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Shao M, Kruse A, Nelson P, Langer DJ, Silverstein JW. Neuromonitoring Identifies Occlusion of Femoral Artery in STA-MCA Bypass Procedure: A Case Report. Neurodiagn J 2023; 63:180-189. [PMID: 37723081 DOI: 10.1080/21646821.2023.2247952] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/07/2023] [Indexed: 09/20/2023]
Abstract
Intraoperative neurophysiological monitoring (IONM) is a technique used to assess the somatosensory and gross motor systems during surgery. While it is primarily used to detect and prevent surgically induced nervous system trauma, it can also detect and prevent injury to the nervous system that is the result of other causes such as trauma or ischemia that occur outside of the operative field as a result of malpositioning or other problematic physiologic states. We present a case study where a neuromonitoring alert altered the surgical procedure, though the alert was not correlated to the site of surgery. A 69-year-old male with a history of bilateral moyamoya disease and a left middle cerebral artery infarct underwent a right-sided STA-MCA bypass and encephaloduroarteriosynangiosis (EDAS) with multimodal IONM. During the procedure, the patient experienced a loss of motor evoked potential (MEP) recordings in the right lower extremity. Blood pressure was elevated, which temporarily restored the potentials, but they were lost again after the angiography team attempted to place an arterial line in the right femoral artery. The operation was truncated out of concern for left hemispheric ischemia, and it was later discovered that the patient had an acute right external iliac artery occlusion caused by a fresh thrombus in the common femoral artery causing complete paralysis of the limb. This case highlights the importance of heeding IONM alerts and evaluating for systemic causes if the alert is not thought to be of surgical etiology. IONM can detect adverse systemic neurological sequelae that is not necessarily surgically induced.
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Affiliation(s)
- Miriam Shao
- Department of Neurological Surgery Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, New York
| | - Aaron Kruse
- Department of Clinical Neurophysiology Neuro Protective Solutions, New York, New York
| | - Priscilla Nelson
- Department of Anesthesia Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, New York
| | - David J Langer
- Department of Neurological Surgery Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, New York
| | - Justin W Silverstein
- Department of Clinical Neurophysiology Neuro Protective Solutions, New York, New York
- Department of Neurology Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, New York
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Rubenstein RN, Tadros A, Slutsky HL, Plotsker EL, Haglich K, Stern CS, Morrow M, Nelson JA, Nelson P. Increasing rates of general anesthesia use in lumpectomy procedures: A 15-year trends analysis. J Surg Oncol 2023; 127:1092-1102. [PMID: 36915277 PMCID: PMC10823799 DOI: 10.1002/jso.27226] [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: 02/11/2023] [Accepted: 02/18/2023] [Indexed: 03/15/2023]
Abstract
BACKGROUND Anesthesia methods in oncologic breast surgery have evolved with less invasive practices. The aims of this study were primarily to examine trends in anesthesia type used during lumpectomy. METHODS We analyzed lumpectomy procedures from 2005 to 2019 using the NSQIP database. Upon defining the nadir in general anesthesia (GA) and peak in monitored anesthesia care (MAC) use as 2007, we compared patient characteristics and complications in the 2007 versus 2019 GA and MAC cohorts. Multivariable logistic regression was used to examine associations with receipt of GA. RESULTS Of 253 545 lumpectomy patients, 191 773 (75.6%) received GA and 61 772 (24.4%) received MAC. From 2005 to 2019, GA rates increased from 66.7% to 82.5%, while MAC rates decreased from 33.3% to 17.5%. More GA patients were obese and American Society of Anesthesiologists class 3. Over time, age and body mass index (BMI) increased in both GA and MAC cohorts. Odds of receiving GA increased over time, and predictors included concurrent axillary lymph node dissection (p < 0.0001) or sentinel lymph node biopsy (p < 0.0001). CONCLUSIONS We demonstrate increasing use of GA over time for lumpectomy, which may be related to aging lumpectomy patient population with higher BMIs. We also find a strong association between use of GA and concurrent lymph node procedures.
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Affiliation(s)
- Robyn N. Rubenstein
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Audree Tadros
- Department of Surgery, Breast Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Hanna L. Slutsky
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Ethan L. Plotsker
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kathryn Haglich
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Carrie S. Stern
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Monica Morrow
- Department of Surgery, Breast Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jonas A. Nelson
- Department of Surgery, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Priscilla Nelson
- Department of Anesthesiology, Lenox Hill Hospital, Northwell Health, New York, New York, USA
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Magain N, Miadlikowska J, Goffinet B, Goward T, Pardo-De la Hoz C, Jüriado I, Simon A, Mercado-Díaz J, Barlow T, Moncada B, Lücking R, Spielmann A, Canez L, Wang L, Nelson P, Wheeler T, Lutzoni F, Sérusiaux E. High species richness in the lichen genus Peltigera ( Ascomycota, Lecanoromycetes): 34 species in the dolichorhizoid and scabrosoid clades of section Polydactylon, including 24 new to science. Persoonia 2023; 51:1-88. [PMID: 38665978 PMCID: PMC11041898 DOI: 10.3767/persoonia.2023.51.01] [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] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 10/10/2022] [Indexed: 04/28/2024]
Abstract
Applying molecular methods to fungi establishing lichenized associations with green algae or cyanobacteria has repeatedly revealed the existence of numerous phylogenetic taxa overlooked by classical taxonomic approaches. Here, we report taxonomical conclusions based on multiple species delimitation and validation analyses performed on an eight-locus dataset that includes world-wide representatives of the dolichorhizoid and scabrosoid clades in section Polydactylon of the genus Peltigera. Following the recommendations resulting from a consensus species delimitation approach and additional species validation analysis (BPP) performed in this study, we present a total of 25 species in the dolichorhizoid clade and nine in the scabrosoid clade, including respectively 18 and six species that are new to science and formally described. Additionally, one combination and three varieties (including two new to science) are proposed in the dolichorhizoid clade. The following 24 new species are described: P. appalachiensis, P. asiatica, P. borealis, P. borinquensis, P. chabanenkoae, P. clathrata, P. elixii, P. esslingeri, P. flabellae, P. gallowayi, P. hawaiiensis, P. holtanhartwigii, P. itatiaiae, P. hokkaidoensis, P. kukwae, P. massonii, P. mikado, P. nigriventris, P. orientalis, P. rangiferina, P. sipmanii, P. stanleyensis, P. vitikainenii and P. willdenowii; the following new varieties are introduced: P. kukwae var. phyllidiata and P. truculenta var. austroscabrosa; and the following new combination is introduced: P. hymenina var. dissecta. Each species from the dolichorhizoid and scabrosoid clades is morphologically and chemically described, illustrated, and characterised with ITS sequences. Identification keys are provided for the main biogeographic regions where species from the two clades occur. Morphological and chemical characters that are commonly used for species identification in the genus Peltigera cannot be applied to unambiguously recognise most molecularly circumscribed species, due to high variation of thalli formed by individuals within a fungal species, including the presence of distinct morphs in some cases, or low interspecific variation in others. The four commonly recognised morphospecies: P. dolichorhiza, P. neopolydactyla, P. pulverulenta and P. scabrosa in the dolichorhizoid and scabrosoid clades represent species complexes spread across multiple and often phylogenetically distantly related lineages. Geographic origin of specimens is often helpful for species recognition; however, ITS sequences are frequently required for a reliable identification. Citation: Magain N, Miadlikowska J, Goffinet B, et al. 2023. High species richness in the lichen genus Peltigera (Ascomycota, Lecanoromycetes): 34 species in the dolichorhizoid and scabrosoid clades of section Polydactylon, including 24 new to science. Persoonia 51: 1-88. doi: 10.3767/persoonia.2023.51.01.
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Affiliation(s)
- N. Magain
- Evolution and Conservation Biology, InBioS Research Center, University of Liège, Sart Tilman B22, Quartier vallée 1, Chemin de la vallée 4, B-4000 Liège, Belgium
- Department of Biology, Duke University, Box 90338, Durham, North Carolina, 27708 USA
| | - J. Miadlikowska
- Department of Biology, Duke University, Box 90338, Durham, North Carolina, 27708 USA
| | - B. Goffinet
- Ecology and Evolutionary Biology, Unit 3043, University of Connecticut, 75 North Eagleville road, Storrs CT, 06269-3043 USA
| | - T. Goward
- Beaty Biodiversity Museum, University of British Columbia, Vancouver, British Columbia, V6T 1Z4, Canada
| | - C.J. Pardo-De la Hoz
- Department of Biology, Duke University, Box 90338, Durham, North Carolina, 27708 USA
| | - I. Jüriado
- Institute of Ecology and Earth Sciences, University of Tartu, J. Liivi 2, Tartu 50409, Estonia; Institute of Agricultural & Environmental Sciences, Estonian University of Life Sciences, Fr. R. Kreutzwaldi 5, Tartu 51006, Estonia
| | - A. Simon
- Evolution and Conservation Biology, InBioS Research Center, University of Liège, Sart Tilman B22, Quartier vallée 1, Chemin de la vallée 4, B-4000 Liège, Belgium
- Ecology and Evolutionary Biology, Unit 3043, University of Connecticut, 75 North Eagleville road, Storrs CT, 06269-3043 USA
| | - J.A. Mercado-Díaz
- Science & Education, The Field Museum, 1400 S. Lake Shore Drive, Chicago, Illinois, 60605 USA
| | - T. Barlow
- Department of Biology, Duke University, Box 90338, Durham, North Carolina, 27708 USA
| | - B. Moncada
- Licenciatura en Biología, Universidad Distrital Francisco José de Caldas, Cra. 4 No. 26B-54, Torre de Laboratorios, Herbario, Bogotá, Colombia; current address: Botanischer Garten, Freie Universität Berlin, Königin-Luise-Straße 6–8, 14195 Berlin, Germany
| | - R. Lücking
- Botanischer Garten, Freie Universität Berlin, Königin-Luise-Straße 6–8, 14195 Berlin, Germany
| | - A. Spielmann
- Laboratòrio de Botanica / Liquenologia, Instituto de Biociencias, Universidade Federal de Mato Grosso do Sul, Campo Grande – MS, Brazil
| | - L. Canez
- Laboratòrio de Botanica / Liquenologia, Instituto de Biociencias, Universidade Federal de Mato Grosso do Sul, Campo Grande – MS, Brazil
| | - L.S. Wang
- Key Laboratory for Plant Diversity and Biogeography of East Asia, Kunming Institute of Botany, CAS, Kunming 650201, China
| | - P. Nelson
- Natural and Behavioral Sciences Division, University of Maine – Fort Kent, Fort Kent, ME, USA
| | - T. Wheeler
- Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - F. Lutzoni
- Department of Biology, Duke University, Box 90338, Durham, North Carolina, 27708 USA
| | - E. Sérusiaux
- Evolution and Conservation Biology, InBioS Research Center, University of Liège, Sart Tilman B22, Quartier vallée 1, Chemin de la vallée 4, B-4000 Liège, Belgium
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Watanabe R, Kono R, Arai O, Onishi T, Kakuda T, Noda T, Nishimura K, Fukumoto T, Miura N, Kurata M, Miyauchi Y, Kitazawa R, Haffner M, Kikugawa T, Nelson P, Saika T. Detection of intraductal carcinoma of the prostate (IDCP) cases focusing on high-grade prostatic intraepithelial neoplasia (PIN) findings regarding invasive carcinoma of the prostate. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01268-x] [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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Olmsted ZT, Silverstein JW, Einstein EH, Sowulewski J, Nelson P, Boockvar JA, D'Amico RS. Evolution of flash visual evoked potentials to monitor visual pathway integrity during tumor resection: illustrative cases and literature review. Neurosurg Rev 2023; 46:46. [PMID: 36715828 DOI: 10.1007/s10143-023-01955-z] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 12/21/2022] [Accepted: 01/23/2023] [Indexed: 01/31/2023]
Abstract
Flash visual evoked potentials (fVEPs) provide a means to interrogate visual system functioning intraoperatively during tumor resection in which the optic pathway is at risk for injury. Due to technical limitations, fVEPs have remained underutilized in the armamentarium of intraoperative neurophysiological monitoring (IONM) techniques. Here we review the evolution of fVEPs as an IONM technique with emphasis on the enabling technological and intraoperative improvements. A combined approach with electroretinography (ERG) has enhanced feasibility of fVEP neuromonitoring as a practical application to increase safety and reduce error during tumor resection near the prechiasmal optic pathway. The major advance has been towards differentiating true cases of damage from false findings. We use two illustrative neurosurgical cases in which fVEPs were monitored with and without ERG to discuss limitations and demonstrate how ERG data can clarify false-positive findings in the operating room. Standardization measures have focused on uniformity of photostimulation parameters for fVEP recordings between neurosurgical groups.
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Affiliation(s)
- Zachary T Olmsted
- Department of Neurological Surgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, New York, NY, USA.
| | - Justin W Silverstein
- Department of Neurology, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, New York, NY, USA
- Neuro Protective Solutions, New York, NY, USA
| | - Evan H Einstein
- Department of Neurological Surgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, New York, NY, USA
| | | | - Priscilla Nelson
- Department of Anesthesiology, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, New York, NY, USA
| | - John A Boockvar
- Department of Neurological Surgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, New York, NY, USA
| | - Randy S D'Amico
- Department of Neurological Surgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, New York, NY, USA
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6
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Azizi M, Mahfoud F, Weber MA, Sharp ASP, Schmieder RE, Lurz P, Lobo MD, Fisher NDL, Daemen J, Bloch MJ, Basile J, Sanghvi K, Saxena M, Gosse P, Jenkins JS, Levy T, Persu A, Kably B, Claude L, Reeve-Stoffer H, McClure C, Kirtane AJ, Mullin C, Thackeray L, Chertow G, Kahan T, Dauerman H, Ullery S, Abbott JD, Loening A, Zagoria R, Costello J, Krathan C, Lewis L, McElvarr A, Reilly J, Cash M, Williams S, Jarvis M, Fong P, Laffer C, Gainer J, Robbins M, Crook S, Maddel S, Hsi D, Martin S, Portnay E, Ducey M, Rose S, DelMastro E, Bangalore S, Williams S, Cabos S, Rodriguez Alvarez C, Todoran T, Powers E, Hodskins E, Paladugu V, Tecklenburg A, Devireddy C, Lea J, Wells B, Fiebach A, Merlin C, Rader F, Dohad S, Kim HM, Rashid M, Abraham J, Owan T, Abraham A, Lavasani I, Neilson H, Calhoun D, McElderry T, Maddox W, Oparil S, Kinder S, Radhakrishnan J, Batres C, Edwards S, Garasic J, Drachman D, Zusman R, Rosenfield K, Do D, Khuddus M, Zentko S, O'Meara J, Barb I, Foster A, Boyette A, Wang Y, Jay D, Skeik N, Schwartz R, Peterson R, Goldman JA, Goldman J, Ledley G, Katof N, Potluri S, Biedermann S, Ward J, White M, Mauri L, Sobieszczky P, Smith A, Aseltine L, Stouffer R, Hinderliter A, Pauley E, Wade T, Zidar D, Shishehbor M, Effron B, Costa M, Semenec T, Roongsritong C, Nelson P, Neumann B, Cohen D, Giri J, Neubauer R, Vo T, Chugh AR, Huang PH, Jose P, Flack J, Fishman R, Jones M, Adams T, Bajzer C, Mathur A, Jain A, Balawon A, Zongo O, Bent C, Beckett D, Lakeman N, Kennard S, D’Souza RJ, Statton S, Wilkes L, Anning C, Sayer J, Iyer SG, Robinson N, Sevillano A, Ocampo M, Gerber R, Faris M, Marshall AJ, Sinclair J, Pepper H, Davies J, Chapman N, Burak P, Carvelli P, Jadhav S, Quinn J, Rump LC, Stegbauer J, Schimmöller L, Potthoff S, Schmid C, Roeder S, Weil J, Hafer L, Agdirlioglu T, Köllner T, Böhm M, Ewen S, Kulenthiran S, Wachter A, Koch C, Fengler K, Rommel KP, Trautmann K, Petzold M, Ott C, Schmid A, Uder M, Heinritz U, Fröhlich-Endres K, Genth-Zotz S, Kämpfner D, Grawe A, Höhne J, Kaesberger B, von zur Mühlen C, Wolf D, Welzel M, Heinrichs G, Trabitzsch B, Cremer A, Trillaud H, Papadopoulos P, Maire F, Gaudissard J, Sapoval M, Livrozet M, Lorthioir A, Amar L, Paquet V, Pathak A, Honton B, Cottin M, Petit F, Lantelme P, Berge C, Courand PY, Langevin F, Delsart P, Longere B, Ledieu G, Pontana F, Sommeville C, Bertrand F, Feyz L, Zeijen V, Ruiter A, Huysken E, Blankestijn P, Voskuil M, Rittersma Z, Dolmans H, Kroon A, van Zwam W, Vranken J, de Haan. C, Renkin J, Maes F, Beauloye C, Lengelé JP, Huyberechts D, Bouvie A, Witkowski A, Januszewicz A, Kądziela J, Prejbisj A, Hering D, Ciecwierz D, Jaguszewski MJ, Owczuk R. Effects of Renal Denervation vs Sham in Resistant Hypertension After Medication Escalation: Prespecified Analysis at 6 Months of the RADIANCE-HTN TRIO Randomized Clinical Trial. JAMA Cardiol 2022; 7:1244-1252. [PMID: 36350593 PMCID: PMC9647563 DOI: 10.1001/jamacardio.2022.3904] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Importance Although early trials of endovascular renal denervation (RDN) for patients with resistant hypertension (RHTN) reported inconsistent results, ultrasound RDN (uRDN) was found to decrease blood pressure (BP) vs sham at 2 months in patients with RHTN taking stable background medications in the Study of the ReCor Medical Paradise System in Clinical Hypertension (RADIANCE-HTN TRIO) trial. Objectives To report the prespecified analysis of the persistence of the BP effects and safety of uRDN vs sham at 6 months in conjunction with escalating antihypertensive medications. Design, Setting, and Participants This randomized, sham-controlled, clinical trial with outcome assessors and patients blinded to treatment assignment, enrolled patients from March 11, 2016, to March 13, 2020. This was an international, multicenter study conducted in the US and Europe. Participants with daytime ambulatory BP of 135/85 mm Hg or higher after 4 weeks of single-pill triple-combination treatment (angiotensin-receptor blocker, calcium channel blocker, and thiazide diuretic) with estimated glomerular filtration rate (eGFR) of 40 mL/min/1.73 m2 or greater were randomly assigned to uRDN or sham with medications unchanged through 2 months. From 2 to 5 months, if monthly home BP was 135/85 mm Hg or higher, standardized stepped-care antihypertensive treatment starting with aldosterone antagonists was initiated under blinding to treatment assignment. Interventions uRDN vs sham procedure in conjunction with added medications to target BP control. Main Outcomes and Measures Six-month change in medications, change in daytime ambulatory systolic BP, change in home systolic BP adjusted for baseline BP and medications, and safety. Results A total of 65 of 69 participants in the uRDN group and 64 of 67 participants in the sham group (mean [SD] age, 52.4 [8.3] years; 104 male [80.6%]) with a mean (SD) eGFR of 81.5 (22.8) mL/min/1.73 m2 had 6-month daytime ambulatory BP measurements. Fewer medications were added in the uRDN group (mean [SD], 0.7 [1.0] medications) vs sham (mean [SD], 1.1 [1.1] medications; P = .045) and fewer patients in the uRDN group received aldosterone antagonists at 6 months (26 of 65 [40.0%] vs 39 of 64 [60.9%]; P = .02). Despite less intensive standardized stepped-care antihypertensive treatment, mean (SD) daytime ambulatory BP at 6 months was 138.3 (15.1) mm Hg with uRDN vs 139.0 (14.3) mm Hg with sham (additional decreases of -2.4 [16.6] vs -7.0 [16.7] mm Hg from month 2, respectively), whereas home SBP was lowered to a greater extent with uRDN by 4.3 mm Hg (95% CI, 0.5-8.1 mm Hg; P = .03) in a mixed model adjusting for baseline and number of medications. Adverse events were infrequent and similar between groups. Conclusions and Relevance In this study, in patients with RHTN initially randomly assigned to uRDN or a sham procedure and who had persistent elevation of BP at 2 months after the procedure, standardized stepped-care antihypertensive treatment escalation resulted in similar BP reduction in both groups at 6 months, with fewer additional medications required in the uRDN group. Trial Registration ClinicalTrials.gov Identifier: NCT02649426.
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Affiliation(s)
- Michel Azizi
- Université Paris Cité, F-75006 Paris, France,Assistance Publique–Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Hypertension Department and DMU CARTE, F-75015 Paris, France,INSERM, CIC1418, F-75015 Paris, France
| | - Felix Mahfoud
- Klinik für Innere Medizin III, Saarland University Hospital, Homburg/Saar, Germany,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge
| | - Michael A. Weber
- Division of Cardiovascular Medicine, State University of New York, Downstate Medical Center, New York
| | - Andrew S. P. Sharp
- University Hospital of Wales, Cardiff and University of Exeter, Exeter, United Kingdom
| | - Roland E. Schmieder
- Nephrology and Hypertension, University Hospital Erlangen, Friedrich Alexander University, Erlangen, Germany
| | - Philipp Lurz
- Heart Center Leipzig, University of Leipzig, Leipzig, Germany
| | - Melvin D. Lobo
- Barts NIHR Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | | | - Joost Daemen
- Erasmus MC, University Medical Center Rotterdam, Department of Cardiology, Rotterdam, the Netherlands
| | - Michael J. Bloch
- Department of Medicine, University of Nevada School of Medicine, Vascular Care, Renown Institute of Heart and Vascular Health, Reno
| | - Jan Basile
- Division of Cardiovascular Medicine, Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Charleston
| | | | - Manish Saxena
- Barts NIHR Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | | | | | - Terry Levy
- Royal Bournemouth Hospital, Dorset, United Kingdom
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Benjamin Kably
- Assistance Publique–Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Department of Pharmacology, Paris, France
| | | | | | | | - Ajay J. Kirtane
- Columbia University Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Danny Do
- for the RADIANCE-HTN Investigators
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jay Giri
- for the RADIANCE-HTN Investigators
| | | | - Thu Vo
- for the RADIANCE-HTN Investigators
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7
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Greisman JD, Olmsted ZT, Crorkin PJ, Dallimore CA, Zhigin V, Shlifer A, Bedi AD, Kim JK, Nelson P, Sy HL, Patel KV, Ellis JA, Boockvar J, Langer DJ, D'Amico RS. Enhanced Recovery After Surgery (ERAS) for Cranial Tumor Resection: A Review. World Neurosurg 2022; 163:104-122.e2. [PMID: 35381381 DOI: 10.1016/j.wneu.2022.03.118] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 11/15/2022]
Abstract
Enhanced Recovery After Surgery (ERAS) protocols describe a standardized method of preoperative, perioperative, and postoperative care to enhance outcomes and minimize complication risks surrounding elective surgical intervention. A growing body of evidence is being generated as we learn to apply principles of ERAS standardization to neurosurgical patients. First applied in spinal surgery, ERAS protocols have been extended to cranial neuro-oncological procedures. This review synthesizes recent findings to generate evidence-based guidelines to manage neurosurgical oncology patients with standardized systems and assess ability of these systems to coordinate multidisciplinary, patient-centric care efforts. Furthermore, we highlight the potential utility of multimedia, app-based communication platforms to facilitate patient education, autonomy, and team communication within each of the three settings.
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Affiliation(s)
- Jacob D Greisman
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY.
| | - Zachary T Olmsted
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
| | - Patrick J Crorkin
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
| | - Colin A Dallimore
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
| | - Vadim Zhigin
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
| | - Artur Shlifer
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
| | - Anupama D Bedi
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
| | - Jane K Kim
- Department of Anesthesiology, Lenox Hill Hospital/Northwell Health, New York, NY
| | - Priscilla Nelson
- Department of Anesthesiology, Lenox Hill Hospital/Northwell Health, New York, NY
| | - Heustein L Sy
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
| | - Kiran V Patel
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
| | - Jason A Ellis
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
| | - John Boockvar
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
| | - David J Langer
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
| | - Randy S D'Amico
- Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY
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Li L, Jennemann R, Shehzad K, Grimm E, Lopez Perez R, Sandhoff R, Nelson P, Huber P. OC-0286 Wnt-associated DKK3 mediates radiation-induced dermal inflammation and fibrosis. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06836-5] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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9
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Vlisides PE, Vogt KM, Pal D, Schnell E, Armstead WM, Brambrink AM, Kuo P, Nelson P, Vacas S, Goettel N, Aglio LS, Farag E, Gorji R, García PS, Koerner IP. Roadmap for Conducting Neuroscience Research in the COVID-19 Era and Beyond: Recommendations From the SNACC Research Committee. J Neurosurg Anesthesiol 2021; 33:100-106. [PMID: 33660699 PMCID: PMC8310904 DOI: 10.1097/ana.0000000000000758] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 12/28/2020] [Indexed: 12/22/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of neuroscience research. At the 2020 Society of Neuroscience in Anesthesiology and Critical Care (SNACC) Annual Meeting, the SNACC Research Committee met virtually to discuss research challenges encountered during the COVID-19 pandemic along with possible strategies for facilitating research activities. These challenges and recommendations are included in this Consensus Statement. The objectives are to: (1) provide an overview of the disruptions and challenges to neuroscience research caused by the COVID-19 pandemic, and; (2) put forth a set of consensus recommendations for strengthening research sustainability during and beyond the current pandemic. Specific recommendations are highlighted for adapting laboratory and human subject study activities to optimize safety. Complementary research activities are also outlined for both laboratory and clinical researchers if specific investigations are impossible because of regulatory or societal changes. The role of virtual platforms is discussed with respect to fostering new collaborations, scheduling research meetings, and holding conferences such that scientific collaboration and exchange of ideas can continue. Our hope is for these recommendations to serve as a valuable resource for investigators in the neurosciences and other research disciplines for current and future research disruptions.
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Affiliation(s)
- Phillip E. Vlisides
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI USA
- Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI USA
| | - Keith M. Vogt
- Department of Anesthesiology & Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA USA
| | - Dinesh Pal
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI USA
- Center for Consciousness Science, University of Michigan Medical School, Ann Arbor, MI USA
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI USA
| | - Eric Schnell
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, OR USA
| | - William M. Armstead
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Ansgar M. Brambrink
- Department of Anesthesiology, Columbia University Medical Center/New York Presbyterian Hospital, New York, NY USA
| | - Philip Kuo
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY USA
| | - Priscilla Nelson
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY USA
| | - Susana Vacas
- Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA USA
| | - Nicolai Goettel
- Department of Anesthesia, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Linda S. Aglio
- Department of Anesthesiology and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Ehab Farag
- Department of Anesthesiology and Pain Medicine, Cleveland Clinic, Cleveland, OH USA
| | - Reza Gorji
- Department of Anesthesiology, Upstate Medical Center, Syracuse, NY USA
| | - Paul S. García
- Department of Anesthesiology, Columbia University Medical Center/New York Presbyterian Hospital, New York, NY USA
| | - Ines P. Koerner
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, OR USA
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10
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Abstract
Anesthetic management of carotid artery disease requiring carotid endarterectomy or carotid stenting is complex and varies widely, but relies on excellent communication between the anesthesia and surgical team throughout the procedure to ensure appropriate cerebral perfusion. With a systematic approach to vascular access and hemodynamic and neurologic monitoring, anesthesia can be applied to maximize cerebral perfusion while minimizing the risk of postoperative hemorrhage or hyperperfusion.
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Affiliation(s)
- Priscilla Nelson
- Department of Anesthesiology, Weill Cornell Medicine, Weill Cornell Medical College, 525 East 68th Street, Box 124, New York, NY 10065, USA
| | - Maria Bustillo
- Department of Anesthesiology, Weill Cornell Medicine, Weill Cornell Medical College, 525 East 68th Street, Box 124, New York, NY 10065, USA.
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11
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Abstract
In perioperative settings where a patient under general anesthesia, presentation of serotonin syndrome might be far from the "classical" description of this potentially fatal condition. A patient who manifested signs of serotonin toxicity during an intravenous anesthetic, remifentanil, is presented. At the time of surgery, the patient was being treated with tramadol for pain management. The patient displayed myofasciculations on both gastrocnemius muscles confirmed electromyographically. All other conventional signs of serotonin syndrome were absent except hypotension and nystagmus. A presumptive diagnosis of serotonin syndrome was made intraoperatively. The symptoms resolved once remifentanil infusion was discontinued in the operating room without incident. Mild-to-moderate perioperative serotonin syndrome may manifest with myofasciculations in gastrocnemius muscles in the settings of no neuromuscular blockade. In spinal surgeries involving intraoperative EMG monitoring, the neuromonitoring team should be aware of this presentation and include serotonin syndrome in the differential diagnosis of unexplained EMG activity.
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Affiliation(s)
- Otakhon Matchanov
- Neurophysiology, New York Presbyterian Hospital , New York, New York
| | - Priscilla Nelson
- Anesthesiology, Weill Cornell Medical College , New York, New York
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12
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Kachulis B, Tsiouris AJ, Nelson P, Stadnyk I. Dry Spinal Tap. Journal of Neuroanaesthesiology and Critical Care 2020. [DOI: 10.1055/s-0040-1715358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Bessie Kachulis
- Department of Clinical Anesthesiology, Weill Cornell Medicine, New York, New York, United States
| | - Apostolos J. Tsiouris
- Department of Clinical Radiology, Weill Cornell Medicine, New York, New York, United States
| | - Priscilla Nelson
- Department of Clinical Anesthesiology, Weill Cornell Medicine, New York, New York, United States
| | - Irene Stadnyk
- Department of Clinical Anesthesiology, Weill Cornell Medicine, New York, New York, United States
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13
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Nelson JA, Fischer JP, Grover R, Nelson P, Au A, Serletti JM, Wu LC. Intraoperative vasopressors and thrombotic complications in free flap breast reconstruction. J Plast Surg Hand Surg 2017; 51:336-341. [DOI: 10.1080/2000656x.2016.1269777] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jonas A. Nelson
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - John P. Fischer
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Ritwik Grover
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Priscilla Nelson
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
- Department of Anesthesiology, Lankenau Medical Center, Wynnewood, PA, USA
| | - Alex Au
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph M. Serletti
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Liza C. Wu
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Bolam T, Bersuder P, Burden R, Shears G, Morris S, Warford L, Thomas B, Nelson P. Cadmium levels in food containing crab brown meat: A brief survey from UK retailers. J Food Compost Anal 2016. [DOI: 10.1016/j.jfca.2016.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Abstract
Several compounds involved in the creatine phosphate kinase (CPK) pathway were evaluated for their protective effects against the chemical warfare (CW) agent sulphur mustard (HD), in primary chick embryo neuron and first passage human skin keratinocyte cultures. High concentrations of both creatine and creatine phosphate were found to be protective under all culture conditions and increased the LC50 of HD in both culture systems up to ~250%. Little difference was observed in the protective activity of these compounds in undifferentiated versus differentiated neuronal culture, or in proliferating versus differentiating cultures of keratinocytes. The protective effect of these compounds was found to be strictly prophylactic in nature. Although a modest decline in HD half-life was measured in buffer containing creatine phosphate, this did not account for the protective effects of this compound. In contrast to historical literature reporting 90—100% HD-induced CPK inhibition of purified enzyme, less than 30% of CPK activity was found to be inhibited by HD in both human keratinocytes and in swine blood plasma. Incubation of keratinocyte cultures with creatine or creatine phosphate prior to HD exposure did not alter CPK activity, compared with HD-only treated cultures. Although high mM concentrations of both creatine and creatine phosphate exert significant protective effects against HD, these results do not support a role for CPK in its toxicity or in the development of medical countermeasures against this CW agent. Human & Experimental Toxicology (2007) 26, 891—897.
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Affiliation(s)
- P. Nelson
- Casualty Management Section, Defence Research and Development Canada-Suffield Box 4000, Medicine Hat, Alberta, Canada T1A 8K6
| | - A. Burczyk
- Casualty Management Section, Defence Research and Development Canada-Suffield Box 4000, Medicine Hat, Alberta, Canada T1A 8K6
| | - T.W. Sawyer
- Casualty Management Section, Defence Research and Development Canada-Suffield Box 4000, Medicine Hat, Alberta, Canada T1A 8K6,
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16
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Litao M, Bhamra H, DeSousa K, Raz E, Nossek E, Favate A, Shapiro M, Becske T, Nelson P. E-027 Mechanical Thrombectomy for Acute Ischemic Stroke in Post-surgical Patients. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Becske T, Potts M, Brinjikji W, Kallmes D, Shapiro M, Nelson P. P-026 pufs primary endpoint complications by aneurysm size. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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18
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Becske T, Potts M, Brinjikji W, Kallmes D, Shapiro M, Nelson P. O-036 pufs safety and effectiveness outcomes by aneurysm shape. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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19
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Kallmes D, Brinjikji W, Nelson P, Lanzino G, Albuquerque F, Szikora I, Lopes D, Hanel R, Almandoz JD, Lylyk P, Cekirge S, Levy E, Jabbour P, Woo H, McDougall C, Beckse T. O-022 safety and efficacy of the pipeline embolization device in treatment of intracranial aneurysms: a combined analysis of pufs, aspire and intreped. J Neurointerv Surg 2015. [DOI: 10.1136/neurintsurg-2015-011917.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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20
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Fordham B, Nelson P, Griffiths C, Bundy C. The acceptability and usefulness of mindfulness-based cognitive therapy for people living with psoriasis: a qualitative study. Br J Dermatol 2015; 172:823-5. [DOI: 10.1111/bjd.13333] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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)
- B.A. Fordham
- Institute of Inflammation and Repair; University of Manchester; Stopford Building Oxford Road Manchester M13 9PT U.K
| | - P. Nelson
- Institute of Inflammation and Repair; University of Manchester; Stopford Building Oxford Road Manchester M13 9PT U.K
| | - C.E.M. Griffiths
- The Dermatology Centre; University of Manchester; Manchester U.K
| | - C. Bundy
- Institute of Inflammation and Repair; University of Manchester; Stopford Building Oxford Road Manchester M13 9PT U.K
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21
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Abstract
Genetic and environmental factors appear to contribute to the pathogenesis of systemic lupus erythematosus (SLE). Viral infections have been reported to be associated with the disease. A number of exogenous viruses have been linked to the pathogenesis of SLE, of which Epstein-Barr virus (EBV) has the most evidence of an aetiological candidate. In addition, human endogenous retroviruses (HERV), HRES-1, ERV-3, HERV-E 4-1, HERV-K10 and HERV-K18 have also been implicated in SLE. HERVs are incorporated into human DNA, and thus can be inherited. HERVs may trigger an autoimmune reaction through molecular mimicry, since homology of amino acid sequences between HERV proteins and SLE autoantigens has been demonstrated. These viruses can also be influenced by oestrogen, DNA hypomethylation, and ultraviolet light (UVB) exposure which have been shown to enhance HERV activation or expression. Viral infection, or other environmental factors, could induce defective apoptosis, resulting in loss of immune tolerance. Further studies in SLE and other autoimmune diseases are needed to elucidate the contribution of both exogenous and endogenous viruses in the development of autoimmunity. If key peptide sequences could be identified as molecular mimics between viruses and autoantigens, then this might offer the possibility of the development of blocking peptides or antibodies as therapeutic agents in SLE and other autoimmune conditions.
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Affiliation(s)
- P Nelson
- 1Molecular Immunology Research Group, Research Institute in Healthcare Science, University of Wolverhampton, UK
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22
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Nelson JA, Fischer JP, Grover R, Mirzabeigi MN, Nelson P, Wes AM, Au A, Serletti JM, Wu LC. Intraoperative perfusion management impacts postoperative outcomes: an analysis of 682 autologous breast reconstruction patients. J Plast Reconstr Aesthet Surg 2014; 68:175-83. [PMID: 25456289 DOI: 10.1016/j.bjps.2014.10.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 07/22/2014] [Accepted: 10/01/2014] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Anesthetic management remains an understudied aspect of free autologous breast reconstruction. This study aims to critically examine intraoperative anesthetic management as it relates to free flap perfusion and its effect on major complications. METHODS A retrospective cohort study was performed examining all abdominally based free autologous breast reconstructions from 2005 to 2011 at a single institution. Analysis focused on perioperative care and specifically fluid administration, urine output (UOP), vasopressor administration, and case duration. Outcomes included major intraoperative and postoperative complications. A post-hoc analysis was performed to determine anesthetic factors associated with thrombotic events. RESULTS Overall, 682 patients (1033 flaps) were included. Patients with low UOP had lower rates of intraoperative fluid infusion rates/kg (p=0.0001), Estimated Blood Loss (EBL) (p=0.006) and pressor administration (p=0.03), but no significant differences were noted in intraoperative thrombotic events according to UOP. However, the below normal UOP cohort demonstrated a significant increased rate of delayed postoperative thromboses (p=0.03). A post hoc analysis of postoperative thrombotic events revealed that low rates of fluid resuscitation (OR=3.01, p=0.04) and low intraoperative UOP (OR=3.67, p=0.04) were independently associated with delayed thrombosis. A sub-analysis demonstrated that patients with ≥2 comorbidities and below normal UOP were at particular risk (any delayed thrombotic event OR=4.3, p=0.03; any delayed venous thrombosis OR=9.1, p=0.03). CONCLUSIONS This study demonstrates that intraoperative fluid under-resuscitation may place patients at increased risk for postoperative flap thrombosis, and low UOP is an important metric whereby intraoperative resuscitation should be gauged. Patients with comorbid conditions and below normal intraoperative UOP should be monitored particularly closely for delayed thrombotic events. LEVEL OF EVIDENCE Prognostic/risk category, level II.
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Affiliation(s)
- Jonas A Nelson
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
| | - John P Fischer
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Ritwik Grover
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Michael N Mirzabeigi
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Ari M Wes
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Alex Au
- Division of Plastic Surgery, Yale New-Haven Hospital, New Haven, CT, USA
| | - Joseph M Serletti
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Liza C Wu
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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23
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Zumofen D, Sahasrabudhe N, Riina H, Raz E, Shapiro M, Becske T, Nelson P. Temporary Solitaire Stent Scaffolding during Cerebral Aneurysm Coil Embolization. J Neurol Surg A Cent Eur Neurosurg 2014. [DOI: 10.1055/s-0034-1383810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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24
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Zumofen D, Raz E, Shapiro M, Becske T, Riina H, Nelson P. Endoluminal Reconstruction of Complex Posterior Cerebral Artery Aneurysms with the Pipeline Embolization Device. J Neurol Surg A Cent Eur Neurosurg 2014. [DOI: 10.1055/s-0034-1383759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Abstract
BACKGROUND Clinical characteristics of malignant hyperthermia (MH) in pediatric patients have not been elucidated. In this study, we used the North American Malignant Hyperthermia Registry to determine differences in clinical characteristics of acute MH across pediatric age groups. We hypothesized that there are differences in clinical presentation, clinical course, and outcomes, which correlate with age. A secondary aim was to determine the types of preexisting medical conditions associated with pediatric MH. METHODS We performed a retrospective review of the North American Malignant Hyperthermia Registry to identify pediatric subjects (up to and including 18 years) with an MH clinical grading score at or above 35 indicating "very likely" or "almost certain" MH. Preoperative patient characteristics, perianesthetic factors, and outcome data were compared for 3 cohorts based on age: 0 to 24 months, 25 months to 12 years, and 13 to 18 years. We used statistical analysis to determine differences among the groups. RESULTS We analyzed 264 records: 35 in the youngest age group, 163 in the middle age group, and 66 in the oldest group. There was no indication of any predisposing risk factors for MH based on family history or physical examination. Sinus tachycardia, hypercarbia, and rapid temperature increase were the most common signs of acute MH (observed in 73.1%, 68.6%, and 48.5%, respectively) and were more common in the oldest age cohort. Higher maximum temperatures and higher peak potassium values were seen in the oldest age cohort. Masseter spasm was more common in the middle age cohort. The youngest age cohort was more likely to develop skin mottling and was approximately half as likely to develop muscle rigidity. The youngest age group also demonstrated significantly higher peak lactic acid levels and lower peak creatine kinase values. Treatments were similar across age cohorts. There were 10 MH-associated deaths, 6 in the middle age group and 4 in the oldest age group. Recrudescence of symptoms after initial treatment occurred in 14.4% of subjects, with no difference across age cohorts. Two of these subjects, 1 in the middle age group and 1 in the oldest age group, died after the recrudescence event. CONCLUSIONS There are differences in clinical characteristics of acute MH among different age cohorts in childhood. Older subjects demonstrated higher body temperatures and higher potassium levels, and the youngest subjects had greater levels of metabolic acidosis. Most children in each age group were phenotypically normal before developing MH.
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Affiliation(s)
- Priscilla Nelson
- From the Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Schmit B, O'Malley K, DeSart K, Berceli S, Nelson P. Pre-Operative Levels of Circulating Endothelial Cells in Peripheral Blood as a Predictor of Outcome in Lower Extremity Angioplasty. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.325] [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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27
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Koren M, Giugliano RP, Raal F, Sullivan D, Bolognese M, Langslet G, Civeira F, Nelson P, Xu F, Sabatine M. Safety, tolerability, and efficacy of long-term administration of AMG 145: preliminary results from the OSLER study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4182] [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: 11/12/2022] Open
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Varrin-Doyer M, Spencer C, Schulze Topphoff U, Nelson P, Stroud R, Cree B, Zamvil S. T Cells from Patients with Neuromyelitis Optica Recognize Discrete T Cell Determinants of Aquaporin-4 and Exhibit a Proinflammatory Th17 Bias (S60.003). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s60.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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31
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Singhal D, Hack N, Abner E, Schmitt F, Nelson P, Jicha G. Examining Instability and Reversion in the Diagnosis of Mild Cognitive Impairment (P04.207). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p04.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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32
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Schulze Topphoff U, Shetty A, Varrin-Doyer M, Molnarfi N, Sagan S, Sobel R, Nelson P, Zamvil S. Laquinimod Promotes T Cell Immune Modulation in Central Nervous System Autoimmunity Via Type II (M2) Myeloid APC (P02.105). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p02.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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33
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Nelson P, Varrin-Doyer M, Spencer C, Sagan S, Boyd C, Sobel R, Bennett J, Zamvil S. Aquaporin-4 Peptide-Specific T Cells Induce CNS Inflammation (P02.134). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p02.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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34
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Singhal D, Abner E, Schmitt F, Nelson P, Jicha G. Antipsychotic Use Is Not Associated with an Increased Burden of Cerebrovascular Pathology at Autopsy (S04.004). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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35
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Abstract
This review brings together for the first time the existing quantitative and qualitative research evidence about the experiences of parents caring for a child with a cleft. It summarizes salient themes on the emotional, social and service-related experiences of parents and critiques the literature to date, comparing it with wider, selected literature from the field of children's long-term conditions, including disability. The review suggests that there are similarities and differences between the literatures, in terms of research focus and approach. Similarities are found across children's conditions in the perspectives of parents on emotional, social and service-related aspects, although much of the cleft literature is focused on the early stages of children's lives. However, the quality of cleft research to date about parents' experiences has also been variable, with a narrow emphasis on cross-sectional, deficit-orientated psychological approaches focused mainly on mothers. Despite a substantial literature, little qualitative research has examined parents' perspectives in-depth, particularly about their child's treatment journey. This contrasts with the wider children's literature, which has traditionally drawn not only on psychological approaches but also on the broader perspectives of sociology, social policy, nursing and health services research, using both qualitative and quantitative methods, often in integrated ways. Such approaches have been able to highlight a greater range of experiences from both mothers and fathers, about caring for a child with a long-term condition and views about treatment. The review identifies a lack of comparable research in the cleft field to examine parents' experiences and needs at different stages of their children's lives. Above all, research is needed to investigate how both mothers and fathers might experience the long-term and complex treatment journey as children become older and to elicit their views about decision making for cleft treatments, particularly elective surgeries.
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Affiliation(s)
- P Nelson
- School of Community Based Medicine, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
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Sellheyer K, Nelson P, Kutzner H. Fibroepithelioma of Pinkus is a true basal cell carcinoma developing in association with a newly identified tumour-specific type of epidermal hyperplasia. Br J Dermatol 2011; 166:88-97. [PMID: 21910710 DOI: 10.1111/j.1365-2133.2011.10612.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fibroepithelioma of Pinkus (FEP) has long been viewed as a subtype of basal cell carcinoma (BCC). Recently, however, the proposal has been made that FEP represents a fenestrated trichoblastoma/trichoepithelioma. One of the main arguments is the presence of Merkel cells in FEP, which typically do not occur in BCC. OBJECTIVES As the new stem cell marker, PHLDA1 (TDAG51), labels trichoepithelioma but not BCC, our aim was to characterize its staining pattern in FEP. Because adnexal tumours have been viewed as recapitulating embryogenesis, we also examined PHLDA1 immunoreactivity in the skin of human embryos and fetuses. METHODS We studied immunohistochemically PHLDA1 staining in 31 FEPs, 14 BCCs and 16 trichoepitheliomas and compared this with its staining pattern in embryonic skin and with the distribution of Merkel cells. RESULTS In FEP, PHLDA1 labels the anastomosing network of thin cellular strands but not the basaloid nubbins. During embryogenesis, PHLDA1 stains the basal cell layer of the epidermis, as long as adnexal structures develop. Immunoreactivity for PHLDA1 correlates positively with the presence of Merkel cells. CONCLUSIONS We propose that the thin anastomosing network of PHLDA1-positive cells represents a type of epidermal hyperplasia specific to FEP. The multifocal BCCs that are PHLDA1-negative develop from this network which becomes incorporated into the tumour. Viewing the anastomosing network as a tumour-specific form of epidermal hyperplasia explains the hitherto enigmatic presence of Merkel cells in FEP.
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Affiliation(s)
- K Sellheyer
- Department of Dermatology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
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Krajcer Z, Nelson P, Bianchi C, Rao V, Morasch M, Bacharach J. Percutaneous endovascular abdominal aortic aneurysm repair: methods and initial outcomes from the first prospective, multicenter trial. J Cardiovasc Surg (Torino) 2011; 52:651-659. [PMID: 21796092] [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: 05/31/2023]
Abstract
AIM A totally percutaneous approach to endovascular abdominal aortic aneurysm repair (PEVAR) has been shown in multiple single center reports to be feasible. Nonetheless, questions regarding the broader applicability of the approach remain due to the lack of a randomized multicenter trial, thus preventing more widespread adoption. We report the methods and outcomes from the roll-in phase of the first prospective, multicenter trial of PEVAR. METHODS Among 19 institutions participating in the PEVAR Trial (NCT01070069), 38 consecutive patients with abdominal aortic aneurysm were enrolled in a roll-in phase between April 2010 and May 2011. PEVAR procedures with adjunctive "pre-close" of the common femoral arteries (CFAs) targeted for large sheath access using the ProGlide or Prostar XL closure devices were performed using the Endologix IntuiTrak System. All patients were followed periprocedurally and to 30 days for major adverse events and access-related vascular complications. RESULTS Patients presented at a mean age of 71 years with mean aneurysm sac diameter of 5.6cm. Technical success of the pre-close procedure was 97% (37/38 patients). In one patient, ProGlide devices failed to achieve ipsilateral CFA hemostasis, leading to bleeding requiring transfusion and surgical vascular repair. All endovascular repairs were successful. No mortality or major adverse events occurred. Other pre-close related complications occurring within 30 days included pseudoaneurysm, lower extremity ischemia, and blood transfusion. CONCLUSION PEVAR with adjunctive 'pre-close' techniques using the ProGlide or Prostar XL devices is safe and feasible as applied in this multicenter experience. Continued evaluation in the prospective, randomized trial is warranted.
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Affiliation(s)
- Z Krajcer
- St. Luke's Episcopal Hospital, Texas Heart Institute Houston, TX, USA.
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Sellheyer K, Atanaskova-Mesinkovska N, Nelson P, Bergfeld W. Differential expression of stem cell markers in lichen planopilaris and alopecia areata. Br J Dermatol 2011; 165:1149-51. [DOI: 10.1111/j.1365-2133.2011.10491.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Horyniak D, Nelson P, Cowie B, Hagan H, Jarlais DD, Degenhardt L, Kinner S. P2-416 Estimating the prevalence of hepatitis B infection among people who inject drugs: results from a global systematic review. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976l.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Schoch CL, Crous PW, Groenewald JZ, Boehm EWA, Burgess TI, de Gruyter J, de Hoog GS, Dixon LJ, Grube M, Gueidan C, Harada Y, Hatakeyama S, Hirayama K, Hosoya T, Huhndorf SM, Hyde KD, Jones EBG, Kohlmeyer J, Kruys A, Li YM, Lücking R, Lumbsch HT, Marvanová L, Mbatchou JS, McVay AH, Miller AN, Mugambi GK, Muggia L, Nelsen MP, Nelson P, Owensby CA, Phillips AJL, Phongpaichit S, Pointing SB, Pujade-Renaud V, Raja HA, Plata ER, Robbertse B, Ruibal C, Sakayaroj J, Sano T, Selbmann L, Shearer CA, Shirouzu T, Slippers B, Suetrong S, Tanaka K, Volkmann-Kohlmeyer B, Wingfield MJ, Wood AR, Woudenberg JHC, Yonezawa H, Zhang Y, Spatafora JW. A class-wide phylogenetic assessment of Dothideomycetes. Stud Mycol 2011; 64:1-15S10. [PMID: 20169021 PMCID: PMC2816964 DOI: 10.3114/sim.2009.64.01] [Citation(s) in RCA: 344] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We present a comprehensive phylogeny derived from 5 genes, nucSSU, nucLSU rDNA, TEF1, RPB1 and RPB2, for 356 isolates and 41 families (six newly described in this volume) in Dothideomycetes. All currently accepted orders in the class are represented for the first time in addition to numerous previously unplaced lineages. Subclass Pleosporomycetidae is expanded to include the aquatic order Jahnulales. An ancestral reconstruction of basic nutritional modes supports numerous transitions from saprobic life histories to plant associated and lichenised modes and a transition from terrestrial to aquatic habitats are confirmed. Finally, a genomic comparison of 6 dothideomycete genomes with other fungi finds a high level of unique protein associated with the class, supporting its delineation as a separate taxon.
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Affiliation(s)
- C L Schoch
- National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, 45 Center Drive, MSC 6510, Bethesda, Maryland 20892-6510, U.S.A
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Mostaghel EA, Marck B, Matsumoto AM, Nelson P, Vessella R, Plymate SR, Montgomery RB. Tumor response and adaptation to CYP17 inhibition in prostate cancer: Induction of steroidogenesis and androgen receptor splice variants. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.18] [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: 11/20/2022] Open
Abstract
18 Background: Abiraterone is a novel inhibitor of the steroidogenic enzyme CYP17 and suppresses tumor growth in patients with castration-resistant prostate cancer (CRPC). The efficacy of abiraterone in suppressing tumor androgens or mechanisms of resistance to abiraterone are not known. Methods: Human CRPC xenografts LuCaP 23 and LuCaP 35 grown in castrated male mice were treated with abiraterone to determine effects on tumor growth and tumor androgen levels. Tumor gene expression measurements were obtained to delineate mechanisms of abiraterone resistance. Results: Abiraterone i.p. for 21 days improved survival (time to tumor size 750 mm3) vs vehicle control (VC) in LuCaP 35 (HR 3.8 [95% CI 3.1-53.7] median survival 39 vs 18 days) and LuCap 23 (HR 2.4 [1.43-10.24] median survival 24 vs. 14 days). Greater anti-tumor activity correlated with superior tumor androgen suppression. Tumor testosterone was strongly suppressed in both LuCaP35 (0.20 + 0.24 vs VC 0.69 + 0.36 pg/mg) and LuCaP 23 (0.07 + 0.11 vs VC 0.49 + 0.22 pg/mg). DHT levels were also markedly suppressed in LuCaP35 (1.17 + 1.46 vs VC 3.49 + 1.81pg/mg). In contrast, DHT levels in LuCap23 were unchanged early (day 7-21) and only partially suppressed at longer time points (VC 5.73 + 1.88; early 5.31 + 2.69; late 2.82 + 2.27 pg/mg). Expression of the abiraterone target CYP17 was upregulated in both xenografts (LuCaP23 2.5 fold, p<0.0001; LuCap35 2.9 fold, p=0.028). Overall, LuCap23 appeared resistant to suppression of tumor androgens due to induction of steroidogenic transcripts (including STAR, CYP11, HSD3B1 and AKR1C3) without statistically significant increases in androgen receptor (AR). In contrast, LuCap35 demonstrated strong induction of transcripts for AR and AR splice variants (AR 3.8 fold, p<0.0001, V7 AR splice variant 3.7 fold, p<0.0001), with induction of steroidogenic transcripts only at late time points. Conclusions: Abiraterone treatment suppressed intratumoral androgen levels and reduced growth of CRPC xenografts. Abiraterone resistance may occur through upregulation of the abiraterone target CYP17, and/or the induction of AR and AR splice variants that confer ligand-independent AR trans-activation. [Table: see text]
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Affiliation(s)
- E. A. Mostaghel
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA; University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Urology, University of Washington, Seattle, WA
| | - B. Marck
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA; University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Urology, University of Washington, Seattle, WA
| | - A. M. Matsumoto
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA; University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Urology, University of Washington, Seattle, WA
| | - P. Nelson
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA; University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Urology, University of Washington, Seattle, WA
| | - R. Vessella
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA; University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Urology, University of Washington, Seattle, WA
| | - S. R. Plymate
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA; University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Urology, University of Washington, Seattle, WA
| | - R. B. Montgomery
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA; University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Urology, University of Washington, Seattle, WA
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Valentini F, Nelson P, Osaghae S. UP-2.43: Nervous control of lower urinary tract (LUT) during detrusor overactivity (DO): an approach using modeled analysis of filling cystometries and pressure-flow studies. Urology 2010. [DOI: 10.1016/j.urology.2010.07.277] [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: 10/19/2022]
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Valentini F, Marti B, Robain G, Nelson P, Osaghae S. UP-2.42: Phasic or terminal detrusor overactivity in women: age, urodynamic findings and sphincter behavior relationships. Urology 2010. [DOI: 10.1016/j.urology.2010.07.276] [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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Valentini F, Nelson P, Turner D, Osaghae S. MP-05.03: Sources of variability when using only penile cuff test (PCT) can be rubbed out by combination with “VBN” method. Urology 2010. [DOI: 10.1016/j.urology.2010.07.417] [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: 10/19/2022]
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Slovin SF, Fine S, Nelson P, Steinbrecher J, Eastham J, Coleman J, Touijer KA, Carver BS, Laudone V, Scher HI. Total androgen-receptor gene expression inhibitor therapy (TARGET): A phase II trial of neoadjuvant SAHA (S) followed prostatectomy for patients (pts) with high-risk prostate cancer (pc). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e15133] [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: 11/20/2022] Open
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Beer TM, Rademacher BL, Geng H, Pittsenbarger J, Garzotto M, Nelson P, Higano CS, Qian DZ. Effect of ID1 expression change following chemotherapy on chemotherapy sensitivity. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4548] [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: 11/20/2022] Open
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Risk MC, Mostaghel EA, Marck B, Matsumoto AM, Nelson P, Montgomery RB, Lin DW. Effect of tissue ischemia on prostatic androgen levels. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4643] [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: 11/20/2022] Open
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Sellheyer K, Nelson P, Krahl D. Dermatofibrosarcoma protuberans: a tumour of nestin-positive cutaneous mesenchymal stem cells? Br J Dermatol 2009; 161:1317-22. [DOI: 10.1111/j.1365-2133.2009.09363.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Dugas J, Nieuwenhuijsen MJ, Martinez D, Iszatt N, Nelson P, Elliott P. Use of biocides and insect repellents and risk of hypospadias. Occup Environ Med 2009; 67:196-200. [DOI: 10.1136/oem.2009.047373] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cade JE, Kirk SFL, Nelson P, Hollins L, Deakin T, Greenwood DC, Harvey EL. Can peer educators influence healthy eating in people with diabetes? Results of a randomized controlled trial. Diabet Med 2009; 26:1048-54. [PMID: 19900238 DOI: 10.1111/j.1464-5491.2009.02808.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To assess whether the Expert Patient Programme (EPP), adapted for people with Type 2 diabetes, can be used to promote healthy eating to improve glycaemic control. METHODS Adults with Type 2 diabetes (n = 317) were randomized to receive either a diabetes-specific EPP (n = 162) or individual one-off appointments with a dietitian (control group) (n = 155). The diabetes-specific EPP followed the standard National Health Service programme although all participants in the group had diabetes only, rather than a mix of chronic conditions. Participants attended a group session for 2 h once per week for 6 weeks. In addition, a final seventh-week 2-h session was included that was specific to issues concerning diabetes. Outcomes were assessed at baseline, 6 and 12 months. RESULTS There were no statistically significant differences between the control and the intervention group in any of the clinical outcomes measured. There was no significant difference between the groups in any dietary outcome. There was a higher starch intake in the EPP group, although this did not reach statistical significance (effect size for starch adjusted for baseline values 8.8 g; 95% CI -1.3 to 18.9). There was some loss of participants between baseline measurement and randomization, although this did not appear to have had an important impact on baseline balance. CONCLUSIONS In this study of people with Type 2 diabetes, the EPP approach was not effective in changing measures of diabetes control or diet.
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Affiliation(s)
- J E Cade
- Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds LS2 9JT, UK.
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