, Leipzig, Germany
| | | | - M May
- HGC Healthcare Consultants GmbH, Duesseldorf, Germany
| | - K Kolbe
- HGC Healthcare Consultants GmbH, Duesseldorf, Germany
| | - S Schreiber
- HGC Healthcare Consultants GmbH, Duesseldorf, Germany
| | - H Riess
- Medical Department, Division of Oncology and Hematology, Campus Charité Mitte, Charité Universitätsmedizin Berlin, Germany
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Schneider F, Schulz CM, May M, Schneider G, Jacob M, Mutlak H, Pawlik M, Zoller M, Kretzschmar M, Koch C, Kees MG, Burger M, Lebentrau S, Novotny A, Hübler M, Koch T, Heim M. [Is the discipline associated with self-confidence in handling rational antibiotic prescription? : Results from the MR2 study in German hospitals]. Anaesthesist 2020; 69:162-169. [PMID: 32055886 DOI: 10.1007/s00101-020-00736-3] [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: 10/16/2019] [Revised: 12/12/2019] [Accepted: 01/14/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Besides public awareness and specialist knowledge and training of physicians, their self-confidence plays a key role for clinical decision-making in the respective area. OBJECTIVE This exploratory study investigated the influence of the discipline on differences in self-confidence in dealing with antibiotics and in the self-rated knowledge. METHODS In 2015 the multi-institutional reconnaissance of practice with multiresistant bacteria (MR2) questionnaire containing items on antibiotic prescription and multiresistant pathogens was sent out to 1061 physicians working in departments for internal medicine, general surgery, gynecology and obstetrics and urology. In 2017 a similar MR2 survey was sent to 1268 specialist and assistant physicians in anesthesiology in Germany. Besides demographic data 4 items on self-confidence in the use of antibiotic treatment and 11 items concerning self-rated knowledge about rational antibiotic therapy and multiresistant pathogens were included in the present analysis. Logistic regression analysis, the χ2-test and the Kruskal-Wallis test were used for statistical analysis of the influence of the discipline on these items. RESULTS The response rates were 43% (456 out of 1061) from the non-anesthetists and 56% (705 out of 1268) from the anesthetists. Of the non-anesthetists 44% and 57% of the anesthetists had had no advanced training on antibiotic stewardship during the year before the study. In the overall analysis anesthetists (mean±SD: 2.53±0.54) were significantly less self-confident about antibiotics than colleagues from other departments (internal medicine: 3.10±0.50, general surgery: 2.97±0.44, gynecology and obstetrics: 3.12±0.42 and urology: 3.15±0.44) in the unadjusted (all p<0.001) and adjusted comparison. The analysis of self-rated knowledge about rational antibiotic prescription showed similar results. Senior consultant status and advanced training in infectiology were significantly associated with self-confidence and self-rated knowledge about antibiotics. CONCLUSION Anesthetists showed significantly less self-confidence in dealing with antibiotics than colleagues from other disciplines. Advanced training on a rational prescription of antibiotics was associated with a greater self-confidence, so that the implementation of compulsory courses on rational antibiotic stewardship in the respective residency curriculum needs to be considered.
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Affiliation(s)
- F Schneider
- Fakultät für Medizin, Klinik für Anästhesiologie und Intensivmedizin, Technische Universität München, München, Deutschland. .,Klinik für Anästhesiologie und Intensivmedizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
| | - C M Schulz
- Fakultät für Medizin, Klinik für Anästhesiologie und Intensivmedizin, Technische Universität München, München, Deutschland
| | - M May
- Urologische Klinik, St. Elisabeth-Klinikum Straubing, Straubing, Deutschland
| | - G Schneider
- Fakultät für Medizin, Klinik für Anästhesiologie und Intensivmedizin, Technische Universität München, München, Deutschland
| | - M Jacob
- Klinik für Anästhesiologie, Operative Intensivmedizin und Schmerzmedizin, Klinikum St. Elisabeth Straubing, Straubing, Deutschland
| | - H Mutlak
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt, Deutschland
| | - M Pawlik
- Klinik für Anästhesiologie, Krankenhaus St. Josef Regensburg, Regensburg, Deutschland
| | - M Zoller
- Klinik für Anästhesiologie der Universität München, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland
| | - M Kretzschmar
- Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - C Koch
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Justus-Liebig-Universität Gießen, Gießen, Deutschland
| | - M G Kees
- Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - M Burger
- Urologische Klinik, Caritas St. Josef Krankenhaus, Universität Regensburg, Regensburg, Deutschland
| | - S Lebentrau
- Urologische Klinik, Ruppiner Kliniken GmbH, Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Deutschland
| | - A Novotny
- Fakultät für Medizin, Klinik und Poliklinik für Chirurgie, Technische Universität München, München, Deutschland
| | - M Hübler
- Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - T Koch
- Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - M Heim
- Fakultät für Medizin, Klinik für Anästhesiologie und Intensivmedizin, Technische Universität München, München, Deutschland
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Distler FA, Pahernik S, Gakis G, Hutterer G, Lebentrau S, Rink M, Nuhn P, Brookman-May S, Burger M, Gratzke C, Wolff I, May M. Adherence to the EAU guideline recommendations for systemic chemotherapy in penile cancer: results of the E-PROPS study group survey. World J Urol 2019; 38:2523-2530. [PMID: 31834472 DOI: 10.1007/s00345-019-03052-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/06/2019] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To validate the adherence of urologists to chemotherapy recommendations given in the EAU guidelines on PeCa. The European Association of Urology (EAU) guidelines on penile cancer (PeCa) are predominantly based on retrospective studies with low level of evidence. MATERIALS AND METHODS A 14-item-survey addressing general issues of PeCa treatment was developed and sent to 45 European hospitals. 557 urologists participated in the survey of which 43.5%, 19.3%, and 37.2% were in-training, certified, and in leading positions, respectively. Median response rate among participating departments was 85.7% (IQR 75-94%). Three of 14 questions addressed clinical decisions on neoadjuvant, adjuvant, and palliative chemotherapy. Survey results were analyzed by bootstrap-adjusted multivariate logistic-regression-analysis to identify predictors for chemotherapy recommendations consistent with the guidelines. RESULTS Neoadjuvant, adjuvant, and palliative chemotherapy was recommended according to EAU guidelines in 21%, 26%, and 48%, respectively. For neoadjuvant chemotherapy, urologists holding leading positions or performing chemotherapy were more likely to recommend guideline-consistent treatment (OR 1.85 and 1.92 with p(bootstrap) = 0.007 and 0.003, respectively). Supporting resources (i.e., guidelines, textbooks) were used by 23% of survey participants and significantly improved consistency between treatment recommendations and Guideline recommendations in all chemotherapy settings (p(bootstrap) = 0.010-0.001). Department size and university center status were no significant predictors for all three endpoints. CONCLUSIONS In this study, we found a very low rate of adherence to the EAU guidelines on systemic treatment for PeCa. Further investigations are needed to clarify whether this missing adherence is a consequence of limited individual knowledge level or of the low grade of guideline recommendations.
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Affiliation(s)
- F A Distler
- Department of Urology, Klinikum Nuremberg, Paracelsus Medical University Nuremberg, Nuremberg, Germany.
| | - S Pahernik
- Department of Urology, Klinikum Nuremberg, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - G Gakis
- Department of Urology and Pediatric Urology, University Hospital of Würzburg, Würzburg, Germany
| | - G Hutterer
- Department of Urology, Medical University of Graz, Graz, Austria
| | - S Lebentrau
- Department of Urology, Brandenburg Medical School Theodor Fontane, Ruppiner Kliniken, Neuruppin, Germany
| | - M Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Nuhn
- Department of Urology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - S Brookman-May
- Department of Urology, Großhadern, LMU Munich, Munich, Germany
| | - M Burger
- Department of Urology, St. Josef-Hospital Regensburg, Medical University Regensburg, Regensburg, Germany
| | - C Gratzke
- Department of Urology, University of Freiburg, Freiburg, Germany
| | - I Wolff
- Department of Urology, University Medicine Greifswald, Greifswald, Germany
| | - M May
- Department of Urology, St. Elisabeth-Hospital Straubing, Straubing, Germany
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May M, Schönthaler M, Gilfrich C, Wolff I, Peter J, Miernik A, Fritsche HM, Burger M, Schostak M, Lebentrau S. [Interrater reliability and clinical impact of the Post-Ureteroscopic Lesion Scale (PULS) grading system for ureteral lesions after ureteroscopy : Results of the German prospective multicenter BUSTER project]. Urologe A 2019; 57:172-180. [PMID: 29322235 DOI: 10.1007/s00120-017-0565-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND The Post-ureteroscopic Lesion Scale (PULS) was designed as a standardized classification system for ureteral lesions after uretero(reno)scopy (URS). This study evaluates its routine use and a possible clinical impact based on a representative patient cohort. MATERIALS AND METHODS Data of 307 patients in 14 German centers within the BUSTER project were used to test 3 hypotheses (H): PULS score shows a high interrater reliability (IRR) after independent assessment by urologic surgeon and assistance personnel (H1); PULS score is correlated with the frequency of postoperative complications during hospital stay (H2); post-URS stenting of the ureter is associated with higher PULS scores (H3). RESULTS Median age of patients was 54.4 years (interquartile range [IQR] 44.4-65.8; 65.5% male). Median diameter of index stones was 6 mm (IQR 4-8) with 117 (38.4%) pyelo-caliceal and 188 (61.6%) ureteral stones. Overall, 70 and 82.4% of patients had pre-stenting and post-URS stenting, respectively. Stone-free status was achieved in 68.7% after one URS procedure with a complication rate of 10.8% (mostly grade 1-2 according to Clavien-Dindo). PULS scores 0, 1, 2 and 3 were assessed in 40%, 52.1%, 6.9% and 1% of patients, respectively, when estimated by urologic surgeons. PULS score showed a high IRR between the urologic surgeon and assistance personnel (κ = 0.883, p < 0.001), but was not significantly correlated with complications (ρ = 0.09, p = 0.881). In contrast, a significant positive correlation was found between PULS score and post-URS stenting (ρ = 0.287, p < 0.001). A PULS score of 1 multiplied the likelihood of post-URS stenting by 3.24 (95% confidence interval 1.43-7.34; p = 0.005) as opposed to PULS score 0. CONCLUSIONS Removal of upper urinary tract stones using URS is safe and efficacious. Real-world data provided by this study confirm a high IRR of the PULS score and its clinical impact on the indication for post-URS stenting. A future prospective randomized trial should evaluate a possible standardization of post-URS stenting based on PULS score assessment.
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Affiliation(s)
- M May
- Urologische Kliniken, St. Elisabeth-Klinikum Straubing, St.-Elisabeth-Str. 23, 94315, Straubing, Deutschland.
| | - M Schönthaler
- Urologische Kliniken, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - C Gilfrich
- Urologische Kliniken, St. Elisabeth-Klinikum Straubing, St.-Elisabeth-Str. 23, 94315, Straubing, Deutschland
| | - I Wolff
- Urologische Kliniken, Carl-Thiem-Klinikum Cottbus, Cottbus, Deutschland
| | - J Peter
- Urologische Kliniken, St. Elisabeth-Klinikum Straubing, St.-Elisabeth-Str. 23, 94315, Straubing, Deutschland
| | - A Miernik
- Urologische Kliniken, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - H-M Fritsche
- Urologische Kliniken, Universitätsklinikum Regensburg, Caritas-Krankenhaus St. Josef, Regensburg, Deutschland.,Urologische Abteilung der Chirurgischen Klinik München-Bogenhausen, München, Deutschland
| | - M Burger
- Urologische Kliniken, Universitätsklinikum Regensburg, Caritas-Krankenhaus St. Josef, Regensburg, Deutschland
| | - M Schostak
- Urologische Kliniken, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Deutschland
| | - S Lebentrau
- Urologische Kliniken, Ruppiner Kliniken GmbH, Hochschulklinikum der MHB, Neuruppin, Deutschland
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May M, Brown DR. International Committee on Systematics of Prokaryotes Subcommittee on the taxonomy of Mollicutes: Minutes of the closed meeting, 8 July 2018, Portsmouth, New Hampshire, USA. Int J Syst Evol Microbiol 2019; 69:2169-2171. [PMID: 30856090 DOI: 10.1099/ijsem.0.003342] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This report documents the International Committee on Systematics of Prokaryotes Subcommittee on the taxonomy of Mollicutes by recording the minutes of the meeting, held 8 July 2018, Portsmouth, New Hampshire, USA.
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Affiliation(s)
- M May
- 1University of New England, USA
| | - D R Brown
- 2University of Florida College of Veterinary Medicine, USA
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Kretzschmar A, May M, Heinken A, Riess H. Anticoagulant treatment of patients (pts) with cancer associated thromboembolism (CAT) in Germany: Real world data from a 4 million people sample generated by insurance captured data. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy297.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mutlak H, Zacharowski K, Ernst C, May M. Kenntnisse deutscher Anästhesisten zu Antibiotic Stewardship. Anaesthesist 2018; 67:793-796. [DOI: 10.1007/s00101-018-0491-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Borgmann H, Musquera M, May M, Brookman-May SD. Answer to comment on manuscript "Prognostic significance of Fuhrman grade and age for cancer-specific and overall survival in patients with papillary renal cell carcinoma: results of an international multi-institutional study on 2189 patients". World J Urol 2018; 36:2091-2092. [PMID: 30022407 DOI: 10.1007/s00345-018-2383-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 06/16/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- H Borgmann
- Department of Urology, University Hospital Mainz, Mainz, Germany
| | - M Musquera
- Hospital Clínic, University of Barcelona, Barcelona, Spain.
| | - M May
- Department of Urology, Klinikum St. Elisabeth Straubing, Straubing, Germany
| | - S D Brookman-May
- Department of Urology, Ludwig-Maximilians-University, Campus Grosshadern, Marchionistrasse 15, 81377, Munich, Germany
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Wolff I, Lebentrau S, Miernik A, Ecke T, Gilfrich C, Hoschke B, Schostak M, May M. Impact of surgeon's experience on outcome parameters following ureterorenoscopic stone removal. Urolithiasis 2018; 47:473-479. [PMID: 29974193 DOI: 10.1007/s00240-018-1073-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022]
Abstract
Within the BUSTER trial, we analyzed the surgeon's amount of experience and other parameters associated with URS procedures regarding the stone-free rate, complication rate, and operative time. Patient characteristics and surgical details on 307 URS procedures were prospectively documented according to a standardized study protocol at 14 German centers 01-04/2015. Surgeon's experience was correlated to clinical characteristics, and its impact on the stone-free rate, complication rate, and operative time subjected to multivariate analysis. 76 (25%), 66 (21%) and 165 (54%) of 307 URS procedures were carried out by residents, young specialists, and experienced specialists (> 5 years after board certification), respectively. Median stone size was 6 mm, median operative time 35 min. A ureteral stent was placed at the end of 82% of procedures. Stone-free rate and stone-free rate including minimal residual stone fragments (adequate for spontaneous clearance) following URS were 69 and 91%, respectively. No complications were documented during the hospital stays of 89% of patients (Clavien-Dindo grade 0). According to multivariate analysis, experienced specialists achieved a 2.2-fold higher stone-free rate compared to residents (p = 0.038), but used post-URS stenting 2.6-fold more frequently (p = 0.023). Surgeon's experience had no significant impact on the complication rate. We observed no differences in this study's main endpoints, namely the stone-free and complication rates, between residents and young specialists, but experienced specialists' stone-free rate was significantly higher. During this cross-sectional study, 75% of URS procedures were performed by specialists. The experienced specialists' more than two-fold higher stone-free rate compared to residents' justifies ongoing efforts to establish structured URS training programs.
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Affiliation(s)
- I Wolff
- Klinik für Urologie und Neuro-Urologie, Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Germany. .,Urologische Klinik, Carl-Thiem-Klinikum Cottbus gGmbH, Cottbus, Germany.
| | - S Lebentrau
- Klinik für Urologie und Kinderurologie, Brandenburg Medical School, Ruppiner Kliniken GmbH, Neuruppin, Germany
| | - A Miernik
- Klinik für Urologie, Universitätsklinikum Freiburg, Freiburg, Germany
| | - T Ecke
- Klinik für Urologie, Helios Klinikum Bad Saarow, Bad Saarow, Germany
| | - C Gilfrich
- Klinik für Urologie, Klinikum St. Elisabeth Straubing GmbH, Straubing, Germany
| | - B Hoschke
- Urologische Klinik, Carl-Thiem-Klinikum Cottbus gGmbH, Cottbus, Germany
| | - M Schostak
- Universitätsklinik für Urologie und Kinderurologie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - M May
- Klinik für Urologie, Klinikum St. Elisabeth Straubing GmbH, Straubing, Germany
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15
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Roiner M, Maurer O, Lebentrau S, Gilfrich C, Schäfer C, Haberl C, Brookman-May S, Burger M, May M, Hakenberg O. [Management of penile cancer patients: new aspects of a rare tumour entity]. Aktuelle Urol 2018; 49:242-249. [PMID: 29237189 DOI: 10.1055/s-0043-121223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Over the past few decades, some principles in the treatment of penile cancer have changed fundamentally. While 15 years ago a negative surgical margin of at least 2 cm was considered mandatory, organ-sparing surgery permitting minimal negative surgical margins has a high priority nowadays. The current treatment principle requires as much organ preservation as possible and as much radicality as necessary. The implementation of organ-sparing and reconstructive surgical techniques has improved the quality of life of surviving patients. However, oncological and functional outcomes are still unsatisfactory. Alongside with adequate local treatment of the primary tumour, a consistent management of inguinal lymph nodes is of fundamental prognostic significance. In particular, clinically inconspicuous inguinal lymph nodes staged T1b and upwards need a surgical approach. Sentinel node biopsy, minimally-invasive surgical techniques and modified inguinal lymphadenectomy have reduced morbidity compared to conventional inguinal lymph node dissection. Multimodal treatment with surgery and chemotherapy is required in all patients with lymph node-positive disease; neoadjuvant chemotherapy has been established for patients with locally advanced lymph node disease, and adjuvant treatment after radical inguinal lymphadenectomy for lymph node-positive disease. An increasing understanding of the underlying tumour biology, in particular the role of the human papilloma virus (HPV) and epidermal growth factor receptor (EGFR) status, has led to a new pathological classification and may further enhance treatment options. This review summarises current aspects in the therapeutic management of penile cancer.
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Affiliation(s)
- M. Roiner
- Urologische Klinik, Klinikum St. Elisabeth Straubing
| | - O. Maurer
- Urologische Klinik, Klinikum St. Elisabeth Straubing
| | - S. Lebentrau
- Klinik für Urologie und Kinderurologie, Ruppiner Kliniken GmbH Neuruppin, Hochschulklinikum der MHB
| | - C. Gilfrich
- Urologische Klinik, Klinikum St. Elisabeth Straubing
| | - C. Schäfer
- Fachbereich Strahlentherapie, MVZ des Klinikums St. Elisabeth Straubing
| | - C. Haberl
- Sektion Onkologie und Hämatologie der I. Medizinischen Klinik, Klinikum St. Elisabeth Straubing
| | - S. Brookman-May
- Urologische Klinik, Ludwigs-Maximilians-Universität (LMU) München
| | - M. Burger
- Urologische Klinik, Caritas-Krankenhaus St. Josef, Universität Regensburg
| | - M. May
- Urologische Klinik, Klinikum St. Elisabeth Straubing
| | - O. Hakenberg
- Urologische Klinik und Poliklinik, Universitätsklinikum Rostock
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16
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Tang WW, McGee P, Lachin JM, Li DY, Hoogwerf B, Hazen SL, Nathan D, Zinman B, Crofford O, Genuth S, Brown‐Friday J, Crandall J, Engel H, Engel S, Martinez H, Phillips M, Reid M, Shamoon H, Sheindlin J, Gubitosi‐Klug R, Mayer L, Pendegast S, Zegarra H, Miller D, Singerman L, Smith‐Brewer S, Novak M, Quin J, Genuth S, Palmert M, Brown E, McConnell J, Pugsley P, Crawford P, Dahms W, Gregory N, Lackaye M, Kiss S, Chan R, Orlin A, Rubin M, Brillon D, Reppucci V, Lee T, Heinemann M, Chang S, Levy B, Jovanovic L, Richardson M, Bosco B, Dwoskin A, Hanna R, Barron S, Campbell R, Bhan A, Kruger D, Jones J, Edwards P, Bhan A, Carey J, Angus E, Thomas A, Galprin A, McLellan M, Whitehouse F, Bergenstal R, Johnson M, Gunyou K, Thomas L, Laechelt J, Hollander P, Spencer M, Kendall D, Cuddihy R, Callahan P, List S, Gott J, Rude N, Olson B, Franz M, Castle G, Birk R, Nelson J, Freking D, Gill L, Mestrezat W, Etzwiler D, Morgan K, Aiello L, Golden E, Arrigg P, Asuquo V, Beaser R, Bestourous L, Cavallerano J, Cavicchi R, Ganda O, Hamdy O, Kirby R, Murtha T, Schlossman D, Shah S, Sharuk G, Silva P, Silver P, Stockman M, Sun J, Weimann E, Wolpert H, Aiello L, Jacobson A, Rand L, Rosenzwieg J, Nathan D, Larkin M, Christofi M, Folino K, Godine J, Lou P, Stevens C, Anderson E, Bode H, Brink S, Cornish C, Cros D, Delahanty L, eManbey ., Haggan C, Lynch J, McKitrick C, Norman D, Moore D, Ong M, Taylor C, Zimbler D, Crowell S, Fritz S, Hansen K, Gauthier‐Kelly C, Service F, Ziegler G, Barkmeier A, Schmidt L, French B, Woodwick R, Rizza R, Schwenk W, Haymond M, Pach J, Mortenson J, Zimmerman B, Lucas A, Colligan R, Luttrell L, Lopes‐Virella M, Caulder S, Pittman C, Patel N, Lee K, Nutaitis M, Fernandes J, Hermayer K, Kwon S, Blevins A, Parker J, Colwell J, Lee D, Soule J, Lindsey P, Bracey M, Farr A, Elsing S, Thompson T, Selby J, Lyons T, Yacoub‐Wasef S, Szpiech M, Wood D, Mayfield R, Molitch M, Adelman D, Colson S, Jampol L, Lyon A, Gill M, Strugula Z, Kaminski L, Mirza R, Simjanoski E, Ryan D, Johnson C, Wallia A, Ajroud‐Driss S, Astelford P, Leloudes N, Degillio A, Schaefer B, Mudaliar S, Lorenzi G, Goldbaum M, Jones K, Prince M, Swenson M, Grant I, Reed R, Lyon R, Kolterman O, Giotta M, Clark T, Friedenberg G, Sivitz W, Vittetoe B, Kramer J, Bayless M, Zeitler R, Schrott H, Olson N, Snetselaar L, Hoffman R, MacIndoe J, Weingeist T, Fountain C, Miller R, Johnsonbaugh S, Patronas M, Carney M, Mendley S, Salemi P, Liss R, Hebdon M, Counts D, Donner T, Gordon J, Hemady R, Kowarski A, Ostrowski D, Steidl S, Jones B, Herman W, Martin C, Pop‐Busui R, Greene D, Stevens M, Burkhart N, Sandford T, Floyd J, Bantle J, Flaherty N, Terry J, Koozekanani D, Montezuma S, Wimmergren N, Rogness B, Mech M, Strand T, Olson J, McKenzie L, Kwong C, Goetz F, Warhol R, Hainsworth D, Goldstein D, Hitt S, Giangiacomo J, Schade D, Canady J, Burge M, Das A, Avery R, Ketai L, Chapin J, Schluter M, Rich J, Johannes C, Hornbeck D, Schutta M, Bourne P, Brucker A, Braunstein S, Schwartz S, Maschak‐Carey B, Baker L, Orchard T, Cimino L, Songer T, Doft B, Olson S, Becker D, Rubinstein D, Bergren R, Fruit J, Hyre R, Palmer C, Silvers N, Lobes L, Rath PP, Conrad P, Yalamanchi S, Wesche J, Bratkowksi M, Arslanian S, Rinkoff J, Warnicki J, Curtin D, Steinberg D, Vagstad G, Harris R, Steranchak L, Arch J, Kelly K, Ostrosaka P, Guiliani M, Good M, Williams T, Olsen K, Campbell A, Shipe C, Conwit R, Finegold D, Zaucha M, Drash A, Morrison A, Malone J, Bernal M, Pavan P, Grove N, Tanaka E, McMillan D, Vaccaro‐Kish J, Babbione L, Solc H, DeClue T, Dagogo‐Jack S, Wigley C, Ricks H, Kitabchi A, Chaum E, Murphy M, Moser S, Meyer D, Iannacone A, Yoser S, Bryer‐Ash M, Schussler S, Lambeth H, Raskin P, Strowig S, Basco M, Cercone S, Zinman B, Barnie A, Devenyi R, Mandelcorn M, Brent M, Rogers S, Gordon A, Bakshi N, Perkins B, Tuason L, Perdikaris F, Ehrlich R, Daneman D, Perlman K, Ferguson S, Palmer J, Fahlstrom R, de Boer I, Kinyoun J, Van Ottingham L, Catton S, Ginsberg J, McDonald C, Harth J, Driscoll M, Sheidow T, Mahon J, Canny C, Nicolle D, Colby P, Dupre J, Hramiak I, Rodger N, Jenner M, Smith T, Brown W, May M, Lipps Hagan J, Agarwal A, Adkins T, Lorenz R, Feman S, Survant L, White N, Levandoski L, Grand G, Thomas M, Joseph D, Blinder K, Shah G, Burgess D, Boniuk I, Santiago J, Tamborlane W, Gatcomb P, Stoessel K, Ramos P, Fong K, Ossorio P, Ahern J, Gubitosi‐Klug R, Meadema‐Mayer L, Beck C, Farrell K, Genuth S, Quin J, Gaston P, Palmert M, Trail R, Dahms W, Lachin J, Backlund J, Bebu I, Braffett B, Diminick L, Gao X, Hsu W, Klumpp K, Pan H, Trapani V, Cleary P, McGee P, Sun W, Villavicencio S, Anderson K, Dews L, Younes N, Rutledge B, Chan K, Rosenberg D, Petty B, Determan A, Kenny D, Williams C, Cowie C, Siebert C, Steffes M, Arends V, Bucksa J, Nowicki M, Chavers B, O'Leary D, Polak J, Harrington A, Funk L, Crow R, Gloeb B, Thomas S, O'Donnell C, Soliman E, Zhang Z, Li Y, Campbell C, Keasler L, Hensley S, Hu J, Barr M, Taylor T, Prineas R, Feldman E, Albers J, Low P, Sommer C, Nickander K, Speigelberg T, Pfiefer M, Schumer M, Moran M, Farquhar J, Ryan C, Sandstrom D, Williams T, Geckle M, Cupelli E, Thoma F, Burzuk B, Woodfill T, Danis R, Blodi B, Lawrence D, Wabers H, Gangaputra S, Neill S, Burger M, Dingledine J, Gama V, Sussman R, Davis M, Hubbard L, Budoff M, Darabian S, Rezaeian P, Wong N, Fox M, Oudiz R, Kim L, Detrano R, Cruickshanks K, Dalton D, Bainbridge K, Lima J, Bluemke D, Turkbey E, der Geest ., Liu C, Malayeri A, Jain A, Miao C, Chahal H, Jarboe R, Nathan D, Monnier V, Sell D, Strauch C, Hazen S, Pratt A, Tang W, Brunzell J, Purnell J, Natarajan R, Miao F, Zhang L, Chen Z, Paterson A, Boright A, Bull S, Sun L, Scherer S, Lopes‐Virella M, Lyons T, Jenkins A, Klein R, Virella G, Jaffa A, Carter R, Stoner J, Garvey W, Lackland D, Brabham M, McGee D, Zheng D, Mayfield R, Maynard J, Wessells H, Sarma A, Jacobson A, Dunn R, Holt S, Hotaling J, Kim C, Clemens Q, Brown J, McVary K. Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study. J Am Heart Assoc 2018. [PMCID: PMC6015340 DOI: 10.1161/jaha.117.008368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus.
Methods and Results
A random subcohort of 349 participants was selected from the
DCCT
/
EDIC
(Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from
DCCT
baseline, year 1, and closeout of
DCCT
, and 1 to 2 years post‐
DCCT
(
EDIC
years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F
2α
isoprostanes, and its metabolite, 2,3 dinor‐8
iso
prostaglandin F
2α
. Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8
iso
prostaglandin F
2α
, an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase,
P
<0.003; −5.3% risk for 10% higher 2,3 dinor‐8
iso
prostaglandin F
2α
,
P
=0.0092). In contrast, the oxidative markers myeloperoxidase and F
2α
isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between
DCCT
intensive and conventional treatment groups in the change in all biomarkers across time segments.
Conclusions
Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control.
Clinical Trial Registration
URL
:
https://www.clinicaltrials.gov
. Unique identifiers:
NCT
00360815 and
NCT
00360893.
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Affiliation(s)
- W.H. Wilson Tang
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
| | - Paula McGee
- The Biostatistics Center, George Washington University, Rockville, MD
| | - John M. Lachin
- The Biostatistics Center, George Washington University, Rockville, MD
| | - Daniel Y. Li
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | | | - Stanley L. Hazen
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
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17
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Ting A, May M, Mitchell H, Carver C, Kim Y. 0865 Dyadic Effects of Daily Stress and Satisfaction on Sleep Efficiency: A Preliminary Report among Colorectal Cancer Survivors and Their Spouses. Sleep 2018. [DOI: 10.1093/sleep/zsy061.864] [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: 11/13/2022] Open
Affiliation(s)
- A Ting
- University of Miami, Coral Gables, FL
| | - M May
- University of Miami, Coral Gables, FL
| | | | - C Carver
- University of Miami, Coral Gables, FL
| | - Y Kim
- University of Miami, Coral Gables, FL
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18
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Relich R, Schmitt B, Raposo H, Barker L, Blosser S, May M. Legionella indianapolisensis sp. nov., isolated from a patient with pulmonary abscess. Int J Infect Dis 2018; 69:26-28. [DOI: 10.1016/j.ijid.2018.01.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 01/17/2018] [Accepted: 01/19/2018] [Indexed: 11/25/2022] Open
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19
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Stinkens R, van der Kolk BW, Jordan J, Jax T, Engeli S, Heise T, Jocken JW, May M, Schindler C, Havekes B, Schaper N, Albrecht D, Kaiser S, Hartmann N, Letzkus M, Langenickel TH, Goossens GH, Blaak EE. The effects of angiotensin receptor neprilysin inhibition by sacubitril/valsartan on adipose tissue transcriptome and protein expression in obese hypertensive patients. Sci Rep 2018; 8:3933. [PMID: 29500454 PMCID: PMC5834447 DOI: 10.1038/s41598-018-22194-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 02/19/2018] [Indexed: 01/30/2023] Open
Abstract
Increased activation of the renin-angiotensin system is involved in the onset and progression of cardiometabolic diseases, while natriuretic peptides (NP) may exert protective effects. We have recently demonstrated that sacubitril/valsartan (LCZ696), a first-in-class angiotensin receptor neprilysin inhibitor, which blocks the angiotensin II type-1 receptor and augments natriuretic peptide levels, improved peripheral insulin sensitivity in obese hypertensive patients. Here, we investigated the effects of sacubitril/valsartan (400 mg QD) treatment for 8 weeks on the abdominal subcutaneous adipose tissue (AT) phenotype compared to the metabolically neutral comparator amlodipine (10 mg QD) in 70 obese hypertensive patients. Abdominal subcutaneous AT biopsies were collected before and after intervention to determine the AT transcriptome and expression of proteins involved in lipolysis, NP signaling and mitochondrial oxidative metabolism. Both sacubitril/valsartan and amlodipine treatment did not significantly induce AT transcriptional changes in pathways related to lipolysis, NP signaling and oxidative metabolism. Furthermore, protein expression of adipose triglyceride lipase (ATGL) (Ptime*group = 0.195), hormone-sensitive lipase (HSL) (Ptime*group = 0.458), HSL-ser660 phosphorylation (Ptime*group = 0.340), NP receptor-A (NPRA) (Ptime*group = 0.829) and OXPHOS complexes (Ptime*group = 0.964) remained unchanged. In conclusion, sacubitril/valsartan treatment for 8 weeks did not alter the abdominal subcutaneous AT transcriptome and expression of proteins involved in lipolysis, NP signaling and oxidative metabolism in obese hypertensive patients.
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Affiliation(s)
- R Stinkens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - B W van der Kolk
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - J Jordan
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany.,Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - T Jax
- Profil GmbH, Neuss, Germany
| | - S Engeli
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | | | - J W Jocken
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - M May
- Clinical Research Center Hannover, Hannover Medical School, Hannover, Germany
| | - C Schindler
- Clinical Research Center Hannover, Hannover Medical School, Hannover, Germany
| | - B Havekes
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - N Schaper
- Department of Internal Medicine, Division of Endocrinology, Maastricht University Medical Center+, Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - D Albrecht
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - S Kaiser
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - N Hartmann
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - M Letzkus
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - T H Langenickel
- Translational Medicine, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - G H Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - E E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.
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20
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21
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Ali SM, Chen D, Ali A, Krecko L, Leitzel K, Vasekar M, Nagabhairu V, Marks E, Polimera H, Richardson A, May M, He W, Patel P, Lavin M, Hofsess S, Sweetman R, Hortobagyi G, Baselga J, Lipton A. Abstract P1-07-09: Serum activin A and outcomes in HR+ /HER2- metastatic breast cancer patients treated with everolimus: Results from BOLERO-2. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-07-09] [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: Everolimus (EVE) plus exemestane (EXE) doubled progression-free survival (PFS) while maintaining quality of life versus EXE alone in postmenopausal women with hormone receptor positive (HR+), HER2-negative metastatic breast cancer (mBC) (BOLERO-2 phase 3; NCT00863655). Pretreatment serum activin A was previously reported as a prognostic factor in first-line hormone therapy (letrozole vs tamoxifen) (Novartis P025) and anti-HER2 mBC (lapatinib vs trastzmab) (CCTG MA.31) trials. Here we investigate the prognostic and predictive ability of activin A in BOLERO-2.
Methods: Activin A levels were determined on pretreatment serum samples using ELISA. Cox-proportional hazards model was used to assess the efficacy of EVE in the activin A low and high subgroups (median cut-point), and the prognostic effect of activin A on PFS and overall survival (OS).
Results: Baseline activin A levels were determined in 513 patients (71% of 725 BOLERO-2 patients randomized 2:1 to EVE+EXE or EXE). Predictive and prognostic signals are shown in the table below
Predictive and prognostic signalsPredictive/PrognosticEnd-pointAct-ivin ATreatmentNEventsMedian PFSHR (95% CI); p valuepredictivePFSHEXE93832.5 (1.5-2.8)-predictivePFSHEVE+EXE1631325.4 (4.1-6.8)0.46 (0.34 - 0.60); <0.0001predictivePFSLEXE89774.2 (2.0 -5.4)-predictivePFSLEVE+EXE1681059.9 (8.1-12.5)0.38 (0.28 - 0.51); <0.0001predictiveOSHEXE936820.1 (13.8-22.6)-predictiveOSHEVE+EXE16312917.7 (15.7-22.3)1.04 (0.78 - 1.40); 0.78predictiveOSLEXE8939NA (34.7-NA)-predictiveOSLEVE+EXE1687241.4 (36.4-NA)1.02 (0.69 - 1.50); 0.93prognosticPFSH 2562154.1 (2.9-4.2)-prognosticPFSL 2571826.9 (6.7-8.5)0.54 (0.45 - 0.66); <0.0001prognosticOSH 25619718.0 (16.5-21.1)-prognosticOSL 25711142.3 (38.5-NA)0.34 (0.27 - 0.42); <0.0001
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In multivariate analysis (including sensitivity to prior hormone therapy and visceral disease), activin A remained a significant independent prognostic factor for PFS and OS [HR 0.57 (0.46-0.69) and 0.34 (0.27-0.43), respectively].
Conclusions: Higher serum activin A was strongly associated with shorter PFS and OS in HR+/HER2- mBC patients. Everolimus was efficacious regardless of serum activin A level. These results are similar to our previous studies in phase 3 trials of letrozole-tamoxifen (Novartis P025), and HER2-targeted therapy, lapatinib vs trastuzmab (CCTG MA.31): pretreatment serum activin A was prognostic for outcome, but was not a predictive factor for treatment arm selection.
Citation Format: Ali SM, Chen D, Ali A, Krecko L, Leitzel K, Vasekar M, Nagabhairu V, Marks E, Polimera H, Richardson A, May M, He W, Patel P, Lavin M, Hofsess S, Sweetman R, Hortobagyi G, Baselga J, Lipton A. Serum activin A and outcomes in HR+ /HER2- metastatic breast cancer patients treated with everolimus: Results from BOLERO-2 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-07-09.
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Affiliation(s)
- SM Ali
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - D Chen
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Ali
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - L Krecko
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - K Leitzel
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - M Vasekar
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - V Nagabhairu
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - E Marks
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - H Polimera
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Richardson
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - M May
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - W He
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - P Patel
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - M Lavin
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - S Hofsess
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - R Sweetman
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - G Hortobagyi
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Baselga
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Lipton
- Penn State Hershey Medical Center, Hershey, PA; Lebanon VA Medical Center, Lebanon, PA; Novartis Pharmaceutical Corp, East Hanover, NJ; Pinnacle Health System, Harrisburg, PA; R & D Systems, Minneapolis, MN; MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY
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May M, Gunia S, Helke C, Braun KP, Pickenhain S, Hoschke B. Is it Possible to Provide a Prognosis after Radical Prostatectomy for Prostate Cancer by Means of a Psa Regression Model? Int J Biol Markers 2018; 20:112-8. [PMID: 16011041 DOI: 10.1177/172460080502000205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background For over 15 years, studies have been done to evaluate the elimination kinetics of the prostate-specific antigen (PSA) after radical prostatectomy. Even though evaluation of PSA regression in the two-compartment model has become established, no clear data are currently available as to whether a statement can be made with regard to tumor prognosis from a computation of the PSA half-life (PSA-HL). This study focuses on the determination of the PSA-HL in the two-compartment model and on its correlation with the biochemical recurrence-free survival. In addition, a computer program is being developed to simplify the determination of PSA-HL. Material and methods Seventy-seven prospective patients were examined who subsequently had a radical prostatectomy at our facility without neoadjuvant or adjuvant hormone deprivation. In addition to preoperative measurement of the PSA value (d0), PSA determinations were carried out postoperatively on days 5, 10 and 60, and at four-monthly intervals thereafter (mean follow-up: 16 months). By means of the computer program developed for this purpose, CTK. TumW, the PSA half-lives for the first (d0–d5, PSA-HL1) and second (d5–d10, PSA-HL2) compartments were subsequently determined and their effect on biochemical recurrence-free survival was assessed. Results PSA-HL1 and PSA-HL2 were 1.89 (± 0.03) and 3.39 (± 0.14) days, respectively. Whilst PSA-HL1 did not permit any prognostic statement, the median PSA-HL in the second compartment between patients with and without disease progression differed significantly (4.44 versus 3.12 days; p<0.001). Discrimination analysis produced a cutoff of 3.8 days for the second compartment; patients with a PSA-HL2 ≥3.8 days had a significantly worse biochemical recurrence-free survival after 18 months than the other patients (27% versus 93%; p<0.001). Conclusion The PSA regression kinetics after radical prostatectomy follows a two-compartment model in which the prognostic value of the PSA-HL1 is limited. When a cutoff of 3.8 days is used, evaluation of the PSA-HL in compartment 2 (d5–10) appears to permit a prognostic statement. Due to the limited postsurgical follow-up, the disease process was only assessed as biochemical recurrence-free survival, and a longer follow-up will be necessary to generate data on progression-free survival.
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Affiliation(s)
- M May
- Urology Clinic, Carl-Thiem Hospital, Cottbus, Germany. M.
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Roiko M, May M, Relich RF. Characterization of Pontibacter altruii, sp. nov., isolated from a human blood culture. New Microbes New Infect 2017; 19:71-77. [PMID: 28725439 PMCID: PMC5502793 DOI: 10.1016/j.nmni.2017.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 05/23/2017] [Indexed: 01/25/2023] Open
Abstract
The genus Pontibacter is a recent addition to the family Cytophagaceae, phylum Bacteroidetes. Previous reports of its cultivation and molecular detection are from a variety of environmental sources, including marine and desert habitats. We report the first description of a Pontibacter sp., which was initially identified as Elizabethkingia meningoseptica, isolated from a human clinical specimen. On the basis of 16S rRNA gene sequence, unique mass spectral profile and phenotypic characterization, this isolate represents a novel species within the genus Pontibacter that has been named Pontibacter altruii, sp. nov., strain Grand Forks.
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Affiliation(s)
- M Roiko
- Altru Health System, Department of Pathology and Laboratory Services, Grand Forks, ND, USA
| | - M May
- University of New England College of Osteopathic Medicine, Department of Biomedical Sciences, Biddeford, ME, USA
| | - R F Relich
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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May M, Vetterlein MW, Wagenlehner FM, Brookman-May SD, Gilfrich C, Fritsche HM, Spachmann PJ, Burger M, Schostak M, Lebentrau S. [What is the perception of the 10-point plan of the German Federal Ministry of Health against multidrug-resistant pathogens and measures of antibiotic stewardship? : An interdisciplinary analysis among German clinicians and development of a decision tool for urologists]. Urologe A 2017; 56:1302-1310. [PMID: 28593351 DOI: 10.1007/s00120-017-0425-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Due to increasing antibiotic resistances, relevant treatment problems are currently emerging in clinical practice. In March 2015, the German Federal Ministry of Health (BMG) published a 10-point plan designed to combat this development. Furthermore, the first German guideline on antibiotic stewardship (ABS) was implemented in 2013 and instructs physicians of different specialties about several treatment considerations. Evidence is scarce on how such concepts (10-point plan/BMG, ABS) are perceived among clinicians. MATERIALS AND METHODS Within the MR2 study (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria - a survey focusing on German hospitals), a questionnaire including 4 + 35 items was sent to 18 German hospitals between August and October 2015, surveying internists, gynecologists, general surgeons, and urologists. Using multivariate logistic regression models (MLRM), the impact of medical specialty and further criteria on the endpoints (1) awareness of the 10-point plan/BMG and (2) knowledge of ABS measures were assessed. Fulfillment of endpoints was predefined when average or full knowledge was reported (reference: poor to no knowledge). RESULTS Overall response rate was 43% (456/1061) for fully evaluable questionnaires. Only 63.0 and 53.6% of urologists and nonurologists (internists, gynecologists, and general surgeons), respectively, attended training courses regarding multidrug-resistance or antibiotic prescribing in the 12 months prior to the study (P = 0.045). The endpoints average and full knowledge regarding 10-point plan/BMG and ABS measures were fulfilled in only 31.4 and 32.8%, respectively. In MLRM, clinicians with at least one previous training course (reference: no training course) were 2.5- and 3.8-fold more likely to meet respective endpoint criteria (all P < 0.001). Medical specialty (urologists vs. nonurologists) did not significantly impact the endpoints in both MLRM. CONCLUSIONS The 10-point plan/BMG and ABS programs should be implemented into clinical practice, but awareness and knowledge of both is insufficient. Thus, it stands to reason that the actual realization of such measures is inadequate and continuous training towards rational prescription of antibiotics is necessary, regardless of medical specialty.
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Affiliation(s)
- M May
- Urologische Klinik, St. Elisabeth Klinikum, St.-Elisabeth-Str. 23, 94315, Straubing, Deutschland.
| | - M W Vetterlein
- Urologische Universitätsklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
| | - F M Wagenlehner
- Urologische Universitätsklinik, Justus-Liebig Universitätsklinikum, Rudolf-Buchheim-Str. 7, 35392, Gießen, Deutschland
| | - S D Brookman-May
- Klinik für Urologie, LMU München, Marchioninistraße 15, 81377, München, Deutschland
| | - C Gilfrich
- Urologische Klinik, St. Elisabeth Klinikum, St.-Elisabeth-Str. 23, 94315, Straubing, Deutschland
| | - H-M Fritsche
- Urologische Universitätsklinik, Universität Regensburg, Landshuter Straße 65, 93053, Regensburg, Deutschland
| | - P J Spachmann
- Urologische Universitätsklinik, Universität Regensburg, Landshuter Straße 65, 93053, Regensburg, Deutschland
| | - M Burger
- Urologische Universitätsklinik, Universität Regensburg, Landshuter Straße 65, 93053, Regensburg, Deutschland
| | - M Schostak
- Urologische Universitätsklinik, Universitätsklinikum Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - S Lebentrau
- Urologische Klinik, Ruppiner Kliniken, Fehrbelliner Str. 38, 16816, Neuruppin, Deutschland
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Heyer K, Milde S, Schmitt J, May M, Helfrich J, Augustin M. [A standard data set for the evaluation of venous leg ulcers in selective contracts : National consensus]. Hautarzt 2017; 68:815-826. [PMID: 28567507 DOI: 10.1007/s00105-017-3990-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Selective agreements are becoming increasingly important in health care management. To date, no standard recommendations for the evaluation of selective contracts are available. OBJECTIVES Against this background, a recommendation on the evaluation of selective contracts in patients with leg ulcers (LU) was developed and approved by the nationwide consensus conference. MATERIALS AND METHODS Based on a systematic literature review and followed by a manual search through other possible evaluation indicators in the care of patients with LU, a Delphi-based consensus process was performed by various scientific societies, professional associations, insurances and supply networks. RESULTS For the evaluation of efficiency and quality of care, a recommendation on the evaluation of selective agreements with patients with LU was consented in six meetings and in five multistage online surveys. In total, 44 evaluation indicators were identified in the quality subareas structure, process, and outcome. The outcome indicators are divided into clinical, patient-related, and cost-related indicators. CONCLUSIONS The developed evaluation indicators represent the quality of care in patients with LU. The indicators can be applied individually, depending on the agreed contract-specific supply target. After implementation of this national standard, the comparability of selective agreements in the management of patients with LU can be ensured and consolidated.
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Affiliation(s)
- K Heyer
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie (IVDP), Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
| | - S Milde
- AOK-Bundesverband, Berlin, Deutschland
| | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), TU Dresden, Dresden, Deutschland
| | - M May
- AOK Rheinland/Hamburg, Hamburg, Deutschland
| | | | - M Augustin
- Competenzzentrum Versorgungsforschung in der Dermatologie (CVderm), Institut für Versorgungsforschung in der Dermatologie (IVDP), Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
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Prael I, Wüst W, Uder M, Geissler F, Köhnen J, May M. Bildqualität der Dual Energy Lungenperfusion in pulmonalarterieller und portalvenöser Kontrastmittelphase. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600451] [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: 10/19/2022]
Affiliation(s)
- I Prael
- Universitätsklinik Erlangen, Radiologie, Erlangen
| | - W Wüst
- Universitätsklinik Erlangen, Radiologie, Erlangen
| | - M Uder
- Universitätsklinik Erlangen, Radiologie, Erlangen
| | - F Geissler
- Universitätsklinik Erlangen, Radiologie, Erlangen
| | - J Köhnen
- Universitätsklinik Erlangen, Radiologie, Erlangen
| | - M May
- Universitätsklinik Erlangen, Radiologie, Erlangen
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Klapsch F, Lurz M, Wüst W, Wiesmüller M, Heiß R, Uder M, May M. Bildqualität in der thorakoabdominellen Staging-Computertomografie – Vergleich zwischen Single Energy mit automatischer Reduktion der Röhrenspannung und Dual Energy. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600211] [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: 10/19/2022]
Affiliation(s)
- F Klapsch
- Universitätsklinik Erlangen, Radiologie, Erlangen
| | - M Lurz
- Universität Erlangen, Radiologisches Institut, Erlangen
| | - W Wüst
- Universität Erlangen, Radiologisches Institut, Erlangen
| | - M Wiesmüller
- Universität Erlangen, Radiologisches Institut, Erlangen
| | - R Heiß
- Universität Erlangen, Radiologisches Institut, Erlangen
| | - M Uder
- Universität Erlangen, Radiologisches Institut, Erlangen
| | - M May
- Universität Erlangen, Radiologisches Institut, Erlangen
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Wiesmüller M, Wüst W, May M, Heiß R, Uder M. Herz-MRT: Interscanner-Reproduzierbarkeit des linksventrikulären T1-Mappings. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600262] [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: 10/19/2022]
Affiliation(s)
| | - W Wüst
- Radiologisches Institut Erlangen
| | - M May
- Radiologisches Institut Erlangen
| | - R Heiß
- Radiologisches Institut Erlangen
| | - M Uder
- Radiologisches Institut Erlangen
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Ellmann S, Kammerer F, Allmendinger T, Hammon M, Brand M, May M, Lell M, Uder M, Kramer M. Bestimmung des Dosisreduktionspotentials iterativer Rekonstruktionen intrakranieller CTA mit einer neuartigen auf paarweisen Bildvergleichen basierenden Methode. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600432] [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: 10/19/2022]
Affiliation(s)
- S Ellmann
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | - F Kammerer
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | | | - M Hammon
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | - M Brand
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | - M May
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | - M Lell
- Klinikum Nürnberg, Institut für Radiologie und Nuklearmedizin, Nürnberg
| | - M Uder
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | - M Kramer
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
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Getzin T, May M, Schmidbauer M, Gutberlet M, Wacker F, Schindler C, Hueper K. Funktionelle MRT zur Quantifizierung des pharmakotherapeutischen Effektes eines ACE-Hemmers auf die Nierenperfusion und die T1-Relaxationszeit. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600190] [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: 10/19/2022]
Affiliation(s)
- T Getzin
- Medizinische Hochschule Hannover, Radiologie, Hannover
| | - M May
- Medizinische Hochschule Hannover, CRC Core Facility, Hannover
| | - M Schmidbauer
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
| | - M Gutberlet
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
| | - F Wacker
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
| | - C Schindler
- Medizinische Hochschule Hannover, CRC Core Facility, Hannover
| | - K Hueper
- Medizinische Hochschule Hannover, Diagnostische und Interventionelle Radiologie, Hannover
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Kopp M, Löwe T, Wüst W, Schmidt B, Nitsch W, Uder M, May M. Anatomisch basierte Dosiskalkulation und Abschätzung des Malignomrisikos in der Ganzkörper-Computertomografie. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600434] [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: 10/19/2022]
Affiliation(s)
- M Kopp
- Universitätsklinikum Erlangen, Radiologisches Institut, Erlangen
| | - T Löwe
- Institut für Medizinische Mikrobiologie und Hygiene TU Dresden
| | - W Wüst
- Radiologisches Institut Universitätsklinikum Erlangen
| | - B Schmidt
- Siemens Healthineers GmbH, Forchheim
| | - W Nitsch
- Fraunhofer Institut für integrierte Schaltungen, Erlangen
| | - M Uder
- Radiologisches Institut Universitätsklinikum Erlangen
| | - M May
- Radiologisches Institut Universitätsklinikum Erlangen
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Schneeweiss A, Park-Simon TW, Albanell J, Lassen U, Cortes J, Dieras V, May M, Schindler C, Marmé F, Cejalvo JM, Martinez-Garcia M, Gonzalez I, Lopez-Martin J, Welt A, Joly F, Michielin F, Jacob W, Adessi C, Moisan A, Meneses-Lorente G, James I, Ceppi M, Hasmann M, Weisser M, Cervantes A. Abstract P6-11-13: Phase Ib study evaluating the safety and clinical activity of lumretuzumab combined with pertuzumab and paclitaxel in HER2-low metastatic breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-11-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Inhibition of HER2 and HER3 heterodimerisation is a novel treatment concept in HER2-”low” expressing breast cancer (BC). Lumretuzumab, a glycoengineered monoclonal anti-HER3 antibody, in combination with pertuzumab has demonstrated synergistic anti-tumor activity in preclinical HER2–low expressing preclinical BC models.
Methods: This open-label, multicenter phase I study selectively enrolled metastatic BC patients (pts) expressing HER3 protein and low levels of HER2 (defined as IHC 1+ and 2+ and ISH-negative) in a formalin-fixed paraffin-embedded pretreatment tumor biopsy sample. Eligible pts were treated with a combination of paclitaxel (PA) qw plus lumretuzumab (L) and pertuzumab (P) q3w in three dose cohorts. The safety, antitumor activity and tumor biomarkers including protein expression (IHC, MS) and mutational data (NGS) in association with clinical activity were evaluated.
Results: Overall, 35 pts were included in this study. The median age was 60 (range: 33 to 77) years. The median number of prior treatments for metastatic disease ranged from 0 to 5 with 23 pts (65.7%) without prior chemotherapy for metastatic disease. Cohort 1 was treated with PA at 80 mg/m2, L at 1000 mg and P at 840 mg for Cycle 1 followed by 420 mg for the following cycles. This cohort was stopped after two pts both experienced grade 3 diarrhea within the first treatment cycle which was considered a dose-limiting toxicity (DLT). For Cohort 2 the dose of L was reduced to 500 mg based on PK modelling and simulation data. No DLTs were seen for the first 6 pts. A total of 20 pts were recruited with an objective response rate (ORR) and disease control rate (DCR) of 30% and 75%, respectively, and 56% and 78%, respectively, for 1st-line pts (n=9) in this cohort. Diarrhea (≥G3) and hypokalemia (≥G3) occurred in 50% and 55% of pts, respectively, and all pts experienced chronic diarrhea throughout the course of treatment. For Cohort 3 the dose of L was maintained at 500 mg, PA at 80 mg/m2, and P was administered at 420 mg at all cycles. In addition, a prophylactic loperamide regimen was introduced. Altogether, 13 pts - all 1st-line for metastatic disease - were treated. No DLTs were seen for the first 6 pts. Diarrhea (≥G3) and hypokalemia (≥G3) were reduced to 31% and 15%, respectively, but chronic diarrhea was still observed throughout the treatment in all pts. The ORR and DCR were 31% and 77%, respectively. Preliminary mechanistic safety experiments revealed HER2/HER3-dependent chloride channels in the intestine as likely cause of diarrhea. Biomarker data will be presented along with updated clinical and safety data.
Conclusions: The combination of L, P and PA was associated with high rates of persistent diarrhea. Dose modifications and prophylactic anti-diarrheal medication led to significantly reduced diarrhea intensity but did not change the incidence and persistence of diarrhea overall. Despite encouraging clinical activity especially in 1st line pts, the therapeutic window of this combination is too low to warrant further clinical development.
Citation Format: Schneeweiss A, Park-Simon T-W, Albanell J, Lassen U, Cortes J, Dieras V, May M, Schindler C, Marmé F, Cejalvo JM, Martinez-Garcia M, Gonzalez I, Lopez-Martin J, Welt A, Joly F, Michielin F, Jacob W, Adessi C, Moisan A, Meneses-Lorente G, James I, Ceppi M, Hasmann M, Weisser M, Cervantes A. Phase Ib study evaluating the safety and clinical activity of lumretuzumab combined with pertuzumab and paclitaxel in HER2-low metastatic breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-11-13.
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Affiliation(s)
- A Schneeweiss
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - T-W Park-Simon
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - J Albanell
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - U Lassen
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - J Cortes
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - V Dieras
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M May
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - C Schindler
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - F Marmé
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - JM Cejalvo
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Martinez-Garcia
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - I Gonzalez
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - J Lopez-Martin
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - A Welt
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - F Joly
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - F Michielin
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - W Jacob
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - C Adessi
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - A Moisan
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - G Meneses-Lorente
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - I James
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Ceppi
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Hasmann
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - M Weisser
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
| | - A Cervantes
- National Center for Tumor Diseases, University Hospital, Heidelberg, Germany; 2Clinics of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; Hospital del Mar, Barcelona, Spain; Rigshospitalet, Copenhagen, Denmark; Vall d'Hebron Institute of Oncology, Barcelona, Spain; Institut Curie, Paris, France; Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; West German Cancer Centre, University Hospital Essen, Essen, Germany; Center François Baclesse, Caen, France; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland; Roche Pharmaceutical Research and Early Development, Roche Innovation Center Munich, Penzberg, Germany; Pharma Research and Early Development, Clinical Pharmacology, Roche Innovation Center Welwyn, Welwyn Garden City, United Kingdom; A4P Consulting Ltd, Sandwich, United Kingdom
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Davies C, Gompels M, May M. Use and Effectiveness of HIV Indicator Conditions in Guiding HIV Testing: A Review of the Evidence. ACTA ACUST UNITED AC 2017. [DOI: 10.9734/isrr/2017/36373] [Citation(s) in RCA: 4] [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: 11/09/2022]
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May M, Protzel C, Vetterlein MW, Gierth M, Noldus J, Karl A, Grimm T, Wullich B, Grimm MO, Nuhn P, Bastian PJ, Roigas J, Hadaschik B, Gilfrich C, Burger M, Fisch M, Brookman-May S, Aziz A, Hakenberg OW. Is there evidence for a close connection between side of intravesical tumor location and ipsilateral lymphatic spread in lymph node-positive bladder cancer patients at radical cystectomy? Results of the PROMETRICS 2011 database. Int Urol Nephrol 2016; 49:247-254. [DOI: 10.1007/s11255-016-1469-7] [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] [Received: 10/04/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
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Jordan J, Stinkens R, Jax T, Engeli S, Blaak EE, May M, Havekes B, Schindler C, Albrecht D, Pal P, Heise T, Goossens GH, Langenickel TH. Improved Insulin Sensitivity With Angiotensin Receptor Neprilysin Inhibition in Individuals With Obesity and Hypertension. Clin Pharmacol Ther 2016; 101:254-263. [DOI: 10.1002/cpt.455] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/27/2016] [Accepted: 08/12/2016] [Indexed: 12/16/2022]
Affiliation(s)
- J Jordan
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - R Stinkens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism; Maastricht University Medical Center; Maastricht The Netherlands
| | | | - S Engeli
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - EE Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism; Maastricht University Medical Center; Maastricht The Netherlands
| | - M May
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - B Havekes
- Department of Internal Medicine, Division of Endocrinology; Maastricht University Medical Center; Maastricht The Netherlands
| | - C Schindler
- Institute for Clinical Pharmacology, Hannover Medical School; Hannover Germany
| | - D Albrecht
- Translational Medicine, Novartis Pharma AG; Basel Switzerland
| | - P Pal
- Biostatistical Sciences, Integrated Development Functions and Regions; Novartis Healthcare Pvt. Ltd; Hyderabad India
| | | | - GH Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism; Maastricht University Medical Center; Maastricht The Netherlands
| | - TH Langenickel
- Translational Medicine, Novartis Pharma AG; Basel Switzerland
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Simone G, De Nunzio C, Ferriero M, Cindolo L, Brookman-May S, Papalia R, Sperduti I, Collura D, Leonardo C, Anceschi U, Tuderti G, Misuraca L, Dalpiaz O, Hatzl S, Lodde M, Trenti E, Pastore A, Palleschi G, Lotrecchiano G, Salzano L, Carbone A, De Cobelli O, Tubaro A, Schips L, Zigeuner R, Tostain J, May M, Guaglianone S, Muto G, Gallucci M. Trends in the use of partial nephrectomy for cT1 renal tumors: Analysis of a 10-yr European multicenter dataset. Eur J Surg Oncol 2016; 42:1729-1735. [DOI: 10.1016/j.ejso.2016.03.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/07/2016] [Accepted: 03/21/2016] [Indexed: 11/16/2022] Open
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Lebentrau S, Lebentrau J, May M, Wick AK, Mathew M, Schostak M. [Results of a Questionnaire-Based Study on Guideline Adherence Regarding Adjuvant Treatment Recommendations for Patients with Non-Muscle-Invasive Bladder Cancer: Just a Disturbing Sidelight?]. Aktuelle Urol 2016; 47:408-13. [PMID: 27299426 DOI: 10.1055/s-0042-104785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The EAU guidelines on non-muscle-invasive bladder cancer (NMIBC) provide for risk stratification in low, intermediate and high risk based on infiltration depth, grading, concomitant carcinoma in situ, recurrence status, focality and tumour size. The aim of this study was to evaluate guideline adherence regarding risk stratification and risk-adapted treatment recommendations in NMIBC. MATERIAL AND METHODS An email-based survey distributed over the urological professional associations of Berlin, Brandenburg, Bremen, Hamburg, Mecklenburg-Western-Pomerania, Lower Saxony and Schleswig-Holstein assessed field of activity (doctor's office vs. clinic) and the presence of the additional qualification "Medical Tumour Therapy" (aqMtt). Also it inquired about the tools used for risk stratification in NMIBC. Finally, 3 scenarios were given, 2 of them corresponding to high-risk NMIBC and one corresponding to intermediate-risk NMIBC. Respondents were asked to provide a treatment recommendation. The results were presented comparatively for field of activity (doctor's office vs. clinic) and presence of aqMtt. RESULTS 74 responses were received (response rate of 12.3%). 57 (77.0%) of respondents had aqMtt. 52 (70.3%) worked in doctor's offices or medical care centres, 12 (16.2%) in a urology clinic, and for 10 (13.5%) respondents this information was lacking. The most frequently used tool for risk stratification was the EAU guideline. Accordingly, treatment recommendations for the three scenarios were considered to be correct if according to EAU guideline. In high-risk NMIBC, an average 29.3% (19.3-37.5%) of adequate treatment recommendations were made depending on the comparison group. An average of 69.8% (62.5-77.2%) and 0.9% (0.0-3.9%) treatment recommendations would lead to under- or overtreatment, respectively. The corresponding values for intermediate-risk NMIBC were 56.8% (52.6-62.5%) for adequate treatment, 43.2% (37.5-47.4%) for undertreatment and 0.0% for overtreatment. Field of activity and the presence of aqMtt had no significant impact on the accuracy of treatment recommendations. CONCLUSION The results of our survey provide strong evidence of poor guideline adherence with a consecutive risk for undertreatment of patients with NMIBC. This requires joint efforts of all those involved in the treatment of NMIBC to improve quality of care.
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Affiliation(s)
- S. Lebentrau
- Klinik für Urologie und Kinderurologie, Ruppiner Kliniken GmbH, Hochschulklinikum der Medizinischen Hochschule Brandenburg, Neuruppin
| | | | - M. May
- Klinik für Urologie, Klinikum St. Elisabeth Straubing GmbH, Straubing
| | - A.-K. Wick
- Klinik für Urologie und Kinderurologie, Ruppiner Kliniken GmbH, Hochschulklinikum der Medizinischen Hochschule Brandenburg, Neuruppin
| | - M. Mathew
- Universitätsklinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg
| | - M. Schostak
- Universitätsklinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Magdeburg A. ö. R., Magdeburg
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May M, Tonn C, Hahn S, Engels G, Hochlenert D. Rückgang von (Major)-Amputationen bei Diabetikern. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1584111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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May M, Alejandro C, Gomez N, Diez F, Copsel S, Iturbe J, Mohr N, Fernandez N, Shayo C, Davio C. P-020 Targeting multidrug resistance – associated protein 4 (MRP4/ABCC4) in pancreatic cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw199.20] [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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Wüst W, Lell M, Uder M, May M. CT der Nasennebenhöhlen – zusätzliche Dosisreduktion mittels Zinn-Vorfilterung. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581594] [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: 10/22/2022]
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May M, Nau D, Wüst W, Uder M, Rompel O. Messgenauigkeit angeborener Ventrikelseptumdefekte in der High Pitch Computertomografie-Angiografie des Thorax im Vergleich zur Echokardiografie und der intraoperativen Messung. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581388] [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: 10/22/2022]
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Gass HD, May M, Rojas P, Abba M, Sequeira G, Martinez Vazquez P, Gonzalez PL, Elía A, Alvarez MM, Molinolo A, Lanari CL. Abstract P4-09-13: Breast cancer recurrence risk: A role for the progesterone receptor isoforms. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-09-13] [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
Progesterone receptor (PR) is currently used as a surrogate marker for functional estrogen receptor activity in breast cancer. Two PR isoforms have been described, PRB and PRA. PRA (94 kDa) is a truncated protein that lacks the first 164 amino acids of the NH2 terminal of PRB (115 kDa), making difficult the development of antibodies that discriminate PRA from PRB by standard immunohistochemistry (IHC). There are few studies describing the expression of PR isoforms in breast cancers. While there is a general consensus that PRA is the prevailing isoform expressed in breast cancer tissues as compared with normal mammary gland, there is controversial data regarding the association between their deregulated expression and endocrine response or aggressiveness. We are currently studying the expression of the PR isoform ratio in breast cancer samples obtained during surgical resection in order to test their antiprogestin responsiveness in tissue cultures. The study has been approved by the IRB (2012-028). Selected samples were studied by RNAseq and the data was used to analyze the PAM50 genes to predict risk of recurrence, and interestingly, almost all the genes related to proliferation were up-regulated in samples categorized as having higher levels of PRB than PRA, being also these patients those with a high risk of recurrence (May and Rojas et al., ASCO Annual Meeting, poster#11016, 2015). These observations are in agreement with data obtained in hormone resistant breast cancer xenografts with higher levels of PRB than PRA (Wargon and Riggio et al, International Journal of Cancer: 2680, 2015). The aim of this study is to evaluate a possible correlation between the PR isoform ratio, proliferation as evaluated by Ki67 or HER2 expression, and clinical outcome in selected breast cancer samples. Ki67 was evaluated by IHC using standard protocols in 80 PR+ samples. The PRA/PRB ratio was also evaluated in nuclear extracts, performed from frozen tissue, from the same patients, by Western Blot. A negative correlation was observed between the Ki67 score and the log2 value of the PRA/PRB ratio (Spearman R:-0.3418; p< 0.0029). Samples were considered PRA+ if PRA/PRB ≥ 1.2 and PRB+, if PRA/PRB ≤ 0.83. Seven out of 62 PRA+ (11.29%), and 7 out of 35 (20%) of PRB+ samples were HER2+. The differences between both groups, although not significant, correlate directly with the Ki67 evaluation. The results of this ongoing project lend support to the hypothesis that the ratio of PRA/PRB is associated with prognosis and highlight the role of PR as key players regulating breast cancer growth.
Citation Format: Gass HD, May M, Rojas P, Abba M, Sequeira G, Martinez Vazquez P, Gonzalez PL, Elía A, Alvarez MM, Molinolo A, Lanari CL. Breast cancer recurrence risk: A role for the progesterone receptor isoforms. [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 P4-09-13.
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Affiliation(s)
- HD Gass
- Hospital Magdalena V. de Martínez de General Pacheco, Tigre, Buenos Aires, Argentina; IBYME-CONICET, CABA, Argentina; CINIBA, La Plata, Buenos Aires, Argentina; And Pharyngeal Cancer Branch, NIDCR, NIH, Bethesda, MD
| | - M May
- Hospital Magdalena V. de Martínez de General Pacheco, Tigre, Buenos Aires, Argentina; IBYME-CONICET, CABA, Argentina; CINIBA, La Plata, Buenos Aires, Argentina; And Pharyngeal Cancer Branch, NIDCR, NIH, Bethesda, MD
| | - P Rojas
- Hospital Magdalena V. de Martínez de General Pacheco, Tigre, Buenos Aires, Argentina; IBYME-CONICET, CABA, Argentina; CINIBA, La Plata, Buenos Aires, Argentina; And Pharyngeal Cancer Branch, NIDCR, NIH, Bethesda, MD
| | - M Abba
- Hospital Magdalena V. de Martínez de General Pacheco, Tigre, Buenos Aires, Argentina; IBYME-CONICET, CABA, Argentina; CINIBA, La Plata, Buenos Aires, Argentina; And Pharyngeal Cancer Branch, NIDCR, NIH, Bethesda, MD
| | - G Sequeira
- Hospital Magdalena V. de Martínez de General Pacheco, Tigre, Buenos Aires, Argentina; IBYME-CONICET, CABA, Argentina; CINIBA, La Plata, Buenos Aires, Argentina; And Pharyngeal Cancer Branch, NIDCR, NIH, Bethesda, MD
| | - P Martinez Vazquez
- Hospital Magdalena V. de Martínez de General Pacheco, Tigre, Buenos Aires, Argentina; IBYME-CONICET, CABA, Argentina; CINIBA, La Plata, Buenos Aires, Argentina; And Pharyngeal Cancer Branch, NIDCR, NIH, Bethesda, MD
| | - PL Gonzalez
- Hospital Magdalena V. de Martínez de General Pacheco, Tigre, Buenos Aires, Argentina; IBYME-CONICET, CABA, Argentina; CINIBA, La Plata, Buenos Aires, Argentina; And Pharyngeal Cancer Branch, NIDCR, NIH, Bethesda, MD
| | - A Elía
- Hospital Magdalena V. de Martínez de General Pacheco, Tigre, Buenos Aires, Argentina; IBYME-CONICET, CABA, Argentina; CINIBA, La Plata, Buenos Aires, Argentina; And Pharyngeal Cancer Branch, NIDCR, NIH, Bethesda, MD
| | - MM Alvarez
- Hospital Magdalena V. de Martínez de General Pacheco, Tigre, Buenos Aires, Argentina; IBYME-CONICET, CABA, Argentina; CINIBA, La Plata, Buenos Aires, Argentina; And Pharyngeal Cancer Branch, NIDCR, NIH, Bethesda, MD
| | - A Molinolo
- Hospital Magdalena V. de Martínez de General Pacheco, Tigre, Buenos Aires, Argentina; IBYME-CONICET, CABA, Argentina; CINIBA, La Plata, Buenos Aires, Argentina; And Pharyngeal Cancer Branch, NIDCR, NIH, Bethesda, MD
| | - CL Lanari
- Hospital Magdalena V. de Martínez de General Pacheco, Tigre, Buenos Aires, Argentina; IBYME-CONICET, CABA, Argentina; CINIBA, La Plata, Buenos Aires, Argentina; And Pharyngeal Cancer Branch, NIDCR, NIH, Bethesda, MD
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Neubert N, Vogt PM, May M, Boyce M, Koenneker S, Budde E, Jokuszies A. Does an Early and Aggressive Combined Wrapping and Dangling Procedure Affect the Clinical Outcome of Lower Extremity Free Flaps?-A Randomized Controlled Prospective Study Using Microdialysis Monitoring. J Reconstr Microsurg 2015; 32:262-70. [PMID: 26676676 DOI: 10.1055/s-0035-1568882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background The ideal starting point for flap training (FT) with the combined wrapping and dangling procedure is still a question of debate. Most units follow their own established protocols and currently evidence of flap compromise due to FT is still lacking. The aim of this study was to prove if an early and "aggressive" wrapping and dangling protocol could lead to metabolic changes, measured by microdialysis, indicating ischemia resulting in compromised flap perfusion. Methods Between 2010 and 2014, 49 patients with microvascular free flap reconstruction of the lower limb were included in this study. Patients were randomized into two groups. Group I started FT on the 7th postoperative day, and group II started on day 3. FT consisted of a combined wrapping and dangling procedure doubling its duration daily and ending at day 5. Flaps were monitored clinically and by microdialysis for ischemia-induced changes and metabolic parameters in the flap tissue in respect to different starting points of FT. Results All 49 patients in both groups were able to complete the postoperative FT without complications. Noninferiority of the early group could be proven and microdialysis results showed no differences between both groups. Conclusion We could prove by microdialysis that an early start of FT does not lead to compromised flap perfusion. Moreover, an early start of FT can lead to a reduced length of hospital stay. Furthermore, a reduced risk for deep vein thrombosis, pulmonary embolism, and pneumonia due to earlier mobilization might be an appreciated side effect.
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Affiliation(s)
- Nils Neubert
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - P M Vogt
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - M May
- Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany
| | - M Boyce
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - S Koenneker
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - E Budde
- Institute for Biostatistics, Hannover Medical School, Hannover, Germany
| | - A Jokuszies
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
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Turner K, Nicholls J, Muir P, North P, Ferguson R, May M, Macleod J, Horner P. P09.01 Cost-effectiveness of testing for trichomonas vaginalisin genitourinary medicine clinics and primary care in england using aptima tv naat. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.385] [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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Nicholls J, Horner P, North P, Ferguson R, May M, Turner K, Macleod J, Muir P. O10.1 Tv in primary care: is there more out there than you think? Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.132] [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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Nicholls J, Muir P, North P, Ferguson R, May M, Turner K, Macleod J, Horner P. P07.14 Aptima tv naat test performance in gum clinics and primary care in the uk. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Engeli S, May M, Jordan J. Pharmacokinetic Issues in Obese Patients. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wüst W, Lell M, May M, Scharf M, Schlundt C, Achenbach S, Uder M, Schmid A. Mikrovaskuläre Obstruktion und Infarktgröße mittels steady state free precession Bildgebung nach Kontrastmittelgabe in der kardialen MRT. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kramer M, Schwab S, Eller A, Kammerer F, May M, Lell M, Uder M. Ganzkörper-MRA oder CTA zur präoperativen Gefäßdarstellung vor freien Lappenplastiken im Kopf-/Halsbereich. Ein intraindividueller Vergleich. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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May M, Wüst W, Uder M, Lell M, Rompel O. Herzphasenabhängige Bildqualität der Koronararterien in der High-Pitch Computertomografie des Herzens im ersten Lebensjahr. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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