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Arendt AM, Heubach F, Maier CP, Giardino S, Jung G, Kowalewski E, Rabsteyn A, Amorelli G, Seitz C, Schlegel P, Handgretinger R, Lang P. Targeting GD2 after allogeneic SCT: effector cell composition defines the optimal use of ch14.18 and the bispecific antibody construct NG-CU (GD2-CD3). Cancer Immunol Immunother 2023; 72:3813-3824. [PMID: 37742286 PMCID: PMC10576705 DOI: 10.1007/s00262-023-03536-x] [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: 05/11/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023]
Abstract
We investigated whether T cell-recruiting bispecific anti-CD3/GD2 antibody NG-CU might be an alternative to therapeutic anti-GD2 monoclonal antibody (mAb) ch14.18, mediating complement-dependent cytotoxicity (CDC) and antibody-dependent cell-mediated cytotoxicity (ADCC) through natural killer (NK) cells for immunotherapy in high-risk/relapsed neuroblastoma after autologous/allogeneic stem cell transplantation (auto/alloSCT). Different antibody concentrations and effector-to-target ratios (E:T) were evaluated using xCELLigence RTCA system, peripheral blood mononuclear cells (PBMCs) (healthy donors and patients after alloSCT), and neuroblastoma cell lines (LS/LAN-1). Mean specific lysis of LS cells utilizing PBMCs from healthy donors and ch14.18 (1 µg/ml) was 40/66/75% after 12/24/48 h compared to 66/93/100% in the presence of NG-CU (100 ng/ml). NG-CU showed enhanced cytotoxicity compared to ch14.18, even at lower concentrations and E:T ratios, and completely eradicated LS cells after 72 h. To decipher the influence of effector cell subsets on lysis, different ratios of T and NK cells were tested. At a ratio of 1:1, ch14.18 was more effective than NG-CU. Using patient PBMCs taken at different time points posttransplant, significant lysis with both constructs was detectable depending on percentages and total numbers of T and NK cells; in the early posttransplant phase, NK cells were predominant and ch14.18 was superior, whereas later on, T cells represented the majority of immune cells and NG-CU was more effective. Our study highlights the importance of analyzing effector cell subsets in patients before initiating antibody-based therapy. Consequently, we propose an adjusted administration of both antibody constructs, considering the state of posttransplant immune recovery, to optimize anti-tumor activity.
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Affiliation(s)
- A-M Arendt
- Department of General Pediatrics, Oncology/Hematology, Children's University Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany.
| | - F Heubach
- Department of General Pediatrics, Oncology/Hematology, Children's University Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany
| | - C P Maier
- Department of General Pediatrics, Oncology/Hematology, Children's University Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany
- Department of Hematology/Oncology, Center for Internal Medicine, University Hospital, Tübingen, Germany
| | - S Giardino
- Hematopoietic Stem Cell Transplantation Unit, Department of Hematology and Oncology, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - G Jung
- Interfaculty Institute for Cell Biology, Department of Immunology, Eberhard Karls University Tuebingen, Tübingen, Germany
| | - E Kowalewski
- Department of General Pediatrics, Oncology/Hematology, Children's University Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany
| | - A Rabsteyn
- Department of General Pediatrics, Oncology/Hematology, Children's University Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany
| | - G Amorelli
- Department of General Pediatrics, Oncology/Hematology, Children's University Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany
| | - C Seitz
- Department of General Pediatrics, Oncology/Hematology, Children's University Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany
| | - P Schlegel
- Department of General Pediatrics, Oncology/Hematology, Children's University Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany
| | - R Handgretinger
- Department of General Pediatrics, Oncology/Hematology, Children's University Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany
| | - P Lang
- Department of General Pediatrics, Oncology/Hematology, Children's University Hospital Tuebingen, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany
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Palma DA, Bahig H, Hope AJ, Harrow S, Debenham BJ, Louie A, Vu T, Filion EJ, Bezjak A, Campeau MP, Duimering A, Giuliani M, Laba JM, Lang P, Lok BH, Qu MX, Raman S, Rodrigues G, Goodman C, Gaede S, Morisset J, Warner A, Dhaliwal I, Ryerson C. Assessment of Precision Irradiation in Early Non-Small Cell Lung Cancer and Interstitial Lung Disease (ASPIRE-ILD): Primary Analysis of a Phase II Trial. Int J Radiat Oncol Biol Phys 2023; 117:S28-S29. [PMID: 37784467 DOI: 10.1016/j.ijrobp.2023.06.289] [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) The use of stereotactic ablative radiotherapy (SABR) in patients with fibrotic interstitial lung disease (ILD) has been associated with an increased risk of toxicity, but patients with ILD and lung cancer may have no other options for curative-intent treatment. The goal of the ASPIRE-ILD trial was to assess the benefits and toxicities of SABR in patients with fibrotic ILD. MATERIALS/METHODS We enrolled patients with fibrotic ILD and a diagnosis of T1-2N0 NSCLC who were not candidates for surgery. All patients were centrally reviewed prior to enrollment to confirm the presence and subtype of ILD. After stratification by the ILD-GAP score (a measure of ILD severity and prognosis), patients were treated with SABR to a dose of 50 Gy in 5 fractions EOD (BED = 100 Gy10), with a built-in de-escalation protocol in case of unacceptable toxicity. The primary endpoint was overall survival (OS), powered to distinguish 1-year OS >70% vs. an unacceptable rate of ≤50%. Secondary endpoints included toxicity (CTC-AE version 4.0), progression-free survival (PFS), local control (LC), patient-reported outcomes (FACT-L quality of life and cough severity), and changes in pulmonary function tests (PFTs). The study pre-specified that SABR would be considered worthwhile if median OS was >1 year, with a grade 3-4 toxicity risk <35% and a grade 5 toxicity risk <15%. Target accrual was 39 treated patients. RESULTS Thirty-nine patients were enrolled and treated with SABR between March 2019 and January 2022, all to a dose of 50 Gy in 5 fractions, at 5 institutions in Canada and 1 in Scotland. Median age was 78 years (interquartile range: 67-83), 59% were male, and 92% had a history of smoking (median 43 pack-years). At baseline, 70% reported dyspnea, median FEV1 was 80% predicted and median DLCO was 49% predicted. ILD-GAP scores were as follows: ≤2 (i.e., best ILD status): n = 14; 3-5: n = 23; ≥6 (i.e., worst ILD status): n = 2. Median follow-up was 19 months. OS at 1-year was 78.9% (p<0.001 by binomial test vs. the unacceptable rate). Median OS was 25 months, median PFS was 19 months, and 2-year LC was 92%. AE rates (possibly, probably or definitely related) were as follows (highest grade per patient): grade 1-2: n = 12 (31%); grade 3: n = 4 (10%); grade 4; n = 0; grade 5 n = 3 (7.7%, all due to respiratory deterioration). AE rates did not differ by ILD-GAP category or ILD subtype. FACT-L scores trended downward over time (p = 0.07), and cough severity scale scores worsened over time (p = 0.02). Comparing last-available PFTs with baseline, DLCO declined (median: -4%; p = 0.046), FVC trended downward (median: -2.5%; p = 0.11), and FEV1 remained stable (median change: 0%). CONCLUSION The use of SABR in patients with ILD met the pre-specified acceptability thresholds for both toxicity and efficacy, supporting the use of SABR for curative-intent treatment after a careful discussion of risks and benefits. Further studies exploring pharmacologic options to reduce toxicity may be beneficial in this population. ().
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Affiliation(s)
- D A Palma
- Department of Oncology, Western University, London, ON, Canada
| | - H Bahig
- Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - A J Hope
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - S Harrow
- Edinburgh Cancer Centre, Edinburgh, United Kingdom
| | | | - A Louie
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - T Vu
- Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - E J Filion
- Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - A Bezjak
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - M P Campeau
- Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | | | - M Giuliani
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - J M Laba
- London Health Sciences Centre, London, ON, Canada
| | - P Lang
- Department of Oncology, Western University, London, ON, Canada
| | - B H Lok
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - M X Qu
- London Regional Cancer Centre, London, ON, Canada
| | - S Raman
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - G Rodrigues
- London Health Sciences Centre, London, ON, Canada
| | - C Goodman
- Department of Radiation Oncology, London Health Sciences Centre, London, ON, Canada
| | - S Gaede
- Department of Medical Physics, Western University, London, ON, Canada
| | - J Morisset
- Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - A Warner
- London Health Sciences Centre, London, ON, Canada
| | - I Dhaliwal
- London Health Sciences Centre, London, ON, Canada
| | - C Ryerson
- University of British Columbia, Vancouver, BC, Canada
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Liu T, Zhou Z, Zhang M, Lang P, Li J, Liu Z, Zhang Z, Li L, Zhang L. Cuproptosis-immunotherapy using PD-1 overexpressing T cell membrane-coated nanosheets efficiently treats tumor. J Control Release 2023; 362:502-512. [PMID: 37652367 DOI: 10.1016/j.jconrel.2023.08.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/02/2023]
Abstract
The cuproptosis cell death pathway brings fresh opportunities for tumor therapy. However, efficient and targeted cuproptosis induction in tumors is still a challenge. Unfortunately, the well-known cuproptosis initiator, disulfiram and copper complex (DSF/Cu2+), also increases PD-L1 level in tumors, which may diminish the final therapeutic outcome. In this study, DSF/Cu2+-loading MXene nanosheets are coated with PD-1 overexpressing T cell membrane to generate CuX-P system. CuX-P could recognize and stick to PD-L1 on tumor cells like a patch, which promotes the endocytosis of both CuX-P and PD-L1 by tumor cells. Following internalization and release of DSF/Cu2+ in the cytoplasm, PD-L1 expression is upregulated. However, due to the presence of CuX-P in the tumor microenvironment, the then supplemented PD-L1 on tumor surface again binds CuX-P for internalization. This feedback loop keeps blocking and consuming the PD-L1 on tumor surface and promotes the enrichment of CuX-P in tumors to induce cuproptosis. After CuX-P treatment with laser irradiation, strong anti-tumor immune responses are stimulated in a mouse model with triple-negative breast cancer. Thus, this study develops a tumor-targeted biomimetic system that offers simultaneous cuproptosis killing, photothermal therapy (PTT) and immunotherapy in mice.
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Affiliation(s)
- Tiantian Liu
- Med-X Center for Materials, College of Polymer Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Zehang Zhou
- State Key Laboratory of Polymer Materials Engineering Polymer Research Institute of Sichuan University, College of Polymer Science and Engineering, Chengdu 610065, China
| | - Mengxing Zhang
- Med-X Center for Materials, College of Polymer Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Puxin Lang
- Med-X Center for Materials, College of Polymer Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Jing Li
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Zhenmi Liu
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Zhirong Zhang
- Key Laboratory of Drug Targeting and Drug Delivery Systems of Ministry of Education, West China School of Pharmacy, Sichuan University, Chengdu 610065, China
| | - Lin Li
- Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.
| | - Ling Zhang
- Med-X Center for Materials, College of Polymer Science and Engineering, Sichuan University, Chengdu 610065, China.
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Wang E, Abdallah H, Snir J, Chong J, Palma DA, Mattonen SA, Lang P. Predicting Dosimetry of Stereotactic Ablative Radiotherapy for the Treatment of Multiple Lung Lesions. Int J Radiat Oncol Biol Phys 2023; 117:e732. [PMID: 37786130 DOI: 10.1016/j.ijrobp.2023.06.2254] [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) Stereotactic ablative radiotherapy (SABR) has recently been used to treat increasing numbers of lung metastases, either synchronously or over multiple courses of treatment. Selecting the optimal dose and fractionation to balance risk of local failure and treatment toxicity is challenging. This project uses machine learning to provide rapid dosimetry predictions of SABR to multiple lung lesions, allowing exploration of different dose prescription options prior to the radiation (RT) planning process. MATERIALS/METHODS A generative adversarial network (GAN) was trained to predict the dosimetry of multi-lesion thoracic SABR treatment from the planning CT scan, target and organ at risk contours, and the prescribed dose-fractionation without the need to carry out treatment planning. RT plans of patients who received at least one SABR treatment for ≥2 lung lesions between 2014-2020 at a single tertiary center were included in the analysis. All prescriptions were converted to their equivalent doses in two Gray fractions (EQD2). SABR treatments received at different timepoints were registered, and EQD2 doses were accumulated with no repair. Model performance was assessed using 5-fold cross validation. Plans were randomly divided into 5 folds, stratified by the number of lesions (no patients crossed folds). Each fold served as the testing set once, with the model trained on the other 4 folds. The model was evaluated on the difference in the volume of lung receiving above 20 Gray (V20) of the predicted dosimetry compared to the true dosimetry. RESULTS Treatment plans (n = 103) were included from 81 patients with 280 lesions (62, 23, 8, and 10 plans had 2, 3, 4, and ≥5 lesions respectively). Fifty-five, 18, and 4 patients had a single, 2 and 3 courses of RT respectively. Fifty-two patients were treated for primary lung cancer, 28 patients treated for metastases from other sites, and 1 patient for both. Seven patients (8.6%) developed ≥ Grade 2 pneumonitis. Doses prescribed were 60/8 (n = 136), 55/5 (n = 49), 54/3 (n = 27), 24/1 (n = 21), 35/5 (n = 13), 30/5 (n = 9), and other (n = 25). The mean lung V20 for all patients was 11.3% [1.5%-29.6%]; the mean lung V20 was 9.3%, 12.2%, 13.5% and 20.4% for plans with 2, 3, 4, ≥ 5 lesions respectively. The mean absolute difference (MAD) in lung V20 between the predicted dosimetry and true dosimetry over all 5-folds was 1.9% [0.0%-13.4%]; the MAD in lung V20 between the predicted and actual dosimetry was 1.6%, 2.1%, 2.9% and 2.6% for plans with 2, 3, 4, ≥ 5 lesions respectively. CONCLUSION The GAN-based model created in this study can predict the dosimetry of any number of lesions in the thorax treated with SABR. The model can be used to quickly determine the feasibility of SABR treatment for multiple synchronous lesions, or in the retreatment setting. The ability to explore the dosimetry of different prescription options for a given patient prior to RT planning may allow for personalized risk-adapted treatment if combined with local control and toxicity modelling.
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Affiliation(s)
- E Wang
- Department of Medical Biophysics, Western University, London, ON, Canada
| | - H Abdallah
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - J Snir
- London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada
| | - J Chong
- Department of Medical Imaging, Western University, London, ON, Canada
| | - D A Palma
- Department of Oncology, Western University, London, ON, Canada
| | - S A Mattonen
- Department of Medical Biophysics, Western University, London, ON, Canada
| | - P Lang
- Department of Oncology, Western University, London, ON, Canada
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Lang P, Liu T, Huang S, Zhou Z, Zhang M, Lin Y, He Q, Yao Y, Liu Z, Zhang L. Degradable Temperature-Sensitive Hydrogel Loaded with Heparin Effectively Prevents Post-Operative Tissue Adhesions. ACS Biomater Sci Eng 2023. [PMID: 37179492 DOI: 10.1021/acsbiomaterials.3c00017] [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: 05/15/2023]
Abstract
Tissue adhesions could occur following surgeries, and severe tissue adhesions can lead to serious complications. Medical hydrogels could be applied at surgical sites as a physical barrier to prevent tissue adhesion. For practical reasons, spreadable, degradable, and self-healable gels are highly demanded. To meet these requirements, we applied carboxymethyl chitosan (CMCS) to poloxamer-based hydrogels to generate low Poloxamer338 (P338) content gels displaying low viscosity at refrigerator temperature and improved mechanical strength at body temperature. Heparin, an effective adhesion inhibitor, was also added to construct P338/CMCS-heparin composite hydrogel (PCHgel). PCHgel presents as a flowable liquid below 20 °C and could rapidly transform into gel when spread on the surface of damaged tissue due to temperature change. The introduction of CMCS enabled hydrogels to form a stable self-healable barrier at injured positions and slowly release heparin during the wound healing period before being degraded after ∼14 days. Ultimately, PCHgel significantly reduced tissue adhesion in model rats and displayed higher efficiency than P338/CMCS gel without heparin. Its adhesion suppression mechanism was verified, and it also displayed good biosafety. Therefore, PCHgel showed good clinical transformation potential with high efficacy, good safety, and ease of use.
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Affiliation(s)
- Puxin Lang
- College of Polymer Science and Engineering, Sichuan University, Chengdu, Sichuan 610000, China
| | - Tiantian Liu
- College of Polymer Science and Engineering, Sichuan University, Chengdu, Sichuan 610000, China
| | - Shiqi Huang
- College of Polymer Science and Engineering, Sichuan University, Chengdu, Sichuan 610000, China
| | - Zhaojie Zhou
- College of Polymer Science and Engineering, Sichuan University, Chengdu, Sichuan 610000, China
| | - Mengxing Zhang
- College of Polymer Science and Engineering, Sichuan University, Chengdu, Sichuan 610000, China
| | - Yunzhu Lin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610000, China
- West China School of Pharmacy, Sichuan University, Chengdu, Sichuan 610000, P. R. China
| | - Qin He
- Med-X Center for Materials, Sichuan University, Chengdu, Sichuan 610000, China
- West China School of Pharmacy, Sichuan University, Chengdu, Sichuan 610000, P. R. China
| | - Yuqin Yao
- Med-X Center for Materials, Sichuan University, Chengdu, Sichuan 610000, China
| | - Zhenmi Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610000, China
| | - Ling Zhang
- College of Polymer Science and Engineering, Sichuan University, Chengdu, Sichuan 610000, China
- Med-X Center for Materials, Sichuan University, Chengdu, Sichuan 610000, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610000, China
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Gulstene S, Lang P, Qu M, Laba J, Yaremko B, Rodrigues G, Yu E, Warner A, Palma D. Assessing Treatment Response after Lung SABR: An Evaluation of the Predictive Value of RECIST Criteria. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1510] [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: 11/27/2022]
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McCready A, Quinn M, Francis P, Stortz R, Kuruvilla S, Stewart P, Palma D, Lang P, Read N, Sathya J, Venkatesan V, Nichols A, MacNeil D, Fung K, Mendez A, Carreau C, Hawkins S, Parker C, Warner L, Winquist E. Impact of a Head and Neck Cancer Chemoradiation (HNC CRT) Nurse Practitioner (NP) on Patient Outcomes. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zayed S, Lin C, Boldt G, Lang P, Read N, Venkatesan V, Sathya J, Fung K, MacNeil D, Mendez A, Yoo J, Warner A, Nichols A, Palma D. Survival Outcomes in Primary Head and Neck Adult Sarcoma: A Systematic Review and Meta-Analysis. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1115] [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: 10/20/2022]
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Zayed S, Lin C, Boldt G, Lang P, Read N, Venkatesan V, Sathya J, Fung K, MacNeil D, Mendez A, Yoo J, Warner A, Nichols A, Palma D. Survival Outcomes in Primary Angiosarcoma of the Head and Neck: A Systematic Review and Meta-Analysis. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wegener D, Lang P, Paulsen F, Weidner N, Zips D, Ebinger M, Holzer U, Döring M, Heinzelmann F. Primary immunosuppressive TNI-based conditioning regimens in pediatric patients treated with haploidentical hematopoietic cell transplantation. Strahlenther Onkol 2021; 198:66-72. [PMID: 34476532 PMCID: PMC8760200 DOI: 10.1007/s00066-021-01840-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/09/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This retrospective analysis aims to address the toxicity and efficacy of a modified total nodal irradiation (TNI)-based conditioning regimen before haploidentical hematopoietic cell transplantation (HCT) in pediatric patients. MATERIALS AND METHODS Patient data including long-term follow-up were evaluated of 7 pediatric patients with malignant (n = 2) and non-malignant diseases (n = 5) who were treated by a primary TNI-based conditioning regimen. TNI was performed using anterior/posterior opposing fields. All patients received 7 Gy single-dose TNI combined with systemic agents followed by an infusion of peripheral blood stem cells (n = 7). All children had haploidentical family donors. RESULTS Engraftment was reached in 6/7 children after a median time of 9.5 days; 1 child had primary graft failure but was successfully reconditioned shortly thereafter. After an average follow-up time of 103.5 months (range 8.8-138.5 months), event-free (EFS) and overall survival (OS) rates were 71.4% and 85.7%, respectively. One child with a non-malignant disease died 8.8 months after transplantation due to a relapse and a multiple organ failure. Follow-up data was available for 5/6 long-term survivors with a median follow-up (FU) of 106.2 months (range 54.5-138.5 months). Hypothyroidism and deficiency of sexual hormones was present in 3/5 patients each. Mean forced expiratory volume in 1 s (FEV1) after TNI was 71%; mean vital capacity (VC) was 78%. Growth failure (< 10th percentile) occurred in 2/5 patients (height) and 1/5 patient (weight). No secondary malignancies were reported. CONCLUSION In this group of patients, a primary single-dose 7 Gy TNI-based conditioning regimen before HCT in pediatric patients allowed sustained engraftment combined with a tolerable toxicity profile leading to long-term OS/EFS. Late toxicity after a median FU of over 9 years includes growth failure, manageable hormonal deficiencies, and acceptable decrease in lung function.
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Affiliation(s)
- D Wegener
- Department of Radiation Oncology, University Clinic of Tuebingen, Tuebingen, Germany.
| | - P Lang
- Department of Paediatrics I, Hematology and Oncology, University Clinic of Tuebingen, Tuebingen, Germany
| | - F Paulsen
- Department of Radiation Oncology, University Clinic of Tuebingen, Tuebingen, Germany
| | - N Weidner
- Department of Radiation Oncology, University Clinic of Tuebingen, Tuebingen, Germany
| | - D Zips
- Department of Radiation Oncology, University Clinic of Tuebingen, Tuebingen, Germany
| | - M Ebinger
- Department of Paediatrics I, Hematology and Oncology, University Clinic of Tuebingen, Tuebingen, Germany
| | - U Holzer
- Department of Paediatrics I, Hematology and Oncology, University Clinic of Tuebingen, Tuebingen, Germany
| | - M Döring
- Department of Paediatrics I, Hematology and Oncology, University Clinic of Tuebingen, Tuebingen, Germany
| | - F Heinzelmann
- Department of Radiation Oncology, Clinic of Esslingen, Esslingen, Germany
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Thiel U, Schober SJ, Ranft A, Gassmann H, Jabar S, Gall K, von Lüttichau I, Wawer A, Koscielniak E, Diaz MA, Ussowicz M, Kazantsev I, Afanasyev B, Merker M, Klingebiel T, Prete A, Gruhn B, Bader P, Jürgens H, Dirksen U, Handgretinger R, Burdach S, Lang P. Correction to: No difference in survival after HLA mismatched versus HLA matched allogeneic stem cell transplantation in Ewing sarcoma patients with advanced disease. Bone Marrow Transplant 2021; 56:2320. [PMID: 34373590 PMCID: PMC8410592 DOI: 10.1038/s41409-021-01421-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- U Thiel
- Department of Pediatrics and Children's Cancer Research Center, School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany.
| | - S J Schober
- Department of Pediatrics and Children's Cancer Research Center, School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany
| | - A Ranft
- Pediatrics III, West German Cancer Centre Essen, University Hospital Essen, Essen, Germany
| | - H Gassmann
- Department of Pediatrics and Children's Cancer Research Center, School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany
| | - S Jabar
- Pediatrics III, West German Cancer Centre Essen, University Hospital Essen, Essen, Germany
| | - K Gall
- Department of Pediatrics and Children's Cancer Research Center, School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany
| | - I von Lüttichau
- Department of Pediatrics and Children's Cancer Research Center, School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany
| | - A Wawer
- Department of Pediatrics and Children's Cancer Research Center, School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany
| | - E Koscielniak
- Department of Pediatric Oncology, Hematology and Immunology, Olgahospital, Stuttgart, Germany
| | - M A Diaz
- Department of Pediatric Hematology-Oncology and Hematopoietic Stem Cell Transplantation, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - M Ussowicz
- Department of Pediatric Hematology, Oncology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - I Kazantsev
- Raisa Gorbacheva Memorial Institute for Pediatric Oncology, Hematology and Transplantat, Pavlov First St. Petersburg State Universityion, St. Petersburg, Russia
| | - B Afanasyev
- Raisa Gorbacheva Memorial Institute for Pediatric Oncology, Hematology and Transplantat, Pavlov First St. Petersburg State Universityion, St. Petersburg, Russia
| | - M Merker
- Department of Pediatric Hematology and Oncology, Universitätsklinikum Frankfurt, Frankfurt, Germany
| | - T Klingebiel
- Department of Pediatric Hematology and Oncology, Universitätsklinikum Frankfurt, Frankfurt, Germany
| | - A Prete
- Department of Pediatric Hematology and Oncology, Ospedale S Orsola Malpighi, Bologna, Italy
| | - B Gruhn
- Department of Pediatrics, Jena University Hospital, Jena, Germany
| | - P Bader
- Department of Pediatric Hematology and Oncology, Universitätsklinikum Frankfurt, Frankfurt, Germany
| | - H Jürgens
- Department of Pediatric Hematology and Oncology, Universitätsklinikum Münster, Münster, Germany
| | - U Dirksen
- Pediatrics III, West German Cancer Centre Essen, University Hospital Essen, Essen, Germany
| | - R Handgretinger
- Department of Pediatric Hematology and Oncology, Universitätsklinikum Tübingen, Tübingen, Germany
| | - S Burdach
- Department of Pediatrics and Children's Cancer Research Center, School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany
| | - P Lang
- Department of Pediatric Hematology and Oncology, Universitätsklinikum Tübingen, Tübingen, Germany
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Dahan LS, Giorgi R, Vergez S, Le Taillandier de Gabory L, Costes-Martineau V, Herman P, Poissonnet G, Mauvais O, Malard O, Garrel R, Uro-Coste E, Barry B, Bach C, Chevalier D, Mouawad F, Merol JC, Bastit V, Thariat J, Gilain L, Dufour X, Righini CA, Moya-Plana A, Even C, Radulesco T, Michel J, Baujat B, Fakhry N, Albert S, Andry G, Babin E, Bach C, Badet JM, Badoual C, Baglin A, Banal A, Barry B, Baudin E, Baujat B, Bensadoun R, Bertolus C, Bessède JP, Blanchard D, Borel C, Bozorg-Grayeli A, Breheret R, Breton P, Brugel L, Calais G, Casiraghi O, Cassagnau E, Castillo L, Ceruse P, Chabolle F, Chevalier D, Chobaut J, Choussy O, Cosmidis A, Coste A, Costes V, Crampette L, Darrouzet V, Demez P, Dessi P, Devauchelle B, Dolivet G, Dubrulle F, Duflo S, Dufour X, Faivre S, Fakhry N, Ferron C, Floret F, de Gabory L, Garrel R, Geoffrois L, Gilain L, Giovanni A, Girod A, Guerrier B, Hans S, Herman P, Hofman P, Housset M, Jankowski R, Jegoux F, Juliéron M, Kaminsky MC, Kolb F, St Guily JL, Laccoureye L, Lallemant B, Lang P, Lartigau E, Lavieille JP, Lefevre M, Leroy X, Malard O, Massip F, Mauvais O, Merol JC, Michel J, Mom T, Morinière S, de Monès E, Moulin G, Noel G, Poissonnet G, Prades JM, Radulesco T, de Raucourt D, Reyt E, Righini C, Robin YM, Rolland F, Ruhin B, Sarroul N, Schultz P, Serrano E, Sterkers O, Strunski V, Sudaka A, Tassart M, Testelin S, Thariat J, Timochenko A, Toussaint B, Coste EU, Valette G, Van den Abbeele T, Varoquaux A, Veillon F, Vergez S, Wassef M. Mucoepidermoid carcinoma of salivary glands: A French Network of Rare Head and Neck Tumors (REFCOR) prospective study of 292 cases. Eur J Surg Oncol 2021; 47:1376-1383. [DOI: 10.1016/j.ejso.2020.11.123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/31/2020] [Accepted: 11/13/2020] [Indexed: 12/18/2022] Open
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Weißleder A, Kulla M, Annecke T, Beese A, Lang P, Beinkofer D, Lefering R, Trentzsch H, Jost C, Treffer D. [Acute treatment of pregnant women after severe trauma-a retrospective multicenter analysis]. Unfallchirurg 2020; 123:944-953. [PMID: 33180155 DOI: 10.1007/s00113-020-00915-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND For the medical team, the management of pregnant trauma patients is a particular challenge. The aim of this study is to compile this data and to determine differences between pregnant and not pregnant trauma patients. MATERIALS AND METHODS We carried out a retrospective data analysis from the TraumaRegister DGU® with a comparison of 102 pregnant and 3135 not pregnant women of child-bearing age (16-45 years) from 2016-2018 who were treated in a trauma center. All patients were delivered to the resuscitation room and received intensive care treatment. RESULTS In Germany, Austria and Switzerland 3.2% of all trauma patients (102 women) were pregnant. Women with an average age of 29 years suffered most often trauma as a result of a road traffic accident. Major trauma (Injury Severity Score [ISS] ≥16 points) was seen in 24.5% of the pregnant women and 37.4% of the nonpregnant women. A computer tomography (whole body computer tomography) was carried out in 32.7% of all pregnant women but in 79.8% of the nonpregnant women. As a result of the trauma, 2.9% of the pregnant and 3.5% of the not pregnant women died. The standardised mortality rate (SMR) was 0.42 in pregnant women and 0.63 in nonpregnant women. CONCLUSION For the first time there is data regarding incidence, trauma mechanism, prehospital and in-hospital care as well as intensive care of pregnant trauma patients in Germany, Austria and Switzerland. Further research regarding foetal outcome and trauma-related injuries in pregnant women is needed to develop an adjusted management for these patients ready to implement in trauma centres. Gynaecologists and obstetricians should be implemented in the trauma room team when needed.
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Affiliation(s)
- A Weißleder
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.
- Klinik XX Gynäkologie, Bundeswehrkrankenhaus Westerstede, Westerstede, Deutschland.
| | - M Kulla
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland
| | - T Annecke
- Universität zu Köln, Medizinische Fakultät und Uniklinik, Klinik für Anästhesiologie und Operative Intensivmedizin, Kerpener Straße 62, 50937, Köln, Deutschland
- Klinik für Anästhesiologie und operative Intensivmedizin, Klinikum der Universität Witten/Herdecke - Krankenhaus Köln-Merheim, Köln, Deutschland
| | - A Beese
- Praxis für Frauenheilkunde & Geburtshilfe Jena, Jena, Deutschland
| | - P Lang
- Klinik für Unfallchirurgie und Orthopädie, Septische und Rekonstruktive Chirurgie, Sporttraumatologie, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke am Campus Köln-Merheim, Köln-Merheim, Deutschland
| | - D Beinkofer
- Klinik XX Gynäkologie, Bundeswehrkrankenhaus Westerstede, Westerstede, Deutschland
| | - R Lefering
- Klinik für Unfallchirurgie und Orthopädie, Septische und Rekonstruktive Chirurgie, Sporttraumatologie, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke am Campus Köln-Merheim, Köln-Merheim, Deutschland
| | - H Trentzsch
- Institut für Notfallmedizin und Medizinmanagement (INM), Klinikum der Universität München, LMU München, Schillerstraße 53, 80336, München, Deutschland
| | - C Jost
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland
| | - D Treffer
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland
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Steinfeldt T, Kessler P, Vicent O, Schwemmer U, Döffert J, Lang P, Mathioudakis D, Hüttemann E, Armbruster W, Sujatta S, Lange M, Weber S, Reisig F, Hillmann R, Volk T, Wiesmann T. [Peripheral truncal blocks-Overview and assessment]. Anaesthesist 2020; 69:860-877. [PMID: 32620990 DOI: 10.1007/s00101-020-00809-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
By implementation of sonography for regional anesthesia, truncal blocks became more relevant in the daily practice of anesthesia and pain therapy. Due to visualized needle guidance ultrasound supports more safety and helps to avoid complications during needle placement. Additionally, complex punctures are possible that were associated with higher risk using landmarks alone. Next to the blocking of specific nerve structures, interfascial and compartment blocks have also become established, whereby the visualization of individual nerves and plexus structures is not of relevance. The present review article describes published and clinically established puncture techniques with respect to the indications and procedures. The clinical value is reported according to the scientific evidence and the analgesic profile. Moreover, the authors explain potential risks, complications and dosing of local anesthetic agents.
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Affiliation(s)
- T Steinfeldt
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Diakoneo DIAK Klinikum, Diakoniestr. 10, 74523, Schwäbisch Hall, Deutschland.
- Klinik für Anästhesie und Intensivtherapie, Philipps-Universität Marburg, Baldingerstr., 35033, Marburg, Deutschland.
| | - P Kessler
- Abteilung für Anästhesiologie, Intensiv- und Schmerzmedizin, Orthopädische Universitätsklinik Friedrichsheim, Marienburgstraße 2, 60528, Frankfurt am Main, Deutschland
| | - O Vicent
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Karl-Gustav Carus, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - U Schwemmer
- Klinik für Anästhesiologie und Intensivmedizin, Kliniken des Landkreises Neumarkt i.d.OPf., Nürnberger Str. 12, 92318, Neumarkt i.d.OPf., Deutschland
| | - J Döffert
- , Leipzigerstraße 18, 76356, Weingarten, Deutschland
| | - P Lang
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Klinikum am Bruderwald, Sozialstiftung Bamberg, Burger Str. 80, 96049, Bamberg, Deutschland
| | - D Mathioudakis
- Centre Hospitalier Bienne, Chante-Merle 84, Case postale, 2501, Bienne, Schweiz
| | - E Hüttemann
- Klinik für Anästhesiologie und Intensivmedizin, Klinikum Worms gGmbH, Gabriel-von-Seidl-Straße 81, 67550, Worms, Deutschland
| | - W Armbruster
- Klinik für Anästhesiologie, Intensivmedizin, Schmerztherapie, Evangelisches Krankenhaus Unna, Holbeinstraße 10, 59423, Unna., Deutschland
| | - S Sujatta
- Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum Bayreuth GmbH, Preuschwitzer Straße 101, 95445, Bayreuth, Deutschland
| | - M Lange
- Abteilung Anästhesie und Intensivtherapie, Waldkrankenhaus "Rudolf Elle" GmbH, Klosterlausnitzer Straße 81, 07607, Eisenberg, Deutschland
| | - S Weber
- Klinik für Anästhesie, Intensivmedizin und Schmerztherapie, Heilig Geist Krankenhaus Köln, Graseggerstr. 105, 50737, Köln, Deutschland
| | - F Reisig
- Standort Burgdorf, Schweiz. Abteilung für Anästhesiologie, Spital Emmental, Oberburgstraße 54, 3400, Burgdorf, Schweiz
| | - R Hillmann
- , Goethestr. 35, 73614, Schorndorf, Deutschland
| | - T Volk
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, Gebäude 57, 66421, Homburg, Deutschland
| | - T Wiesmann
- Klinik für Anästhesie und Intensivtherapie, UKGM Gießen-Marburg, Standort Marburg, Baldingerstr., 35033, Marburg, Deutschland
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15
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Hütter C, Lanner M, Aigmüller T, Simon K, Hofmann P, Kratky M, Engelmann G, Mutz-Eckhart C, Blatt-Gunegger M, Klammer S, Berger G, Bermann C, Resetarits K, Huber A, Lang P, Lessiak V, Tamussino K. Implementierung der prophylaktischen bilateralen Salpingektomie (PBS) bei der minimal-invasiven Hysterektomie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713204] [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: 10/24/2022] Open
Affiliation(s)
- C Hütter
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz
| | - M Lanner
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz
| | | | - K Simon
- LKH Hochsteiermark, Standort Leoben
| | - P Hofmann
- LKH Weststeiermark, Standort Deutschlandsberg
| | - M Kratky
- LKH Weststeiermark, Standort Deutschlandsberg
| | - G Engelmann
- LKH Murtal, Standort Judenburg
- LKH Rottenmann
| | | | | | | | | | | | | | | | - P Lang
- Krankenhaus der Barmherzigen Brüder Graz
| | - V Lessiak
- Krankenhaus der Barmherzigen Brüder Graz
| | - K Tamussino
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz
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16
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Tomasch G, Lemmerer M, Oswald S, Schauer C, Schütz AM, Bliem B, Lang P, Rosanelli G, Ronaghi F, Tschmelitsch J, Tamussino K. Prophylaktische Salpingektomie im Rahmen der laparoskopischen Cholezystektomie (SaLCHE): Geht das? Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3403401] [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: 10/24/2022] Open
Affiliation(s)
- G Tomasch
- Univ.-Klinik für Frauenheilkunde und Geburtshilfe, MedUni Graz
| | - M Lemmerer
- Abteilung für Chirurgie, KH der Barmherzigen Brüder (BHB) Graz
- Univ.-Klinik für Chirurgie, MedUni Graz
| | - S Oswald
- Abteilung für Chirurgie, KH der Elisabethinen Graz
| | - C Schauer
- Abteilung für Gynäkologie, KH der BHB Graz
| | - A M Schütz
- Univ.-Klinik für Frauenheilkunde und Geburtshilfe, MedUni Graz
| | - B Bliem
- Univ.-Klinik für Frauenheilkunde und Geburtshilfe, MedUni Graz
| | - P Lang
- Abteilung für Gynäkologie, KH der BHB Graz
| | - G Rosanelli
- Abteilung für Chirurgie, KH der Elisabethinen Graz
| | - F Ronaghi
- Abteilung für Gynäkologie und Geburtshilfe, KH der BHB St.Veit/Glan
| | | | - K Tamussino
- Univ.-Klinik für Frauenheilkunde und Geburtshilfe, MedUni Graz
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17
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Hütter C, Lanner M, Aigmüller T, Simon K, Hofmann P, Kratky M, Engelmann G, Mutz-Eckhart C, Blatt-Gunegger M, Klammer S, Berger G, Bermann C, Resetarits K, Huber A, Lang P, Lessiak V, Tamussino K. Implementierung der prophylaktischen bilateralen Salpingektomie (PBS) bei der minimal-invasiven Hysterektomie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3403389] [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: 10/24/2022] Open
Affiliation(s)
- C Hütter
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz
| | - M Lanner
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz
| | | | - K Simon
- LKH Hochsteiermark, Standort Leoben
| | - P Hofmann
- LKH Weststeiermark, Standort Deutschlandsberg
| | - M Kratky
- LKH Weststeiermark, Standort Deutschlandsberg
| | | | | | | | | | | | | | | | | | - P Lang
- Krankenhaus der Barmherzigen Brüder Graz
| | - V Lessiak
- Krankenhaus der Barmherzigen Brüder Graz
| | - K Tamussino
- Universitätsklinik für Frauenheilkunde und Geburtshilfe der Med. Universität Graz
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Rinner H, Trost J, Schilcher D, Schauer C, Lang P. Nutzen einer endozervikalen Kürettage unmittelbar nach einer Konisation. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3403397] [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: 10/24/2022] Open
Affiliation(s)
- H Rinner
- Abteilung für Gynäkologie, Krankenhaus Barmherzige Brüder Graz
| | - J Trost
- Abteilung für Gynäkologie, Krankenhaus Barmherzige Brüder Graz
| | - D Schilcher
- Abteilung für Gynäkologie, Krankenhaus Barmherzige Brüder Graz
| | - C Schauer
- Abteilung für Gynäkologie, Krankenhaus Barmherzige Brüder Graz
| | - P Lang
- Abteilung für Gynäkologie, Krankenhaus Barmherzige Brüder Graz
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19
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Varatheeswaran R, Hassan U, Pillen S, Lang P, Yuen K, Meyer B, Kalisch R, Bergmann T. P12 Connectivity-informed concurrent TMS-fMRI for indirect stimulation of the ventromedial prefrontal cortex. Clin Neurophysiol 2020. [DOI: 10.1016/j.clinph.2019.12.123] [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: 10/24/2022]
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20
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Mack I, Erlanger TE, Lang P, Sinniger P, Perisa D, Heininger U. Dose-dependent effectiveness of acellular pertussis vaccine in infants: A population-based case-control study. Vaccine 2019; 38:1444-1449. [PMID: 31813648 DOI: 10.1016/j.vaccine.2019.11.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 09/24/2019] [Revised: 11/23/2019] [Accepted: 11/27/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pertussis is a vaccine-preventable disease which is most severe in young infants. More than two decades after the introduction of acelluar pertussis vaccines (aPV) in national immunization programs in many countries worldwide, a resurgence of pertussis has been recognized. Suboptimal effectiveness of aPV has been blamed as one major reason but only few studies have evaluated dose-dependent vaccine effectiveness (VE) provided by aPV in current practice. METHODS We performed a population-based retrospective case-control study by comparing pertussis immunization data of children 2.5 months to 2 years of age hospitalized for pertussis and residing in Switzerland with immunization data of a random control sample of children aged 2 years and residing in Switzerland. VE was defined as the percentage of hospitalizations avoided by number of aPV doses. It was calculated as 1-infection rate ratio (IRR)*100. IRR was calculated by dividing infection rates of vaccinated children and infection rates of unvaccinated children. To get dose specific VE,infection rates were stratified by number doses received. RESULTS VE against hospitalization due to pertussis increased significantly with each consecutive aPV dose in a "3 + 1" primary course in infants: 42.1% (95% CI: 11.3-62.6), 83.9% (70.2-92.1), 98.2% (96.1-99.3), and 100% (97.9-100) after the 1st, 2nd, 3rd, and 4th dose, respectively. CONCLUSION Acellular pertussis vaccines continue to demonstrate protection against hospitalization due to pertussis in infants and young children. Therefore, together with advancing immunization of pregnant women and household contacts, better control of severe pertussis in young infants can be achieved by timely initiation of immunization.
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Affiliation(s)
- I Mack
- University of Basel Children's Hospital, Paediatric Infectious Diseases and Vaccinology Unit, Basel, Switzerland; University of Basel, Faculty of Medicine, Basel, Switzerland.
| | - T E Erlanger
- University Hospital Basel and University of Basel, Department of Clinical Research, Clinical Trial Unit, Basel, Switzerland
| | - P Lang
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Department of Public Health, Zurich, Switzerland
| | - P Sinniger
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Department of Public Health, Zurich, Switzerland
| | - D Perisa
- Swiss Federal Office of Public Health, Division of Infectious Diseases, Bern, Switzerland
| | - U Heininger
- University of Basel Children's Hospital, Paediatric Infectious Diseases and Vaccinology Unit, Basel, Switzerland; University of Basel, Faculty of Medicine, Basel, Switzerland
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21
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Frikha M, Auperin A, Tao Y, Elloumi F, Toumi N, Blanchard P, Lang P, Sun S, Racadot S, Thariat J, Alfonsi M, Tuchais C, Cornely A, Moussa A, Guigay J, Daoud J, Bourhis J. A randomized trial of induction docetaxel-cisplatin-5FU followed by concomitant cisplatin-RT versus concomitant cisplatin-RT in nasopharyngeal carcinoma (GORTEC 2006-02). Ann Oncol 2019; 29:731-736. [PMID: 29236943 DOI: 10.1093/annonc/mdx770] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Concomitant chemotherapy (CT)-radiotherapy (RT) is a standard of care in locally advanced nasopharyngeal carcinoma (NPC) and a role for induction CT is not established. Methods Patients with locally advanced NPC, WHO type 2 or 3, were randomized to induction TPF plus concomitant cisplatin-RT or concomitant cisplatin-RT alone. The TPF regimen consisted of three cycles of Docetaxel 75 mg/m2 day 1; cisplatin 75 mg/m2 day 1; 5FU 750 mg/m2/day days 1-5. RT consisted of 70 Gy in 7 weeks plus concomitant cisplatin 40 mg/m2 weekly. Results A total of 83 patients were included in the study. Demographics and tumour characteristics were well balanced between both arms. Most of the patients (95%) in the TPF arm received three cycles of induction CT. The rate of grade 3-4 toxicity and the compliance (NCI-CTCAE v3) during cisplatin-RT were not different between both arms. With a median follow-up of 43.1 months, the 3-year PFS rate was 73.9% in the TPF arm versus 57.2% in the reference arm [hazard ratio (HR) = 0.44; 95% confidence interval (CI): 0.20-0.97, P = 0.042]. Similarly the 3 years overall survival rate was 86.3% in the TPF arm versus 68.9% in the reference arm (HR = 0.40; 95% CI: 0.15-1.04, P = 0.05). Conclusion In conclusion, several important aspects can be emphasized: the compliance to induction TPF was good and TPF did not compromise the tolerance of the concomitant RT-cisplatin phase. The improved PFS and overall survival rates needs to be confirmed by further trials.
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Affiliation(s)
- M Frikha
- Medical Oncology Department, Sfax University Hospital, Sfax, Tunisia
| | - A Auperin
- Department of Statistics, Gustave-Roussy, Villejuif, France
| | - Y Tao
- Department of Radiation Oncology, Gustave-Roussy, Villejuif, France
| | - F Elloumi
- Radiation Oncology Department, Sfax University Hospital, Sfax, Tunisia
| | - N Toumi
- Radiation Oncology Department, Sfax University Hospital, Sfax, Tunisia
| | - P Blanchard
- Department of Radiation Oncology, Gustave-Roussy, Villejuif, France
| | - P Lang
- Radiation Oncology Department, Pitié Salpetrière, Paris, France
| | - S Sun
- Radiation Oncology Department, Centre Hospitalier Montbeliard, Montbeliard, France
| | - S Racadot
- Radiation Oncology Department, Centre L. Bérard, Lyon, France
| | - J Thariat
- Department of Oncology, Centre A. Lacassagne, Nice, France
| | - M Alfonsi
- Radiation Oncology Department, Clinique St Catherine, Avignon, France
| | - C Tuchais
- Radiation Oncology Department, Centre C. Papin, Angers, France
| | - A Cornely
- Department of Statistics, Gustave-Roussy, Villejuif, France
| | - A Moussa
- Department of Statistics, Gustave-Roussy, Villejuif, France
| | - J Guigay
- Department of Oncology, Centre A. Lacassagne, Nice, France
| | - J Daoud
- Radiation Oncology Department, Sfax University Hospital, Sfax, Tunisia.
| | - J Bourhis
- Department of Radiation Oncology, Gustave-Roussy, Villejuif, France; Radiation Oncology Department, CHUV, Lausanne, Switzerland.
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Chung H, Lang P, Kayvanrad M, Thompson R, Chu W, Gennatas E, Valdes G, Cheung P. EP-1453 Machine learning prediction of early distant progression after SBRT for colorectal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31873-0] [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: 11/27/2022]
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23
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Yuen H, Stachowicz A, Lang P, Levy D, Whiteside J. 87: Factors associated with emergency department utilization after benign gynecologic surgery. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.01.117] [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: 10/27/2022]
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24
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Tamussino K, Tomasch G, Oswald S, Lemmerer M, Uranitsch S, Schütz AM, Schauer C, Berger A, Lang P, Rosanelli G, Uranüs S. Prophylaktische Salpingektomie bei der laparaskopischen Cholezystektomie (SaLCHE): Geht das? Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671382] [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: 10/28/2022] Open
Affiliation(s)
- K Tamussino
- UFK Graz, Abteilung Gynäkologie, Graz, Österreich
| | - G Tomasch
- UFK Graz, Abteilung Gynäkologie, Graz, Österreich
| | - S Oswald
- KH der Elisabethinen Graz, Abteilung Chirurgie, Graz, Österreich
| | - M Lemmerer
- KH der Barmherzigen Brüder Graz, Abteilung Chirurgie, Graz, Österreich
| | - S Uranitsch
- KH der Barmherzigen Brüder Graz, Abteilung Chirurgie, Graz, Österreich
| | - AM Schütz
- UFK Graz, Abteilung Gynäkologie, Graz, Österreich
| | - C Schauer
- KH der Barmherzigen Brüder Graz, Abteilung Gynäkologie, Graz, Österreich
| | - A Berger
- KH der Barmherzigen Brüder Graz, Abteilung Chirurgie, Graz, Österreich
| | - P Lang
- KH der Barmherzigen Brüder Graz, Abteilung Gynäkologie, Graz, Österreich
| | - G Rosanelli
- KH der Elisabethinen Graz, Abteilung Chirurgie, Graz, Österreich
| | - S Uranüs
- Univ.-Klinik für Chirurgie, Abteilung Viszeralchirurgie, Graz, Österreich
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25
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Burkauskas J, Lang P, Bunevičius A, Neverauskas J, Bučiūtė-Jankauskienė M, Mickuvienė N. Cognitive function in patients with coronary artery disease: A literature review. J Int Med Res 2018; 46:4019-4031. [PMID: 30157691 PMCID: PMC6166352 DOI: 10.1177/0300060517751452] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/11/2017] [Indexed: 12/16/2022] Open
Abstract
Objective Cognitive function impairment is a well-documented complication of cerebrovascular disease (CBVD). Less is known about what factors affect the deterioration of cognitive function in patients with coronary artery disease (CAD). The aim of this review is to explore recent studies investigating factors associated with cognitive function in patients with CAD. Methods Studies published from 2010 to 2016 were identified through a systematic search of MEDLINE/PubMed and were included if they addressed factors affecting cognitive function in the CAD population. Results Of the 227 publications identified, 32 were selected for the review. Five factors tentatively affecting cognitive function in patients with CAD were identified: coronary artery bypass grafting (CABG) surgery, apolipoprotein E4 (APOE4) genotype, left ventricular ejection fraction (LVEF), medication use, and various hormones and biomarkers. Conclusion New techniques in CABG surgery have proven to alleviate postoperative cognitive decline. Researchers are still debating the effects of APOE4 genotype, LVEF, and the use of cardiovascular medications on cognitive function. Thyroid hormones and biomarkers are associated with cognitive function, but the exact nature of the association is debatable. Longitudinal studies should clarify those associations. In addition, cross-sectional studies addressing other causes of cognitive decline in patients with CAD are warranted.
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Affiliation(s)
- J. Burkauskas
- Behavioral Medicine Institute, Lithuanian University of Health
Sciences, Vydūno Str. 4/J. Šliūpo Str. 7, LT-00135, Palanga, Lithuania
| | - P. Lang
- Harvard Medical School, Laboratory of Clinical &
Experimental Psychopathology, Dr. John C. Corrigan Mental Health Center,
Harvard
Medical School, 49 Hillside Street, Fall
River, MA 02720, USA
| | - A. Bunevičius
- Laboratory of Clinical Research, Neuroscience Institute,
Lithuanian University of Health Sciences, Eivenių st. 4, LT-50161, Kaunas,
Lithuania
| | - J. Neverauskas
- Behavioral Medicine Institute, Lithuanian University of Health
Sciences, Vydūno Str. 4/J. Šliūpo Str. 7, LT-00135, Palanga, Lithuania
| | - M. Bučiūtė-Jankauskienė
- Behavioral Medicine Institute, Lithuanian University of Health
Sciences, Vydūno Str. 4/J. Šliūpo Str. 7, LT-00135, Palanga, Lithuania
| | - N. Mickuvienė
- Behavioral Medicine Institute, Lithuanian University of Health
Sciences, Vydūno Str. 4/J. Šliūpo Str. 7, LT-00135, Palanga, Lithuania
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26
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Polen-De C, Lang P, Meganathan K, Hohmann S, Whiteside J. A nationwide analysis of salpingectomy rates for sterilization following the 2015 American College of Obstetricians and Gynecologists committee opinion, “Salpingectomy for ovarian cancer prevention”. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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27
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Legouté F, Bensadoun R, Seegers V, Lang P, Prévost A, Martin L, Schick U, Capitain O, Morvant B, Jadaud E. EP-1138: Laser Therapy for radiochemotherapy-induced mucositis in HNC: a randomised, phase III trial. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31448-8] [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: 10/14/2022]
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28
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Lang P, Quezada Y, Whiteside J. 20: A randomized trial comparing conventional and “fast track” indwelling urinary catheter management among women undergoing benign gynecologic surgery. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Die 24-Std.-Retentionsmessung im Ganzkörperzähler ist ein exaktes Verfahren zur Quantifizierung der Knochenaffinität eines Radiopharmazeutikums. Dieser 24-Std.-Ganzkörperretentionswert (24-Std.-GKRW) wurde bei 200 Patienten bestimmt. Für 99mTc-Methylen-Diphosphonat (MDP) war er von der Nierenfunktion unabhängig, wenn diese normal oder nur leicht eingeschränkt war. Es bestand eine diskrete Altersabhängigkeit, wobei der GKRW bei Kindern und Jugendlichen bis zum 20. Lebensjahr kontinuierlich abfiel, bei den 20- bis 25jährigen am niedrigsten war und dann mit zunehmendem Alter wieder anstieg. Als Normalbereich für den 24-Std.-GKRW wurde für die Altersgruppe der über 20jährigen 31,8 ± 5% der injizierten Radioaktivität ermittelt. Einzelne fokale Mehranreicherungen im Skelettszintigramm - wie bei Tumorpatienten mit ein bis zwei Metastasen - riefen keinen signifikanten Unterschied zum Normalkollektiv (p < 0,1) hervor. Dagegen bestand eine hochsignifikante Differenz (p < 0,001) gegenüber dem Normalkollektiv bei Patienten mit multiplen Metastasen (24-Std.-GKRW: 38,2 ± 7%), bei Patienten mit diffusen Knochenerkrankungen wie dem primären Hyperparathyreoidismus (24-Std.-GKRW: 49 ± 11,7%) (P < 0,001) und der Osteoporose (24-Std.-GKRW: 45%). Der 24-Std.-GKRW erwies sich damit als sehr empfindliches Maß für diffuse Veränderungen im Knochen. Dies zeigte sich sowohl an einzelnen Beispielen bei Verlaufskontrollen bei Tumorpatienten, wo sich der 24-Std.-GKRW neben dem Skelettszintigramm als zusätzlicher Parameter in der Erfassung einer Progredienz oder Remission bewährte, als auch an der engen Korrelation des 24-Std.-GKRW mit den bioptisch gesicherten Knochenmarksbefunden bei einer kleineren Patientengruppe mit Erkrankungen aus dem lymphatischen Formenkreis.
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30
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Igitkhanov Y, Day C, Lang P, Plöckl B. Assesment of Pumping Requirements in DEMO Reactor. Fusion Science and Technology 2017. [DOI: 10.1080/15361055.2017.1347465] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Yu. Igitkhanov
- Karlsruhe Institute of Technology, ITEP, Karlsruhe, Germany
| | - Ch. Day
- Karlsruhe Institute of Technology, ITEP, Karlsruhe, Germany
| | - P. Lang
- Max-Planck Institute of Plasma Physics, IPP, Garching, Germany
| | - B. Plöckl
- Max-Planck Institute of Plasma Physics, IPP, Garching, Germany
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31
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Palm HG, Kulla M, Wettberg M, Lefering R, Friemert B, Lang P. Changes in trauma management following the implementation of the whole-body computed tomography: a retrospective multi-centre study based on the trauma registry of the German Trauma Society (TraumaRegister DGU ®). Eur J Trauma Emerg Surg 2017; 44:759-766. [PMID: 29101416 DOI: 10.1007/s00068-017-0870-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 10/30/2017] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Whole-body computed tomography (WBCT) plays an increasingly important role in the diagnostic assessment of trauma room patients. It is still unclear whether its use has led to changes of trauma room procedures and patient outcomes. METHODS In a retrospective multi-centric study based on the trauma registry of the German Trauma Society (TraumaRegister DGU®), we analysed patients with an ISS ≥ 9 between 2002 and 2013. Two periods of time, i.e. up to 3 years preceding (pre-WBCT) and up to 3 years following the introduction of the WBCT (WBCT-group), were assessed separately for every hospital (TR-DGU Project ID 2014-020). RESULTS 19,838 patients underwent treatment in 77 hospitals. Of these, 5621 were assigned to the pre-WBCT group and 11,307 to the WBCT group. Basic data did not differ relevantly. The time spent in the trauma room decreased from 77.9 min (pre-WBCT) to 63.3 min (WBCT). Following the introduction of the trauma scan, the number of diagnoses per patient increased from 4.6 to 5.1. The percentage of patients who underwent surgery immediately after the completion of trauma room procedures decreased from 44.5 to 39.1%. There was an increase in mortality from 15.7 to 15.9%. CONCLUSIONS Routine use of WBCT is not superior to a combination of conventional radiography, ultrasound and focused CT in terms of mortality. The entire process involving the introduction of the trauma scan and the further development of algorithms has caused changes that can be observed in the trauma room setting.
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Affiliation(s)
- H-G Palm
- Trauma Research Group, Department of Orthopaedics and Trauma Surgery, Reconstructive and Septic Surgery, and Sports Traumatology, Bundeswehrhospital Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
| | - M Kulla
- Department of Anaesthesiology and Intensive Care Medicine, Bundeswehrhospital Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
| | - M Wettberg
- Trauma Research Group, Department of Orthopaedics and Trauma Surgery, Reconstructive and Septic Surgery, and Sports Traumatology, Bundeswehrhospital Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
| | - R Lefering
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany
| | - B Friemert
- Trauma Research Group, Department of Orthopaedics and Trauma Surgery, Reconstructive and Septic Surgery, and Sports Traumatology, Bundeswehrhospital Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
| | - P Lang
- Trauma Research Group, Department of Orthopaedics and Trauma Surgery, Reconstructive and Septic Surgery, and Sports Traumatology, Bundeswehrhospital Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany.
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32
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Legouté F, Bensadoun RJ, Pointreau Y, Seegers V, Schick U, Capitain O, Caron D, Martin L, Prévost A, Lang P, Jadaud E. Traitement des mucites radio- et chimio-induites par laser de basse énergie en cancérologie ORL : résultats de l’essai de phase III randomisé multicentrique « Laser mucite ORL ». Cancer Radiother 2017. [DOI: 10.1016/j.canrad.2017.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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33
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Lang P, Moseley D, Bernchou U, Brink C, Hope A. CBCT-Derived Radiosensitivity Marker Associated with Radiation Pneumonitis. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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34
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Huber A, Bernert M, Brezinsek S, Chankin A, Sergienko G, Huber V, Wiesen S, Abreu P, Beurskens M, Boboc A, Brix M, Calabrò G, Carralero D, Delabie E, Eich T, Esser H, Groth M, Guillemaut C, Jachmich S, Järvinen A, Joffrin E, Kallenbach A, Kruezi U, Lang P, Linsmeier C, Lowry C, Maggi C, Matthews G, Meigs A, Mertens P, Reimold F, Schweinzer J, Sips G, Stamp M, Viezzer E, Wischmeier M, Zohm H. Comparative H-mode density limit studies in JET and AUG. Nuclear Materials and Energy 2017. [DOI: 10.1016/j.nme.2017.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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35
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Michalitsch R, El Kassmi A, Lang P, Yassar A, Garnier F. Electrochemical behavior of self-assembled monolayers based on functionalized oligothiophenes. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp:1998278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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36
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Scheruebel S, Koyani C, Lang P, Bernhart E, Hallstroem S, Maechler H, Plank G, Zorn-Pauly K, Pelzmann B. P1707Interatrial differences in AF remodelling. Europace 2017. [DOI: 10.1093/ehjci/eux161.017] [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: 11/13/2022] Open
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37
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Lang P, Mekhalif Z, Garnier F. Blocking and chemical pretreatments of platinum electrode for the electropolymerization of thiophenes. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1992891063] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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38
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Lang P, Chao F, Costa M, Museux E, Garnier F. Rôle des oligomères dans l’électropolymérisation du 3-méthylthiophène étudié par électrode tournante et par ellipsométrie. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1989860107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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39
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Lang P, Valat P, Horowitz G, Garnier F, Yassar A, Wittmann JC, Lotz B, Meyer S. Orientation et structure de films de sexithiophène (6T) déposés sur couches de PTFE orientées par friction. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1995920963] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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40
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Lang P, Hajlaoui R, Dallas JP, Garnier F, Yassar A, Horowitz G. Étude de l’orientation et de la structure de films de sexithiophène (6T) déposés sur les surfaces de SiO2 et de SiH/Si. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1995920967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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41
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Mekhalif Z, Lang P, Garnier F, Régis A. Prétraitements du platine et de métaux oxydables par des thiols aromatiques pour le greffage du polybithiophène. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1995920831] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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42
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Laky R, Aigmueller T, Bader A, Bjelic-Radisic V, Taumberger N, Bornemann-Cimenti H, Lang P, Ralph G, Tamussino K. 59: Vaginal hysterectomy versus total laparoscopic hysterectomy for benign indications: A randomized trial. Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.12.106] [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: 10/20/2022]
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43
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Lang P, Muffly T, Leonard A, Whiteside J. 41: What do internet-based patient evaluations of obstetricians and gynecologists mean? Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.12.088] [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: 10/20/2022]
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44
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Lang P, Karram M. 29: Anatomy of an enterocele and surgical management at the time of vaginal hysterectomy. Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.12.042] [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: 10/20/2022]
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45
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Palm HG, Uhl S, Zollo M, Lang P, Friemert B, Riesner HJ. [Influence of Peridural Infiltration Therapy on Postural Control in Chronic Pain of the Lower Lumbar Spine - A Prospective Clinical Study]. Z Orthop Unfall 2016; 154:583-590. [PMID: 27249046 DOI: 10.1055/s-0042-107077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Background: Postural control, balance stability, is reduced in patients with chronic low back pain, due to pain. Epidural injection therapy (EI) is an established treatment of low back pain. The objective of our study was to investigate whether EI-induced pain relief also leads to improvement in postural control, as detected by computerised dynamic posturography (CDP). Patients and Methods: In a prospective study, 32 patients underwent CDP during and after the EI series of three injections. The main objective was to measure changes in overall stability index (OSI) in a pre- and post-intervention comparison. Results: The pain, measured by the Visual Analog Scale (VAS), decreased by 62.8 %, from 4.3 ± 2.5 points to 1.6 ± 1.9 points (p < 0.001). Likewise, the OSI improved by 21.6 %, from 3.7 ± 1.7° to 2.9 ± 1.4° (day 5) (p = 0.019). Conclusion: Pain relief induced by EI results in improved postural control, which is of importance for supportive physiotherapy and rehabilitation.
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Affiliation(s)
- H-G Palm
- Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm
| | - S Uhl
- Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm
| | - M Zollo
- Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm
| | - P Lang
- Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm
| | - B Friemert
- Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm
| | - H-J Riesner
- Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm
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Laky R, Aigmüller T, Bader A, Bjelic-Radisic V, Greimel E, Taumberger N, Lang P, Ralph G, Batka M, Neunteufel W, Edler K, Sarlos D, Schär G, Tamussino K. Vaginale Hysterektomie versus Total Laparoskopische Hysterektomie für benigne Indikationen: Eine randomisierte kontrollierte Studie. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592789] [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: 10/20/2022] Open
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47
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Leibler C, Moktefi A, Matignon M, Desvaux D, Debiais C, Lang P, Cohen J, Grimbert P, Audard V. Les récidives des glomérulonéphrites fibrillaires sont étroitement liées à la reconstitution lymphocytaire B après traitement par rituximab. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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48
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Boudhabhay I, Desvaux D, Matignon M, Caudwell V, Lang P, Grimbert P, Frémeaux-Bacchi V, Audard V. Récidive histologique d’une glomérulonéphrite à dépôts de C3 après greffe rénale en rapport avec une mutation du facteur I homozygote sans traduction clinique. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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49
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Audard V, Deux JF, Guillaud C, Anoosha H, Galacteros F, Stehlé T, Grimbert P, Lang P, Rahmouni A, Bartolucci P. Des anomalies de l’oxygénation et de la perfusion tissulaire peuvent être détectées par IRM pendant les crises vaso-occlusives drépanocytaires. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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50
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Attias P, Moktefi A, Matignon M, Haioun C, Desvaux D, Goujon J, Debiais C, Moroch J, Dudreuilh C, Grimbert P, Lang P, Audard V. Néphrite interstitielle à plasmocytes chez un patient avec une gammapathie monoclonale d’allure bénigne. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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