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Cali Daylan AE, Maia CM, Attarian S, Guo X, Ginsberg M, Castellucci E, Gucalp R, Haigentz M, Halmos B, Cheng H. HIV Associated Lung Cancer: Unique Clinicopathologic Features and Immune Biomarkers Impacting Lung Cancer Screening and Management. Clin Lung Cancer 2024; 25:159-167. [PMID: 38158315 PMCID: PMC10922688 DOI: 10.1016/j.cllc.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES Lung cancer contributes significantly to morbidity and mortality in people with HIV (PWH). We study the clinicopathologic characteristics and immune microenvironment in HIV associated lung cancer. MATERIAL AND METHODS Clinicopathological characteristics including immunotherapy outcomes were collected for 174 PWH diagnosed with lung cancer. Immunohistochemical staining for PD-L1, CD4, and CD8 was performed. RESULTS At diagnosis, patients with HIV associated lung cancer were significantly younger (56.9 vs. 69 years, P < .0001) and more frequently had advanced disease (70% vs. 53%, P = .01). The majority were African American (60% vs. 42%, P < .0001) and were smoking at the time of diagnosis or smoked in the past (98% vs. 86%, P = .0001). Only 10% of HIV associated lung cancer was diagnosed through the screening program. The median CD4+ lymphocyte count was 334 cells/µL, 31% had a CD4 ≤200 cells/µL and 63% of the cohort was virally suppressed. HIV associated non-small-cell lung cancer(NSCLC) was characterized by limited PD-L1 expression compared to the HIV negative cohort, 64% vs. 31% had TPS <1%, and 20% vs. 34% had TPS≥50%, respectively (P = .04). Higher CD8+ TILs were detected in PD-L1-high tumors (P < .0001). 50% of patients achieved disease control in the metastatic setting with the use of immunotherapy, and there were no new safety signals in 19 PWH treated with immunotherapy. CONCLUSION Lung cancer in PWH demonstrates unique features highlighting the need for a specialized screening program. Despite low PD-L1 expression, immunotherapy is well tolerated with reasonable disease control. Altered immune system in lung cancer pathogenesis in PWH should be further investigated.
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Affiliation(s)
- Ayse Ece Cali Daylan
- Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Catarina Martins Maia
- Department of Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY
| | - Shirin Attarian
- Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Xiaoling Guo
- Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx NY
| | - Mindy Ginsberg
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx NY
| | - Enrico Castellucci
- Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Rasim Gucalp
- Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Missak Haigentz
- Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Balazs Halmos
- Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Haiying Cheng
- Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY.
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Rimner A, Huang J, Pagano A, Ginsberg M, Chang J, Riely G, Simone CB, Gomez DR, Shepherd AF. Phase II Study of Hemithoracic Intensity-Modulated Pleural Radiation Therapy (IMPRINT) for Patients with Pleural Metastases from Thymic Malignancies. Int J Radiat Oncol Biol Phys 2023; 117:e56-e57. [PMID: 37785717 DOI: 10.1016/j.ijrobp.2023.06.771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Pleural metastases are common sites for recurrence and progression in patients with thymic malignancies. The management of pleural metastases typically involves surgical resection with or without neoadjuvant or adjuvant systemic therapy. After surgical resection of pleural metastases, the 5-year progression-free survival (PFS) rate is about 29-45%. While radiation therapy (RT) is standardly used in the management of locally-advanced thymic malignancies, the role of RT in patients with pleural metastases in unclear. Intensity-modulated pleural radiation therapy (IMPRINT) is a RT technique currently being used to treat malignant pleural mesothelioma (MPM) patients with 2 intact lungs at centers that specialize in MPM treatment. This IMPRINT technique can potentially be extrapolated to thymic patients with pleural metastases. Because the risk of toxicity is of greater concern for thymic patients given their overall relatively favorable prognosis, the rate of toxicity, particularly radiation pneumonitis, needs to be established in the thymic patient population. MATERIALS/METHODS This is a single-arm, single institution Phase II study of hemithoracic IMPRINT for patients with pleural metastases from thymic malignancies. The primary endpoint of this study is grade 3 or higher radiation pneumonitis within 4 months of completing RT. Secondary endpoints include any toxicity, progression-free survival, patterns of failure and overall survival. Patients must have a pathologically confirmed diagnosis of a thymic malignancy with radiologic or pathologic evidence of pleural metastases. Thymoma or thymic carcinoma are allowed. Patients may have de novo stage IVA disease or recurrent disease in the pleura. There must be no evidence of extrathoracic metastatic disease or contralateral pleural/pericardial disease. Surgical resection of the pleural nodules (ex: pleurectomy/decortication, debulking/metastasectomy) are allowed. Extrapleural pneumonectomy is not allowed. Patients are excluded if they have undergone prior thoracic radiation therapy preventing hemithoracic pleural IMRT, whereas prior thymic bed radiation and/or prior pleural SBRT are allowed. RT will be administered to the ipsilateral pleura to 50.4 Gy in 28 fractions. An optional dose-painting boost to gross disease up to 60 Gy while respecting normal tissue constraints is allowed. Patients can be treated with photon or proton therapy. Simulation, contouring and RT planning guidelines have been developed. Patients will be followed per protocol at regular intervals for at least 12 months following RT. The expected accrual is 36 patients over 4 years. Further information can be found on clinicaltrials.gov (NCT05354570). RESULTS To be determined. CONCLUSION To be determined.
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Affiliation(s)
- A Rimner
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Huang
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Pagano
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - M Ginsberg
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Chang
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - G Riely
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - D R Gomez
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - A F Shepherd
- Memorial Sloan Kettering Cancer Center, New York, NY
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Ukegbu TE, Wylie-Rosett J, Groisman-Perelstein AE, Diamantis PM, Rieder J, Ginsberg M, Lichtenstein AH, Matthan NR, Shankar V. Waist-to-height ratio associated cardiometabolic risk phenotype in children with overweight/obesity. BMC Public Health 2023; 23:1549. [PMID: 37582739 PMCID: PMC10426079 DOI: 10.1186/s12889-023-16418-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 07/28/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Childhood overweight/obesity has been associated with an elevated risk of insulin resistance and cardiometabolic disorders. Waist-to-height ratio (WHtR) may be a simple screening tool to quickly identify children at elevated risk for cardiometabolic disorders. The primary objective of the present study was to create sex-specific tertile cut points of WHtR and assess its association with Insulin resistance and elevated liver enzyme concentrations in children, factors using cross-sectional data from the randomized, controlled Family Weight Management Study. METHODS Baseline data from 360 children (7-12 years, mean Body Mass Index (BMI) ≥ 85th percentile for age and sex) were used to calculate WHtR tertiles by sex, male: ≤ 0.55 (T1), > 0.55- ≤ 0.59 (T2), > 0.59 (T3); female: ≤ 0.56 (T1), > 0.56- ≤ 0.6 (T2), > 0.6 (T3). The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was used to categorize participants as insulin-resistant (HOMA-IR ≥ 2.6) and insulin-sensitive (HOMA-IR < 2.6). Liver enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were categorized as normal vs. elevated (AST of < 36.0 µkat/L or ≥ 36.0 µkat/L; ALT of < 30.0 µkat/L or ≥ 30.0 µkat/L; ALT > 26 µkat/L males, > 22 µkat/L females). We examined differences in baseline cardiometabolic risk factors by WHtR tertiles and sex-specific multivariable logistic regression models to predict HOMA-IR and elevation of liver enzymes. RESULTS Study participants had a mean WHtR of 0.59 ([SD: 0.06]). Irrespective of sex, children in WHtR T3 had higher BMIz scores, blood pressure, triglycerides, 2-h glucose, fasting 2-h insulin, and lower high-density lipoprotein cholesterol (HDL-C) concentrations than those in T2 and T1. After adjusting for covariates, the odds of elevated HOMA-IR (> 2.6) were over five-fold higher among males in T3 versus T1 [OR, 95%CI: 5.83, 2.34-14.52] and T2 [OR, 95%CI: 4.81, 1.94-11.92] and females in T3 [OR, 95%CI: 5.06, 2.10-12.20] versus T1. The odds of elevated ALT values (≥ 30) were 2.9 [95%CI: 1.01-8.41] fold higher among females in T3 compared to T1. CONCLUSION In public health settings, WHtR may be a practical screening tool in pediatric populations to identify children at risk of metabolic syndrome.
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Affiliation(s)
- Tochi E Ukegbu
- Sophie Davis School of Biomedical Education, The City College of New York, 160 Convent Ave, New York, NY, 10031, USA
| | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Adriana E Groisman-Perelstein
- Department of Pediatrics, Albert Einstein College of Medicine, Jacobi Medical Center, NY, 10461, Pelham Pkwy S, Bronx, USA
| | - Pamela M Diamantis
- Department of Pediatrics, Albert Einstein College of Medicine, Jacobi Medical Center, NY, 10461, Pelham Pkwy S, Bronx, USA
| | - Jessica Rieder
- Department of Pediatrics, Albert Einstein College of Medicine Children's Hospital at Montefiore, Bronx, NY, 10467, USA
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Alice H Lichtenstein
- Cardiovascular Nutrition Laboratory, JM USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington St, MA, 02111, Boston, USA
| | - Nirupa R Matthan
- Cardiovascular Nutrition Laboratory, JM USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington St, MA, 02111, Boston, USA
| | - Viswanathan Shankar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
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Rimner A, Lok B, Gelblum D, Kotecha R, Albrecht F, Shin J, Laplant Q, Namakydoust A, Shepherd A, Gomez D, Shaverdian N, Wu A, Simone C, Yu H, Ng K, Daly R, Offin M, Ginsberg M, Zhang Z, Rudin C. 169P Phase I dose escalation trial combining olaparib and thoracic radiation therapy in extensive-stage small cell lung cancer. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00423-9] [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: 04/03/2023]
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Bielopolski N, Heyman E, Bassan H, BenZeev B, Tzadok M, Ginsberg M, Blumkin L, Michaeli Y, Sokol R, Yosha-Orpaz N, Hady-Cohen R, Banne E, Lev D, Lerman-Sagie T, Wald-Altman S, Nissenkorn A. "Virtual patch clamp analysis" for predicting the functional significance of pathogenic variants in sodium channels. Epilepsy Res 2022; 186:107002. [PMID: 36027690 DOI: 10.1016/j.eplepsyres.2022.107002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Opening of voltage-gated sodium channels is crucial for neuronal depolarization. Proper channel opening and influx of Na+ through the ion pore, is dependent upon binding of Na+ ion to a specific amino-acid motif (DEKA) within the pore. In this study we used molecular dynamic simulations, an advanced bioinformatic tool, to research the dysfunction caused by pathogenic variants in SCN1a, SCN2a and SCN8a genes. METHOD Molecular dynamic simulations were performed in six patients: three patients with Dravet syndrome (p.Gly177Ala,p.Ser259Arg and p.Met1267Ile, SCN1a), two patients with early onset drug resistant epilepsy(p.Ala263Val, SCN2a and p.Ile251Arg, SCN8a), and a patient with autism (p.Thr155Ala, SCN2a). After predicting the 3D-structure of mutated proteins by homology modeling, time dependent molecular dynamic simulations were performed, using the Schrödinger algorithm. The opening of the sodium channel, including the detachment of the sodium ion to the DEKA motif and pore diameter were assessed. Results were compared to the existent patch clamp analysis in four patients, and consistency with clinical phenotype was noted. RESULTS The Na+ ion remained attached to DEKA filter longer when compared to wild type in the p.Gly177Ala, p.Ser259Arg,SCN1a, and p.Thr155Ala, SCN2a variants, consistent with loss-of-function. In contrast, it detached quicker from DEKA than wild type in the p.Ala263Val,SCN2a variant, consistent with gain-of-function. In the p.Met1267Ile,SCN1a variant, detachment from DEKA was quicker, but pore diameter decreased, suggesting partial loss-of-function. In the p.Leu251Arg,SCN8a variant, the pore remained opened longer when compared to wild type, consistent with a gain-of-function. The molecular dynamic simulation results were consistent with the existing patch-clamp analysis studies, as well as the clinical phenotype. SIGNIFICANCE Molecular dynamic simulation can be useful in predicting pathogenicity of variants and the disease phenotype, and selecting targeted treatment based on channel dysfunction. Further development of these bioinformatic tools may lead to "virtual patch-clamp analysis".
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Affiliation(s)
| | - E Heyman
- Pediatric Epilepsy Department, Shamir Medical Center, Asaf Ha Rofeh, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - H Bassan
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Unit, Shamir Medical Center, Asaf HaRofeh, Israel.
| | - B BenZeev
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Pediatric Neurology Unit, Safra Children's Hospital, Sheba Medical Center, Tel HaShomer, Israel.
| | - M Tzadok
- Pediatric Neurology Unit, Safra Children's Hospital, Sheba Medical Center, Tel HaShomer, Israel.
| | - M Ginsberg
- Rare Diseases Institute-Magen, Edith Wolfson Medical Center, Holon, Israel; Pediatric Neurology Unit, Edith Wolfson Medical Center, Holon, Israel.
| | - L Blumkin
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Rare Diseases Institute-Magen, Edith Wolfson Medical Center, Holon, Israel; Pediatric Neurology Unit, Edith Wolfson Medical Center, Holon, Israel.
| | - Y Michaeli
- Rare Diseases Institute-Magen, Edith Wolfson Medical Center, Holon, Israel; Pediatric Neurology Unit, Edith Wolfson Medical Center, Holon, Israel.
| | - R Sokol
- Pediatric Neurology Unit, Edith Wolfson Medical Center, Holon, Israel.
| | - N Yosha-Orpaz
- Rare Diseases Institute-Magen, Edith Wolfson Medical Center, Holon, Israel; Pediatric Neurology Unit, Edith Wolfson Medical Center, Holon, Israel.
| | - R Hady-Cohen
- Rare Diseases Institute-Magen, Edith Wolfson Medical Center, Holon, Israel.
| | - E Banne
- Pediatric Epilepsy Department, Shamir Medical Center, Asaf Ha Rofeh, Israel; Genetics Institute, Edith Wolfson Medical Center, Holon, Israel
| | - D Lev
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Rare Diseases Institute-Magen, Edith Wolfson Medical Center, Holon, Israel; Genetics Institute, Edith Wolfson Medical Center, Holon, Israel.
| | - T Lerman-Sagie
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Rare Diseases Institute-Magen, Edith Wolfson Medical Center, Holon, Israel; Pediatric Neurology Unit, Edith Wolfson Medical Center, Holon, Israel.
| | | | - A Nissenkorn
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Rare Diseases Institute-Magen, Edith Wolfson Medical Center, Holon, Israel; Pediatric Neurology Unit, Edith Wolfson Medical Center, Holon, Israel.
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Wang S, Spielman A, Ginsberg M, Petri M, Rovin BH, Buyon J, Broder A. Short- and Long-Term Progression of Kidney Involvement in Systemic Lupus Erythematosus Patients with Low-Grade Proteinuria. Clin J Am Soc Nephrol 2022; 17:1150-1158. [PMID: 35882508 PMCID: PMC9435982 DOI: 10.2215/cjn.01280122] [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: 01/29/2022] [Accepted: 06/20/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Lupus nephritis remains a common cause of morbidity and mortality in systemic lupus erythematosus (SLE). Current guidelines recommend performing a kidney biopsy at a urine protein-creatinine ratio of ≥0.5 g/g. However, cross-sectional studies reported a high prevalence of active histologic lupus nephritis lesions, and even chronic irreversible scarring, in patients with low-grade proteinuria. This study was initiated to assess disease progression in patients with SLE and low-grade proteinuria to identify risk factors for progression to overt proteinuria suggestive of clinical lupus nephritis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Patients with SLE who had an incident urinary protein-creatinine ratio of ≥0.2 and <0.5 g/g without known lupus nephritis were identified from the Einstein Rheumatic Disease Registry. Patients who developed a random urinary protein-creatinine ratio of ≥0.5 g/g with or without biopsy during the follow-up period were defined as "progressors." Patients who progressed to a urinary protein-creatinine ratio of ≥0.5 g/g within 2 years of developing a urinary protein-creatinine ratio of ≥0.2 and <0.5 g/g were defined as "fast progressors," a subgroup expected to benefit most from early biopsies and therapeutic interventions. RESULTS Among 151 eligible patients with SLE and low-grade proteinuria at study entry, 76 (50%) progressed to a urinary protein-creatinine ratio of ≥0.5 g/g, of which 44 underwent a clinically indicated biopsy. The median (interquartile range) time from a urinary protein-creatinine ratio of ≥0.2 and <0.5 g/g to progression was 1.2 (0.3-3.0) years. Of the 20 biopsies performed in the first 2 years, 16 specimens showed active, treatable lupus nephritis. Low complement and shorter SLE duration at low-grade proteinuria onset were associated with progression to overt proteinuria across different analyses. Other associated factors included hypertension, diabetes mellitus, younger age, and the presence of hematuria. CONCLUSIONS In this longitudinal cohort of patients with SLE and low-grade proteinuria at study entry, over half progressed to a urinary protein-creatinine ratio of ≥0.5 g/g in a short time period.
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Affiliation(s)
- Shudan Wang
- Division of Rheumatology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Allan Spielman
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Michelle Petri
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brad H. Rovin
- Division of Nephrology, Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jill Buyon
- Division of Rheumatology, New York University Grossman School of Medicine, New York, New York
| | - Anna Broder
- Division of Rheumatology, Hackensack University Medical Center, Hackensack, New Jersey
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Matthan NR, Barger K, Wylie-Rosett J, Xue X, Groisman-Perelstein AE, Diamantis PM, Ginsberg M, Mossavar-Rahmani Y, Lichtenstein AH. Spillover Effects of a Family-Based Childhood Weight-Management Intervention on Parental Nutrient Biomarkers and Cardiometabolic Risk Factors. Curr Dev Nutr 2022; 6:nzab152. [PMID: 35155982 PMCID: PMC8826936 DOI: 10.1093/cdn/nzab152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Parental involvement has been shown to favorably affect childhood weight-management interventions, but whether these interventions influence parental diet and cardiometabolic health outcomes is unclear. OBJECTIVES The aim was to evaluate whether a 1-y family-based childhood weight-management intervention altered parental nutrient biomarker concentrations and cardiometabolic risk factors (CMRFs). METHODS Secondary analysis from a randomized-controlled, parallel-arm clinical trial (NCT00851201). Families were recruited from a largely Hispanic population and assigned to either standard care (SC; American Academy of Pediatrics overweight/obesity recommendations) or SC + enhanced program (SC+EP; targeted diet/physical activity strategies, skill building, and monthly support sessions). Nutrient biomarkers (plasma carotenoids and fat-soluble vitamins, RBC fatty acid profiles) and CMRFs (BMI, blood pressure, glucose, insulin, lipid profile, inflammatory and endothelial dysfunction markers, adipokines) were measured in archived samples collected from parents of participating children at baseline and end of the 1-y intervention. RESULTS Parents in both groups (SC = 106 and SC+EP = 99) had significant reductions in trans fatty acid (-14%) and increases in MUFA (2%), PUFA n-6 (ɷ-6) (2%), PUFA n-3 (7%), and β-carotene (20%) concentrations, indicative of lower partially hydrogenated fat and higher vegetable oil, fish, and fruit/vegetable intake, respectively. Significant reductions in high-sensitivity C-reactive protein (hsCRP; -21%) TNF-α (-19%), IL-6 (-19%), and triglycerides (-6%) were also observed in both groups. An additional significant improvement in serum insulin concentrations (-6%) was observed in the SC+EP parents. However, no major reductions in BMI or blood pressure and significant unfavorable trajectories in LDL-cholesterol and endothelial dysfunction markers [P-selectin, soluble intercellular adhesion molecule (sICAM), thrombomodulin] were observed. Higher carotenoid, MUFA, and PUFA (n-6 and n-3) and lower SFA and trans fatty acid concentrations were associated with improvements in circulating glucose and lipid measures, inflammatory markers, and adipokines. CONCLUSIONS The benefits of a family-based childhood weight-management intervention can spill over to parents, resulting in apparent healthier dietary shifts that are associated with modest improvements in some CMRFs.
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Affiliation(s)
- Nirupa R Matthan
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Kathryn Barger
- Biostatistics and Data Management Core Unit, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Pamela M Diamantis
- Department of Pediatrics, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY, USA
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Alice H Lichtenstein
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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Rohan TE, Ginsberg M, Wang Y, Couch FJ, Feigelson HS, Greenlee RT, Honda S, Stark A, Chitale D, Wang T, Xue X, Oktay MH, Sparano JA, Loudig O. Molecular markers of risk of subsequent invasive breast cancer in women with ductal carcinoma in situ: protocol for a population-based cohort study. BMJ Open 2021; 11:e053397. [PMID: 34702732 PMCID: PMC8549665 DOI: 10.1136/bmjopen-2021-053397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Ductal carcinoma in situ (DCIS) of the breast is a non-obligate precursor of invasive breast cancer (IBC). Many DCIS patients are either undertreated or overtreated. The overarching goal of the study described here is to facilitate detection of patients with DCIS at risk of IBC development. Here, we propose to use risk factor data and formalin-fixed paraffin-embedded (FFPE) DCIS tissue from a large, ethnically diverse, population-based cohort of 8175 women with a first diagnosis of DCIS and followed for subsequent IBC to: identify/validate miRNA expression changes in DCIS tissue associated with risk of subsequent IBC; evaluate ipsilateral IBC risk in association with two previously identified marker sets (triple immunopositivity for p16, COX-2, Ki67; Oncotype DX Breast DCIS score); examine the association of risk factor data with IBC risk. METHODS AND ANALYSIS We are conducting a series of case-control studies nested within the cohort. Cases are women with DCIS who developed subsequent IBC; controls (2/case) are matched to cases on calendar year of and age at DCIS diagnosis. We project 485 cases/970 controls in the aim focused on risk factors. We estimate obtaining FFPE tissue for 320 cases/640 controls for the aim focused on miRNAs; of these, 173 cases/346 controls will be included in the aim focused on p16, COX-2 and Ki67 immunopositivity, and of the latter, 156 case-control pairs will be included in the aim focused on the Oncotype DX Breast DCIS score®. Multivariate conditional logistic regression will be used for statistical analyses. ETHICS AND DISSEMINATION Ethics approval was obtained from the Institutional Review Boards of Albert Einstein College of Medicine (IRB 2014-3611), Kaiser Permanente Colorado, Kaiser Permanente Hawaii, Henry Ford Health System, Mayo Clinic, Marshfield Clinic Research Institute and Hackensack Meridian Health, and from Lifespan Research Protection Office. The study results will be presented at meetings and published in peer-reviewed journals.
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Affiliation(s)
- Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Yihong Wang
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Providence, Rhode Island, USA
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Robert T Greenlee
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Stacey Honda
- Center for Integrated Healthcare, Kaiser Permanente, Hawaii Permanente Medical Group, Honolulu, Hawaii, USA
| | - Azadeh Stark
- Department of Pathology and Laboratory Medicine, Henry Ford Health System, Detroit, Michigan, USA
- Breast Oncology Program and Department of Pathology, Henry Ford Health System, Detroit, Michigan, USA
| | - Dhananjay Chitale
- Department of Pathology and Laboratory Medicine, Henry Ford Health System, Detroit, Michigan, USA
- Breast Oncology Program and Department of Pathology, Henry Ford Health System, Detroit, Michigan, USA
| | - Tao Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Maja H Oktay
- Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
- Department of Anatomy and Structural Biology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Joseph A Sparano
- Department of Oncology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York, USA
| | - Olivier Loudig
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, New Jersey, USA
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Matthan N, Barger K, Wylie-Rosett J, Xue X, Gao Q, Groisman-Perelstein A, Diamantis P, Ginsberg M, Mossavar-Rahmani Y, Lichtenstein A. Spillover Effects of a Family-Based Childhood Obesity Intervention on Parental Nutrient Biomarkers and Cardiometabolic Risk Factors. Curr Dev Nutr 2021. [DOI: 10.1093/cdn/nzab055_043] [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: 11/13/2022] Open
Abstract
Abstract
Objectives
To evaluate the impact of a family-based weight management intervention for children with overweight/obesity on parental nutrient biomarker concentrations and cardiometabolic risk factors (CMRF).
Methods
Secondary analysis from a randomized-controlled, parallel-arm clinical trial. Families were recruited from a largely Hispanic population and assigned to either Standard Care (SC; American Academy of Pediatrics overweight/obesity recommendations) or Standard Care + Enhanced Program (SC + EP; eight skill-building cores, subsequent monthly support sessions, targeted diet/physical activity strategies). Nutrient biomarkers (plasma carotenoids and fat soluble vitamins; red blood cell [RBC] fatty acid profiles) and CMRF (BMI, blood pressure, plasma glucose, insulin, lipid profile, inflammatory markers and adipokine concentrations) were measured in archived samples collected from the parents at baseline and at the end of the 1-year intervention.
Results
Parents of children in both groups (SC = 106; SC + EP = 99) had significantly lower total SFA (−3%) and trans fatty acid (−14%), and higher MUFA (2%), PUFAn-6 (2%), PUFAn-3 (7%) and beta-carotene (20%) concentrations, indicative of decreased partially-hydrogenated fat and increased vegetable oil, fish and fruit/vegetable intake, respectively. In both groups, there were significant reductions in inflammatory markers (hsCRP [−21%], TNFα [−19%] and IL-6 [−19%]), but not in BMI, blood pressure or lipid profile. Parents with children assigned to the SC + EP group had additional improvements in serum insulin (−6%) and leptin (−1.3%) concentrations. Using multiple linear regression models adjusted for sex, age, group, baseline BMI, and baseline CMRF values, improvements in circulating inflammatory and glucose metabolism markers, and adipokine concentrations were associated with higher carotenoid and PUFAn-3 (specifically 20:5n-3), and lower SFA and trans fatty acid concentrations, at the end of the 1-year intervention.
Conclusions
These results suggest that a family-based childhood obesity intervention can spill over to parents, resulting in apparent healthier dietary shifts that are associated with modest improvements in some CMRF.
Funding Sources
NIH, NIDDK, USDA.
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Affiliation(s)
| | | | | | | | - Qi Gao
- Albert Einstein College of Medicine
| | | | | | | | | | - Alice Lichtenstein
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University
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10
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Klugman M, Fazzari M, Xue X, Ginsberg M, Rohan TE, Halmos B, Hanna DB, Shuter J, Hosgood HD. The associations of CD4 count, CD4/CD8 ratio, and HIV viral load with survival from non-small cell lung cancer in persons living with HIV. AIDS Care 2021; 34:1014-1021. [PMID: 34074183 PMCID: PMC8633167 DOI: 10.1080/09540121.2021.1934380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
HIV status may influence survival from non-small cell lung cancer (NSCLC). Among NSCLC patients in the Bronx, NY, we assessed (1) associations of CD4 count, CD4/CD8 ratio and HIV viral load (VL) with survival and (2) prognostic factors among persons living with HIV (PLWH). We compared survival from NSCLC diagnosis (2004-2017) between HIV-negative persons (HIV-, n=2,881) and PLWH (n=88) accounting for clinical and sociodemographic factors. HIV-survival was also compared with PLWH, dichotomized by CD4 (<200 vs. ≥200cells/µL), CD4/CD8 (median, <0.43 vs. ≥0.43) and VL (<75 vs. ≥75copies/mL) at NSCLC diagnosis. Among PLWH, we assessed the relationships of CD4, CD4/CD8, and VL with survival, adjusting for age, sex, and cancer stage. PLWH with CD4< 200cells/µL had lower survival than HIV- [hazard ratio, 95% confidence interval [HR(95%CI)]=1.86(0.98-3.55)]. Survival was similar between PLWH with CD4≥ 200cells/µL and HIV- [HR(95%CI) = 0.90(0.61-1.33)]. Results were similar when categorizing PLWH by CD4/CD8 [vs. HIV-: low CD4/CD8: HR(95%CI) = 1.74(1.07-3.89); high CD4/CD8: HR(95%CI) = 0.63(0.37-1.07)] and VL [vs. HIV-: <75copies/mL: HR(95%CI) = 0.74(0.46-1.21), ≥75copies/mL: HR(95%CI) = 1.41(0.88-2.27)]. Among PLWH, CD4< 200cells/µL was associated with worse survival [vs. CD4≥ 200cells/µL: HR(95%CI) = 2.37(1.14-4.92)]. CD4, CD4/CD8, and VL may be prognostic markers for PLWH with NSCLC, suggesting immune status may be important in NSCLC survival among PLWH.
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Affiliation(s)
- M Klugman
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - M Fazzari
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - X Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - M Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - T E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - B Halmos
- Department of Medicine (Oncology), Montefiore Medical Center, Bronx, NY, USA
| | - D B Hanna
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - J Shuter
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.,Department of Medicine (Infectious Diseases), Montefiore Medical Center, Bronx, NY, USA
| | - H D Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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11
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Figueroa JD, Gierach GL, Duggan MA, Fan S, Pfeiffer RM, Wang Y, Falk RT, Loudig O, Abubakar M, Ginsberg M, Kimes TM, Richert-Boe K, Glass AG, Rohan TE. Risk factors for breast cancer development by tumor characteristics among women with benign breast disease. Breast Cancer Res 2021; 23:34. [PMID: 33736682 PMCID: PMC7977564 DOI: 10.1186/s13058-021-01410-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/22/2021] [Indexed: 11/23/2022] Open
Abstract
Background Among women diagnosed with invasive breast cancer, 30% have a prior diagnosis of benign breast disease (BBD). Thus, it is important to identify factors among BBD patients that elevate invasive cancer risk. In the general population, risk factors differ in their associations by clinical pathologic features; however, whether women with BBD show etiologic heterogeneity in the types of breast cancers they develop remains unknown. Methods Using a nested case-control study of BBD and breast cancer risk conducted in a community healthcare plan (Kaiser Permanente Northwest), we assessed relationships of histologic features in BBD biopsies and patient characteristics with subsequent breast cancer risk and tested for heterogeneity of associations by estrogen receptor (ER) status, tumor grade, and size. The study included 514 invasive breast cancer cases (median follow-up of 9 years post-BBD diagnosis) and 514 matched controls, diagnosed with proliferative or non-proliferative BBD between 1971 and 2006, with follow-up through mid-2015. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using multivariable polytomous logistic regression models. Results Breast cancers were predominantly ER-positive (86%), well or moderately differentiated (73%), small (74% < 20 mm), and stage I/II (91%). Compared to patients with non-proliferative BBD, proliferative BBD with atypia conferred increased risk for ER-positive cancer (OR = 5.48, 95% CI = 2.14–14.01) with only one ER-negative case, P-heterogeneity = 0.45. The presence of columnar cell lesions (CCLs) at BBD diagnosis was associated with a 1.5-fold increase in the risk of both ER-positive and ER-negative tumors, with a 2-fold increase (95% CI = 1.21–3.58) observed among postmenopausal women (56%), independent of proliferative BBD status with and without atypia. We did not identify statistically significant differences in risk factor associations by tumor grade or size. Conclusion Most tumors that developed after a BBD diagnosis in this cohort were highly treatable low-stage ER-positive tumors. CCL in BBD biopsies may be associated with moderately increased risk, independent of BBD histology, and irrespective of ER status. Supplementary Information The online version contains supplementary material available at 10.1186/s13058-021-01410-1.
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Affiliation(s)
- Jonine D Figueroa
- National Cancer Institute, National Institutes of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA. .,The Usher Institute, Old Medical School, The University of Edinburgh, Teviot Place, Edinburgh, UK. .,CRUK Edinburgh Centre, The University of Edinburgh, Edinburgh, UK.
| | - Gretchen L Gierach
- National Cancer Institute, National Institutes of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Máire A Duggan
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Alberta, Calgary, Canada
| | - Shaoqi Fan
- National Cancer Institute, National Institutes of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Ruth M Pfeiffer
- National Cancer Institute, National Institutes of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Yihong Wang
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Roni T Falk
- National Cancer Institute, National Institutes of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Olivier Loudig
- Center for Discovery and Innovation (CDI), Hackensack Meridian Health, Nutley, NJ, USA
| | - Mustapha Abubakar
- National Cancer Institute, National Institutes of Health, Division of Cancer Epidemiology and Genetics, Bethesda, MD, USA
| | - Mindy Ginsberg
- Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, 1300 Morris Park Avenue, Belfer Building, Room 1301, Bronx, NY, 10461, USA
| | - Teresa M Kimes
- Kaiser Permanente Center for Health Research, Portland, OR, USA
| | | | - Andrew G Glass
- Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - Thomas E Rohan
- Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, 1300 Morris Park Avenue, Belfer Building, Room 1301, Bronx, NY, 10461, USA.
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12
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Wu A, Plodkowski A, Ginsberg M, Shin J, Laplant Q, Shepherd A, Shaverdian N, Ng V, Yue Y, Gilbo P, Gelblum D, Braunstein L, Gomez D, Rimner A. P02.14 Radiotherapy-Associated CT Imaging as a Potential Screening Tool for COVID-19. J Thorac Oncol 2021. [PMCID: PMC7976875 DOI: 10.1016/j.jtho.2021.01.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Filho JA, Murciano-Goroff Y, Gibbs P, Perez-Johnston R, Lai W, Rudin C, Li B, Ginsberg M. P47.06 Delta-Radiomics Features for Assessment of Individualized Therapeutic Response in Small Cell Lung Cancer – A Pilot Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.862] [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: 11/30/2022]
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14
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Rohan TE, Arthur R, Wang Y, Weinmann S, Ginsberg M, Loi S, Salgado R. Infiltrating immune cells in benign breast disease and risk of subsequent invasive breast cancer. Breast Cancer Res 2021; 23:15. [PMID: 33516237 PMCID: PMC7846992 DOI: 10.1186/s13058-021-01395-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background It is well established that tumors are antigenic and can induce an immune response by the host, entailing lymphocytic infiltration of the tumor and surrounding stroma. The extent and composition of the immune response to the tumor, assessed through evaluation of tumor-infiltrating lymphocyte counts, has been shown in many studies to have prognostic and predictive value for invasive breast cancer, but currently, there is little evidence regarding the association between infiltrating immune cell counts (IICCs) in women with benign breast disease (BBD) and risk of subsequent invasive breast cancer. Methods Using a cohort of 15,395 women biopsied for BBD at Kaiser Permanente Northwest, we conducted a nested case-control study in which cases were women who developed a subsequent invasive breast cancer during follow-up and controls were individually matched to cases on age at BBD diagnosis. We assessed IICCs in normal tissue and in the BBD lesions, and we used unconditional logistic regression to estimate the multivariable odds ratios (OR) and 95% confidence intervals (CI) for the associations between IICCs and breast cancer risk. Results There was no association between the IICC in normal tissue (multivariable OR per 5% increase in IICC = 1.05, 95% CI = 0.96–1.16) or in the BBD lesion (OR per 5% increase in IICC = 1.06, 95% CI = 0.96–1.18) and risk of subsequent invasive breast cancer. Also, there were no associations within subgroups defined by menopausal status, BBD histology, BMI, and history of smoking. Conclusion The results of this study suggest that IICCs in BBD tissue are not associated with altered risk of subsequent invasive breast cancer.
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Affiliation(s)
- Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA.
| | - Rhonda Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA
| | - Yihong Wang
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Sheila Weinmann
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA
| | - Sherene Loi
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.,Division of Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Roberto Salgado
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Australia.,Department of Pathology, GZA-ZNA, Antwerp, Belgium
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15
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Matthan NR, Wylie-Rosett J, Xue X, Gao Q, Groisman-Perelstein AE, Diamantis PM, Ginsberg M, Mossavar-Rahmani Y, Barger K, Lichtenstein AH. Effect of a Family-Based Intervention on Nutrient Biomarkers, Desaturase Enzyme Activities, and Cardiometabolic Risk Factors in Children with Overweight and Obesity. Curr Dev Nutr 2020; 4:nzz138. [PMID: 31922084 PMCID: PMC6943838 DOI: 10.1093/cdn/nzz138] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 11/21/2019] [Accepted: 11/29/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Developing dietary strategies to prevent excess weight gain during childhood is critical to stem the current obesity epidemic and associated adverse cardiometabolic consequences. OBJECTIVES We aimed to assess how participation in a family-based weight-management intervention affected nutrient biomarkers and cardiometabolic risk factors (CMRFs) in children (7-12 y old; n = 321) with baseline BMI z score (BMIz) ≥85th percentile. METHODS This was a secondary analysis from a randomized-controlled, parallel-arm clinical trial. Families of children, recruited from a largely Hispanic population, were assigned to Standard Care (SC; American Academy of Pediatrics overweight/obesity recommendations), or SC + Enhanced Program (SC + EP; 8 skill-building cores, monthly support sessions, targeted diet/physical activity strategies). Nutrient biomarkers (plasma carotenoids, fat-soluble vitamins, RBC fatty acid profiles, desaturase indexes) and CMRFs were measured in archived blood samples collected at baseline and the end of the 1-y intervention. RESULTS Children in both groups had significantly lower trans fatty acid and higher pentadecylic acid (15:0), PUFA n-3, and β-carotene concentrations, indicative of decreased hydrogenated fat and increased dairy, vegetable oil, fish, and fruit/vegetable intake, respectively. Similar changes were seen in de novo lipogenesis and desaturase indexes, as well as CMRFs (BMIz, lipid profile, inflammation, adipokines, liver enzymes) in both groups. Using multiple logistic regression, increase in carotenoids and decrease in endogenously synthesized SFA, MUFA, PUFA n-6, and desaturase indexes were associated with improvements in BMIz, blood pressure, lipid profile, glucose metabolism, inflammatory biomarkers, adipokines, and liver enzymes. Trans fatty acids were associated with improvements in BMIz, glucose metabolism, and leptin, with less favorable effects on inflammatory markers and adiponectin. CONCLUSIONS Providing targeted family-based behavioral counseling, as part of SC, can help overweight/obese children adopt healthier eating patterns that are associated with modest improvements in BMIz and several CMRFs. Limited additional benefit was observed with SC + EP. These results provide critical data to design subsequent interventions to increase the impact of family-based obesity prevention programs.This trial was registered at clinicaltrials.gov as NCT00851201.
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Affiliation(s)
- Nirupa R Matthan
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Judith Wylie-Rosett
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Xiaonan Xue
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Qi Gao
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Pamela M Diamantis
- Department of Pediatrics, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY, USA
| | - Mindy Ginsberg
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kathryn Barger
- Biostatistics and Data Management Core Unit, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Alice H Lichtenstein
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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16
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Klugman M, Xu X, Ginsberg M, Rohan T, Hosgood HD. Abstract 4207: Elucidating drivers of the Hispanic paradox in non-small cell lung cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-4207] [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
The Hispanic paradox refers to findings in the United States (US) showing similar or better health outcomes in Hispanics than in non-Hispanic whites (NHWs) despite lower average socioeconomic status (SES). This paradox has been reported for non-small cell lung cancer (NSCLC) using data from national cancer registries, with Hispanics experiencing lower mortality rates than Non-Hispanics (NHs). However, these registries often lack critical covariate data such as smoking. To this end, we developed the Lung Cancer Clinical Cohort at Montefiore Medical Center (LC3MMC) in the Bronx, NY, to describe the growing but understudied US Hispanic population and to further elucidate factors in lung cancer survival. Subjects in LC3MMC were ≥18 years old with no prior cancer history who were diagnosed with incident primary lung carcinoma of any histology and of stage 1-4, between 2004-2017. Demographic and clinical data were obtained from MMC’s clinical systems, and tumor-related information was obtained from MMC/Einstein’s Cancer Registry. Of the 5102 subjects in LC3MMC, the mean age at diagnosis was 68 (±12) years, 50% were male, 80% were ever-smokers, 72% had known ethnicity [NHW: n=1278, Non-Hispanic Black (NHB): n=1222, Hispanic: n=855], and 80% had known histology (NSCLC: n=3554, SCLC: n=505). Based on log-rank tests, overall survival was greater in Hispanics compared to NHs (all subjects: p=0.01, NSCLC only: p=0.01) and did not differ between NHWs and NHBs (all: p=0.26, NSCLC: p=0.21). Cancer subtype (χ2: NSCLC vs. SCLC: p=0.18) and treatment rates (yes vs. no) [χ2: surgery (all: p=.08, NSCLC: p=0.12), radiation (all: p=.85, NSCLC: p=0.55), chemotherapy (all: p=0.26, NSCLC: p=0.23)] did not vary by ethnicity. Multivariate Cox proportional hazards modeling compared survival between Hispanics and NHs while adjusting for age; gender; stage; adenocarcinoma histology; smoking status; receipt of surgery, chemotherapy, radiation, and palliative care; marital status; and SES. In NSCLC patients, Hispanic ethnicity was associated with decreased risk of death (HR=0.86, 95% CI=0.74-0.99). When limiting the model to Hispanics, stage (regional: HR=2.81, 95% CI=1.72-4.57; distant: HR=6.78, 95% CI=4.24-10.85; unknown: HR=4.17, 95% CI=2.42-7.18), receipt of surgery (HR=0.53, 95% CI=0.39-0.72) and receipt of chemotherapy (HR=0.74, 95% CI=0.57-0.97) were associated with survival. Hispanic ethnicity was not associated with better survival in SCLC subjects (adjusted HR=0.97, 95% CI: 0.68-1.39). We have observed the Hispanic paradox in NSCLC in one of the largest US academic medical centers. Clinical and social factors do not fully explain the improved survival in this group. Our results provide the basis for detailed exploration of the demographic, cultural, and molecular drivers of lung cancer survival disparities among different racial/ethnic groups in the Bronx.
Citation Format: Madelyn Klugman, Xiaonan Xu, Mindy Ginsberg, Thomas Rohan, H. Dean Hosgood. Elucidating drivers of the Hispanic paradox in non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4207.
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Affiliation(s)
| | - Xiaonan Xu
- Albert Einstein College of Medicine, Bronx, NY
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17
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Swencionis C, Smith-Wexler L, Lent MR, Cimino C, Segal-Isaacson CJ, Ginsberg M, Caban-Pocai A, Wassertheil-Smoller S, Theodore JL, Wylie-Rosett J. Triggers of Lapse and Relapse of Diet and Exercise in Behavioral Weight Loss. Obesity (Silver Spring) 2019; 27:888-893. [PMID: 31033215 PMCID: PMC6533136 DOI: 10.1002/oby.22437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 01/15/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study aimed to (1) develop instruments to evaluate situations that lead to lapse and relapse in diet and exercise and (2) prospectively investigate when and which psychosocial situations predict failure to lose weight in a clinical trial of intentional weight loss. METHODS Participants were 469 individuals with overweight or obesity participating in a behavioral weight loss program (age: mean = 53.6 years, SD = 11.4; BMI: mean = 35.7 kg/m2 , SD = 6.5). RESULTS The Cronbach alphas for the Diet Lapse and Relapse Triggers Scale and the Exercise Lapse and Relapse Triggers Scale were 0.93 and 0.91, respectively. Subscale alphas ranged from 0.60 to 0.96. Lapse and relapse were assessed at 3 and 9 months for associations with weight loss at 12 months. At 9 months, diet triggers were negative emotional states (beta = 0.11, P = 0.02) and urges (beta = 0.14, P = 0.01). Predicted social situations showed the opposite (beta = -0.09, P = 0.02). Exercise subscales were all nonsignificant. CONCLUSIONS Findings suggest the ongoing importance of addressing negative emotional states and the contributing influence of urges. The novel finding that participants whose difficulties arise in social situations may do better over time requires further study.
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Affiliation(s)
- Charles Swencionis
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, New York, USA
- Department of Epidemiology/Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, New York, USA
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, New York, USA
| | | | - Michelle R Lent
- Department of Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
| | - Christopher Cimino
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, New York, USA
| | - C J Segal-Isaacson
- Department of Epidemiology/Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, New York, USA
| | - Mindy Ginsberg
- Department of Epidemiology/Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, New York, USA
| | - Arlene Caban-Pocai
- Department of Epidemiology/Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, New York, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology/Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, New York, USA
| | - John L Theodore
- Department of Psychology, Iona College, New Rochelle, New York, USA
| | - Judith Wylie-Rosett
- Department of Epidemiology/Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, New York, USA
- Department of Medicine, Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, New York, USA
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18
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Rohan TE, Wang T, Weinmann S, Wang Y, Lin J, Ginsberg M, Loudig O. A miRNA Expression Signature in Breast Tumor Tissue Is Associated with Risk of Distant Metastasis. Cancer Res 2019; 79:1705-1713. [PMID: 30760517 DOI: 10.1158/0008-5472.can-18-2779] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/17/2018] [Accepted: 02/06/2019] [Indexed: 11/16/2022]
Abstract
Dysregulation of miRNA expression may influence breast cancer progression, and experimental evidence suggests that miRNA silencing might suppress breast cancer metastasis. However, the relationship between miRNA and metastasis must be confirmed before this approach can be applied in the clinic. To this end, we conducted a two-stage study in a cohort of 3,760 patients with breast cancer to first identify and then validate the association between miRNA expression and risk of distant metastasis. The first stage (discovery) entailed miRNA sequencing of 126 case-control pairs; qPCR was used to validate the findings in a separate set of 80 case-control pairs. The 13 miRNAs most differentially expressed between cases and controls were combined into an miRNA score that was significantly associated with risk of distant metastasis in a logistic regression model that also included clinical variables (tumor size and number of positive lymph nodes) (ORper unit increase in score = 1.30; 95% confidence interval, 1.03-1.66). The results of this study suggest that in women with invasive breast cancer, a miRNA score that incorporates both clinical variables and miRNA expression levels in breast tumor tissue is moderately predictive of risk of subsequent distant metastasis. SIGNIFICANCE: A novel predictive scoring system for patients with breast cancer includes clinical variables and the expression levels of 13 miRNAs and may help to identify those at increased risk of distant metastasis.
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Affiliation(s)
- Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York.
| | - Tao Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Sheila Weinmann
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon
| | - Yihong Wang
- Department of Pathology and Laboratory of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Juan Lin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Olivier Loudig
- Hackensack University Medical Center, Hackensack, New Jersey
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Zauderer M, Muller S, Lai W, Ni A, Jungbluth A, Ginsberg M, Daly R, Hellmann M, Ladanyi M, Sauter J. P2.06-40 VISTA is Highly Expressed in Malignant Pleural Mesothelioma (MPM) and Independent of PD-L1 Expression. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1295] [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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20
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Paik P, Ahn L, Ginsberg M, Mcfarland D, Doyle L, Rudin C. P2.13-44 Targeting NFE2L2 Mutations in Advanced Squamous Cell Lung Cancers with the TORC1/2 Inhibitor TAK-228. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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21
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Li B, Offin M, Hembrough T, Cecchi F, Shen R, Olah Z, Panora E, Myers M, Brzostowski E, Buonocore D, Ginsberg M, Rudin C, Kris M, Weitsman G, Barber P, Ng T, Ulaner G, Arcila M, Scaltriti M. P1.13-43 Molecular and Imaging Predictors of Response to Ado-Trastuzumab Emtansine in Patients with HER2 Mutant Lung Cancers: An Exploratory Phase 2 Trial. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Attarian S, Singh AP, Su C, Haigentz M, Cheng H, Pareek V, Ginsberg M, Guo X, Halmos B. Institutional cohort study of HIV-positive patients with lung cancer: Implications for screening? J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e13582] [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: 11/20/2022] Open
Affiliation(s)
- Shirin Attarian
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | | | | | - Missak Haigentz
- Atlantic Health System, Morristown Medical Center, Morristown, NJ
| | - Haiying Cheng
- Department of Medical Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
| | - Vipul Pareek
- University of Oklahoma Health Sciences Center, Tulsa, OK
| | - Mindy Ginsberg
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
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Arthur R, Wang Y, Ye K, Glass AG, Ginsberg M, Loudig O, Rohan T. Correction to: Association between lifestyle, menstrual/reproductive history, and histological factors and risk of breast cancer in women biopsied for benign breast disease. Breast Cancer Res Treat 2018; 170:203. [PMID: 29644560 DOI: 10.1007/s10549-018-4780-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The third category for extent of involution in Table 4 was published incorrectly in the original publication. The correct classification is ≥ 75% and the corrected Table 4 is given in the Correction article.
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Affiliation(s)
- Rhonda Arthur
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA.
| | - Yihong Wang
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Lifespan Medical Center, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
| | - Kenny Ye
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA
| | - Andrew G Glass
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA
| | - Olivier Loudig
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA
| | - Thomas Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY, 10461, USA
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24
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Rohan T, Ye K, Wang Y, Glass AG, Ginsberg M, Loudig O. MicroRNA expression in benign breast tissue and risk of subsequent invasive breast cancer. PLoS One 2018; 13:e0191814. [PMID: 29432432 PMCID: PMC5809016 DOI: 10.1371/journal.pone.0191814] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/11/2018] [Indexed: 01/06/2023] Open
Abstract
MicroRNAs are endogenous, small non-coding RNAs that control gene expression by directing their target mRNAs for degradation and/or posttranscriptional repression. Abnormal expression of microRNAs is thought to contribute to the development and progression of cancer. A history of benign breast disease (BBD) is associated with increased risk of subsequent breast cancer. However, no large-scale study has examined the association between microRNA expression in BBD tissue and risk of subsequent invasive breast cancer (IBC). We conducted discovery and validation case-control studies nested in a cohort of 15,395 women diagnosed with BBD in a large health plan between 1971 and 2006 and followed to mid-2015. Cases were women with BBD who developed subsequent IBC; controls were matched 1:1 to cases on age, age at diagnosis of BBD, and duration of plan membership. The discovery stage (316 case-control pairs) entailed use of the Illumina MicroRNA Expression Profiling Assay (in duplicate) to identify breast cancer-associated microRNAs. MicroRNAs identified at this stage were ranked by the strength of the correlation between Illumina array and quantitative PCR results for 15 case-control pairs. The top ranked 14 microRNAs entered the validation stage (165 case-control pairs) which was conducted using quantitative PCR (in triplicate). In both stages, linear regression was used to evaluate the association between the mean expression level of each microRNA (response variable) and case-control status (independent variable); paired t-tests were also used in the validation stage. None of the 14 validation stage microRNAs was associated with breast cancer risk. The results of this study suggest that microRNA expression in benign breast tissue does not influence the risk of subsequent IBC.
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Affiliation(s)
- Thomas Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
- * E-mail:
| | - Kenny Ye
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Yihong Wang
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Andrew G. Glass
- Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, United States of America
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Olivier Loudig
- Hackensack University Medical Center, Hackensack, New Jersey, United States of America
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25
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Wylie-Rosett J, Groisman-Perelstein AE, Diamantis PM, Jimenez CC, Shankar V, Conlon BA, Mossavar-Rahmani Y, Isasi CR, Martin SN, Ginsberg M, Matthan NR, Lichtenstein AH. Embedding weight management into safety-net pediatric primary care: randomized controlled trial. Int J Behav Nutr Phys Act 2018; 15:12. [PMID: 29357894 PMCID: PMC5778780 DOI: 10.1186/s12966-017-0639-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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 12/21/2017] [Indexed: 01/27/2023] Open
Abstract
Background Implementing evidence-based recommendations for treating pediatric overweight and obesity is challenging in low-resource settings. We conducted a randomized controlled trial to evaluate the effects of implementing the American Academy of Pediatrics overweight/obesity recommendations using a Standard Care approach alone or with the addition of an enhanced program in a safety-net pediatric primary care setting (located in Bronx, New York, United States). Methods In a 12-month trial, families of children (age 7–12 years; body mass index ≥85th American percentile for age and sex; 74% self-identified as Hispanic/Latino; n = 360) were randomly assigned to receive Standard Care Alone or Standard Care + Enhanced Program. An English/Spanish bilingual staff provided the Standard Care Alone consisting of quarterly semi-structured pediatrician visits targeting family-based behavioral changes. The Standard Care + Enhanced Program was enriched with eight Skill-Building Core and monthly Post-Core Support sessions. Results The mean body mass index Z-score declined in both arms (P < 0.01) with no significant difference between the Standard Care Alone (0.12 kg [SE: 0.03]) and Standard Care + Enhanced Program (0.15 kg [SE: 0.03]) arm (P = 0.15). Compared to the Standard Care Alone, the Standard Care + Enhanced Program resulted in significantly greater improvements in total cholesterol (P = 0.05), low-density lipoprotein cholesterol (P = 0.04), aspartate aminotransferase (P = 0.02), and alanine transaminase (P = 0.03) concentrations. Conclusions Safety-net primary care settings can provide efficacious pediatric weight management services. Targeted family-based behavioral counseling helps overweight/obese children achieve a modest body mass index Z-score improvement. A more intensive lifestyle intervention program may improve some metabolic parameters. Trial registration ClinicalTrials.gov Identifier: NCT00851201. Registered 23 February 2009. Electronic supplementary material The online version of this article (10.1186/s12966-017-0639-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
| | - Adriana E Groisman-Perelstein
- Department of Pediatrics, Albert Einstein College of Medicine, Jacobi Medical Center, 1400 Pelham Pkwy S, Bronx, NY, 10461, USA
| | - Pamela M Diamantis
- Department of Pediatrics, Albert Einstein College of Medicine, Jacobi Medical Center, 1400 Pelham Pkwy S, Bronx, NY, 10461, USA
| | - Camille C Jimenez
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Viswanathan Shankar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Beth A Conlon
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Sarah N Martin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Nirupa R Matthan
- Cardiovascular Nutrition Laboratory, JM USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington St, Boston, MA, 02111, USA
| | - Alice H Lichtenstein
- Cardiovascular Nutrition Laboratory, JM USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington St, Boston, MA, 02111, USA
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Li B, Shen R, Buonocore D, Olah Z, Ni A, Ginsberg M, Ulaner G, Weber W, Tsui D, Offin M, Won H, Ladanyi M, Riely G, Solit D, Hyman D, Rudin C, Berger M, Baselga J, Scaltriti M, Arcila M, Kris M. OA 14.05 Phase 2 Basket Trial of Ado-Trastuzumab Emtansine in Patients with HER2 Mutant or Amplified Lung Cancers. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.410] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Huang J, Raz D, Cristea M, Tan K, Deonaraine K, Starr A, Travis W, Ginsberg M, Jones D, Rusch V, Kris M, Riely G. OA 03.03 Phase II Trial of Cetuximab and Chemotherapy Followed by Surgical Resection for Locally Advanced Thymoma. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.336] [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: 10/18/2022]
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28
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Hametner C, MacIsaac RL, Kellert L, Abdul-Rahim AH, Ringleb PA, Lees KR, Alexandrov A, Bath P, Bluhmki E, Bornstein N, Chen C, Claesson L, Davis S, Donnan G, Diener H, Fisher M, Ginsberg M, Gregson B, Grotta J, Hacke W, Hennerici M, Hommel M, Kaste M, Lyden P, Marler J, Muir K, Venketasubramanian N, Sacco R, Shuaib A, Teal P, Wahlgren N, Warach S, Weimar C. Sex and Stroke in Thrombolyzed Patients and Controls. Stroke 2017; 48:367-374. [DOI: 10.1161/strokeaha.116.014323] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/02/2016] [Accepted: 09/19/2016] [Indexed: 01/22/2023]
Abstract
Background and Purpose—
We hypothesized that any sex-related difference in outcome poststroke is explained by other prognostic factors and that the response to intravenous recombinant tissue-type plasminogen activator (r-tPA) is equal in males and females after adjustment for such factors.
Methods—
We accessed an independent collection of randomized clinical trials—the VISTA (Virtual International Stroke Trials Archive). Data were preprocessed by selecting complete cases (n=8028) and matching females to males (coarsened exact matching, n=4575, 24.3% r-tPA). Outcome was assessed by the 7-point modified Rankin Scale (mRS) measured at 90 days after ischemic stroke. Relationship among variables was estimated by adjusted regression analysis.
Results—
In nonthrombolyzed patients, ordinal analysis of mRS adjusting for stroke- and sex-related prognostic factors suggested comparable outcomes for females and males (odds ratio, 0.96; 95% confidence interval, 0.85–1.06). Females responded comparably to r-tPA as did males, irrespective of the outcome definition of mRS (ordinal:
P
Interaction
=0.46, relative excess risk because of interaction=0). The number needed to treat was 6.8 and 11.2 for 1 female to achieve mRS score of 0 to 2 and 0 to 1, which was highly congruent with males. Analysis for a nonlinear variation of age-by-sex revealed a good outcome for females <45 years with significant disadvantage thereafter (mRS score of 0–2:
P
Interaction
=0.004). No relationship between sex, r-tPA, and bleeding complications was evident.
Conclusions—
Functional outcome (mRS) without r-tPA was overall similar between the sexes, as was the response to r-tPA. Nonlinear sex-by-age interaction improved estimates of functional independence; this should be considered in sex-related studies in stroke.
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Affiliation(s)
- Christian Hametner
- From the Department of Neurology, Division of Vascular Neurology, University of Heidelberg, Germany (C.H., L.K., P.A.R.); Queen Elizabeth University Hospital (R.L.M., A.H.A.-R.) and BHF Cardiovascular Research Centre (K.R.L.), Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom; and Department of Neurology, Ludwig-Maximilians-University Munich, Germany (L.K.)
| | - Rachael L. MacIsaac
- From the Department of Neurology, Division of Vascular Neurology, University of Heidelberg, Germany (C.H., L.K., P.A.R.); Queen Elizabeth University Hospital (R.L.M., A.H.A.-R.) and BHF Cardiovascular Research Centre (K.R.L.), Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom; and Department of Neurology, Ludwig-Maximilians-University Munich, Germany (L.K.)
| | - Lars Kellert
- From the Department of Neurology, Division of Vascular Neurology, University of Heidelberg, Germany (C.H., L.K., P.A.R.); Queen Elizabeth University Hospital (R.L.M., A.H.A.-R.) and BHF Cardiovascular Research Centre (K.R.L.), Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom; and Department of Neurology, Ludwig-Maximilians-University Munich, Germany (L.K.)
| | - Azmil H. Abdul-Rahim
- From the Department of Neurology, Division of Vascular Neurology, University of Heidelberg, Germany (C.H., L.K., P.A.R.); Queen Elizabeth University Hospital (R.L.M., A.H.A.-R.) and BHF Cardiovascular Research Centre (K.R.L.), Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom; and Department of Neurology, Ludwig-Maximilians-University Munich, Germany (L.K.)
| | - Peter A. Ringleb
- From the Department of Neurology, Division of Vascular Neurology, University of Heidelberg, Germany (C.H., L.K., P.A.R.); Queen Elizabeth University Hospital (R.L.M., A.H.A.-R.) and BHF Cardiovascular Research Centre (K.R.L.), Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom; and Department of Neurology, Ludwig-Maximilians-University Munich, Germany (L.K.)
| | - Kennedy R. Lees
- From the Department of Neurology, Division of Vascular Neurology, University of Heidelberg, Germany (C.H., L.K., P.A.R.); Queen Elizabeth University Hospital (R.L.M., A.H.A.-R.) and BHF Cardiovascular Research Centre (K.R.L.), Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom; and Department of Neurology, Ludwig-Maximilians-University Munich, Germany (L.K.)
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Kabat GC, Ginsberg M, Sparano JA, Rohan TE. Risk of Recurrence and Mortality in a Multi-Ethnic Breast Cancer Population. J Racial Ethn Health Disparities 2016; 4:1181-1188. [PMID: 28004356 DOI: 10.1007/s40615-016-0324-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 11/30/2016] [Accepted: 12/01/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Compared to non-Hispanic whites, African-American women tend to be diagnosed with breast cancer at an earlier age, to have less favorable tumor characteristics, and to have poorer outcomes from breast cancer. The extent to which differences in clinical characteristics account for the black/white disparity in breast cancer mortality is unclear. The purpose of this investigation was to examine the association of clinical, demographic, and treatment variables with total mortality and breast cancer recurrence by race/ethnicity in a cohort of women diagnosed with invasive breast cancer. METHODS To this end, we used data on 3890 invasive breast cancer cases diagnosed at a single medical center. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the association of tumor characteristics and treatment variables with mortality and recurrence. RESULTS Compared to white women, black women with breast cancer presented with tumors that had worse prognostic factors, particularly higher stage, lower frequency of hormone-receptor positive tumors, and higher frequency of comorbidities. Hispanics also generally had less favorable prognostic factors compared to non-Hispanic whites. Among estrogen receptor-positive cases, blacks had roughly a two-fold increased risk of recurrence compared to non-Hispanic whites. However, ethnicity/race was not associated with total mortality. Tumor stage, tumor size, and Charlson comorbidity index were positively associated with mortality, and mammography and chemotherapy and hormone therapy were inversely associated with mortality. CONCLUSION In spite of poorer prognostic factors among blacks compared whites, race/ethnicity was not associated with total mortality in our study.
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Affiliation(s)
- Geoffrey C Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, 10461, USA.
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Joseph A Sparano
- Department of Medicine, Albert Einstein College of Medicine; Montefiore Medical Center, Bronx, NY, 10461, USA
| | - Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
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30
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Cossarini F, Hanna D, Ginsberg M, Anastos K, Felsen U. Characteristics of Patients Who Acquired Human Immunodeficiency Virus (HIV) Infection Despite Accessing Healthcare: Implications for HIV Prevention Strategies. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.340] [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: 11/14/2022] Open
Affiliation(s)
| | - David Hanna
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Kathryn Anastos
- Department of Medicine, Division of General Internal Medicine; Department of Epidemiology and Population Health; Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Bronx, New York
| | - Uriel Felsen
- Department of Medicine, Montefiore Medical Center, Bronx, New York
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31
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Heo M, Irvin E, Ostrovsky N, Isasi C, Blank AE, Lounsbury DW, Fredericks L, Yom T, Ginsberg M, Hayes S, Wylie-Rosett J. Behaviors and Knowledge of HealthCorps New York City High School Students: Nutrition, Mental Health, and Physical Activity. J Sch Health 2016; 86:84-95. [PMID: 26762819 PMCID: PMC4714839 DOI: 10.1111/josh.12355] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 05/11/2015] [Accepted: 04/17/2015] [Indexed: 06/01/2023]
Abstract
BACKGROUND HealthCorps provides school wellness programming using curricula to promote changes in nutrition, mental health, and physical activity behaviors. The research objective was to evaluate effects of implementing its curricula on nutrition, mental health, and physical activity knowledge and behavior. METHODS Pre- and postsurvey data were collected (N = 2255) during the 2012-2013 academic year from 14 New York City public high schools. An 18-item knowledge questionnaire addressed 3 domains; 26 behavioral items were analyzed by factor analysis to identify 6 behavior domains, breakfast being a seventh 1-item domain. We examined the effects stratified by sex, applying mixed-effects models to take into account clustering effects of schools and participants adjusted for age. RESULTS The HealthCorps program significantly increased all 3 knowledge domains (p < .05), and significantly changed several key behavioral domains. Boys significantly increased fruits/vegetables intake (p = .03). Girls increased acceptance of new fruits/vegetables (p = .03) and breakfast consumption (p = .04), and decreased sugar-sweetened beverages and energy dense food intake (p = .03). The associations between knowledge and behavior were stronger in boys than girls. CONCLUSION The HealthCorps program significantly increased participants' knowledge on nutrition, mental health, and physical activity. It also improved several key behavioral domains, which are targets of the 2010 Dietary Guidelines to address obesity in youth.
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Affiliation(s)
- Moonseong Heo
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer 13-th Floor, Bronx, NY 10461.
| | - Erica Irvin
- HealthCorps, 75 Broad Street, 24th Floor, New York, NY 10004.
| | - Natania Ostrovsky
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer 13-th Floor, Bronx, NY 10461.
| | - Carmen Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer 13-th Floor, Bronx, NY 10461.
| | - Arthur E Blank
- Department of Family and Social Medicine, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Harold and Muriel Block Building, Room 409, 1300 Morris Park Avenue, Bronx, NY 10461.
| | - David W Lounsbury
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer 13-th Floor, Bronx, NY 10461.
| | - Lynn Fredericks
- FamilyCook Productions, 330 East 43rd Street, Ste. 704, New York, NY 10017.
| | - Tiana Yom
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer 13-th Floor, Bronx, NY 10461.
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer 13-th Floor, Bronx, NY 10461.
| | - Shawn Hayes
- HealthCorps, 555 Capitol Mall, Suite 250, Sacramento, CA 95814.
| | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, 1307 Belfer Building, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461.
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32
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Khan UI, McGinn AP, Isasi CR, Groisman-Perelstein A, Diamantis PM, Ginsberg M, Wylie-Rosett J. Differences in Cardiometabolic Risk between Insulin-Sensitive and Insulin-Resistant Overweight and Obese Children. Child Obes 2015; 11:289-96. [PMID: 25774664 PMCID: PMC4485365 DOI: 10.1089/chi.2014.0112] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND It is known that 15-30% overweight/obese adults do not suffer cardiometabolic consequences. There is limited literature examining factors that can be used to assess cardiometabolic health in overweight/obese children. If such factors can be identified, they would aid in differentiating those most in need for aggressive management. METHODS Baseline data from 7- to 12-year-old, overweight, and obese children enrolled in a weight management program at an urban hospital were analyzed. Homeostatic model assessment for insulin resistance (HOMA-IR) <2.6 was used to define insulin-sensitive and HOMA-IR ≥2.6 was used to defined insulin-resistant participants. Demographics, physical activity measures, and cardiometabolic risk factors were compared between the two phenotypes. Odds ratios (ORs) examining the association between intermediate endpoints (metabolic syndrome [MetS], nonalcoholic fatty liver disease [NAFLD], systemic inflammation, and microalbuminuria) and the two metabolic phenotypes were evaluated. RESULTS Of the 362 overweight/obese participants, 157 (43.5%) were insulin sensitive and 204 (56.5%) were insulin resistant. Compared to the insulin-sensitive group, the insulin-resistant group was older (8.6±1.6 vs. 9.9±1.7; p<0.001) and had a higher BMI z-score (1.89±0.42 vs. 2.04±0.42; p=0.001). After multivariable adjustment, compared to the insulin-sensitive group, the insulin-resistant group had higher odds of having MetS (OR, 5.47; 95% confidence interval [CI]: 1.72, 17.35; p=0.004) and NAFLD (OR, 8.66; 95% CI, 2.48, 30.31; p=0.001), but not systemic inflammation (OR, 1.06; 95% CI: 0.56, 2.03; p=0.86) or microalbuminuria (OR, 1.71; 95% CI, 0.49, 6.04; p=0.403). CONCLUSIONS Using a HOMA-IR value of ≥2.6, clinical providers can identify prepubertal and early pubertal children most at risk. Focusing limited resources on aggressive weight interventions may lead to improvement in cardiometabolic health.
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Affiliation(s)
- Unab I. Khan
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Aileen P. McGinn
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | | | | | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Judith Wylie-Rosett
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
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Sykora M, Siarnik P, Diedler J, Lees K, Alexandrov A, Bath P, Bluhmki E, Bornstein N, Claesson L, Davis S, Donnan G, Diener HC, Fisher M, Ginsberg M, Gregson B, Grotta J, Hacke W, Hennerici M, Hommel M, Kaste M, Lyden P, Marler J, Muir K, Sacco R, Shuaib A, Teal P, Wahlgren N, Warach S, Weimar C. β-Blockers, Pneumonia, and Outcome After Ischemic Stroke. Stroke 2015; 46:1269-74. [DOI: 10.1161/strokeaha.114.008260] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 01/21/2015] [Indexed: 02/02/2023]
Abstract
Background and Purpose—
Increased sympathetic drive after stroke is involved in the pathophysiology of several complications including poststroke immunudepression. β-Blocker (BB) therapy has been suggested to have neuroprotective properties and to decrease infectious complications after stroke. We aimed to examine the effects of random pre- and on-stroke BB exposure on mortality, functional outcome, and occurrence of pneumonia after ischemic stroke.
Methods—
Data including standard demographic and clinical variables as well as prestroke and on-stroke antihypertensive medication, incidence of pneumonia, functional outcome defined using modified Rankin Scale and mortality at 3 months were extracted from the Virtual International Stroke Trials Archive. For statistical analysis multivariable Poisson regression was used.
Results—
In total, 5212 patients were analyzed. A total of 1155 (22.2%) patients were treated with BB before stroke onset and 244 (4.7%) patients were newly started with BB in the acute phase of stroke. Mortality was 17.5%, favorable outcome (defined as modified Rankin Scale, 0–2) occurred in 58.2% and pneumonia in 8.2% of patients. Prestroke BB showed no association with mortality. On-stroke BB was associated with reduced mortality (adjusted risk ratio, 0.63; 95% confidence interval, 0.42–0.96). Neither prestroke BB nor on-stroke BB showed an association with functional outcome. Both prestroke and on-stroke BB were associated with reduced frequency of pneumonia (adjusted risk ratio, 0.77; 95% confidence interval, 0.6–0.98 and risk ratio, 0.49; 95% confidence interval, 0.25–0.95).
Conclusions—
In this large nonrandomized comparison, on-stroke BB was associated with reduced mortality. Prestroke and on-stroke BB were inversely associated with incidence of nosocomial pneumonia. Randomized trials investigating the potential of β-blockade in acute stroke may be warranted.
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Affiliation(s)
- Marek Sykora
- From the Department of Neurology, University of Heidelberg, Heidelberg, Germany (M.S., J.D.); Department of Neurology, Comenius University, Bratislava, Slovakia (P.S.); and Department of Neurology, University of Tübingen, Tübingen, Germany (J.D.)
| | - Pavel Siarnik
- From the Department of Neurology, University of Heidelberg, Heidelberg, Germany (M.S., J.D.); Department of Neurology, Comenius University, Bratislava, Slovakia (P.S.); and Department of Neurology, University of Tübingen, Tübingen, Germany (J.D.)
| | - Jennifer Diedler
- From the Department of Neurology, University of Heidelberg, Heidelberg, Germany (M.S., J.D.); Department of Neurology, Comenius University, Bratislava, Slovakia (P.S.); and Department of Neurology, University of Tübingen, Tübingen, Germany (J.D.)
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Abdul-Rahim AH, Fulton RL, Sucharew H, Kleindorfer D, Khatri P, Broderick JP, Lees KR, Alexandrov A, Bath P, Bluhmki E, Bornstein N, Claesson L, Curram J, Davis S, Donnan G, Diener H, Fisher M, Ginsberg M, Gregson B, Grotta J, Hacke W, Hennerici M, Hommel M, Kaste M, Lyden P, Marler J, Muir K, Sacco R, Shuaib A, Teal P, Wahlgren N, Warach S, Weimar C. National Institutes of Health Stroke Scale Item Profiles as Predictor of Patient Outcome. Stroke 2015; 46:395-400. [DOI: 10.1161/strokeaha.114.006837] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Azmil H. Abdul-Rahim
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (A.H.A.-R., R.L.F., K.R.L.); Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Centre, OH (H.S.); Department of Neurology, University of Cincinnati College of Medicine, OH (D.K., P.K., J.P.B.)
| | - Rachael L. Fulton
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (A.H.A.-R., R.L.F., K.R.L.); Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Centre, OH (H.S.); Department of Neurology, University of Cincinnati College of Medicine, OH (D.K., P.K., J.P.B.)
| | - Heidi Sucharew
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (A.H.A.-R., R.L.F., K.R.L.); Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Centre, OH (H.S.); Department of Neurology, University of Cincinnati College of Medicine, OH (D.K., P.K., J.P.B.)
| | - Dawn Kleindorfer
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (A.H.A.-R., R.L.F., K.R.L.); Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Centre, OH (H.S.); Department of Neurology, University of Cincinnati College of Medicine, OH (D.K., P.K., J.P.B.)
| | - Pooja Khatri
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (A.H.A.-R., R.L.F., K.R.L.); Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Centre, OH (H.S.); Department of Neurology, University of Cincinnati College of Medicine, OH (D.K., P.K., J.P.B.)
| | - Joseph P. Broderick
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (A.H.A.-R., R.L.F., K.R.L.); Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Centre, OH (H.S.); Department of Neurology, University of Cincinnati College of Medicine, OH (D.K., P.K., J.P.B.)
| | - Kennedy R. Lees
- From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (A.H.A.-R., R.L.F., K.R.L.); Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Centre, OH (H.S.); Department of Neurology, University of Cincinnati College of Medicine, OH (D.K., P.K., J.P.B.)
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Rohan TE, Xue X, Lin HM, D'Alfonso TM, Ginter PS, Oktay MH, Robinson BD, Ginsberg M, Gertler FB, Glass AG, Sparano JA, Condeelis JS, Jones JG. Tumor microenvironment of metastasis and risk of distant metastasis of breast cancer. J Natl Cancer Inst 2014; 106:dju136. [PMID: 24895374 DOI: 10.1093/jnci/dju136] [Citation(s) in RCA: 141] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Tumor microenvironment of metastasis (TMEM), consisting of direct contact between a macrophage, an endothelial cell, and a tumor cell, has been associated with metastasis in both rodent mammary tumors and human breast cancer. We prospectively examined the association between TMEM score and risk of distant metastasis and compared risk associated with TMEM score with that associated with IHC4. METHODS We conducted a case-control study nested within a cohort of 3760 patients with invasive ductal breast carcinoma diagnosed between 1980 and 2000 and followed through 2010. Case patients were women who developed a subsequent distant metastasis; control subjects were matched (1:1) on age at and calendar year of primary diagnosis. TMEM was assessed by triple immunostain and IHC4 by standard methods; slides were read by pathologists blinded to outcome. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression, adjusted for clinical variables. A Receiver Operating Characteristic analysis was performed, and the area under the curve was estimated. All statistical tests were two-sided. RESULTS TMEM score was associated with increased risk of distant metastasis in estrogen receptor (ER)(+)/human epidermal growth factor receptor (HER2)(-) tumors (multivariable OR high vs low tertile = 2.70; 95% CI = 1.39 to 5.26; P trend = .004), whereas IHC4 score had a borderline positive association (OR10 unit increase = 1.06; 95% CI = 1.00 to 1.13); the association for TMEM score persisted after adjustment for IHC4 score. The area under the curve for TMEM, adjusted for clinical variables, was 0.78. Neither TMEM score nor IHC4 score was independently associated with metastatic risk overall or in the triple negative or HER2(+) subgroups. CONCLUSIONS TMEM score predicted risk of distant metastasis in ER(+)/HER2(-) breast cancer independently of IHC4 score and classical clinicopathologic features.
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Affiliation(s)
- Thomas E Rohan
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ).
| | - Xiaonan Xue
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
| | - Hung-Mo Lin
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
| | - Timothy M D'Alfonso
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
| | - Paula S Ginter
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
| | - Maja H Oktay
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
| | - Brian D Robinson
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
| | - Mindy Ginsberg
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
| | - Frank B Gertler
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
| | - Andrew G Glass
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
| | - Joseph A Sparano
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
| | - John S Condeelis
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
| | - Joan G Jones
- Affiliation of authors: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER, XX, MG); Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, NY (H-ML); Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY (TMD'A, PSG, BDR); Department of Pathology, Montefiore Medical Center, Bronx, NY (MHO); Department of Biology, Massachusetts Institute of Technology, Cambridge, MA (FBG); Center for Health Research, Kaiser Permanente Northwest, Portland, OR (AGG); Department of Oncology, Montefiore Medical Center, Bronx, NY (JAS); Department of Anatomy and Structural Biology, Albert Einstein College of Medicine, Bronx, NY (JSC); Department of Pathology, Albert Einstein College of Medicine, Bronx, NY (JGJ)
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Siega-Riz AM, Sotres-Alvarez D, Ayala GX, Ginsberg M, Himes JH, Liu K, Loria CM, Mossavar-Rahmani Y, Rock CL, Rodriguez B, Gellman MD, Van Horn L. Food-group and nutrient-density intakes by Hispanic and Latino backgrounds in the Hispanic Community Health Study/Study of Latinos. Am J Clin Nutr 2014; 99:1487-98. [PMID: 24760972 PMCID: PMC4021787 DOI: 10.3945/ajcn.113.082685] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Hispanics are a heterogeneous group of individuals with a variation in dietary habits that is reflective of their cultural heritage and country of origin. It is important to identify differences in their dietary habits because it has been well established that nutrition contributes substantially to the burden of preventable diseases and early deaths in the United States. OBJECTIVE We estimated the distribution of usual intakes (of both food groups and nutrients) by Hispanic and Latino backgrounds by using National Cancer Institute methodology. DESIGN The Hispanic Community Health Study/Study of Latinos is a population-based cohort study that recruited participants who were 18-74 y of age from 4 US cities in 2008-2011 (Miami, Bronx, Chicago, and San Diego). Participants who provided at least one 24-h dietary recall and completed a food propensity questionnaire (n = 13,285) were included in the analyses. Results were adjusted for age, sex, field center, weekend, sequencing, and typical amount of intake. RESULTS Overall, Cubans (n = 2128) had higher intakes of total energy, macronutrients (including all subtypes of fat), and alcohol than those of other groups. Mexicans (n = 5371) had higher intakes of vitamin C, calcium, and fiber. Lowest intakes of total energy, macronutrients, folate, iron, and calcium were reported by Dominicans (n = 1217), whereas Puerto Ricans (n = 2176) had lowest intakes of vitamin C and fiber. Food-group servings reflected nutrient intakes, with Cubans having higher intakes of refined grains, vegetables, red meat, and fats and Dominicans having higher intakes of fruit and poultry, whereas Puerto Ricans had lowest intakes of fruit and vegetables. Central and South Americans (n = 1468 and 925, respectively) were characterized by being second in their reported intakes of fruit and poultry and the highest in fish intake in comparison with other groups. CONCLUSION Variations in diet noted in this study, with additional analysis, may help explain diet-related differences in health outcomes observed in Hispanics and Latinos.
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Affiliation(s)
- Anna Maria Siega-Riz
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
| | - Daniela Sotres-Alvarez
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
| | - Guadalupe X Ayala
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
| | - Mindy Ginsberg
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
| | - John H Himes
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
| | - Kiang Liu
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
| | - Catherine M Loria
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
| | - Yasmin Mossavar-Rahmani
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
| | - Cheryl L Rock
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
| | - Brendaly Rodriguez
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
| | - Marc D Gellman
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
| | - Linda Van Horn
- From the Departments of Epidemiology and Nutrition (AMS-R) and Biostatistics and the Collaborative Studies Coordinator Center (DS-A), Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; the Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, San Diego, CA (GXA); the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (MG and YM-R); the Division of Epidemiology and Community Health, University of Minnesota, School of Public Health, Minneapolis, MN (JHH); the Departments of Preventive Medicine (KL) and Preventive Medicine, Feinberg School of Medicine (LVH), University of Illinois at Chicago, Chicago, IL; the Epidemiology Branch, National Heart, Lung, and Blood Institute, Bethesda, MD (CML); the Department of Family and Preventive Medicine, Moores University of California at San Diego Cancer Center, University of California at San Diego, San Diego, CA (CLR); and the Department of Psychology, Behavioral Medicine Research Center, University of Miami, Miami, FL (BR and MDG)
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Shcherba M, Hosgood HD, Lin J, Hanna D, Felsen UR, Ginsberg M, Fisher L, Wilson K, Chung J, Xue X, Anastos K, Piperdi B, Spivack S, Keller SM, Strickler HD, Haigentz M. Characteristics of HIV+ lung cancer cases in a large clinical population: Implications for lung cancer screening. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.1569] [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: 11/20/2022] Open
Affiliation(s)
- Marina Shcherba
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | - H. Dean Hosgood
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Juan Lin
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - David Hanna
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Uriel R. Felsen
- Montefiore Medical Center, Albert Einstein College of Medicine, and The Einstein-Montefiore Center for AIDS Research, Bronx, NY
| | - Mindy Ginsberg
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Linda Fisher
- Montefiore Medical Center, Health Information Management, Bronx, NY
| | - Kevin Wilson
- Montefiore Medical Center, Health Information Management, Bronx, NY
| | - Julie Chung
- Montefiore Medical Center, Health Information Management, Bronx, NY
| | - Xiaonan Xue
- Albert Einstein College of Medicine, Bronx, NY
| | - Kathryn Anastos
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Bilal Piperdi
- Montefiore Medical Center Department of Medical Oncology, Bronx, NY
| | - Simon Spivack
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY
| | - Steven M. Keller
- Montefiore Medical Center Department of Cardiovascular & Thoracic Surgery, Bronx, NY
| | - Howard D. Strickler
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Missak Haigentz
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
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38
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Swencionis C, Wylie-Rosett J, Lent MR, Ginsberg M, Cimino C, Wassertheil-Smoller S, Caban A, Segal-Isaacson CJ. Weight change, psychological well-being, and vitality in adults participating in a cognitive-behavioral weight loss program. Health Psychol 2013; 32:439-46. [PMID: 22888821 PMCID: PMC4733266 DOI: 10.1037/a0029186] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Excess weight has been associated with numerous psychological problems, including depression and anxiety. This study examined the impact of intentional weight loss on the psychological well-being of adults participating in three clinical weight loss interventions. METHODS This population consisted of 588 overweight or obese individuals randomized into one of three weight loss interventions of incremental intensity for 12 months. Psychological well-being was measured at baseline and 6, and 12 months using the Psychological Well-Being Index. RESULTS Mean weight loss was 5.0 pounds at 12 months. Weight change at 12 months was associated with higher overall psychological well-being (r = -.20, p < .001), lower levels of anxiety (r = -.16, p = .001) and depression (r = -.13, p = .004), and higher positive well-being (r = -.19, p < .001), self-control (r = -.13, p = .004), and vitality (r = -.22, p < .001). Vitality was found to be the best predictor of weight change at 12 months (p < .001). CONCLUSIONS Weight loss was associated with positive changes in psychological well-being. Increased vitality contributed the largest percentage of variance to this change.
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Affiliation(s)
- Charles Swencionis
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY 10461, USA.
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39
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Rolfs A, Fazekas F, Grittner U, Dichgans M, Martus P, Holzhausen M, Böttcher T, Heuschmann PU, Tatlisumak T, Tanislav C, Jungehulsing GJ, Giese AK, Putaala J, Huber R, Bodechtel U, Lichy C, Enzinger C, Schmidt R, Hennerici MG, Kaps M, Kessler C, Lackner K, Paschke E, Meyer W, Mascher H, Riess O, Kolodny E, Norrving B, Rolfs A, Ginsberg M, Hennerici MG, Kessler C, Kolodny E, Martus P, Norrving B, Ringelstein EB, Rothwell PM, Venables G, Bornstein N, deDeyn P, Dichgans M, Fazekas F, Markus H, Rieß O, Biedermann C, Böttcher T, Brüderlein K, Burmeister J, Federow I, König F, Makowei G, Niemann D, Rolfs A, Rösner S, Zielke S, Grittner U, Martus P, Holzhausen M, Fazekas F, Enzinger C, Schmidt R, Ropele S, Windisch M, Sterner E, Bodamer O, Fellgiebel A, Hillen U, Jonas L, Kampmann C, Kropp P, Lackner K, Laue M, Mascher H, Meyer W, Paschke E, Weidemann F, Berrouschot J, Stoll A, Rokicha A, Sternitzky C, Thomä M, DeDeyn PP, Sheorajpanday R, De Brabander I, Yperzeele L, Brouns R, Oschmann P, Pott M, Schultes K, Schultze C, Hirsekorn J, Jungehulsing GJ, Villringer A, Schmidt W, Liman T, Nowe T, Ebinger M, Wille A, Loui H, Objartel A, übelacker A, Mette R, Jegzentis K, Nabavi DG, Crome O, Bahr D, Ebke M, Platte B, Kleinen C, Mermolja Gunther K, Heide W, Pape O, Hanssen JR, Stangenberg D, Klingelhofer J, Schmidt B, Schwarz S, Schwarze J, Frandlih L, Iwanow J, Steinbach I, Krieger D, Boysen G, Leth Jeppesen L, Petersen A, Reichmann H, Becker U, Dzialkowski I, Hentschel H, Lautenschlager C, Hanso H, Gahn G, Ziemssen T, Fleischer K, Sehr B, McCabe DJH, Tobin O, Kinsella J, Murphy RP, Jander S, Hartung HP, Siebler M, Bottcher C, Kohne A, Platzen J, Brosig TC, Rothhammer V, Henseler C, Neumann-Haefelin T, Singer OC, Ermis U, dos Santos IMRM, Schuhmann C, van de Loo S, Kaps M, Allendorfer J, Tanislav C, Brandtner M, Muir K, Dani K, MacDougall N, Smith W, Rowe A, Welch A, Fazekas F, Schrotter G, Krenn U, Horner S, Pendl B, Pluta-Fuerst A, Trummer U, Kessler C, Chatzopoulos M, v Sarnowski B, Schminke U, Link T, Khaw A, Nieber E, Zierz S, Muller T, Wegener N, Wartenberg K, Gaul C, Richter D, Rosenkranz M, Krützelmann AC, Hoppe J, Choe CU, Narr S, Magnus TU, Thomalla G, Leypoldt F, Otto D, Lichy C, Hacke W, Barrows RJ, Tatlisumak T, Putaala J, Curtze S, Metso M, Willeit J, Furtner M, Spiegel M, Knoflach MH, Prantl B, Witte OW, Brämer D, Günther A, Prell T, Herzau C, Aurich K, Deuschl G, Wodarg F, Zimmermann P, Eschenfelder CC, Levsen M, Weber JR, Marecek SM, Schneider D, Michalski D, Kloppig W, Küppers-Tiedt L, Schneider M, Schulz A, Matzen P, Weise C, Hobohm C, Meier H, Langos R, Urban D, Gerhardt I, Thijs V, Lemmens R, Marcelis E, Hulsbosch C, Aichner F, Haring HP, Bach E, Machado Candido J, e Silva AA, Lourenco M, de Sousa AIM, Derex L, Cho TH, Díez-Tejedor E, Fuentes B, Martínez-Sanchez P, Pérez-Guevara MI, Hamer H, Metz A, Hallenberger K, Müller P, Baron P, Bersano A, Gattinoni M, Vella N, Mallia M, Jauss M, Adam L, Heidler F, Gube C, Kiszka M, Dichgans M, Karpinska A, Mewald Y, Straub V, Dörr A, Zollver A, Ringelstein EB, Schilling M, Borchert A, Preuth N, Duning T, Kuhlenbäumer G, Schulte D, Rothwell PM, Marquardt L, Schlachetzki F, Boy S, Mädl J, Ertl GM, Fehm NPR, Stadler C, Benecke R, Dudesek A, Kolbaske S, Lardurner G, Sulzer C, Zerbs A, Lilek S, Walleczek AM, Sinadinowska D, Janelidze M, Beridze M, Lobjanidze N, Dzagnidze A, Melms A, Horber K, Fink I, Liske B, Ludolph AC, Huber R, Knauer K, Hendrich C, Raubold S, Czlonkowska A, Baranowska A, Blazejewska-Hyzorek B, Lang W, Kristoferitsch W, Ferrari J, Ulrich E, Flamm-Horak A, Lischka-Lindner A, Schreiber W, Demarin V, Tranjec Z, Bosner-Puretic M, Jurašić MJ, Basic Kes V, Budisic M, Kopacevic L. Acute Cerebrovascular Disease in the Young. Stroke 2013; 44:340-9. [PMID: 23306324 DOI: 10.1161/strokeaha.112.663708] [Citation(s) in RCA: 150] [Impact Index Per Article: 13.6] [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
Background and Purpose—
Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients.
Methods—
Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396), hemorrhagic stroke (271), transient ischemic attack (1071) were enrolled in 15 European countries and 47 centers between April 2007 and January 2010 undergoing a detailed, standardized, clinical, laboratory, and radiological protocol.
Results—
Median age in the overall cohort was 46 years. Definite Fabry disease was diagnosed in 0.5% (95% confidence interval, 0.4%–0.8%; n=27) of all patients; and probable Fabry disease in additional 18 patients. Males dominated the study population (2962/59%) whereas females outnumbered men (65.3%) among the youngest patients (18–24 years). About 80.5% of the patients had a first stroke. Silent infarcts on magnetic resonance imaging were seen in 20% of patients with a first-ever stroke, and in 11.4% of patients with transient ischemic attack and no history of a previous cerebrovascular event. The most common causes of ischemic stroke were large artery atherosclerosis (18.6%) and dissection (9.9%).
Conclusions—
Definite Fabry disease occurs in 0.5% and probable Fabry disease in further 0.4% of young stroke patients. Silent infarcts, white matter intensities, and classical risk factors were highly prevalent, emphasizing the need for new early preventive strategies.
Clinical Trial Registration Information—
URL:
http://www.clinicaltrials.gov
.Unique identifier: NCT00414583
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Affiliation(s)
- Arndt Rolfs
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Franz Fazekas
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Ulrike Grittner
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Martin Dichgans
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Peter Martus
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Martin Holzhausen
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Tobias Böttcher
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Peter U. Heuschmann
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Turgut Tatlisumak
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Christian Tanislav
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Gerhard J. Jungehulsing
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Anne-Katrin Giese
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Jukaa Putaala
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Roman Huber
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Ulf Bodechtel
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Christoph Lichy
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Christian Enzinger
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Reinhold Schmidt
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Michael G. Hennerici
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Manfred Kaps
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Christof Kessler
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Karl Lackner
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Eduard Paschke
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Wolfgang Meyer
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Hermann Mascher
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Olaf Riess
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Edwin Kolodny
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - Bo Norrving
- From the Albrecht-Kossel-Institute for Neuroregeneration, University of Rostock, Rostock, Germany (A.R., T.B., A.K.G.); Department of Neurology, University of Graz, Graz, Austria (F.F., C.E., R.S.); Institute for Biostatistics and Clinical Epidemiology, Charite-University Medicine, Berlin, Germany (U.G., P.M., M.H.); Institute for Stroke and Dementia Research and Department of Neurology, Ludwig-Maximillians University, Munich, Germany (M.D.); Center for Stroke Research Berlin,
| | - A Rolfs
- University of Rostock, Rostock, Germany
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- University of Rostock, Rostock, Germany
| | - F König
- University of Rostock, Rostock, Germany
| | - G Makowei
- University of Rostock, Rostock, Germany
| | - D Niemann
- University of Rostock, Rostock, Germany
| | - A Rolfs
- University of Rostock, Rostock, Germany
| | - S Rösner
- University of Rostock, Rostock, Germany
| | - S Zielke
- University of Rostock, Rostock, Germany
| | - U Grittner
- Department of Biostatistics and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Germany
| | - P Martus
- Department of Biostatistics and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Germany
| | - M Holzhausen
- Department of Biostatistics and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Germany
| | - F Fazekas
- Dept of Neurology, Medical University of Graz, Graz, Austria
| | - C Enzinger
- Dept of Neurology, Medical University of Graz, Graz, Austria
| | - R Schmidt
- Dept of Neurology, Medical University of Graz, Graz, Austria
| | - S Ropele
- Dept of Neurology, Medical University of Graz, Graz, Austria
| | | | | | | | | | - U Hillen
- (Essen, Germany) immunohistochemistry
| | - L Jonas
- (Rostock, Germany) electron-microscopy
| | | | - P Kropp
- (Rostock, Germany) headache and pain
| | | | - M Laue
- (Rostock, Germany) electron-microscopy
| | | | - W Meyer
- (London) epidemiology and neuropsychiatry
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- Berlin – Charite/Germany, University
| | - T Liman
- Berlin – Charite/Germany, University
| | - T Nowe
- Berlin – Charite/Germany, University
| | - M Ebinger
- Berlin – Charite/Germany, University
| | - A Wille
- Berlin – Charite/Germany, University
| | - H Loui
- Berlin – Charite/Germany, University
| | | | | | - R Mette
- Berlin – Charite/Germany, University
| | | | | | | | - D Bahr
- Berlin – Neukolln/Germany
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- Dresden/Germany, University
| | | | | | - B Sehr
- Dresden/Germany, University
| | | | | | | | | | | | | | | | | | - A Kohne
- Dusseldorf/Germany, University
| | | | | | | | | | | | - OC Singer
- Frankfurt am Main/Germany, University
| | - U Ermis
- Frankfurt am Main/Germany, University
| | | | | | | | - M Kaps
- Giessen/Germany, University
| | | | | | | | - K Muir
- Glasgow/United Kingdom, University
| | - K Dani
- Glasgow/United Kingdom, University
| | | | - W Smith
- Glasgow/United Kingdom, University
| | - A Rowe
- Glasgow/United Kingdom, University
| | - A Welch
- Glasgow/United Kingdom, University
| | | | | | - U Krenn
- Graz/Austria, Medical University
| | - S Horner
- Graz/Austria, Medical University
| | - B Pendl
- Graz/Austria, Medical University
| | | | | | | | | | | | | | - T Link
- Greifswald/Germany, University
| | - A Khaw
- Greifswald/Germany, University
| | | | | | | | | | | | - C Gaul
- Halle/Germany, University
| | | | | | | | | | | | - S Narr
- Hamburg/Germany, University
| | | | | | | | - D Otto
- Hamburg/Germany, University
| | - C Lichy
- Heidelberg/Germany, University
| | - W Hacke
- Heidelberg/Germany, University
| | | | | | | | | | - M Metso
- Helsinki/Finland, University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - A Metz
- Marburg/Germany, University
| | | | | | | | | | | | | | | | - M Jauss
- Muhlhausen/Thuringen/Germany
| | - L Adam
- Muhlhausen/Thuringen/Germany
| | | | - C Gube
- Muhlhausen/Thuringen/Germany
| | | | | | | | | | | | - A Dörr
- Munich/Germany, University
| | | | | | | | | | | | | | | | | | | | | | | | - S Boy
- Regensburg/Germany, University
| | - J Mädl
- Regensburg/Germany, University
| | - GM Ertl
- Regensburg/Germany, University
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - A Melms
- Tubingen/Germany, University
| | | | - I Fink
- Tubingen/Germany, University
| | - B Liske
- Tubingen/Germany, University
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Kabat GC, Kandel RA, Glass AG, Jones JG, Olson N, Duggan C, Ginsberg M, Negassa A, Rohan TE. A Cohort Study of p53 Mutations and Protein Accumulation in Benign Breast Tissue and Subsequent Breast Cancer Risk. J Oncol 2011; 2011:970804. [PMID: 21869889 PMCID: PMC3160103 DOI: 10.1155/2011/970804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 04/11/2011] [Accepted: 05/03/2011] [Indexed: 01/10/2023]
Abstract
Mutations in the p53 tumor suppressor gene and accumulation of its protein in breast tissue are thought to play a role in breast carcinogenesis. However, few studies have prospectively investigated the association of p53 immunopositivity and/or p53 alterations in women with benign breast disease in relation to the subsequent risk of invasive breast cancer. We carried out a case-control study nested within a large cohort of women biopsied for benign breast disease in order to address this question. After exclusions, 491 breast cancer cases and 471 controls were available for analysis. Unconditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI). Neither p53 immunopositivity nor genetic alterations in p53 (either missense mutations or polymorphisms) was associated with altered risk of subsequent breast cancer. However, the combination of both p53 immunopositivity and any p53 nucleotide change was associated with an approximate 5-fold nonsignificant increase in risk (adjusted OR 4.79, 95% CI 0.28-82.31) but the confidence intervals were extremely wide. Our findings raise the possibility that the combination of p53 protein accumulation and the presence of genetic alterations may identify a group at increased risk of breast cancer.
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Affiliation(s)
- Geoffrey C. Kabat
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Rita A. Kandel
- Department of Pathology and Laboratory Medicine, The Mount Sinai Hospital, Toronto, ON, Canada M5G 1X5
| | - Andrew G. Glass
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR 97227, USA
| | - Joan G. Jones
- Department of Pathology and Laboratory Medicine, Weill-Cornell Medical Center, New York, NY 10065, USA
| | - Neal Olson
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR 97227, USA
| | - Catherine Duggan
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98104, USA
| | - Mindy Ginsberg
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Abdissa Negassa
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Thomas E. Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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Rohan TE, Negassa A, Chlebowski RT, Ceria-Ulep CD, Cochrane BB, Lane DS, Ginsberg M, Wassertheil-Smoller S, Page DL. A randomized controlled trial of calcium plus vitamin D supplementation and risk of benign proliferative breast disease. Breast Cancer Res Treat 2008; 116:339-50. [PMID: 18853250 DOI: 10.1007/s10549-008-0213-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Accepted: 09/29/2008] [Indexed: 10/21/2022]
Abstract
Experimental evidence provides strong support for anti-carcinogenic effects of calcium and vitamin D with respect to breast cancer. Observational epidemiologic data also provide some support for inverse associations with risk. We tested the effect of calcium plus vitamin D supplementation on risk of benign proliferative breast disease, a condition which is associated with increased risk of breast cancer. We used the Women's Health Initiative randomized controlled trial. The 36,282 participants were randomized either to 500 mg of elemental calcium as calcium carbonate plus 200 IU of vitamin D(3) (GlaxoSmithKline) twice daily (n = 18,176) or to placebo (n = 18,106). Regular mammograms and clinical breast exams were performed. We identified women who had had a biopsy for benign breast disease and subjected histologic sections from the biopsies to standardized review. After an average follow-up period of 6.8 years, 915 incident cases of benign proliferative breast disease had been ascertained, with 450 in the intervention group and 465 in the placebo group. Calcium plus vitamin D supplementation was not associated with altered risk of benign proliferative breast disease overall (hazard ratio = 0.99, 95% confidence interval = 0.86-1.13), or by histologic subtype. Risk varied significantly by levels of age at baseline, but not by levels of other variables. Daily use of 1,000 mg of elemental calcium as calcium carbonate plus 400 IU of vitamin D(3) for almost 7 years by postmenopausal women did not alter the overall risk of benign proliferative breast disease.
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Affiliation(s)
- Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
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Rohan TE, Negassa A, Chlebowski RT, Lasser NL, McTiernan A, Schenken RS, Ginsberg M, Wassertheil-Smoller S, Page DL. Estrogen plus progestin and risk of benign proliferative breast disease. Cancer Epidemiol Biomarkers Prev 2008; 17:2337-43. [PMID: 18725513 DOI: 10.1158/1055-9965.epi-08-0380] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Women with benign proliferative breast disease are at increased risk of subsequent breast cancer. Estrogens and progesterone exert proliferative effects on mammary epithelium, and combined hormone replacement therapy has been associated with increased breast cancer risk. We tested the effect of conjugated equine estrogen plus progestin on the risk of benign proliferative breast disease in the Women's Health Initiative (WHI) randomized controlled trial. In the WHI trial of estrogen plus progestin, 16,608 postmenopausal women were randomly assigned either to 0.625 mg/day of conjugated equine estrogen plus 2.5 mg/day of medroxyprogesterone acetate or to placebo. Baseline and annual breast exams and mammograms were required. The trial was terminated early (average follow-up, 5.5 years). We identified women who had had a biopsy for benign breast disease, and subjected histologic sections from the biopsies to standardized review. Overall, 178 incident cases of benign proliferative breast disease were ascertained in the estrogen plus progestin group and 99 in the placebo group. The use of estrogen plus progestin was associated with a 74% increase in the risk of benign proliferative breast disease [hazard ratio, 1.74; 95% confidence interval (CI), 1.35-2.25]. For benign proliferative breast disease without atypia the hazard ratio was 2.00 (95% CI, 1.50-2.66), while for atypical hyperplasia it was 0.76 (95% CI, 0.38-1.52). The risk varied little by levels of baseline characteristics. The results of this study suggest that the use of estrogen plus progestin may increase the risk of benign proliferative breast disease.
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Affiliation(s)
- Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
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43
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Rohan TE, Negassa A, Caan B, Chlebowski RT, Curb JD, Ginsberg M, Lane DS, Neuhouser ML, Shikany JM, Wassertheil-Smoller S, Page DL. Low-fat dietary pattern and risk of benign proliferative breast disease: a randomized, controlled dietary modification trial. Cancer Prev Res (Phila) 2008; 1:275-84. [PMID: 19138971 DOI: 10.1158/1940-6207.capr-08-0003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Modifiable factors, including diet, might alter breast cancer risk. We used the Women's Health Initiative Dietary Modification trial to test the effect of the intervention on risk of benign proliferative breast disease, a condition associated with increased risk of, and considered to be on the pathway to, invasive breast cancer. The Women's Health Initiative Dietary Modification trial was a randomized, controlled, primary prevention trial conducted in 40 U.S. clinical centers from 1993 to 2005. A total of 48,835 postmenopausal women, ages 50 to 79 years, without prior breast cancer, were enrolled. Participants were randomly assigned to the dietary modification intervention group or to the comparison group. The intervention was designed to reduce total dietary fat intake to 20% of total energy intake, and to increase fruit and vegetable intake to > or =5 servings/d and intake of grain products to > or =6 servings/d, but resulted in smaller, albeit significant, changes in practice. Participants had biennial mammograms and regular clinical breast exams. We identified women who reported breast biopsies free of cancer, obtained the histologic sections, and subjected them to standardized central review. During follow-up (average, 7.7 years), 570 incident cases of benign proliferative breast disease were ascertained in the intervention group and 793 in the comparison group. The hazard ratio for the association between dietary modification and benign proliferative breast disease was 1.09 (95% confidence interval, 0.98-1.23). Risk varied by levels of baseline total vitamin D intake but it varied little by levels of other baseline variables. These results suggest that a modest reduction in fat intake and increase in fruit, vegetable, and grain intake do not alter the risk of benign proliferative breast disease.
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Affiliation(s)
- Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
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Leshinsky-Silver E, Michelson M, Cohen S, Ginsberg M, Sadeh M, Barash V, Lerman-Sagie T, Lev D. A defect in the thymidine kinase 2 gene causing isolated mitochondrial myopathy without mtDNA depletion. Eur J Paediatr Neurol 2008; 12:309-13. [PMID: 17951082 DOI: 10.1016/j.ejpn.2007.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Revised: 08/28/2007] [Accepted: 09/02/2007] [Indexed: 11/24/2022]
Abstract
Isolated mitochondrial myopathies (IMM) are either due to primary defects in mtDNA, in nuclear genes that control mtDNA abundance and structure such as thymidine kinase 2 (TK2), or due to CoQ deficiency. Defects in the TK2 gene have been found to be associated with mtDNA depletion attributed to a depleted mitochondrial dNTP pool in non-dividing cells. We report an unusual case of IMM, homozygous for the H90N mutation in the TK2 gene but unlike other cases with the same mutation, does not demonstrate mtDNA depletion. The patient's clinical course is relatively mild and a muscle biopsy showed ragged red muscle fibers with a mild decrease in complexes I and an increase in complexes IV and II activities. This report extends the phenotypic expression of TK2 defects and suggests that all patients who present with an IMM even with normal quantities of mtDNA should be screened for TK2 mutations.
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Rohan TE, Negassa A, Chlebowski RT, Habel L, McTiernan A, Ginsberg M, Wassertheil-Smoller S, Page DL. Conjugated equine estrogen and risk of benign proliferative breast disease: a randomized controlled trial. J Natl Cancer Inst 2008; 100:563-71. [PMID: 18398105 DOI: 10.1093/jnci/djn075] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Estrogens stimulate proliferation of breast epithelium and may therefore increase the risk of benign proliferative breast disease, a condition that is associated with increased risk of breast cancer. We tested the effect of conjugated equine estrogen (CEE) on risk of benign proliferative breast disease in the Women's Health Initiative (WHI) randomized controlled trial. METHODS In the WHI CEE trial, 10,739 postmenopausal women were randomly assigned to 0.625 mg/d of CEE or to placebo. Baseline and annual breast examinations and mammograms were required. We identified women in the trial who reported breast biopsies that were free of cancer, obtained the associated histological sections, and subjected them to standardized central review. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. RESULTS A total of 232 incident cases of benign proliferative breast disease were ascertained during follow-up (average duration, 6.9 years), with 155 in the CEE group and 77 in the placebo group. Use of CEE was associated with a more than two-fold increase in the risk of benign proliferative breast disease (HR = 2.11, 95% CI = 1.58 to 2.81). For benign proliferative breast disease without atypia, the HR was 2.34 (95% CI = 1.71 to 3.20), whereas for atypical hyperplasia, it was 1.12 (95% CI = 0.53 to 2.40). Risk varied little by levels of baseline characteristics. CONCLUSION Use of 0.625 mg/d of CEE was associated with a statistically significant increased risk of benign proliferative breast disease.
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Affiliation(s)
- Thomas E Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10461, USA.
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Riely GJ, Rudin CM, Kris MG, Senturk E, Azzoli CG, Brahmer J, Fogle M, Ginsberg M, Miller VA, Rizvi NA. A randomized phase II trial comparing pulsed erlotinib before or after carboplatin and paclitaxel in patients with stage IIIB or IV non-small cell lung cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7619 Background: A randomized phase 3 trial failed to show any improvement in response rate (RR) or overall survival (OS) when erlotinib was added to carboplatin and paclitaxel (TRIBUTE). However, preclinical data suggested that administration of erlotinib before or after chemotherapy may improve efficacy of chemotherapy [Gumerlock et al ASCO 2003, Solit et al Clin Can Res 2005]. We designed this trial to test the hypothesis that administration of pulsed erlotinib prior to or following chemotherapy would improve the response rate in patients with advanced NSCLC. Methods: All patients had chemotherapy naive, stage IIIB or IV NSCLC and were former or current smokers. All patients received carboplatin (AUC 6) and paclitaxel (200 mg/m2). Patients were randomly assigned to one of three arms: erlotinib 150 mg days 1,2, and chemotherapy on day 3; erlotinib 1500 mg days 1, 2 and chemotherapy on day 3; or chemotherapy on day 1 and erlotinib 1500 mg on days 2,3. Patients received up to six 21-day cycles of treatment. The primary endpoint was overall RR (CR+PR) using RECIST. We planned to enroll 29 patients to each arm in a “pick the winner” design comparing arms to the chemotherapy alone arm of TRIBUTE (RR 19%) with a desirable RR of 50%. Results: Eighty-seven patients were randomized to 3 arms. Accrual is complete. The most common grade 3/4 toxicities were neutropenia (39%), fatigue (15%), and anemia (12%). Grade 3/4 rash or diarrhea were uncommon. Conclusions: Treatment with erlotinib before (150 mg on days 1 and 2 or 1500 mg on days 1 and 2) or after (1500 mg on days 2 and 3) administration of carboplatin and paclitaxel failed to improve response rates compared to TRIBUTE. The benefit of pulsatile administration of erlotinib predicted by preclinical models was not evident in this clinical trial. Supported by Genentech, Inc. [Table: see text] [Table: see text]
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Affiliation(s)
- G. J. Riely
- Memorial Sloan-Kettering Cancer Center, New York, NY; The Johns Hopkins Medical Institutions, Baltimore, MD
| | - C. M. Rudin
- Memorial Sloan-Kettering Cancer Center, New York, NY; The Johns Hopkins Medical Institutions, Baltimore, MD
| | - M. G. Kris
- Memorial Sloan-Kettering Cancer Center, New York, NY; The Johns Hopkins Medical Institutions, Baltimore, MD
| | - E. Senturk
- Memorial Sloan-Kettering Cancer Center, New York, NY; The Johns Hopkins Medical Institutions, Baltimore, MD
| | - C. G. Azzoli
- Memorial Sloan-Kettering Cancer Center, New York, NY; The Johns Hopkins Medical Institutions, Baltimore, MD
| | - J. Brahmer
- Memorial Sloan-Kettering Cancer Center, New York, NY; The Johns Hopkins Medical Institutions, Baltimore, MD
| | - M. Fogle
- Memorial Sloan-Kettering Cancer Center, New York, NY; The Johns Hopkins Medical Institutions, Baltimore, MD
| | - M. Ginsberg
- Memorial Sloan-Kettering Cancer Center, New York, NY; The Johns Hopkins Medical Institutions, Baltimore, MD
| | - V. A. Miller
- Memorial Sloan-Kettering Cancer Center, New York, NY; The Johns Hopkins Medical Institutions, Baltimore, MD
| | - N. A. Rizvi
- Memorial Sloan-Kettering Cancer Center, New York, NY; The Johns Hopkins Medical Institutions, Baltimore, MD
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Gomez J, Azzoli C, Krug L, Ginsberg M, Henry R, Tyson L, Pizzo B, Dunne M, Kris M, Sirotnak F. P-486 Phase 1 study of 10-propargyl-10-deazaaminopterin (PDX,pralatrexate) plus docetaxel in patients with advanced Non-small Cell Lung Cancer (NSCLC). Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80979-1] [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: 10/25/2022]
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Motzer RJ, Rakhit A, Thompson J, Gurney H, Selby P, Figlin R, Negrier S, Ernst S, Siebels M, Ginsberg M, Rittweger K, Hooftman L. Phase II trial of branched peginterferon-alpha 2a (40 kDa) for patients with advanced renal cell carcinoma. Ann Oncol 2002; 13:1799-805. [PMID: 12419754 DOI: 10.1093/annonc/mdf288] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [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: 11/12/2022] Open
Abstract
BACKGROUND Peginterferon-alpha 2a (40 kDa), PEGASYS(TM) (PEG-IFN), is a modified form of recombinant human interferon (IFN)-alpha 2a with sustained absorption and prolonged half-life after subcutaneous administration. A phase II trial was conducted in previously untreated patients with advanced renal cell carcinoma (RCC) to assess efficacy, toxicity and pharmacokinetic profile. PATIENTS AND METHODS Forty previously untreated patients with advanced RCC were enrolled on this multicenter trial. The median age was 60 years and 63% had prior nephrectomy. PEG-IFN was administered at a dose of 450 micro g/week on a weekly basis by subcutaneous injection. Serial venous blood samples were drawn to assess concentrations of PEG-IFN. RESULTS Five (13%) patients achieved a major response (four partial and one complete). The median time to progression was 3.8 months, and 63% of patients were alive at 1 year. The toxicity profile was mostly mild to moderate in intensity. Toxicity higher than grade 2 included neutropenia (six patients), fatigue/asthenia (four patients), nausea/vomiting (three patients) and elevated hepatic transaminase concentrations (four patients). Serum drug levels were studied in all patients; mean C(max) at week 1 was 19 ng/ml, and levels were sustained at close to peak over 1 week. With chronic dosing, drug concentration was increased 3-fold, and steady state was achieved in 5-9 weeks. CONCLUSIONS The sustained maintenance of serum levels of PEG-IFN allows once-weekly dosing. The efficacy and tolerability profile was qualitatively similar to standard IFN-alpha, and adverse events were mostly mild to moderate in nature.
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Affiliation(s)
- R J Motzer
- Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
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Wylie-Rosett J, Swencionis C, Ginsberg M, Cimino C, Wassertheil-Smoller S, Caban A, Segal-Isaacson CJ, Martin T, Lewis J. Computerized weight loss intervention optimizes staff time: the clinical and cost results of a controlled clinical trial conducted in a managed care setting. J Am Diet Assoc 2001; 101:1155-62; quiz 1163-4. [PMID: 11678486 DOI: 10.1016/s0002-8223(01)00284-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate the costs and effects of incremental components of a weight-loss program. DESIGN A 3-arm, 12-month randomized controlled clinical trial to evaluate 3 incremental levels of intervention intensity. SUBJECTS/SETTING The study included 588 individuals (BMI > 25 kg/m2) in a freestanding health maintenance organizalion and achieved an 81% completion rate. INTERVENTION Using a cognitive behavioral approach for tailoring lifestyle modification goals, the incremental levels of intervention included a) a workbook alone, b) the addition of computerized tailoring using onsite computer kiosks with touch screen monitors, and c) the addition of both computers and staff consultation. MAIN OUTCOME MEASURES Endpoints included weight parameters, lipid profile, plasma glucose, blood pressure, intervention costs, dietary intake, and physical activity. STATISTICAL ANALYSIS PERFORMED Study endpoints were analyzed using analysis of variance for normally distributed variables and analysis of covariance to control for any baseline differences. Regression and correlation analysis assessed the relationship between weight loss and other variables. RESULTS For the increasing levels of intervention intensity, the mean 12-month weight losses were 2.2, 4.7, and 7.4 pounds, with the respective cost per participant being $12.33, $41.99, and $133.74. The decreases in mean BMIs for these respective intervelation levels were 0.4, 0.9 and 1.2. All groups reported a decrease in energy and fat intake and an increase in blocks walked (P<.01). Intervention variables that correlated with weight loss included more computer log-ons, achieving computer-selected goals, more self-monitoring, increased walking, and decreased energy and fat intake, as well as higher attendance in staff consultation group sessions for that treatment condition. Weight loss correlated with decreases in fasting glucose and blood pressure. APPLICATIONS/CONCLUSIONS In a weight-loss program, computers can facilitate selecting behavioral change goals. More frequent usage resulted in greater weight loss. Staff counseling to augment the computer intervention achieved the most weight loss.
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Affiliation(s)
- J Wylie-Rosett
- Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine Bronx, NYC 10461, USA
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Abstract
BACKGROUND People with chronic hepatitis B virus (HBV) infection are the major source of HBV transmission in the United States. The Public Health Service recommends prevention counseling for HBV-infected people and vaccination of their household contacts and sexual partners. OBJECTIVES To describe the implementation of these recommendations by community physicians. METHODS Telephone survey of 69 people with chronic HBV infection and their healthcare providers, October 1997 through November 1997, in San Diego, California. MAIN OUTCOME MEASURES Counseling of people with chronic HBV infection and vaccination of their household contacts and sexual partners. RESULTS Forty-three percent of providers reported providing prevention counseling to their HBV-infected patients to reduce transmission; 16% of patients reported receiving counseling. For the 32 pairs for which both the patient and provider could be reached and the patients were aware of their HBV infection, 20 (63%) providers reported counseling patients, and 10 (50%) of these providers' patients reported receiving counseling. Fifty-five percent of providers recommended vaccination of contacts; 13% of eligible adult household contacts and sexual partners and 20% of eligible child household contacts had begun hepatitis B vaccination. CONCLUSIONS Prevention counseling of people with chronic HBV infection and vaccination of their contacts occur infrequently despite guidelines and an effective vaccine. Collaborative efforts between providers and people involved in public health are needed to improve delivery of these preventive health services.
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Affiliation(s)
- M S Weinberg
- Health and Human Services Agency, San Diego, California, USA.
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