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Lattery G, Kaulfers T, Cheng C, Hasan S, Choi IJ, Simone CB, Lin H, Kang M, Chang J. Proton Single-Energy Bragg-Peak FLASH Using Clinical Systems Can Achieve IMPT-Equivalent Plan Quality for Breast and Prostate Cancers. Int J Radiat Oncol Biol Phys 2023; 117:S141. [PMID: 37784361 DOI: 10.1016/j.ijrobp.2023.06.551] [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) Most current proton FLASH-RT studies focus on transmission proton techniques. In this study, we propose a novel method for achieving FLASH dose rate in hypofractionated proton radiotherapy using the Bragg peak of a single-energy proton beam. The dosimetric characteristics using this novel technique for proton pencil beam scanning (PBS) stereotactic body radiation therapy (SBRT) of prostate and breast cancers were first investigated based on the clinically available cyclotron beam parameters. MATERIALS/METHODS This novel approach uses the distal tracking technique that enables PBS Bragg-peak of the highest proton energy to adapt to the target distally. Positioning of the Bragg peak at different depths is achieved using a universal range shifter and range compensator. To investigate the feasibility of this approach, we developed an in-house treatment planning platform for intensity-modulated proton therapy (IMPT) delivery and performed dosimetric studies on prostate and breast SBRT cases previously treated with conventional proton PBS technique. FLASH plans were generated using a similar clinical beam arrangement to deliver 40 Gy (RBE) in 5 fractions. Dose metrics were compared between the clinical and FLASH plans. Dose-rate volume histograms (DRVH) were also calculated to investigate the 40 Gy/s coverage (V40 Gy/s) of organs-at-risk (OARs) for FLASH plans. RESULTS The distal tracking can precisely stop the Bragg peak at the target distal edge, and Bragg peak plans achieved tumor coverage and dose conformality equivalent to IMPT plans. The clinical IMPT plans yielded slightly superior target dose uniformity -CTV Dmax of FLASH plans was 10% higher for prostate and 2% higher for breast. There was no significant difference between the clinical and FLASH plans in dose metrics for major OARs, including rectum, large bowel, heart, and lung. Higher maximal doses to femoral heads (∼2 Gy) and urethra (∼6 Gy) were observed in prostate FLASH plans than in the clinical plans but were still within clinically accepted dose limits. The V40 Gy/s for OARs were >90% for prostate FLASH plans and >76.5% for breast FLASH plans. CONCLUSION The proposed single-energy Bragg-peak FLASH technique eliminates exit dose associated with transmission proton FLASH and can still yield comparable plan quality and OAR sparing while preserve sufficient FLASH dose rate coverage for prostate and breast proton SBRT. This study demonstrates the potential application of Bragg peaks for highly conformal FLASH-RT using clinical cyclotron systems to treat prostate and breast cancer patients, which moves towards clinical application.
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Affiliation(s)
- G Lattery
- Department of Physics and Astronomy, Hofstra University, HEMPSTEAD, NY
| | - T Kaulfers
- Department of Physics and Astronomy, Hofstra University, HEMPSTEAD, NY
| | - C Cheng
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - S Hasan
- Allegheny Health Network, Department of Radiation Oncology, Pittsburgh, PA
| | - I J Choi
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - H Lin
- New York Proton Center, New York, NY
| | - M Kang
- New York Proton Center, New York, NY
| | - J Chang
- Center for Advanced Medicine-Northwell Health, Lake Success, NY
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Li P, Yang D, Meng Z, Kang M. Exploring the Clinical Characteristics and Survival of Early-Onset and Late-Onset Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e596. [PMID: 37785799 DOI: 10.1016/j.ijrobp.2023.06.1953] [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) Presently, early-onset and late-onset nasopharyngeal cancer (EONPC and LONPC, defined as age ≤ 50 years and > 50 years old, respectively) are seldom studied. The purpose of this study is to determine the clinical and survival characteristics between the NPC patients of these two age groups. MATERIALS/METHODS Patients diagnosed with NPC in The Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2018 years, and in our institution from 2014 to 2017 years were reviewed in this study. Clinicopathological characteristics, treatment modalities, and survival outcomes of EONPC and LONPC patients were analyzed and compared. RESULTS A total of 2943 patients (including 935 patients with EONPC and 2008 patients with LONPC) in the SEER database and 833 domestic patients (including 518 patients with EONPC and 315 patients with LONPC) in our center were finally enrolled. In the SEER database, both EONPC and LONPC patients displayed a greater prevalence in men. EONPC patients presented with a worse staging of regional lymph node metastasis (p < 0.001), but had a better prognosis than that in the LONPC patients (p < 0.001). More EONPC patients received chemotherapy and radiation (p < 0.001). Similar results were validated in our center, and in addition, it was found that EONPC patients had an advanced clinical stage (stage III, IVA, 92.1% vs. 85.1%, p = 0.016) and larger primary tumor volume (41.7% vs. 35.7%, p = 0.049). Meanwhile, EONPC patients had a superior overall survival (OS) (p = 0.017) and cancer-specific survival (CSS) (p = 0.004) compared to that in the LONPC patients. In univariate and multivariate Cox regression analysis, early-onset was independently associated with a higher 5-year OS (82.4% vs. 73.3%, p = 0.006). CONCLUSION EONPC patients present with more advanced lymph node metastasis stage and clinical stage, but have a better survival compared to LONPC patients. Age ≤ 50 years was an independent prognostic factor for survival outcome in NPC patients. To achieved the better individualization of the therapeutic regimen, there is the need for further studies on EONPC.
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Affiliation(s)
- P Li
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China; Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - D Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China; The First Affiliated Hospital, Department of Radiation Oncology, Hengyang Medical School, University of South China, Hengyang 421001, Hunan, China
| | - Z Meng
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China; Department of Oncology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530021, Guangxi, China
| | - M Kang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, Guangxi, China
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Shen M, Lin X, Yang C, Ziyan Z, Yang D, Meng Z, Chen S, Yin Y, Qin Y, Huang H, Huang L, Long L, Yang Z, Kang M. Potential Predictive Value of Intravoxel Incoherent Motion Magnetic Resonance for Xerostomia of Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e624-e625. [PMID: 37785867 DOI: 10.1016/j.ijrobp.2023.06.2012] [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) Xerostomia, caused by radiation-induced parotid damage, is the most commonly reported complications of radiotherapy (RT) to nasopharyngeal carcinoma (NPC). This study aimed to evaluate the value of IVIM MR in monitoring radiation parotid gland damage and predicting the risk of xerostomia. MATERIALS/METHODS A total of 54 patients were enrolled and underwent IVIM MR scans at before RT, after the fifth fraction, halfway through the course of RT, and at the end of radiotherapy. The parameters of IVIM MR include pseudo-diffusion coefficient (D*), perfusion fraction (f), and pure diffusion coefficient (D). The degree of xerostomia in NPC patients was assessed before each MR examination using the acute radiation morbidity scoring criteria proposed by the Radiation Therapy Oncology Group (RTOG). Concurrently, the time when the patient first reported suffering from xerostomia was recorded. The IVIM parameters trend throughout the RT, and the relationships between IVIM parameters and xerostomia, were analyzed. RESULTS All of the IVIM parameters increased from pre-RT to post-RT significantly (all p < 0.001). The increase rate of D from pre-RT to halfway through the RT was 32.61%, which was significantly higher than 15.64% from halfway to post-RT (p<0.001), indicating that cell necrosis in the first half of treatment is significantly higher than that in the second half. Both D* and F had significantly increased from pre-RT to halfway through the radiotherapy (p<0.001), with an increase rate of 19.58% and 29.38%, respectively. However, no significant increase was observed from Halfway to post-RT (p>0.05), with an increase rate of 4.10% and 8.30%, respectively. This may be due to radiation-induced vasculitic dilation that is significant in the first half of the radiotherapy but plateaus in the second half. Pre-D (OR = 23.85; 95% CI = 2.39, 237.82; p = .007) and pre-D* (OR = 0.75; 95% CI = 0.63, 0.91; p = 0.003) are independent influencing factors for xerostomia at 3 months after the completion of RT. D and F were significantly higher after the fifth fraction compared with Pre-RT (both p<0.05), respectively increased 31.25% and 25.16%. D* increase by 15% (p = 0.081). IVIM scans can assess parotid gland damage early. And the average time of parotid damage underwent IVIM scan was 5.99 ± 0.84 (day), much earlier than 11.84 ± 2.74 (day) according to RTOG. CONCLUSION Our study indicates that IVIM MR can dynamically monitor radiotherapy-induced parotid gland damage, and much earlier and objectively than RTOG.
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Affiliation(s)
- M Shen
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, Guangxi, China
| | - X Lin
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, Guangxi, China
| | - C Yang
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, Guangxi, China
| | - Z Ziyan
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, Guangxi, China
| | - D Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Z Meng
- Department of Oncology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530021, Guangxi, China
| | - S Chen
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Y Yin
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Y Qin
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, Guangxi, China
| | - H Huang
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, China
| | - L Huang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, Guangxi, China
| | - L Long
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, Guangxi, China
| | - Z Yang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, Guangxi, China
| | - M Kang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
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Zhao L, Yang Y, Liu P, Yu F, Hu L, Kang M, Lin H, Ding X. Introducing an Experimental Approach to Predict Spot Scanning Time Parameters for a Superconducting Cyclotron Proton Therapy Machine. Int J Radiat Oncol Biol Phys 2023; 117:e748. [PMID: 37786166 DOI: 10.1016/j.ijrobp.2023.06.2290] [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) Proton pencil beam scanning (PBS) delivery sequence varies a lot among institutions due to the differences in vendors, machine types, and beamline configurations, which impacts PBS interplay effects and treatment delivery time estimation. This study aims to develop an independent experimental approach to predict the spot scanning time parameters for a clinical superconducting cyclotron proton therapy machine. MATERIALS/METHODS This independent experimental approach employed an open-air parallel-plate detector with a temporal resolution of 0.05ms. A series of spot, energy, and dose rate patterns were designed and delivered, including (1) Spot switching time (SSWT) under different spot spacing for IEC-X, IEC-Y directions and diagonal direction (traveling in both X and Y direction) for three energy layers (110, 170 and 230 MeV); The Wilcoxon test is used to validate the prediction of SSWT along the diagonal direction. (2) Energy layer switching time (ELST) with different descending energy gaps for a fixed initial energy and different initial energies for a fixed descending energy gap. (3) Dose rate (MU/min) are measured for different minimum-MU-per-energy-layer (MMPEL), which are compared with the previous publication. RESULTS A SSWT jump at 10mm (can be customized) spot spacing is observed because of triggering the machine's "raster mode" threshold. Discontinuous two variable piecewise linear functions were used to fit the SSWT in X/Y for spot spacing and energy. SSWT in X/Y is increasing as spot spacing and energy increase. SSWT in the diagonal direction is determined by the time either in the x-direction or y-direction, whichever takes longer (see Table 1 for one example of validations). ELST is linear depending on descending energy gap. The dose rate dependence on MMPEL is confirmed with previous publications of a similar type of machine. CONCLUSION The study provided the first independent quantitative experimental modeling of the beam delivery time parameters without any information from vendors. Such machine-specific delivery sequence models could pave the foundation of precise interplay effect evaluation for clinical decision-making.
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Affiliation(s)
- L Zhao
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI
| | - Y Yang
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - P Liu
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI
| | - F Yu
- New York Proton Center, New York, NY
| | - L Hu
- New York Proton Center, New York, NY
| | - M Kang
- New York Proton Center, New York, NY
| | - H Lin
- New York Proton Center, New York, NY
| | - X Ding
- Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI
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Lin H, Yu F, Gorovets D, Kabarriti R, Alektiar KM, Ohri N, Hasan S, Tsai P, Shim A, Kang M, Barker CA, Wolden SL, Hajj C, Mehta KJ, Lee NY, Chhabra AM, Shepherd AF, Choi IJ, Yamada Y, Simone CB. Pencil Beam Scanning Proton Stereotactic Body Radiation Therapy (SBRT): A Robust Single Institution Experience. Int J Radiat Oncol Biol Phys 2023; 117:e686-e687. [PMID: 37786018 DOI: 10.1016/j.ijrobp.2023.06.2155] [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) To describe the feasibility of treating a complex and diverse group of patients using pencil beam scanning (PBS) proton stereotactic body radiation therapy (SBRT: 5 or fewer fractions, with a fraction size of at least 5 Gy). MATERIALS/METHODS Our center treats on average 105-120 PBS proton treatments daily, of which 9.5% of treatment courses are proton SBRT. Statistics of disease sites, treatment planning parameters (target volume, prescriptions, number of fields, SFO vs. MFO), and treatment efficiencies (scheduled time slots, actual treatment time) are presented for 305 consecutive SBRT patients receiving 1507 fractions in the past three years. Thermoplastic masks or Vacuum-lock bags are used to immobilize SBRT patients and index the patients' treatment position. Imaging guidance of orthogonal kV images and volumetric cone-beam CT is routinely used for patient setup. RESULTS SBRT patients are grouped based on the target locations: pelvis (31%), liver (17%), thoracic (13%), spine (8%), abdominal (8%), brain (7%), non-spine bone (7%), ocular (6%), and head and neck (2%). Only 112 patients (37%) were receiving their 1st RT course, whereas 113 (37%) had one prior in-field RT course, and 80 (26%) had multiple prior in-field RT courses. The median [IQR] target volume was 65.4 [29.3, 168] cc (range: 0.3-2475 cc). 72% of cases were planned with SFO and 28% with MFO. On average, 3.76 fields (range: 2 to 12) were planned for each treatment. 44% of the treatments were planned with three or fewer fields, and 10% received more than five fields, most of which involved repainting for moving targets. Over 97% of treatments were delivered in 5 fractions, with ∼3% delivered in 3 fractions. The median [IQR] prescription per treatment was 8 [7, 10] Gy (range: 5-18 Gy per treatment). 85% (84%) of the SBRT treatments were scheduled (delivered) in a 45-minute or shorter slot, and 6% (7%) of treatments were scheduled (delivered) in over a one-hour slot, most commonly for multiple isocenter treatments. 93% of treatments were delivered within 15 minutes of the planned treatment time or shorter. Deep-inspiration breath-hold (DIBH) was applied to 45% of liver SBRT cases, with the remaining 55% planned on 4D CT with (14%) or without (86%) abdominal compression. DIBH was applied in 13% of lung SBRT cases. The application of other motion mitigation approaches, such as volumetric repainting, was determined by the target motion amplitude and whether the patient could tolerate DIBH. CONCLUSION In the most diverse and largest proton SBRT experience delivered in the world over the past 3 years, over 300 patients were treated, demonstrating the feasibility and efficiency of delivering proton SBRT in a very busy center. The planning and treatment parameter statistics reported serve as a helpful reference for the proton community.
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Affiliation(s)
- H Lin
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
| | - F Yu
- New York Proton Center, New York, NY
| | - D Gorovets
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - R Kabarriti
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - K M Alektiar
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - N Ohri
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - S Hasan
- New York Proton Center, New York, NY; Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - P Tsai
- New York Proton Center, New York, NY
| | - A Shim
- New York Proton Center, New York, NY
| | - M Kang
- New York Proton Center, New York, NY
| | - C A Barker
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - S L Wolden
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - C Hajj
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - K J Mehta
- Department of Radiation Oncology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - N Y Lee
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - A M Chhabra
- New York Proton Center, New York, NY; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - A F Shepherd
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - I J Choi
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
| | - Y Yamada
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - C B Simone
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
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Meng Z, Li P, Yang D, Dong H, Li R, Wang S, Chen X, Huang H, Kang M. The Feasibility of Level Ib Sparing Intensity Modulated Radiation Therapy in Nasopharyngeal Carcinoma Patients with High-Risk Factors: Based on International Guideline. Int J Radiat Oncol Biol Phys 2023; 117:e606-e607. [PMID: 37785826 DOI: 10.1016/j.ijrobp.2023.06.1976] [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) In spite of the rarity of level Ib recurrence after intensity-modulated radiation therapy, the International Guideline (IG) provides the risk factors for prophylactic coverage. In practice, however, there are significant differences between institutions. The purpose of this study is to examine the feasibility of sparing level Ib IMRT in NPC patients with high-risk factors based on IG. MATERIALS/METHODS From January 2014 to October 2017, newly-diagnostic, non-metastatic NPC patients in our center were retrospectively reviewed. According to the risk factors of prophylactic level Ib coverage in patients with negative level Ib recommended by IG, the characteristics of pre-treatment MRI were analyzed. Four high-risk factors were identified: a. involvement of the structures that drain to level Ib as first echelon (FES), including anterior half of nasal cavity, oral cavity, b. involvement of submandibular gland (SMG), c. with radiologic extranodal extension (rENE) in level II LNs, or d. maximal axial diameter (MAD)≧2 cm in level II LNs. Patients with risk factors were divided into Cohort A (with risk factors a), Cohort B (with risk factor b, but without a), and Cohort C (only with risk factors c and/or d). Recurrence rates of level Ib and regional relapse-free survival (RRFS) rates were evaluated in different cohorts. RESULTS A total of 961 patients were finally included. Thirty-six cases (3.7%) presented with radiologically positive level Ib metastasis. For the other patients with negative Ib LNs, there were 18, 65, 421, and 444 cases classified as FES involvement, SMG involvement, level II LNs with rENE, and level II nodal with MAD ≧2 cm. Excluding overlap, a total of 571 patients with risk factors were divided into three groups: Cohort A (n = 18), Cohort B (n = 49) and Cohort C (n = 504). Nine patients (9/961, 0.94%) developed level Ib recurrence. Except for 1 patient with positive Ib LNs at diagnosis, 2 did not meet any of the risk factors, while the other six (6/9, 66.7%) met at least one risk factor. The rate of recurrence at neck level Ib was highest in Cohort A (11.1%, 2/18; Ib-sparing group: 0/10, 0.0% vs Ib-covering group: 2/8, 25.0%; P = 0.183). In Cohort B, no cases were found with level Ib recurrence (0.0%, 0/49). In Cohort C, the rates were rare (0.8%, 4/504) in both groups (0.7%, 2/276 vs 0.9%, 2/228; P > 0.999). Among the three Cohorts, there were no significant differences in 5-year RRFS between two groups, which were 90.0% vs 62.5% (p = 0.248), 90.9% vs 92.0% (p = 0.905), and 92.6% vs 90.1% (p = 0.445), respectively. Among patients with high-risk factors, the incidence of grade 3-4 late dry mouth symptom was higher in the level Ib-covering group (3.1% vs 7.5%, P = 0.033). CONCLUSION Level Ib sparing appears safe and feasible for NPC patients with negative level Ib LNs, even if combined with risk factors: SMG involvement, and/or level II with rENE, and/or level II MAD ≧2 cm. Level Ib-sparing irradiation reduces dry mouth symptoms compared with level Ib-irradiation.
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Affiliation(s)
- Z Meng
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; Department of Oncology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - P Li
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; The First Affiliated Hospital, Department of Oncology Radiotherapy, Hengyang Medical School, University of South China, Hengyang, China
| | - D Yang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - H Dong
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; The Second People's Hospital of Yichang, Yichang, China
| | - R Li
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; Department of Medical Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - S Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; Oncology Department, The Third Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - X Chen
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, China
| | - H Huang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, China
| | - M Kang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, China
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Cho HJ, Okekunle AP, Yie GE, Youn J, Kang M, Jin T, Sung J, Lee JE. Association of coffee consumption with type 2 diabetes and glycemic traits: a Mendelian randomization study. Nutr Res Pract 2023; 17:789-802. [PMID: 37529271 PMCID: PMC10375333 DOI: 10.4162/nrp.2023.17.4.789] [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: 08/09/2022] [Revised: 12/23/2022] [Accepted: 01/20/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND/OBJECTIVES Habitual coffee consumption was inversely associated with type 2 diabetes (T2D) and hyperglycemia in observational studies, but the causality of the association remains uncertain. This study tested a causal association of genetically predicted coffee consumption with T2D using the Mendelian randomization (MR) method. SUBJECTS/METHODS We used five single-nucleotide polymorphisms (SNPs) as instrumental variables (IVs) associated with habitual coffee consumption in a previous genome-wide association study among Koreans. We analyzed the associations between IVs and T2D, fasting blood glucose (FBG), 2h-postprandial glucose (2h-PG), and glycated haemoglobin (HbA1C) levels. The MR results were further evaluated by standard sensitivity tests for possible pleiotropism. RESULTS MR analysis revealed that increased genetically predicted coffee consumption was associated with a reduced prevalence of T2D; ORs per one-unit increment of log-transformed cup per day of coffee consumption ranged from 0.75 (0.62-0.90) for the weighted mode-based method to 0.79 (0.62-0.99) for Wald ratio estimator. We also used the inverse-variance-weighted method, weighted median-based method, MR-Egger method, and MR-PRESSO method. Similarly, genetically predicted coffee consumption was inversely associated with FBG and 2h-PG levels but not with HbA1c. Sensitivity measures gave similar results without evidence of pleiotropy. CONCLUSIONS A genetic predisposition to habitual coffee consumption was inversely associated with T2D prevalence and lower levels of FBG and 2h-PG profiles. Our study warrants further exploration.
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Affiliation(s)
- Hyun Jeong Cho
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul 08826, Korea
- K-BIO KIURI Center, Seoul National University, Seoul 08826, Korea
| | - Akinkunmi Paul Okekunle
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul 08826, Korea
- Research Institute of Human Ecology, Seoul National University, Seoul 08826, Korea
| | - Ga-Eun Yie
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul 08826, Korea
| | - Jiyoung Youn
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul 08826, Korea
| | - Moonil Kang
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA 02118, USA
- Complex Disease & Genome Epidemiology Branch, Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
| | - Taiyue Jin
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea
| | - Joohon Sung
- Complex Disease & Genome Epidemiology Branch, Department of Public Health, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul 08826, Korea
- Research Institute of Human Ecology, Seoul National University, Seoul 08826, Korea
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Kang M, Ang TFA, Devine SA, Sherva R, Mukherjee S, Trittschuh EH, Gibbons LE, Scollard P, Lee M, Choi SE, Klinedinst B, Nakano C, Dumitrescu LC, Durant A, Hohman TJ, Cuccaro ML, Saykin AJ, Kukull WA, Bennett DA, Wang LS, Mayeux RP, Haines JL, Pericak-Vance MA, Schellenberg GD, Crane PK, Au R, Lunetta KL, Mez JB, Farrer LA. A genome-wide search for pleiotropy in more than 100,000 harmonized longitudinal cognitive domain scores. Mol Neurodegener 2023; 18:40. [PMID: 37349795 PMCID: PMC10286470 DOI: 10.1186/s13024-023-00633-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND More than 75 common variant loci account for only a portion of the heritability for Alzheimer's disease (AD). A more complete understanding of the genetic basis of AD can be deduced by exploring associations with AD-related endophenotypes. METHODS We conducted genome-wide scans for cognitive domain performance using harmonized and co-calibrated scores derived by confirmatory factor analyses for executive function, language, and memory. We analyzed 103,796 longitudinal observations from 23,066 members of community-based (FHS, ACT, and ROSMAP) and clinic-based (ADRCs and ADNI) cohorts using generalized linear mixed models including terms for SNP, age, SNP × age interaction, sex, education, and five ancestry principal components. Significance was determined based on a joint test of the SNP's main effect and interaction with age. Results across datasets were combined using inverse-variance meta-analysis. Genome-wide tests of pleiotropy for each domain pair as the outcome were performed using PLACO software. RESULTS Individual domain and pleiotropy analyses revealed genome-wide significant (GWS) associations with five established loci for AD and AD-related disorders (BIN1, CR1, GRN, MS4A6A, and APOE) and eight novel loci. ULK2 was associated with executive function in the community-based cohorts (rs157405, P = 2.19 × 10-9). GWS associations for language were identified with CDK14 in the clinic-based cohorts (rs705353, P = 1.73 × 10-8) and LINC02712 in the total sample (rs145012974, P = 3.66 × 10-8). GRN (rs5848, P = 4.21 × 10-8) and PURG (rs117523305, P = 1.73 × 10-8) were associated with memory in the total and community-based cohorts, respectively. GWS pleiotropy was observed for language and memory with LOC107984373 (rs73005629, P = 3.12 × 10-8) in the clinic-based cohorts, and with NCALD (rs56162098, P = 1.23 × 10-9) and PTPRD (rs145989094, P = 8.34 × 10-9) in the community-based cohorts. GWS pleiotropy was also found for executive function and memory with OSGIN1 (rs12447050, P = 4.09 × 10-8) and PTPRD (rs145989094, P = 3.85 × 10-8) in the community-based cohorts. Functional studies have previously linked AD to ULK2, NCALD, and PTPRD. CONCLUSION Our results provide some insight into biological pathways underlying processes leading to domain-specific cognitive impairment and AD, as well as a conduit toward a syndrome-specific precision medicine approach to AD. Increasing the number of participants with harmonized cognitive domain scores will enhance the discovery of additional genetic factors of cognitive decline leading to AD and related dementias.
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Affiliation(s)
- Moonil Kang
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, 72 East Concord Street E200, Boston, MA 02118 USA
| | - Ting Fang Alvin Ang
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
| | - Sherral A. Devine
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
| | - Richard Sherva
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, 72 East Concord Street E200, Boston, MA 02118 USA
| | - Shubhabrata Mukherjee
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Emily H. Trittschuh
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA USA
| | - Laura E. Gibbons
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Phoebe Scollard
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Michael Lee
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Seo-Eun Choi
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Brandon Klinedinst
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Connie Nakano
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Logan C. Dumitrescu
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN USA
| | - Alaina Durant
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN USA
| | - Timothy J. Hohman
- Vanderbilt Memory & Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN USA
| | - Michael L. Cuccaro
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, Miami, FL USA
| | - Andrew J. Saykin
- Indiana Alzheimer’s Disease Research Center, Indiana University School of Medicine, Indianapolis, IN USA
- Department of Radiology and Imaging Services, Indiana University School of Medicine, Indianapolis, IN USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN USA
| | - Walter A. Kukull
- Department of Epidemiology, University of Washington, Seattle, WA USA
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL USA
| | - Li-San Wang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Richard P. Mayeux
- Department of Neurology, Columbia University School of Medicine, New York, NY USA
| | - Jonathan L. Haines
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH USA
| | | | - Gerard D. Schellenberg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA USA
| | - Paul K. Crane
- Department of Medicine, University of Washington School of Medicine, Seattle, WA USA
| | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA USA
| | - Kathryn L. Lunetta
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
| | - Jesse B. Mez
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, 72 East Concord Street E200, Boston, MA 02118 USA
- Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Boston University Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
- Department of Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA USA
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Gao RM, Duceppe MO, Kang M, Naushad S, Ogunremi D, Huang H. Comprehensive genomic analysis of the potential limitations of several published PCR primers targeting prfA-virulence gene cluster in Listeria species. Lett Appl Microbiol 2023:ovad063. [PMID: 37312408 DOI: 10.1093/lambio/ovad063] [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] [Indexed: 06/15/2023]
Abstract
Polymerase chain reaction (PCR) is commonly used to detect Listeria monocytogenes, foodborne pathogen. The present study conducted in silico genomic analysis to investigate the specificity and binding efficacy of four published pairs of PCR primers targeting Listeria prfA-virulence gene cluster (pVGC) based on Listeria sequences available. We first performed comprehensive genomic analyses of the pVGC, the main pathogenicity island in Listeria spp. In total, 2961 prfA, 642 plcB, 629 mpl, and 1181 hlyA gene sequences were retrieved from the NCBI database. Multiple sequence alignments and phylogenetic trees were generated using unique (non-identical or not-shared) sequences of each represented genes, targeting four pairs of PCR primers published previously, namely 202 prfA, 82 plcB, 150 mpl and 176 hlyA unique gene sequences. Only hlyA gene showed strong (over 94%) primer mapping results, while prfA, plcB and mpl genes showed weak (less than 50%) matching results. In addition, nucleotide variations were observed at the 3' end of the primers, indicating non-binding to the targets could potentially cause false-negative results. Thus, we propose designing degenerate primers or multiple PCR primers based on as many isolates as possible, to minimize the false-negative risk and reach the aim of low tolerable limits of detection.
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Affiliation(s)
- R M Gao
- Ottawa Laboratory Fallowfield, Canadian Food Inspection Agency, Ottawa, ON, Canada
| | - M-O Duceppe
- Ottawa Laboratory Fallowfield, Canadian Food Inspection Agency, Ottawa, ON, Canada
| | - M Kang
- Ottawa Laboratory Fallowfield, Canadian Food Inspection Agency, Ottawa, ON, Canada
| | - S Naushad
- Ottawa Laboratory Fallowfield, Canadian Food Inspection Agency, Ottawa, ON, Canada
| | - D Ogunremi
- Ottawa Laboratory Fallowfield, Canadian Food Inspection Agency, Ottawa, ON, Canada
| | - H Huang
- Ottawa Laboratory Fallowfield, Canadian Food Inspection Agency, Ottawa, ON, Canada
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10
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Zhuang YL, Lu J, Wu SK, Zhang ZH, Wei ZM, Li YH, Hu T, Kang M, Deng AP. [Epidemiologic characteristics and influencing factors of influenza outbreaks in Guangdong Province, 2015-2022]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:942-948. [PMID: 37380417 DOI: 10.3760/cma.j.cn112338-20221010-00867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Objective: To grasp the epidemiological characteristics of influenza outbreaks in Guangdong Province by analyzing the outbreaks of influenza-like cases reported in Guangdong Province from January 2015 to the end of August 2022. Methods: In response to the outbreak of epidemics in Guangdong Province from 2015 to 2022, information on on-site epidemic control was collected, and epidemiological analysis was conducted to describe the characteristics of the epidemics. The factors that influence the intensity and duration of the outbreak were determined through a logistic regression model. Results: A total of 1 901 influenza outbreaks were reported in Guangdong Province, with an overall incidence of 2.05%. Most outbreak reports occurred from November to January of the following year (50.24%, 955/1 901) and from April to June (29.88%, 568/1 901). A total of 59.23% (1 126/1 901) of the outbreaks were reported in the Pearl River Delta region, and primary and secondary schools were the main places where outbreaks occurred (88.01%, 1 673/1 901). Outbreaks with 10-29 cases were the most common (66.18%, 1 258/1 901), and most outbreaks lasted less than seven days (50.93%,906/1 779). The size of the outbreak was related to the nursery school (aOR=0.38, 95%CI:0.15-0.93), the Pearl River Delta region (aOR=0.60, 95%CI:0.44-0.83), the time interval between the onset of the first case and the time of report (>7 days compared with ≤3 days: aOR=3.01, 95%CI:1.84-4.90), the influenza A(H1N1) (aOR=2.02, 95%CI:1.15-3.55) and the influenza B (Yamagata) (aOR=2.94, 95%CI: 1.50-5.76). The duration of outbreaks was related to school closures (aOR=0.65, 95%CI: 0.47-0.89), the Pearl River Delta region (aOR=0.65, 95%CI: 0.50-0.83) and the time interval between the onset of the first case and the time of report (>7 days compared with ≤3 days: aOR=13.33, 95%CI: 8.80-20.19; 4-7 days compared with ≤3 days: aOR=2.56, 95%CI: 1.81-3.61). Conclusions: An influenza outbreak in Guangdong Province exhibits two peaks, one in the winter and spring seasons and the other in the summer. Primary and secondary schools are high-risk areas, and early reporting of outbreaks is critical for controlling influenza outbreaks in schools. Furthermore, comprehensive measures should be taken to prevent the spread of the epidemic.
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Affiliation(s)
- Y L Zhuang
- Institute of Infectious Disease Control and Prevention,Guangdong Workstation for Emerging Infectious Disease Control and Prevention,Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511400, China
| | - J Lu
- Institute of Infectious Disease Control and Prevention,Guangdong Workstation for Emerging Infectious Disease Control and Prevention,Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511400, China
| | - S K Wu
- Guangdong Provincial Field Epidemiology Training Program, Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511400, China Chancheng District of Foshan Center for Disease Control and Prevention, Foshan 528000, China
| | - Z H Zhang
- Guangdong Provincial Field Epidemiology Training Program, Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511400, China Zengcheng District of Guangzhou Center for Disease Control and Prevention, Guangzhou 511300, China
| | - Z M Wei
- Guangdong Provincial Field Epidemiology Training Program, Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511400, China Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou 511000, China
| | - Y H Li
- Institute of Infectious Disease Control and Prevention,Guangdong Workstation for Emerging Infectious Disease Control and Prevention,Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511400, China
| | - T Hu
- Institute of Infectious Disease Control and Prevention,Guangdong Workstation for Emerging Infectious Disease Control and Prevention,Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511400, China
| | - M Kang
- Institute of Infectious Disease Control and Prevention,Guangdong Workstation for Emerging Infectious Disease Control and Prevention,Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511400, China
| | - A P Deng
- Institute of Infectious Disease Control and Prevention,Guangdong Workstation for Emerging Infectious Disease Control and Prevention,Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511400, China
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11
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Zhang D, Su GX, Wu FQ, Zhu J, Kang M, Xu YJ, Li M, Lai JM. [Clinical features and prognosis of 118 children with histiocytic necrotizing lymphadenitis]. Zhonghua Er Ke Za Zhi 2023; 61:533-537. [PMID: 37312465 DOI: 10.3760/cma.j.cn112140-20230110-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the clinical features and prognosis of children with histiocytic necrotizing lymphadenitis (HNL). Methods: The clinical data of 118 children with HNL diagnosed and treated in the Department of Rheumatology and Immunology of Children's Hospital, Capital Institute of Pediatrics from January 2014 to December 2021 were retrospectively analyzed. The clinical symptoms, laboratory examination, imaging examination, pathological findings, treatment and follow-up were analyzed. Results: Among the 118 patients, 69 were males and 49 were females. The age of onset was 10.0 (8.0, 12.0) years, ranging from 1.5 to 16.0 years. All the children had fever lymph node enlargement, blood system involvement in 74 cases (62.7%), skin injury in 39 cases (33.1%). The main manifestations of laboratory examination were increased erythrocyte sedimentation rate in 90 cases (76.3%), decreased hemoglobin in 58 cases (49.2%), decreased white blood cells in 54 cases (45.8%) and positive antinuclear antibody in 35 cases (29.7%). Ninety-seven cases (82.2%) underwent B-mode ultrasound of lymph nodes, showing nodular lesions with low echo in the neck; 22 cases (18.6%) underwent cervical X-ray and (or) CT; 7 cases (5.9%) underwent cervical magnetic resonance imaging. Lymph node biopsy was performed in all 118 cases, and the pathological results did not support malignant diseases such as lymphoma or Epstein-Barr virus infection, suggesting HNL. Fifty-seven cases (48.3%) recovered without treatment, 61 cases (51.7%) received oral steroid therapy, and 4 cases (3.4%) received indomethacin as anal stopper. The 118 cases were followed up for 4 (2, 6) years, ranging from 1 to 7 years, 87 cases (73.7%) had one onset and did not develop into other rheumatological diseases, and 24 cases (20.3%) had different degrees of recurrence, 7 cases (5.9%) had multiple system injuries, and all of the tested autoantibodies were positive for medium and high titers. All of them developed into other rheumatic immune diseases, among which 5 cases developed into systemic lupus erythematosus and 2 cases developed into Sjogren's syndrome; 7 cases were given oral steroid therapy, including 6 cases plus immunosuppressant and 2 cases receiving methylprednisolone 20 mg/kg shock therapy. Conclusions: The first-onset HNL portion is self-healing, hormone-sensitive and has a good prognosis. For HNL with repeated disease and multiple system injury, antinuclear antibody titer should be monitored during follow-up, and attention should be paid to the possibility of developing into other rheumatological diseases, with poor prognosis.
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Affiliation(s)
- D Zhang
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - G X Su
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - F Q Wu
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - J Zhu
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - M Kang
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y J Xu
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - M Li
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - J M Lai
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
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12
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Lee J, Lee S, Lee J, Hwang S, Jee B, Kim J, Chung J, Song W, Sung H, Jeon H, Jeong B, Seo S, Jeon S, Lee H, Park S, Kwon G, Kang M. Prognostic value of fat loss in patients with metastatic clear cell renal cell carcinoma treated with immune checkpoint inhibition. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00385-8] [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: 02/12/2023]
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13
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Li H, Yuan L, Yang H, Guo Y, Zheng W, Fan K, Deng S, Gong L, Xu H, Yang Z, Cheng J, Kang M, Deng H. Analysis of SOD1 Variants in Chinese Patients with Familial Amyotrophic Lateral Sclerosis. QJM 2023; 116:365-374. [PMID: 36661322 DOI: 10.1093/qjmed/hcad010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/27/2022] [Accepted: 01/10/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease, and genetic contributors exert a significant role in the complicated pathogenesis. Identification of the genetic causes in ALS families could be valuable for early diagnosis and management. The development of potential drugs for patients with genetic defects will shed new light on ALS therapy. AIM To identify causative variants in three Chinese families with familial ALS (FALS), reveal the pathogenic mechanism, and look for the targeted drug for ALS. DESIGN AND METHODS Whole-exome sequencing and bioinformatics were used to perform genetic analysis of the ALS families. Functional analysis was performed to study the variants' function and search for potential drug targets. RESULTS Three heterozygous missense variants of the SOD1 gene were identified in families with FALS. The clinical manifestations of these patients include spinal onset, predominant lower motor neurons presentation, and absence of cognitive involvement. Functional analysis showed that all three SOD1 variants led to increased reactive oxygen species (ROS) levels, reduced cell viability, and formation of cytoplasmic aggregates. Remarkably, the decreased cell viability induced by variants was rescued after treatment with the ROS inhibitor N-acetylcysteine. CONCLUSIONS This study identified three SOD1 variants in three families with FALS. The variant SOD1 toxicity was associated with oxidative damage and aggregation, and N-acetylcysteine could rescue the decreased cell viability induced by these variants. Our findings support a pathogenic role for ROS in SOD1 deficiencies, and provide a potential drug N-acetylcysteine for ALS therapy, especially in SOD1-patients with limb onset.
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Affiliation(s)
- H Li
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, China
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
| | - L Yuan
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, China
- Disease Genome Research Center, Central South University, Changsha, China
| | - H Yang
- Department of Neurology, the Second Affiliated Hospital of Guizhou Medical University, Kaili, China
| | - Y Guo
- Department of Medical Information, School of Life Sciences, Central South University, Changsha, China
| | - W Zheng
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - K Fan
- Department of Neurology, Guizhou Provincial People's Hospital, Guiyang, China
| | - S Deng
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China
| | - L Gong
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - H Xu
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Z Yang
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
| | - J Cheng
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
| | - M Kang
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
| | - H Deng
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, China
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, China
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, China
- Disease Genome Research Center, Central South University, Changsha, China
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Kang M, Zhu J, Xu YJ, Li SN, Lai JM. [Efficacy and safety of belimumab treatment in childhood-onset systemic lupus erythematosus]. Zhonghua Yi Xue Za Zhi 2022; 102:3881-3885. [PMID: 36540927 DOI: 10.3760/cma.j.cn112137-20220302-00438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Objective: To evaluate the efficacy and safety of belimumab in children with systemic lupus erythematosus (cSLE). Methods: The clinical data of 49 cSLE patients admitted into the Department of Rheumatology and Immunology, Children's Hospital affiliated to the Capital Institute of Pediatrics, from August 2018 to December 2021 were collected. They were divided into the belimumab treatment group (18 cases) and the traditional treatment group (31 cases) according to whether they received belimumab treatment. The cSLE patients in the traditional group had similar baseline SLEDAI scores with the belimumab group and were treated with traditional immunosuppressive drugs. The clinical symptoms and improvements before and after treatment, as well as the differences in adverse events during follow-up were compared between the two groups. Results: In belimumab group, the age was (11.9±1.8) years old, the median (Q1, Q3) of disease duration was 7.5 (2.0, 16.8) months, 3 patients were male, and 15 patients completed 24 weeks of treatment. In the traditional treatment group, 31 patients with cSLE were enrolled, with an average age of (11.3±2.4) years, a median (Q1, Q3) of disease duration of 7.0 (2.5, 10.5) months, among whom 6 patients were male, and 25 patients completed 24 weeks of treatment. At baseline, the belimumab treatment group had a significantly lower oral prednisone dose than the conventional treatment group [(29.58±12.43) mg/d vs (38.20±14.11) mg/d, P=0.037]. After 24 weeks of treatment, the dosage of prednisone in both groups was reduced, and the dosage of prednisone in the belimumab group was (14.12±5.86) mg/d, which was lower than that in the traditional treatment group [(23.51±9.79) mg/d] (P=0.002). After 24 weeks of treatment, the levels of complement C3 and C4 increased, the dsDNA levels and SLEDAI score decreased in both groups (all P>0.05). The incidence of adverse events in belimumab group (3/15, 3 cases) was lower than that in traditional treatment group (32.0%, 8/25) (P>0.05). Conclusions: Belimumab in the treatment of cSLE can reduce the initial dose of prednisone and facilitate the reduction of prednisone dose, significantly improve the clinical symptoms and organ involvement, and reduce the disease activity. The incidence of adverse events was low during belimumab treatment.
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Affiliation(s)
- M Kang
- Department of Rheumatology and Immunology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
| | - J Zhu
- Department of Rheumatology and Immunology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
| | - Y J Xu
- Department of Rheumatology and Immunology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
| | - S N Li
- Department of Rheumatology and Immunology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
| | - J M Lai
- Department of Rheumatology and Immunology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
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Kang M, Mez JB, Ang TFA, Devine SA, Mukherjee S, Trittschuh EH, Saykin AJ, Crane PK, Au R, Lunetta KL, Farrer LA. A Genome‐Wide Search for Pleiotropy in Cognitive Domain Scores. Alzheimers Dement 2022. [DOI: 10.1002/alz.066834] [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: 12/24/2022]
Affiliation(s)
- Moonil Kang
- Department of Medicine, Boston University School of Medicine Boston MA USA
| | - Jesse B. Mez
- Boston University School of Medicine Boston MA USA
| | - Ting Fang Alvin Ang
- Department of Anatomy and Neurobiology, Boston University School of Medicine Boston MA USA
- Framingham Heart Study, Boston University School of Medicine Boston MA USA
- Slone Epidemiology Center, Boston University School of Medicine Boston MA USA
| | - Sherral A. Devine
- Department of Anatomy and Neurobiology, Boston University School of Medicine Boston MA USA
- Framingham Heart Study, Boston University School of Medicine Boston MA USA
| | - Shubhabrata Mukherjee
- Department of General Internal Medicine, University of Washington School of Medicine Seattle WA USA
| | - Emily H. Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine Seattle WA USA
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Puget Sound Health Care System Seattle WA USA
| | - Andrew J. Saykin
- Department of Radiology and Imaging Services, Indiana University School of Medicine Indianapolis IN USA
- Indiana University School of Medicine Indianapolis IN USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine Indianapolis IN USA
| | - Paul K. Crane
- Department of General Internal Medicine, University of Washington School of Medicine Seattle WA USA
- University of Washington Alzheimer’s Disease Research Center, University of Washington School of Medicine Seattle WA USA
| | - Rhoda Au
- Department of Anatomy and Neurobiology, Boston University School of Medicine Boston MA USA
- Framingham Heart Study, Boston University School of Medicine Boston MA USA
- Slone Epidemiology Center, Boston University School of Medicine Boston MA USA
- Department of Neurology, Boston University School of Medicine Boston MA USA
- Department of Epidemiology, Boston University School of Public Health Boston MA USA
| | - Kathryn L. Lunetta
- Department of Biostatistics, Boston University School of Public Health Boston MA USA
| | - Lindsay A. Farrer
- Department of Neurology, Boston University School of Medicine Boston MA USA
- Department of Epidemiology, Boston University School of Public Health Boston MA USA
- Department of Biostatistics, Boston University School of Public Health Boston MA USA
- Boston University School of Medicine, Department of Medicine, Biomedical Genetics Boston MA USA
- Department of Ophthalmology, Boston University School of Medicine Boston MA USA
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16
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Jee B, Kang Y, Kim G, Kang M. 168P Transcriptional profiling of metastatic hormone sensitive prostate cancer (mHSPC) and distinct features are associated with clinical outcome. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.205] [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: 12/07/2022] Open
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17
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Choi S, Kang M, Kim JW, Kim J, Hwang Y, Jeon J, Oh HK, Lee H, Cho J, Kim DW, Cho S, Kim J, Kim K, Kang SB, Jheon S, Lee KW. 48P Long-term clinical outcomes after the second metastasectomy in patients (pts) with resected metastatic colorectal cancer (mCRC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.080] [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: 12/07/2022] Open
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18
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Hosseini F, Pitcher I, Kang M, MacKay M, Singer J, Lee T, Madden K, Cairns J, Wong G, Fordyce C. Association of malnutrition with in-hospital and long-term outcomes among ST-elevation myocardial infarction patients receiving primary PCI. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The impact of malnutrition on outcomes in a contemporary ST-segment-elevation myocardial infarction (STEMI) population is unclear. We hypothesized that malnutrition severity amongst STEMI patients undergoing primary percutaneous coronary intervention (pPCI) is associated with worse long-term outcomes.
Purpose
The aim of this study was 2-fold: 1) to establish the prevalence of malnutrition among STEMI patients undergoing pPCI; 2) to determine the association of malnutrition severity on in-hospital and 1-year outcomes in STEMI patients receiving pPCI
Methods
We retrospectively identified 1,169 STEMI patients of age ≥65 years who had received pPCI (2013–2020). Patients who had presented with out-of-hospital cardiac arrest or those who received fibrinolytic therapy were excluded. The Controlling Nutritional Status (CONUT) score, based on serum albumin, total cholesterol and lymphocyte count, was used as a tool to assess the nutritional status of included patients. Malnourished patients were defined as those with a CONUT score of 5 to 12. To account for the impact of frailty, a frailty index (FI) was determined using the health deficit accumulation model (Table 1). The primary outcome was 1-year all-cause mortality. The secondary outcome was a composite of in-hospital heart failure, cardiogenic shock, re-infarction, major bleeding, stroke, and all-cause mortality. A multivariable model adjusting for baseline covariates, including frailty index score, was performed (Figure 1).
Results
Among 1,169 STEMI patients receiving pPCI, 315 (26.9%) were classified as malnourished. Malnourished patients were older (mean 77.4 vs. 76.0 years, p=0.009) and had a higher comorbidity burden. After multivariable adjustment, worsening malnutrition was associated with increased 1-year all-cause mortality (odds ratio [OR] = 1.29, p<0.001). Worsening malnutrition was also associated with a higher incidence of the in-hospital composite adverse outcome (OR = 1.12, p=0.003) and increased in-hospital all-cause mortality (OR=1.41, p<0.001).
Conclusion
Among STEMI patients receiving pPCI, 1 in 4 were malnourished. Malnutrition was associated with increased rate of in-hospital composite adverse outcome and worse long-term outcomes, even when accounting for frailty. Efforts to routinely identify malnourished STEMI patients and to implement best practices to reduce the risk of adverse events in this vulnerable population are warranted.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Hosseini
- University of British Columbia, Division of Cardiology, Department of Medicine , Vancouver , Canada
| | - I Pitcher
- University of British Columbia, Division of Cardiology, Department of Medicine , Vancouver , Canada
| | - M Kang
- University of British Columbia, Faculty of Medicine , Vancouver , Canada
| | - M MacKay
- University of British Columbia, Centre for Health Evaluation and Outcome Sciences , Vancouver , Canada
| | - J Singer
- University of British Columbia, Division of Cardiology, Department of Medicine , Vancouver , Canada
| | - T Lee
- University of British Columbia, Division of Cardiology, Department of Medicine , Vancouver , Canada
| | - K Madden
- University of British Columbia, Division of Geriatric Medicine, Department of Medicine , Vancouver , Canada
| | - J Cairns
- University of British Columbia, Division of Cardiology, Department of Medicine , Vancouver , Canada
| | - G Wong
- University of British Columbia, Division of Cardiology, Department of Medicine , Vancouver , Canada
| | - C Fordyce
- University of British Columbia, Division of Cardiology, Department of Medicine , Vancouver , Canada
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19
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Zhou C, A. Xiong, Fang J, Li X, Fan Y, Zhuang W, Xie Q, Ma Z, Kang M, Xu T, Xu M, Zhi L, Liu Q, Wang N. 1022P A phase II study of KN046 (a bispecific anti-PD-L1/CTLA-4) in patients with metastatic non-small cell lung cancer (NSCLC) who failed first line treatment. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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20
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Wang CR, Kang M, Xu J, Lyu Y, Jiang YF, Sun MX, Zuo DQ, Shen JK, Ma XJ, Sun W, Hua YQ, Cai Z. [An exploratory clinical study of the efficacy and safety of tumor-infiltrating lymphocytes in the treatment of metastatic osteosarcoma]. Zhonghua Yi Xue Za Zhi 2022; 102:2421-2427. [PMID: 36000370 DOI: 10.3760/cma.j.cn112137-20220101-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the safety and efficacy of tumor-infiltrating lymphocytes (TILs) extracted from tumor tissue in patients with pulmonary metastasis of osteosarcoma, the TILs were amplified in vitro to reach clinical dosage and reinfused to the patients combined with high-dose interleukin 2 (IL-2). Methods: Twelve subjects with pathologically diagnosed osteosarcoma were enrolled from December 2019 to June 20, 2021 in Shanghai General Hospital. All subjects progressed with metastasis after standard chemotherapy and failed multiple lines of treatments. Fresh tumor tissue was obtained from the metastatic site and extracted and amplified by Good Manufacturing Practice (GMP) workshop to produce TILs to clinical treatment dosage (109-1011). High-dose IL-2 (100 000-200 000 U/kg) was administered immediately after autogenous TILs infusion to promote the activation, proliferation and antitumor cytolytic activity in vivo. Adverse events (AE) were graded according to Common Terminology Criteria for Adverse Events (CTCAE) standard and tumor response was assessed according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Results: One patient did not receive treatment due to failure in isolating TILs, total of 11 patients received a single re-infusion of autologous TILs. There were 10 males and 1 female with a median age of 19.9 years (12-33 years). Six of these patients received higher dose levels of 1.0×1010 TILs. The 11 patients were followed-up for 1 to 13 months and tolerated well. The most common adverse events reported were fever (10/11), constipation (3/11) and elevated gamma-glutamyl transferase (GGT) (3/11). The high incidence of fever was due to the IL-2 infusion. All patients experienced a transient drop in lymphocyte count and leukopenia leading to non-myeloid ablative lymphocyte clearance. The AE included grade 4 hematologic toxicity, including 8 cases of lymphocytopenia, 2 cases of neutropenia and 1 case of thrombocytopenia. No AE of neurotoxicity occurred. Of all the 11 patients, 9 patients got stable disease (SD) and 2 patients had progressive disease (PD). The disease control rate was 9/11. The median duration of SD was more than 4 months, and the maximum tumor volume decreased by close to 20%. Patient number 9 had sustained SD status for more than 6 months. Conclusions: TILs with in vitro expansion ability could be isolated from tumor tissues of advanced osteosarcoma patients. TILs amplified and reinfused in vitro have anti-osteosarcoma activity.
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Affiliation(s)
- C R Wang
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China
| | - M Kang
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China Shanghai Cell Therapy Clinical Transformation Engineering Technology Research Center, Shanghai 200080, China
| | - J Xu
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China
| | - Y Lyu
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China
| | - Y F Jiang
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China
| | - M X Sun
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China
| | - D Q Zuo
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China
| | - J K Shen
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China
| | - X J Ma
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China
| | - W Sun
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China
| | - Y Q Hua
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China Shanghai Cell Therapy Clinical Transformation Engineering Technology Research Center, Shanghai 200080, China
| | - Zhengdong Cai
- Department of Bone Tumor, Shanghai General Hospital, Shanghai 200080, China
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21
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Baird TR, Akbarali HI, Dewey WL, Elder H, Kang M, Marsh SA, Peace MR, Poklis JL, Santos EJ, Negus SS. Opioid-like adverse effects of tianeptine in male rats and mice. Psychopharmacology (Berl) 2022; 239:2187-2199. [PMID: 35211768 PMCID: PMC10055856 DOI: 10.1007/s00213-022-06093-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/13/2022] [Indexed: 01/22/2023]
Abstract
RATIONALE Tianeptine is a mu-opioid receptor (MOR) agonist with increasing reports of abuse in human populations. Preclinical data regarding the abuse potential and other opioid-like adverse effects of tianeptine at supratherapeutic doses are sparse. OBJECTIVES The present study evaluated tianeptine in a rat model of abuse potential assessment and in mouse models of motor, gastrointestinal, and respiratory adverse effects. METHODS Abuse potential was assessed in adult male Sprague-Dawley rats using an intracranial self-stimulation (ICSS) procedure to determine effects of acute and repeated tianeptine on responding for electrical brain stimulation. Male ICR mice were used to determine the effects of tianeptine in assays of locomotor behavior and gastrointestinal motility. Male Swiss-Webster mice were monitored for respiratory changes using whole-body plethysmography. RESULTS In rats, acute tianeptine produced weak and delayed evidence for abuse-related ICSS facilitation at an intermediate dose (10 mg/kg, IP) and pronounced, naltrexone-preventable ICSS depression at a higher dose (32 mg/kg, IP). Repeated 7-day tianeptine (10 and 32 mg/kg/day, IP) produced no increase in abuse-related ICSS facilitation, only modest tolerance to ICSS depression, and no evidence of physical dependence. In mice, tianeptine produced dose-dependent, naltrexone-preventable locomotor activation. Tianeptine (100 mg/kg, SC) also significantly inhibited gastrointestinal motility and produced naloxone-reversible respiratory depression. CONCLUSIONS Tianeptine presents as a MOR agonist with resistance to tolerance and dependence in our ICSS assay in rats, and it has lower abuse potential by this metric than many commonly abused opioids. Nonetheless, tianeptine produces MOR agonist-like acute adverse effects that include motor impairment, constipation, and respiratory depression.
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Affiliation(s)
- T R Baird
- Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, 1000 West Cary St., Richmond, VA, 23284, USA.,Department of Forensic Science, Virginia Commonwealth University, 1015 Floyd Avenue, Richmond, VA, 23284, USA
| | - H I Akbarali
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, 410 N. 12th St, Richmond, VA, 23298, USA
| | - W L Dewey
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, 410 N. 12th St, Richmond, VA, 23298, USA
| | - H Elder
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, 410 N. 12th St, Richmond, VA, 23298, USA
| | - M Kang
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, 410 N. 12th St, Richmond, VA, 23298, USA
| | - S A Marsh
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, 410 N. 12th St, Richmond, VA, 23298, USA
| | - M R Peace
- Department of Forensic Science, Virginia Commonwealth University, 1015 Floyd Avenue, Richmond, VA, 23284, USA
| | - J L Poklis
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, 410 N. 12th St, Richmond, VA, 23298, USA
| | - E J Santos
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, 410 N. 12th St, Richmond, VA, 23298, USA
| | - S S Negus
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, 410 N. 12th St, Richmond, VA, 23298, USA.
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22
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Huang Y, Li YH, Xie SL, Rong ZH, Li BS, Kang M, Deng AP, Li Y. [Progress in research of 2019-nCoV Omicron variant]. Zhonghua Liu Xing Bing Xue Za Zhi 2022; 43:655-662. [PMID: 35589568 DOI: 10.3760/cma.j.cn112338-20220121-00061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
2019-nCoV Omicron (B.1.1.529) variant, which has brought new challenges to the prevention and control of COVID-19 pandemic, has the characteristics of stronger transmissibility and more rapid transmission and more significant immune evasion. It took only two months to become a predominant strain worldwide after its identification in South Africa in November 2021. Local epidemics caused by Omicron variant have been reported in several provinces in China. However, the epidemiological characteristics of highly mutated Omicron variant remain unclear. This article summarizes the progress in the research of functional mutations, transmissibility, virulence, immune evasion and cross-reactive immune responses of Omicron variant, to provide references for the effective prevention and control of COVID-19 pandemic caused by Omicron variant.
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Affiliation(s)
- Y Huang
- Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Y H Li
- Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - S L Xie
- Institute for AIDS Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Z H Rong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - B S Li
- Institute of Pathogenic Microbiology, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - M Kang
- Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - A P Deng
- Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Y Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
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23
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Wang XL, Yang Y, Kang M, Li SN, Lai JM. [A case of juvenile idiopathic arthritis with rheumatoid nodules]. Zhonghua Er Ke Za Zhi 2022; 60:474-475. [PMID: 35488646 DOI: 10.3760/cma.j.cn112140-20220114-00047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- X L Wang
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020,China
| | - Y Yang
- Department of Radiology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - M Kang
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020,China
| | - S N Li
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020,China
| | - J M Lai
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020,China
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24
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Li SN, Lai JM, Kang M, Yue T, Wang XL. [Clinical analysis of 5 cases of systemic juvenile idiopathic arthritis with coronary artery dilatation]. Zhonghua Er Ke Za Zhi 2022; 60:462-465. [PMID: 35488642 DOI: 10.3760/cma.j.cn112140-20210923-00818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To investigate the clinical characteristics of systemic juvenile idiopathic arthritis combined with coronary artery dilatation. Methods: A retrospective analysis was performed on the clinical data, including clinical manifestations, blood routine, inflammatory factors, echocardiography, vascular ultrasound and CT angiography, treatment and outcomes, etc, of 5 cases with systemic juvenile idiopathic arthritis combined with coronary artery dilation admitted to Department of Rheumatology in the affiliated Children's Hospital of Capital Institute of Pediatrics from May 2019 to June 2021. Results: There were 2 males and 3 females among 5 cases. The onset age ranged from 7 months to 4 years 7 months.The diagnostic time ranged from 1.5 months to 3.0 months.Four cases were diagnosed as atypical Kawasaki disease. Three cases showed unilateral coronary artery dilation.Two cases showed bilateral coronary artery dilation.Four cases developed multiple organ injuries.Three cases developed macrophage activation syndrome.Three cases developed lung injury.Two cases developed pericardial effusion.One case developed pulmonary hypertension.As for treatment, 3 cases treated with methylprednisolone pulse therapy and methotrexate combined with cyclosporine, improved after the final application of biological agents, and have stopped prednisone. The other 2 cases were treated with adequate oral prednisone and gradually reduced, and methotrexate was added at the same time, 1 case relapsed in the process of reduction. No other vascular involvement was found in 5 cases. Coronary artery dilation recovered completely after 1 to 3 months of treatment. Conclusions: Systemic juvenile idiopathic arthritis combined with coronary artery dilatation has the clinical characteristics of small onset age, long diagnostic time, prone to multiple organ injuries. Corticosteroids and conventional immunosuppressive agents are not sensitive, and biological agents should be used as soon as possible.The prognosis of coronary artery dilation is good after timely treatment.
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Affiliation(s)
- S N Li
- Department of Rheumatology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - J M Lai
- Department of Rheumatology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - M Kang
- Department of Rheumatology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - T Yue
- Department of Rheumatology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - X L Wang
- Department of Rheumatology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
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25
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Kang M, Shin T, Lee Y, Shin S, Seungjung S, Sungyoung C, Seong Soo A A, Jaewoo S, In Bum S, Hoyoung Y. M012 Filterless-filter: Centrifuge-free microfluidic cell separation technology. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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26
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Vujovich-Dunn C, Wand H, Brotherton JML, Gidding H, Sisnowski J, Lorch R, Veitch M, Sheppeard V, Effler P, Skinner SR, Venn A, Davies C, Hocking J, Whop L, Leask J, Canfell K, Sanci L, Smith M, Kang M, Temple-Smith M, Kidd M, Burns S, Selvey L, Meijer D, Ennis S, Thomson C, Lane N, Kaldor J, Guy R. Measuring school level attributable risk to support school-based HPV vaccination programs. BMC Public Health 2022; 22:822. [PMID: 35468743 PMCID: PMC9036743 DOI: 10.1186/s12889-022-13088-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/24/2022] [Indexed: 12/27/2022] Open
Abstract
Background In Australia in 2017, 89% of 15-year-old females and 86% of 15-year-old males had received at least one dose of the HPV vaccine. However, considerable variation in HPV vaccination initiation (dose one) across schools remains. It is important to understand the school-level characteristics most strongly associated with low initiation and their contribution to the overall between-school variation. Methods A population-based ecological analysis was conducted using school-level data for 2016 on all adolescent students eligible for HPV vaccination in three Australian jurisdictions. We conducted logistic regression to determine school-level factors associated with lower HPV vaccination initiation (< 75% dose 1 uptake) and estimated the population attributable risk (PAR) and the proportion of schools with the factor (school-level prevalence). Results The factors most strongly associated with lower initiation, and their prevalence were; small schools (OR = 9.3, 95%CI = 6.1–14.1; 33% of schools), special education schools (OR = 5.6,95%CI = 3.7–8.5; 8% of schools), higher Indigenous enrolments (OR = 2.7,95% CI:1.9–3.7; 31% of schools), lower attendance rates (OR = 2.6,95%CI = 1.7–3.7; 35% of schools), remote location (OR = 2.6,95%CI = 1.6–4.3; 6% of schools,) and lower socioeconomic area (OR = 1.8,95% CI = 1.3–2.5; 33% of schools). The highest PARs were small schools (PAR = 79%, 95%CI:76–82), higher Indigenous enrolments (PAR = 38%, 95%CI: 31–44) and lower attendance rate (PAR = 37%, 95%CI: 29–46). Conclusion This analysis suggests that initiatives to support schools that are smaller, with a higher proportion of Indigenous adolescents and lower attendance rates may contribute most to reducing the variation of HPV vaccination uptake observed at a school-level in these jurisdictions. Estimating population-level coverage at the school-level is useful to guide policy and prioritise resourcing to support school-based vaccination programs. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13088-x.
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Affiliation(s)
- C Vujovich-Dunn
- University of New South Wales, Kirby Institute, Kensington, Australia.
| | - H Wand
- University of New South Wales, Kirby Institute, Kensington, Australia
| | - J M L Brotherton
- Australian Centre for the Prevention of Cervical Cancer, Population Health, East Melbourne, Victoria, Australia.,University of Melbourne, Melbourne School of Population and Global Health, Carlton, VIC, Australia
| | - H Gidding
- University of Sydney, Northern Clinical School, Sydney, Australia.,Women and Babies Research, Kolling Institute, Northern Sydney Local Health District, Sydney, Australia.,School of Population Health, University of New South Wales, Kensington, Australia.,National Centre for Immunisation Research and Surveillance, Sydney, Australia
| | - J Sisnowski
- University of New South Wales, Kirby Institute, Kensington, Australia.,Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia
| | - R Lorch
- University of New South Wales, Kirby Institute, Kensington, Australia
| | - M Veitch
- Department of Health and Human Services, Tasmanian Government, Hobart, Australia
| | - V Sheppeard
- Communicable Diseases Branch, NSW Health, St Leonards, New South Wales, Australia.,University of Sydney, Sydney School of Public Health, Camperdown, NSW, Australia
| | - P Effler
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia
| | - S R Skinner
- University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney, Australia.,Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia
| | - A Venn
- Menzies Institute for Medical Research, University of Tasmania, Tasmanian, Australia
| | - C Davies
- University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney, Australia.,Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia
| | - J Hocking
- University of Melbourne, Melbourne School of Population and Global Health, Carlton, VIC, Australia
| | - L Whop
- Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia.,Menzies School of Health Research, Charles Darwin University, Cairns, QLD, Australia
| | - J Leask
- National Centre for Immunisation Research and Surveillance, Sydney, Australia.,University of Sydney, Sydney Nursing School, Faculty of Medicine and Health, Camperdown, NSW, Australia
| | - K Canfell
- The Daffodil Centre, University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia
| | - L Sanci
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia
| | - M Smith
- The Daffodil Centre, University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, Australia.,School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - M Kang
- University of Sydney, Westmead Clinical School, Sydney, New South Wales, Australia
| | - M Temple-Smith
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia
| | - M Kidd
- Flinders University, Southgate Institute for Health, Society and Equity, Bedford Park, South Australia, Australia
| | - S Burns
- Curtin University, School of Population Health, Bentley, WA, Australia
| | - L Selvey
- University of Queensland, School of Public Health, St Lucia, QLD, Australia
| | - D Meijer
- Immunisation Unit, Health Protection NSW, St Leonard's, New South Wales, Australia
| | - S Ennis
- Immunisation Unit, Health Protection NSW, St Leonard's, New South Wales, Australia
| | - C Thomson
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia
| | - N Lane
- Department of Health and Human Services, Tasmanian Government, Hobart, Australia
| | - J Kaldor
- University of New South Wales, Kirby Institute, Kensington, Australia
| | - R Guy
- University of New South Wales, Kirby Institute, Kensington, Australia
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27
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Zhou Y, Liang WJ, Chen ZH, Liu T, Song T, Chen SW, Wang P, Li JL, Lan YH, Cheng MJ, Huang JX, Niu JW, Xiao JP, Hu JX, Lin LF, Huang Q, Deng AP, Tan XH, Kang M, Chen GM, Dong MR, Zhong HJ, Ma W. [Course of disease and related epidemiological parameters of COVID-19: a prospective study based on contact tracing cohort]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:474-478. [PMID: 35488546 DOI: 10.3760/cma.j.cn112150-20220107-00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To analyze the course of disease and epidemiological parameters of COVID-19 and provide evidence for making prevention and control strategies. Methods: To display the distribution of course of disease of the infectors who had close contacts with COVID-19 cases from January 1 to March 15, 2020 in Guangdong Provincial, the models of Lognormal, Weibull and gamma distribution were applied. A descriptive analysis was conducted on the basic characteristics and epidemiological parameters of course of disease. Results: In total, 515 of 11 580 close contacts were infected, with an attack rate about 4.4%, including 449 confirmed cases and 66 asymptomatic cases. Lognormal distribution was fitting best for latent period, incubation period, pre-symptomatic infection period of confirmed cases and infection period of asymptomatic cases; Gamma distribution was fitting best for infectious period and clinical symptom period of confirmed cases; Weibull distribution was fitting best for latent period of asymptomatic cases. The latent period, incubation period, pre-symptomatic infection period, infectious period and clinical symptoms period of confirmed cases were 4.50 (95%CI:3.86-5.13) days, 5.12 (95%CI:4.63-5.62) days, 0.87 (95%CI:0.67-1.07) days, 11.89 (95%CI:9.81-13.98) days and 22.00 (95%CI:21.24-22.77) days, respectively. The latent period and infectious period of asymptomatic cases were 8.88 (95%CI:6.89-10.86) days and 6.18 (95%CI:1.89-10.47) days, respectively. Conclusion: The estimated course of COVID-19 and related epidemiological parameters are similar to the existing data.
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Affiliation(s)
- Y Zhou
- School of Public Health, Southern Medical University, Guangzhou 510515, China Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - W J Liang
- Institute of Immunization Programme, Guangdong Provincial Center for Disease Control and Prevention; Guangzhou 511430, China
| | - Z H Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - T Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - T Song
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - S W Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - P Wang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - J L Li
- Institute of Immunization Programme, Guangdong Provincial Center for Disease Control and Prevention; Guangzhou 511430, China
| | - Y H Lan
- Institute of Immunization Programme, Guangdong Provincial Center for Disease Control and Prevention; Guangzhou 511430, China
| | - M J Cheng
- Institute of Disinfection and Vector Control, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - J X Huang
- Institute of Environment and School Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - J W Niu
- Institute of Environment and School Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - J P Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - J X Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - L F Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Q Huang
- Institute of Nutrition and Food Safety, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - A P Deng
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - X H Tan
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - M Kang
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - G M Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - M R Dong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - H J Zhong
- Public Health Emergency Preparedness and Response Division, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Wenjun Ma
- School of Public Health, Southern Medical University, Guangzhou 510515, China Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
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Chi Y, Lai JM, Su GX, Kang M, Li SN, Zhang D, Wang XN. [Treatment of 11 cases of juvenile idiopathic arthritis by intra-articular injection of adalimumab]. Zhonghua Er Ke Za Zhi 2022; 60:237-241. [PMID: 35240745 DOI: 10.3760/cma.j.cn112140-20210923-00814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To evaluate the efficacy and safety of intra-articular injection of adalimumab (ADA) in the treatment of refractory oligoarticular juvenile idiopathic arthritis (JIA). Methods: This was a retrospective study. Clinical data on age, gender, and symptoms of joint swelling and pain were collected from 11 children with refractory oligoarticular JIA involving only knee joints admitted to Department of Rheumatism and Immunology of Children's Hospital, Capital Institute of Pediatrics from November 2019 to October 2020. The physician and parent-child evaluation of disease activity, the number of active joints, and the level of erythrocyte sedimentation rate (ESR) at different treatment time points were analyzed at every 4-week observation point after drug administration, and the non-parametric Kruskal-Wallis test was used to compare the differences in clinical evaluation indicators and changes in laboratory tests at different treatment times. The follow-up period was 6 months. Results: Among the 11 children, 5 were boys and 6 were girls. The age was 3.0 (2.8) years. All 11 children had symptoms of joint swelling and pain as well as limitation of movement. After 3 intra-articular injections of ADA, the joint symptoms of 11 children were better than before treatment; the joint symptoms of 7 children disappeared completely, and no recurrence occurred during the 6-month follow-up period. At different treatment times, physician and parent-child evaluation of disease activity, a gradual decrease in the number of active joints in the children, ESR, and juvenile arthritis disease activity score with 27 joints were all statistically significant (χ2=53.99, 59.37, 32.87, 40.07, 54.00, all P<0.001).No significant adverse drug reactions were observed in any of the 11 children during treatment and follow-up. Conclusion: Intra-articular injection of ADA in the treatment of refractory oligoarticular JIA has a significant effect in controlling joint symptoms and is relatively safe.
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Affiliation(s)
- Y Chi
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - J M Lai
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - G X Su
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - M Kang
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - S N Li
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - D Zhang
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - X N Wang
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
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Wei S, Lin H, Hajj C, Press R, Chhabra A, Choi I, Hasan S, Simone II C, Kang M. FLASH in the Clinic Track (Oral Presentations) DOSE AND DOSE RATE QUANTIFICATION FOR LIVER FLASH TREATMENT PLANNING USING PROTON PBS TRANSMISSION BEAMS. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01471-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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30
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Tan XH, Kang M, Deng AP, Li BS, Luo M, Yi Y, Zhuang YL, Zhang YT, Song T. [Analysis on characteristics and influencing factors of COVID-19 confirmed cases with viral nucleic acid re-positive after discharge in Guangdong Province]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:49-55. [PMID: 35092991 DOI: 10.3760/cma.j.cn112150-20211108-01034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To analyze the epidemiological characteristics and influencing factors of COVID-19 confirmed cases with viral nucleic acid re-positive in anal and/or throat swabs after discharge during the domestic imported epidemic stage in Guangdong Province in early 2020. Methods: The COVID-19 confirmed cases with the onset time before March 1, 2020 in Guangdong Province were collected to analyze the demographic data, epidemiological characteristics, and specimen collection and testing data after discharge. Logistic regression model was used for influencing factors analysis of re-positive cases. Results: A total of 1 286 COVID-19 confirmed cases were included, the M(Q1,Q3) of age was 44(32,58)years, 617 cases were male, 224 cases were re-positive in anal and/or throat swabs with the re-positive rate 17.42%. The M(Q1,Q3) of age of re-positive cases was 35(23, 50) years, which was younger than that of re-negative cases age was those 46(33, 59) years (P<0.001). With the increase of age, re-positive rate decreased (χ2trend=52.73, P<0.001). 85.27% (191/224) of re-positive cases were found in 14 d after discharge, the duration time of re-positive status was 13(7, 24) d, and 81.69% (183/224) of re-positive cases were re-tested negative in 28 d after re-positive date. No fever and other symptoms had been observed among re-positive cases during the whole follow-up. No secondary infectious cases had been found among close contacts after 14 d of centralized isolation and sampling screening. Univariate logistic regression model analysis revealed that the influencing factors of the re-positive cases included age, occupation, clusters, clinical types, and admission time. Multivariate logistic regression model analysis revealed that age was an independent risk factor. Conclusions: SARS-CoV-2 viral nucleic acid re-positive is found in COVID-19 confirmed cases after discharge in Guangdong Province. Most re-positive cases are confirmed among 14 d after discharge and re-test to negative among 28 d after re-positive date. Age is an risk factor for re-positive cases after discharge.
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Affiliation(s)
- X H Tan
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - M Kang
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - A P Deng
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - B S Li
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - M Luo
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Y Yi
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Y L Zhuang
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Y T Zhang
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - T Song
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
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31
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Youk S, Le MT, Kang M, Ahn B, Choi M, Kim K, Kim TH, Kim JH, Ho CS, Park C. Development of a high-resolution typing method for SLA-3, swine MHC class I antigen 3. Anim Genet 2021; 53:166-170. [PMID: 34910829 DOI: 10.1111/age.13161] [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] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
We developed a high-resolution and comprehensive typing method for swine leukocyte antigen 3 (SLA-3), an MHC class I gene, employing locus-specific genomic PCR followed by subsequent direct sequencing. A total of 292 individuals from nine pure, one cross-breed and six cell lines were successfully typed. A total of 21 SLA-3 alleles were identified, of which four were found to be novel alleles. However, the allelic diversity of SLA-3 was lower than that of previously reported class I genes, SLA-1 and -2. More SLA-3 alleles were observed in the Landrace and Yorkshire breeds than the other breeds. SLA-3*04:01 was identified in seven out of nine breeds and was the most widely distributed allele across all breeds. Therefore, the typing method reported in this study completes our efforts to develop high-resolution typing methods for major SLA molecules, facilitating the combined analysis of major SLA genes from field samples, which is important to understand the relationship between the adaptive immune responses against pathogens and the immunogenetic makeup of an individual.
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Affiliation(s)
- S Youk
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - M T Le
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - M Kang
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - B Ahn
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - M Choi
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - K Kim
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea.,Livestock Support Department, National Agricultural Cooperative Federation Agribusiness Group, Seoul, 04516, Korea
| | - T H Kim
- Animal Genomics and Bioinformatics Division, National Institute of Animal Science, RDA, Wanju, 55365, Korea
| | - J H Kim
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - C S Ho
- Gift of Hope Organ and Tissue Donor Network, 425 Spring Lake Drive, Itasca, IL, 60143, USA
| | - C Park
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
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Magness C, Kang M, Kennedy M, Alexander S, O'Boyle C, Hasham S, Shepherd L. 1312 Characteristics of Those Who Present with Self-Inflicted Burns: A Burns Unit Service Evaluation Which Challenges Stereotypes. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.725] [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: 11/12/2022]
Abstract
Abstract
Introduction
Self-harm rates in the UK are increasing. Healthcare professionals’ beliefs regarding repeat attendance; attention-seeking; and poor treatment compliance may contribute to patients’ stigma. Self-inflicted burns (SIB) constitute a minority of burns cases, but require disproportionate healthcare input, yet little is known about these patients. Our aim was to evaluate presentations, compliance and outcomes in this patient group.
Method
A retrospective audit of outpatients with SIBs attending a UK Burns Unit over four years (Jan 2016-Dec 2019).
Results
Over the study period, 58 patients presented with 94 burn wounds. Incidence doubled over one year (2018-2019). Most patients were female (85%) with a median age of 29 years (range 19-62). The most commonly associated psychiatric diagnosis was personality disorder. On presentation 22% (n = 21) were admitted under the Mental Health Act. For 83% (n = 48) it was their first presentation with a SIB, although 74% had previously presented with non-burn self-harm. Median burn size was 0.5% TBSA, the most common mechanism was contact (48%) and 77% were deep (n = 77). 92% were compliant with treatment and did not tamper with their wounds or dressings.
Conclusions
The majority, 70% (n = 41), of patients only presented once to the Burns Department during the study period. This challenges the commonly held stereotype that those who self-harm will also seek attention through repeat presentation. Ongoing education among health professionals may dispel some myths regarding these individuals. Further, larger investigations, may permit rigorous comparison of treatment outcomes with non-SIB patients.
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Affiliation(s)
- C Magness
- Burns and Plastic Surgery Department, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom
| | - M Kang
- Burns and Plastic Surgery Department, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom
| | - M Kennedy
- Burns and Plastic Surgery Department, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom
| | - S Alexander
- Burns and Plastic Surgery Department, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom
| | - C O'Boyle
- Burns and Plastic Surgery Department, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom
| | - S Hasham
- Burns and Plastic Surgery Department, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom
| | - L Shepherd
- Burns and Plastic Surgery Department, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham, United Kingdom
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Hou J, Song FY, Xu YJ, Su GX, Kang M, Li SN, Wu FQ, Zhou ZX, Lai JM. [Analysis of 13 cases with pediatric rheumatic disease combined with endocrine disorder]. Zhonghua Er Ke Za Zhi 2021; 59:865-870. [PMID: 34587684 DOI: 10.3760/cma.j.cn112140-20210303-00178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To summarize the clinical characteristics of children with rheumatic disease combined with endocrine disorder. Methods: A retrospective analysis was performed on the clinical data, including sex, age, clinical presentation, laboratory tests, treatment and outcome, of 13 patients with rheumatic diseases combined with endocrine disorder, who were admitted to our department in Children's Hospital, Capital Institute of Pediatrics from January 2014 to December 2020. Results: Among the 13 cases, 3 were males and 10 were females, without family history. Their age was (10±4) years. And the average course of disease was 4.1 months. Eight of them were diagnosed with systemic lupus erythematosus (JSLE), 2 with juvenile idiopathic arthritis (JIA), 1 with childhood vasculitis, 1 with juvenile-onset systemic sclerosis (JSSc) and 1 had juvenile dermatomyositis (JDM). Regarding the initial presentation, 10 cases had symptoms of rheumatic disease, 2 had polydipsia and polyuria, and 1 had goiter. All the 13 patients had multiple system involvement. Regarding endocrine disorder, 10 had thyroiditis or subclinical thyroiditis, 4 had diabetes mellitus and one had both thyroid and pancreas involvement. Thyroid stimulating hormone in 10 patient with thyroid involvment was 19.6 (5.2-34.0) mU/L, and their total thyroxine was 75.3 (45.2-105.4) nmol/L. Besides, thyroid peroxidase antibody or thyroglobulin antibody was positive in 7 cases. The blood glucose of 4 children with pancreatic injury was 25.0 (17.0-33.0) mmol/L, and C-peptide was 0.4 (0.3-0.5) mg/L. Glutamate dehydrogenase antibody, protein tyrosine phosphatase antibody and zinc transporter 8 antibody were positive in two cases. After treatement with immunosuppressant or immunoglobulin combined with glucocorticoid or nonsteroidal antiinflammatory drugs for rheumatic symptoms, and levothyroxine or insulin for endocrine diseases, they were all followed up for more than 6 months and maintained clinical stability. Conclusions: Rheumatic diseases in children can be complicated with endocrine disorders, and the involved organs are usually thyroid and pancreas. In children with rheumatic disease, thyroid injury usually has subtle onset, whereas pancreas injury develops rapidly, even life-threatening. Insulin should be used persistently under the instruction of endocrinologist.
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Affiliation(s)
- J Hou
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - F Y Song
- Department of Endocrinology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y J Xu
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - G X Su
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - M Kang
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - S N Li
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - F Q Wu
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Z X Zhou
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - J M Lai
- Department of Rheumatology and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
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Sisnowski J, Vujovich-Dunn C, Gidding H, Brotherton J, Wand H, Lorch R, Veitch M, Sheppeard V, Effler P, Skinner SR, Venn A, Davies C, Hocking J, Whop L, Leask J, Canfell K, Sanci L, Smith M, Kang M, Temple-Smith M, Kidd M, Burns S, Selvey L, Meijer D, Ennis S, Thomson C, Lane N, Kaldor J, Guy R. Differences in school factors associated with adolescent HPV vaccination initiation and completion coverage in three Australian states. Vaccine 2021; 39:6117-6126. [PMID: 34493408 DOI: 10.1016/j.vaccine.2021.08.076] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Schools are the primary setting for the delivery of adolescent HPV vaccination in Australia. Although this strategy has achieved generally high vaccination coverage, gaps persist for reasons that are mostly unknown. This study sought to identify school-level correlates of low vaccination course initiation and completion in New South Wales, Tasmania, and Western Australia to inform initiatives to increase uptake. METHODS Initiation was defined as the number of first doses given in a school in 2016 divided by vaccine-eligible student enrolments. Completion was the number of third doses given in a school in 2015-2016 divided by the number of first doses. Low initiation and completion were defined as coverage ≤ 25thpercentile of all reporting schools. We investigated correlations between covariates using Spearman's rank correlation coefficients. Due to multicollinearity, we used univariable logistic regression to investigate associations between school characteristics and low coverage. RESULTS Median initiation was 84.7% (IQR: 75.0%-90.4%) across 1,286 schools and median completion was 93.8% (IQR: 86.0%-97.3%) across 1,295 schools. There were strong correlations between a number of school characteristics, particularly higher Indigenous student enrolments and lower attendance, increasing remoteness, higher postcode socioeconomic disadvantage, and smaller school size. Characteristics most strongly associated with low initiation in univariate analyses were small school size, location in Tasmania, and schools catering for special educational needs. Low completion was most strongly associated with schools in Tasmania and Western Australia, remote location, small size, high proportion of Indigenous student enrolments, and low attendance rates. CONCLUSION This study provides indicative evidence that characteristics of schools and school populations are associated with the likelihood of low initiation and completion of the HPV vaccination course. The findings will guide further research and help target initiatives to improve vaccination uptake in schools with profiles associated with lower coverage.
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Affiliation(s)
- J Sisnowski
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia; Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia.
| | - C Vujovich-Dunn
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - H Gidding
- University of New South Wales, School of Public Health and Community Medicine, Kensington, Australia; National Centre for Immunisation Research and Surveillance, Westmead, Australia; The University of Sydney Northern Clinical School, St Leonards, Australia.
| | - J Brotherton
- Population Health, VCS Foundation, East Melbourne, Victoria, Australia; University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.
| | - H Wand
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - R Lorch
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - M Veitch
- Tasmanian Government, Department of Health and Human Services, Hobart, Australia.
| | - V Sheppeard
- Communicable Diseases Branch, Health Protection NSW, St Leonards, New South Wales, Australia; University of Sydney, Sydney School of Public Health, Camperdown, New South Wales, Australia.
| | - P Effler
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia.
| | - S R Skinner
- Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia; University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
| | - A Venn
- Menzies Institute for Medical Research, University of Tasmania, Tasmanian, Australia.
| | - C Davies
- Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia; University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
| | - J Hocking
- University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.
| | - L Whop
- Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia; Menzies School of Health Research, Charles Darwin University, Cairns, Queensland, Australia.
| | - J Leask
- National Centre for Immunisation Research and Surveillance, Westmead, Australia; University of Sydney, Sydney Nursing School, Faculty of Medicine and Health, Camperdown, New South Wales, Australia.
| | - K Canfell
- Cancer Research Division, Cancer Council, New South Wales, Australia.
| | - L Sanci
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, Victoria, Australia.
| | - M Smith
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia; Cancer Research Division, Cancer Council, New South Wales, Australia.
| | - M Kang
- University of Sydney, Westmead Clinical School, New South Wales, Australia.
| | - M Temple-Smith
- University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, Victoria, Australia.
| | - M Kidd
- Flinders University, Southgate Institute for Health, Society and Equity, South Australia, Australia.
| | - S Burns
- Curtin University, School of Population Health, Western Australia, Australia.
| | - L Selvey
- University of Queensland, School of Public Health, Queensland, Australia.
| | - D Meijer
- Immunisation Unit, Health Protection NSW, St Leonards, New South Wales, Australia.
| | - S Ennis
- Immunisation Unit, Health Protection NSW, St Leonards, New South Wales, Australia.
| | - C Thomson
- Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia.
| | - N Lane
- Tasmanian Government, Department of Health and Human Services, Hobart, Australia.
| | - J Kaldor
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
| | - R Guy
- The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia.
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Kim J, Yoo C, Seo S, Jeong J, Ryoo BY, Kim KP, Lee J, Lee KW, Kim JW, Kim IH, Kang M, Ryu H, Cheon J, Park S. 1690P A multicenter randomized phase II open label study to compare the safety and efficacy of direct oral anticoagulants versus subcutaneous dalteparin for cancer-associated venous thromboembolism in patients with advanced upper gastrointestinal, hepatobiliary and pancreatic cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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36
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Sulyanto RM, Kang M, Srirangapatanam S, Berger M, Candamo F, Wang Y, Dickson JR, Ng MW, Ho SP. Biomineralization of Dental Tissues Treated with Silver Diamine Fluoride. J Dent Res 2021; 100:1099-1108. [PMID: 34323107 DOI: 10.1177/00220345211026838] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Silver diamine fluoride (SDF) is a dental biomaterial used to arrest dental caries. To better understand SDF's mechanism of action, we examined the localization of silver within the tissues of SDF-treated teeth. Carious primary teeth fixed within 2 min of SDF application (SDF-minutes, n = 3), at 3 wk after SDF application in vivo (SDF-weeks, n = 4), and at 2 y after multiple SDF applications in vivo (SDF-multiple, n = 1) were investigated in this study. Carious primary teeth without SDF application (no-SDF, n = 3) served as controls. Mineral density and structural analyses were performed via micro-X-ray computed tomography and scanning electron microscopy. Elemental analyses were performed through X-ray fluorescence microprobe and energy-dispersive X-ray spectroscopic techniques. SDF-treated teeth revealed higher X-ray-attenuated surface and subsurface regions within carious lesions, and similar regions were not present in no-SDF teeth. Regions of higher mineral density correlated with regions of silver abundance in SDF-treated teeth. The SDF penetration depth was approximated to 0.5 ± 0.02 mm and 0.6 ± 0.05 mm (mean ± SD) for SDF-minutes and SDF-weeks specimens, respectively. A higher percentage of dentin tubular occlusion by silver or calcium phosphate particles was observed in primary teeth treated with SDF-weeks as compared with SDF-minutes. Elemental analysis also revealed zinc abundance in carious lesions and around the pulp chamber. SDF-weeks teeth had significantly increased tertiary dentin than SDF-minutes and no-SDF teeth. These results suggest that SDF treatment on primary teeth affected by caries promotes pathologic biomineralization by altering their physicochemical properties, occluding dentin tubules, and increasing tertiary dentin volume. These seemingly serendipitous effects collectively contribute to the cariostatic activity of SDF.
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Affiliation(s)
- R M Sulyanto
- Department of Dentistry, Boston Children's Hospital, Boston, MA, USA.,Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA, USA
| | - M Kang
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, USA
| | - S Srirangapatanam
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, USA.,Department of Urology, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - M Berger
- Department of Dentistry, Boston Children's Hospital, Boston, MA, USA.,Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA, USA
| | - F Candamo
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA, USA
| | - Y Wang
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, USA
| | - J R Dickson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - M W Ng
- Department of Dentistry, Boston Children's Hospital, Boston, MA, USA.,Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA, USA
| | - S P Ho
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA, USA.,Department of Urology, School of Medicine, University of California San Francisco, San Francisco, CA, USA
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37
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Gorsi U, Agarwal V, Nair V, Kang M, Kalra N, Sreedhara BC, Gupta R, Rana SS, Dutta U, Sandhu MS. Corrigendum to: "Re: endovascular and percutaneous trans abdominal embolisation of pseudoaneurysms in pancreatitis: an experience from a tertiary care referral centre" [76 (4) e17-e23]. Clin Radiol 2021; 76:629.e19. [PMID: 34045069 DOI: 10.1016/j.crad.2021.04.008] [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: 11/28/2022]
Affiliation(s)
- U Gorsi
- Department of Radiodiagnosis, PGIMER, Chandigarh, India.
| | - V Agarwal
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | - V Nair
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | - M Kang
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | - N Kalra
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | - B C Sreedhara
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | - R Gupta
- Department of Surgery, PGIMER, Chandigarh, India
| | - S S Rana
- Department of Gastroenterology, PGIMER, Chandigarh, India
| | - U Dutta
- Department of Gastroenterology, PGIMER, Chandigarh, India
| | - M S Sandhu
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
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38
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Zhao YY, Luo TY, He D, Kang M, Jiang LL. [Pulmonary space-occupying lesion resulted from Rhodococcus equi infection: report of a case]. Zhonghua Bing Li Xue Za Zhi 2021; 50:400-402. [PMID: 33832005 DOI: 10.3760/cma.j.cn112151-20200713-00553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Y Y Zhao
- Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - T Y Luo
- Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - D He
- Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - M Kang
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
| | - L L Jiang
- Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, China
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Abstract
Forkhead box O1 (FoxO1) is a multifunctional initiator, mediator, and repressor of autoimmune diseases in an organ- or disease-specific manner. However, the role of FoxO1 in the salivary gland has not yet been elucidated. In this study, we discovered that FoxO1 and aquaporin 5 (AQP5) are both significantly downregulated in the patients with primary Sjögren syndrome, an autoimmune disease accompanying salivary gland dysfunction. Pharmacologic or genetic perturbation of FoxO1 in the rat salivary gland acinar cell line, SMG-C6, induced a significant downregulation of AQP5 expression, as observed in clinical specimens. There was a strong correlation between FoxO1 and AQP5 expression because FoxO1 is a direct regulator of AQP5 expression in salivary gland acinar cells through its interaction with the promoter region of AQP5. Serial injection of a FoxO1 inhibitor into mice induced a reduction of AQP5 expression in submandibular glands and, consequently, hyposalivation, which is one of the major clinical symptoms of primary Sjögren syndrome. However, there was no sign of inflammation or cell damage in the submandibular glands harvested from mice treated with the FoxO1 inhibitor. In conclusion, our findings indicate that FoxO1 in salivary gland tissue acts as a direct regulator of AQP5 expression. Thus, downregulation of FoxO1 observed in primary Sjögren syndrome is a putative mechanism for hyposalivation without the involvement of previously reported soluble factors in primary Sjögren syndrome patient sera.
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Affiliation(s)
- S M Lee
- Department of Pharmacology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - S W Lee
- Department of Physiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - M Kang
- Department of Pharmacology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - J K Choi
- Department of Oral Medicine, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - K Park
- Department of Physiology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - J S Byun
- Department of Oral Medicine, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
| | - D Y Kim
- Department of Pharmacology, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
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40
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Hwang S, Kang M, Ham DI, Kong M. Genetic Influence on Choroidal Volume. Am J Ophthalmol 2021; 224:143-149. [PMID: 33340507 DOI: 10.1016/j.ajo.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/03/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the degree of genetic influence on macular choroidal volume. DESIGN A cross-sectional twin and family study. METHODS In total, 353 Korean adults with healthy eyes from 78 households with 2 or more family members were included in the study. Macular choroidal volume was measured using spectral-domain optical coherence tomography with enhanced depth imaging at 9 macular subfields defined by the ETDRS. Demographics and clinical characteristics were investigated, including age, sex, axial length, hypertension, diabetes, drinking habits, and smoking status. The associations of these factors with macular choroidal volume were assessed using univariate and subsequent multivariate regression analyses while accounting for family structure. The heritability estimates of macular choroidal volume in total and at each of the 9 macular subfields were calculated after adjusting the covariates. RESULTS Patients who were younger, male, and had a shorter axial length showed associations with greater choroidal volume (P < .001 for all 3 independent variables). The covariates-adjusted heritability (±standard error) of the total macular choroidal volume was 0.76 ± 0.06, and the heritabilities of choroidal volume at each subfield ranged from 0.55 ± 0.09 (inner temporal subfield) to 0.77 ± 0.08 (inner superior subfield). CONCLUSION The macular choroidal volume is highly heritable.
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Abstract
Acute immune responses to microbial insults in the oral cavity often progress to chronic inflammatory diseases such as periodontitis and apical periodontitis. Chronic oral inflammation causes destruction of the periodontium, potentially leading to loss of the dentition. Previous investigations have demonstrated that the composition of oral immune cells, rather than the overall extent of cellular infiltration, determines the pathological development of chronic inflammation. The role of T lymphocyte populations, including Th1, Th2, Th17, and Treg cells, has been extensively described. Studies now propose pathogenic Th17 cells as a distinct subset, uniquely classifiable from traditional Th17 populations. In situ differentiation of pathogenic Th17 cells has been verified as a source of destructive inflammation, which critically drives pathogenesis in chronic inflammatory diseases such as diabetes, rheumatoid arthritis, and inflammatory bowel disease. Pathogenic Th17 cells resemble a Th1 penotype and produce not only interleukin 17 (IL-17) but also γ-interferon (IFN-γ) and granulocyte-macrophage colony-stimulating factor (GM-CSF). The proinflammatory cytokine-specific mechanisms known to induce IL-17 expression in Th17 cells are well characterized; however, differentiation mechanisms that lead to pathogenic Th17 cells are less understood. Recently, Ca2+ signaling through Ca2+ release-activated Ca2+ channels (CRAC) in T cells has been uncovered as a major signaling axis involved in the regulation of T-cell-mediated chronic inflammation. In particular, pathogenic Th17 cell-mediated immunological diseases appear to be effectively targeted via such Ca2+ signaling pathways. Pathogenic plasticity of Th17 cells has been extensively illustrated in autoimmune and chronic inflammatory diseases. Although their specific causal relationship to oral infection-induced chronic inflammatory diseases is not fully established, pathogenic Th17 cells may be involved in the underlining mechanism. This review highlights the current understanding of T-cell phenotype regulation, calcium signaling pathways in this event, and the potential role of pathogenic Th17 cells in chronic inflammatory disorders of the oral cavity.
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Affiliation(s)
- S Hasiakos
- Division of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, CA, USA.,Department of Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Y Gwack
- Department of Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - M Kang
- Section of Endodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - I Nishimura
- Division of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, CA, USA.,Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA, USA
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Gorsi U, Agarwal V, Nair V, Kang M, Kalra N, Sreedhara BC, Gupta R, Rana SS, Dutta U, Sandhu MS. Endovascular and percutaneous transabdominal embolisation of pseudoaneurysms in pancreatitis: an experience from a tertiary-care referral centre. Clin Radiol 2021; 76:314.e17-314.e23. [PMID: 33526255 DOI: 10.1016/j.crad.2020.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/24/2020] [Indexed: 12/31/2022]
Abstract
AIM To analyse the technical challenges, clinical success, and associated complications of endovascular and percutaneous embolisation of pancreatitis-related pseudoaneurysms. MATERIALS AND METHODS A retrospective study of patients referred for embolisation of pancreatitis-related pseudoaneurysms between January 2014 and March 2019 was conducted. Computed tomography angiography (CTA) was performed to assess the morphology of the aneurysms prior to any intervention. Percutaneous or endovascular embolisation was performed. Details of CTA and methods of embolisation were recorded. Technical success, clinical success, and complications were reported. RESULTS A total of 80 patients (mean age, 40.69 ± 13.41 years, 73 male) underwent embolisation during the study period. Pseudoaneurysms were related to chronic pancreatitis (CP) in 44 (55%) patients and acute pancreatitis (AP) in 36 (45%) patients. Pseudoaneurysms were detected in 65 (81.2%) patients on CTA. The most common site of pseudoaneurysms was gastroduodenal artery (GDA) followed by splenic artery. Seven patients were treated with percutaneous thrombin injection and five were treated with percutaneous glue injection under ultrasound/fluoroscopy guidance. The remaining patients (n=68) underwent catheter angiography with endovascular embolisation. Technical success was achieved in 4/7 (57%) percutaneous thrombin cases and in all the cases (5/5, 100%) with percutaneous glue or endovascular (68/68,100%) embolisation. CONCLUSION Endovascular or percutaneous embolisation of pseudoaneurysms has high technical success with an excellent safety profile.
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Affiliation(s)
- U Gorsi
- Department of Radiodiagnosis, PGIMER, Chandigarh, India.
| | - V Agarwal
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | - V Nair
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | - M Kang
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | - N Kalra
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | - B C Sreedhara
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | - R Gupta
- Department of Surgery, PGIMER, Chandigarh, India
| | - S S Rana
- Department of Gastroenterology, PGIMER, Chandigarh, India
| | - U Dutta
- Department of Gastroenterology, PGIMER, Chandigarh, India
| | - M S Sandhu
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
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43
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Li M, Sun XF, Xu YJ, Hou J, Zhang D, Chi Y, Zhu J, Kang M, Li SN, Su GX, Zhou ZX, Lai JM. [Infliximab in infantile Takayasu arteritis: a case report and literature review]. Zhonghua Er Ke Za Zhi 2021; 58:1001-1005. [PMID: 33256323 DOI: 10.3760/cma.j.cn112140-20200719-00736] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the clinical characteristics of infantile Takayasu arteritis and the efficacy of infliximab (IFX). Methods: Clinical manifestations, laboratory investigations and infliximab intervention of a case with infantile Takayasu arteritis, who was admitted to Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics in January 2018, were reviewed and analyzed. The related literature published from the beginning to March 2020 were retrieved from CNKI, Wanfang, SinoMed and PubMed with the keywords of"Takayasu arteritis","Infant" in both Chinese and English. Results: This case was a 70-day-old boy admitted due to recurrent fever for 20 days. On admission, his blood pressure were 104/90, 95/59, 125/80, and 152/125 mmHg (1 mmHg=0.133 kPa) in the right arm, left arm, right leg, and left leg, respectively. The complete blood cell count showed leukocytosis (22.6×109/L), thrombocytosis (858×109/L) and mild anemia (80 g/L). He also had elevated erythrocyte sedimentation rate (119 mm/1h), serum ferritin (598 μg/L) and C-reactive protein (112 mg/L). Computed tomographic angiography (CTA) showed narrowing of the thoracic and abdominal aorta, with thickening and heterogenous enhancement of the vessel wall. Coronary artery ultrasound detected dilatation and wall thickening of the bilateral coronary arteries, and uneven dilatation of the middle segment of the right coronary artery, showing bead-like change. Vessel wall thickening was also found in the other main arteries, including both femoral arteries, axillary arteries, carotid arteries, and subclavian arteries, and both superficial femoral arteries were slightly narrowed in the distal segments. The diagnosis of TA was confirmed, and the boy was treated with infliximab monotherapy (5 mg/(kg·every time), a total of 13 times). Then his body temperature and all inflammatory markers were normalized, and the vascular pathology was resolved according to the radiography. No side effects such as allergy or infection were noted during the treatment. During the 2 years and 6 months of follow-up, the boy maintained normal growth and development. Literature review found 8 related articles, and one of them was in Chinese but had limited information. In the other 7 papers, a total of 7 infants with TA were reported. The most common symptom was fever (5 cases), and inflammatory markers usually elevated, and the most common affected artery was abdominal aorta (6 cases). Most cases were treated with glucocorticoid. Conclusions: TA is a rare disease in infants, usually presents with fever and increased inflammatory markers. At the early stage, infliximab monotherapy could effectively control the symptoms and ensure normal growth and development.
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Affiliation(s)
- M Li
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - X F Sun
- Department of Radiology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y J Xu
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - J Hou
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - D Zhang
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Y Chi
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - J Zhu
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - M Kang
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - S N Li
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - G X Su
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - Z X Zhou
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
| | - J M Lai
- Department of Rheumatism and Immunology, Children's Hospital, Capital Institute of Pediatrics, Beijing 100020, China
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44
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Zhang YT, Deng AP, Hu T, Chen XG, Zhuang YL, Tan XH, Zheng HZ, Sun LM, Li Y, Zhong HJ, He JF, Song T, Kang M. [Clinical outcomes of COVID-19 cases and influencing factors in Guangdong province]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 41:1999-2004. [PMID: 32340095 DOI: 10.3760/cma.j.cn112338-20200318-00378] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the clinical courses and outcomes of COVID-19 cases and the influencing factors in Guangdong province and provide basis for the formulation or adjustment of medical care and epidemic control strategy for COVID-19. Methods: We collected demographic data, medical histories, clinical courses and outcomes of 1 350 COVID-19 patients reported in Guangdong as of 4 March 2020 via epidemiological investigation and process tracking. Disease severity and clinical course characteristics of the patients and influencing factors of severe illness were analyzed in our study. Results: Among 1 350 cases of COVID-19 cases in Guangdong, 72 (5.3%) and 1 049 (77.7%) were mild and ordinary cases, 164 (12.1%) were severe cases, 58 (4.3%) were critical cases and 7 (0.5%) were fatal. The median duration of illness were 23 days (P(25), P(75): 18, 31 days) and the median length of hospitalization were 20 days (P(25), P(75): 15,27 days). For severe cases, the median time of showing severe manifestations was on the 12(th) day after onset (P(25), P(75): 9(th) to 15(th) days), and the median time of severe manifestation lasted for 8 days (P(25), P(75): 4, 14 days). Among 1 066 discharged/fetal cases, 36.4% (36/99) and 1.0% (1/99) of the mild cases developed to ordinary cases and severe cases respectively after admission; and 5.2% (50/968) and 0.6% (6/968) of the ordinary cases developed to severe cases, and critical cases respectively after admission. In severe cases, 11.4% developed to critical cases (10/88). The influencing factors for severe illness or worse included male (aHR=1.87, 95%CI: 1.43-2.46), older age (aHR=1.67, 95%CI: 1.51-1.85), seeking medical care on day 2-3 after onset (aHR=1.73, 95%CI: 1.20-2.50) pre-existing diabetes (aHR=1.75, 95%CI: 1.12-2.73) and hypertension (aHR=1.49, 95%CI: 1.06-2.09). Conclusions: The course of illness and length of hospitalization of COVID-19 cases were generally long and associated with severity of disease clinical outcomes. The severe cases were mainly occurred in populations at high risk. In the epidemic period, classified management of COVID-19 cases should be promoted according to needs for control and prevention of isolation and treatment for the purpose of rational allocation of medical resources.
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Affiliation(s)
- Y T Zhang
- Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - A P Deng
- Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - T Hu
- Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - X G Chen
- Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - Y L Zhuang
- Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - X H Tan
- Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - H Z Zheng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - L M Sun
- Institute of Immunization, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - Y Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - H J Zhong
- Public Health Emergency Response Department, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - J F He
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - T Song
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
| | - M Kang
- Institute for Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 510000, China
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45
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Kang M, Bilgic A, Radjenovic M, Murrell D. Osteoporosis and bone health in autoimmune blistering skin disease—an evidenced based review. J Eur Acad Dermatol Venereol 2020; 34:2745-2756. [DOI: 10.1111/jdv.16334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 02/12/2020] [Indexed: 11/30/2022]
Affiliation(s)
- M. Kang
- Faculty of Medicine University of New South Wales Sydney NSW Australia
- Department of Dermatology St George Hospital Sydney NSW Australia
| | - A. Bilgic
- Faculty of Medicine University of New South Wales Sydney NSW Australia
- Department of Dermatology St George Hospital Sydney NSW Australia
- Dermatology Clinic Seydisehir State Hospital Seydisehir, Konya Turkey
| | - M. Radjenovic
- Faculty of Medicine University of New South Wales Sydney NSW Australia
- Department of Dermatology St George Hospital Sydney NSW Australia
| | - D.F. Murrell
- Faculty of Medicine University of New South Wales Sydney NSW Australia
- Department of Dermatology St George Hospital Sydney NSW Australia
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46
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Choi J, Choi J, Lee S, Jang Y, Kang M, Lee J, Park T, Yang J, Song Y, Choi K, Hahn J, Choi S, Gwon H, Lee S. Impact of medication adherence to dual antiplatelet therapy on the long-term outcome of drug-eluting or bare-metal stents. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
In percutaneous coronary intervention, drug-eluting stent (DES) showed better clinical outcome compared to bare-metal stent (BMS) but mostly with different DAPT durations. This study investigated the clinical superiority of DES over BMS with regard to the medication adherence to dual antiplatelet therapy (DAPT).
Methods
We retrospectively enrolled all Koreans PCI patients in year 2011 (n=47,291). Medication adherence to DAPT was assessed by proportion of days covered (PDC) per 6 months. Analysis adjusted with the clinical propensity for receiving DES or BMS and DAPT PDC of the first 6 month was performed. Primary outcome was the 5-year major adverse clinical event (MACE) risk consisting all-cause death, revascularization, shock, or stroke.
Results
Patients with DES (n=46,356) showed higher PDC (78% versus 60%, p<0.001) and lower MACE risk (39% versus 56%, p<0.001) compared to patients with BMS (n=935). In the propensity-matched 1,868 patients, MACE risk was lower with DES than BMS (46% versus 54%, HR=0.80, 95% CI: 0.70–0.91, p<0.001). Patients with good medication adherence (PDC ≥80%) showed much lower MACE risk compared to patients with PDC <80% regardless of DES or BMS (HR=0.36, 95% CI: 0.30–0.44; HR=0.40, 95% CI: 0.33–0.48, p<0.001, all). Patients with DES and PDC <80% showed higher MACE risk compared to BMS with and PDC ≥80% (HR=1.30, 95% CI: 1.03–1.64, p=0.027).
Conclusions
Good medication adherence to DAPT in the first 6 month was prerequisite for better clinical outcome in both DES and BMS. DES with poor adherence to DAPT showed worse outcome compared with BMS with good adherence.
Impact of medication adherence to dual antiplatelet therapy.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J.H Choi
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - J.M Choi
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - S.H Lee
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - Y.J Jang
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - M Kang
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - J.M Lee
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - T.K Park
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - J.H Yang
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - Y.B Song
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - K.H Choi
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - J.Y Hahn
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - S.H Choi
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - H.C Gwon
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - S.H Lee
- Samsung Medical Center, Seoul, Korea (Republic of)
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Lin L, Taylor P, Shen J, Saini J, Kang M, Simone C, Bradley J, Li Z, Xiao Y. National Survey of Monte Carlo Dose Calculation Use in US Proton Therapy Centers. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Choi J, Choi J, Jang Y, Kang M, Lee S. Comparison of medication adherence between fixed-dose combination of angiotensin receptor blockers and statin and free-combination therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Non-adherence to angiotensin receptor blockers (ARB) or statin is one of major reasons of insufficient treatment for patients with hyperlipidemia and hypertension. We investigated whether fixed-dose combination (FDC) of ARB and statin improved adherence compared to traditional free combination (FC).
Methods
In this retrospective nationwide cohort study, adherence of 128,369 patients who started ARB and stain including atorvastatin or rosuvastatin between July 2014 and June 2015 was investigated. Primary endpoint was proportion of days covered (PDC) per 180 days up to day 540. Good compliance defined by PDC≥80% and persistency rate defined by patients remaining on medication were also investigated.
Results
Patients were 62.9 years of mean age with 48.2% female gender. Compared to FC (N=90,759, 70.7%), FDC (N=37,610, 29.3%) showed higher PDC at day 180 (86% vs 70%), 360 (77% vs 62%), and 540 (74% vs 55%, p<0.001, all). Frequency of patients with PDC≥80% was also higher in FDC compared to FC at day 180 (80.1% vs 51.8%), 360 (71.7% vs 54.2%), and 540 (69.2% vs 49.3%, p<0.001, all). Persistency rate at day 540 was higher in FDC compared to FC (50.4% vs 27.3%, p<0.001). The mean decline in PDC per 180 days were significantly lower in FDC compared to FC per 180 days (6.0% vs. 7.5%, p<0.001).
Conclusions
In this real-world data analysis, FDC resulted in higher medication adherence and persistence compared to FC among patients who started both ARB and atorvastatin or rosuvastatin.
Persistence rate btw FDC and FC
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J.H Choi
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - J.M Choi
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - Y.J Jang
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - M Kang
- Samsung Medical Center, Seoul, Korea (Republic of)
| | - S.H Lee
- Samsung Medical Center, Seoul, Korea (Republic of)
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Yang YX, Kang M, An XQ, Zeng W, Yang ZW, Ma HC. Clean and Selective Oxidation of Alcohols with Oxone and
Phase-Transfer Catalysts in Water. Russ J Org Chem 2020. [DOI: 10.1134/s1070428020100206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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50
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Park J, Kang M, Cho H. SMA - CLINICAL. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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