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Marcia King B, Joseph G. S, Anthony C, Coleman P, Cottingham B, Culmo R, Curtis R, Dingman L, Johnson R, Lehman G, Loughran J, Martinez S, Moody J, Paisley C, Radloff H, John AS, Schrader E, Sizemore J, Wenger J, White G. Combustion Method for Determination of Crude Protein in Meat and Meat Products: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/76.4.787] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Twelve laboratories participated in a collaborative study to compare a combustion method with the AOAC mercury catalyst Kjeldahl method (928.08) for the determination of crude protein in meat and meat products. Three different combustion instruments were used; consequently, the combustion method for this study is written in generic terms describing the principle, the apparatus specifications, and the performance requirements needed. Fifteen sample pairs were used for the study; each pair consisted of the same commercial meat product from each of 2 different manufacturers. Protein content of all samples ranged from about 10 to 20%. In addition, nicotinic acid and lysine monohydrochloride were used as standards to assess combustion equipment performance. All laboratories and all instruments performed the combustion method satisfactorily on the basis of results for the standards. For the meat samples, repeatability standard deviations (sr) ranged from 0.11 to 0.40 for the Kjeldahl method and from 0.12 to 0.41 for the combustion method; the repeatability relative standard deviations (RSDr) ranged from 0.82 to 2.41% and from 0.60 to 2.23% for the Kjeldahl and combustion methods, respectively. Reproducibility standard deviations (SR) ranged from 0.20 to 0.49 for the Kjeldahl method and from 0.18 to 0.46 for the combustion method, whereas the reproducibility relative standard deviations (RSDR) ranged from 1.59 to 2.84% for the Kjeldahl method and from 1.32 to 3.35% for the combustion method. Overall grand means were 15.59% protein for the Kjeldahl method and 15.75% protein for the combustion method. The combustion method was adopted first action by AOAC International.
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2
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Fetterplace K, Beach LJ, MacIsaac C, Presneill J, Edbrooke L, Parry SM, Rechnitzer T, Curtis R, Berney S, Deane AM, Denehy L. Associations between nutritional energy delivery, bioimpedance spectroscopy and functional outcomes in survivors of critical illness. J Hum Nutr Diet 2019; 32:702-712. [PMID: 31034122 DOI: 10.1111/jhn.12659] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Patients who survive critical illness frequently develop muscle weakness that can impact on quality of life; nutrition is potentially a modifiable risk factor. The present study aimed to explore the associations between cumulative energy deficits (using indirect calorimetry and estimated requirements), nutritional and functional outcomes. METHODS A prospective single-centre observational study of 60 intensive care unit (ICU) patients, who were mechanically ventilated for at least 48 h, was conducted. Cumulative energy deficit was determined from artificial nutrition delivery compared to targets. Measurements included: (i) at recruitment and ICU discharge, weight, fat-free mass (bioimpedance spectroscopy) and malnutrition (Subjective Global Assessment score B/C); (ii) at awakening and ICU discharge, physical function (Physical Function in Intensive Care Test-scored) and muscle strength (Medical Research Council sum-score (MRC-SS). ICU-acquired weakness was defined as a MRC-SS score of less than 48/60. RESULTS The median (interquartile range) cumulative energy deficit compared to the estimated targets up to ICU day 12 was 3648 (2514-5650) kcal. Adjusting for body mass index, age and severity of illness, cumulative energy deficit (per 1000 kcal) was independently associated with greater odds of ICU-acquired weakness [odds ratio (OR) = 2.1, 95% confidence interval (CI) = 1.4-3.3, P = 0.001] and malnutrition (OR = 1.9, 95% CI = 1.1-3.2, P = 0.02). In similar multivariable linear models, cumulative energy deficit was associated with reductions in fat-free mass (-1.3 kg; 95% CI = -2.4 to -0.2, P = 0.02) and physical function scores (-0.6 points; 95% CI = -0.9 to -0.3, P = 0.001). CONCLUSIONS Cumulative energy deficit from artificial nutrition support was associated with reduced functional outcomes and greater loss of fat-free mass in ventilated ICU patients.
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Affiliation(s)
- K Fetterplace
- Department of Allied Health (Clinical Nutrition), Royal Melbourne Hospital, Melbourne, VIC, Australia.,Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia
| | - L J Beach
- Department of Allied Health (Physiotherapy), Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - C MacIsaac
- Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia.,Intensive Care Unit, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - J Presneill
- Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia.,Intensive Care Unit, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - L Edbrooke
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia
| | - S M Parry
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia
| | - T Rechnitzer
- Intensive Care Unit, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - R Curtis
- Department of Allied Health (Physiotherapy), Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - S Berney
- Department of Physiotherapy, Austin Health, Melbourne, VIC, Australia
| | - A M Deane
- Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia.,Intensive Care Unit, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - L Denehy
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC, Australia
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3
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Pot L, Li B, Laforest R, Curtis R, Kim J, Seymour D, Cant J, Doelman J. PSXI-18 Effects of Glucose Infusion on Expression of Genes Related to Amino Acid Metabolism in Muscle and Mammary Glands of Lactating Dairy Cows. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- L Pot
- University of Guelph,Guelph, ON, Canada
| | - B Li
- University of Guelph,Guelph, ON, Canada
| | | | - R Curtis
- University of Guelph,Guelph, ON, Canada
| | - J Kim
- University of Guelph,Guelph, ON, Canada
| | - D Seymour
- University of Guelph,Guelph, ON, Canada
| | - J Cant
- University of Guelph,Guelph, ON, Canada
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4
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Curtis R, Maher C, Plotnikoff R, Vandelanotte C, Olds T, Ryan J, Edney S. Social cognitive theory predicts self-reported but not objectively measured physical activity in inactive Australian adults. J Sci Med Sport 2018. [DOI: 10.1016/j.jsams.2018.09.063] [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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5
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Edney S, Ryan J, Olds T, Vandelanotte C, Plotnikoff R, Curtis R, Maher C. Do birds of a feather flock together within a team-based physical activity intervention? A social network analysis. J Sci Med Sport 2018. [DOI: 10.1016/j.jsams.2018.09.064] [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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6
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Skinner MW, Chai-Adisaksopha C, Curtis R, Frick N, Nichol M, Noone D, O'Mahony B, Page D, Stonebraker JS, Iorio A. The Patient Reported Outcomes, Burdens and Experiences (PROBE) Project: development and evaluation of a questionnaire assessing patient reported outcomes in people with haemophilia. Pilot Feasibility Stud 2018; 4:58. [PMID: 29497561 PMCID: PMC5828307 DOI: 10.1186/s40814-018-0253-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [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: 07/09/2017] [Accepted: 02/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background The interest of health care agencies, private payers and policy makers for patient-reported outcomes (PRO) is continuously increasing. There is a substantial need to improve capacity to collect and interpret relevant PRO data to support implementation of patient-centered research and optimal care in haemophilia. The Patient Reported Outcomes, Burdens and Experiences (PROBE) Project aims to develop a patient-led research network, to develop a standardized questionnaire to gather patient-reported outcomes and to perform a feasibility study of implementing the PROBE questionnaire. Methods A pilot questionnaire was developed using focus group methodology. Content and face validity were assessed by a pool of persons living with haemophilia (PWH) and content experts through interactive workshops. The PROBE questionnaire was translated with the forward-backward approach. PROBE recruited national haemophilia patient non-governmental organizations (NGOs) to administer the questionnaire to people with and without haemophilia. PROBE measured the time to complete the questionnaire and gathered feedback on its content and clarity; staff time and cost required to implement the questionnaire were also collected. Results The PROBE questionnaire is comprised of four major sections (demographic data, general health problems, haemophilia-related health problems and health-related quality of life using EQ-5D-5L and EQ-VAS). Seventeen NGOs participated in the pilot study of the PROBE Project, recruiting 656 participants. Of these, 71% completed the questionnaire within 15 min, and all participants completed within 30 min. The median total staff and volunteer time required for the NGOs to carry out the study within their country was 9 h (range 2 to 40 h). NGO costs ranged from $22.00 to $543.00 USD per country, with printing and postage being the most commonly reported expenditures. Conclusions The PROBE questionnaire assesses patient-important reported outcomes in PWH and control participants, with a demonstrated short completion time. PROBE proved the feasibility to engage diverse patient communities in the structured generation of real-world outcome research at all stages. Trial registration Trial registration: NCT02439710. Electronic supplementary material The online version of this article (10.1186/s40814-018-0253-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M W Skinner
- Institute for Policy Advancement Ltd, 1155 23rd Street NW #3A, Washington, DC 20037 USA
| | - C Chai-Adisaksopha
- 2Department of Medicine, McMaster University, Hamilton, Canada.,10Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - R Curtis
- Factor VIII Computing, Berkeley, USA
| | - N Frick
- 4National Hemophilia Foundation, New York, USA
| | - M Nichol
- 5Sol Price School of Public Policy, University of Southern California, Los Angeles, USA
| | - D Noone
- Irish Haemophilia Society, Dublin, Ireland
| | - B O'Mahony
- Irish Haemophilia Society, Dublin, Ireland.,7Trinity College Dublin, Dublin, Ireland
| | - D Page
- 8Canadian Hemophilia Society, Montreal, Canada
| | - J S Stonebraker
- 9Poole College of Management, North Carolina State University, Raleigh, USA
| | - A Iorio
- 2Department of Medicine, McMaster University, Hamilton, Canada.,10Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
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7
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Abstract
“Steakhouse Syndrome” occurs in patients who swallow meat without proper mastication or who have intrinsic esophageal disease. A history of excessive use of alcohol is frequently obtained and apparently contributes to a tendency for such patients to “bolt” their food and swallow a large bolus, which leads to the obstruction. The enzymatic relief of “Steakhouse Syndrome” appears to be a safe and effective method of therapy, with few adverse effects. This method has been proven successful in many instances and offers an alternative to the reliable but lengthy and difficult procedure of endoscopic removal of the meat bolus.
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8
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Pai M, Key NS, Skinner M, Curtis R, Feinstein M, Kessler C, Lane SJ, Makris M, Riker E, Santesso N, Soucie JM, Yeung CHT, Iorio A, Schünemann HJ. NHF-McMaster Guideline on Care Models for Haemophilia Management. Haemophilia 2016; 22 Suppl 3:6-16. [DOI: 10.1111/hae.13008] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2016] [Indexed: 02/05/2023]
Affiliation(s)
- M. Pai
- Department of Medicine; McMaster University; Hamilton ON Canada
- Department of Pathology and Molecular Medicine; McMaster University; Hamilton ON Canada
- McMaster Centre for Transfusion Research McMaster University; Hamilton ON Canada
| | - N. S. Key
- Department of Medicine; University of North Carolina; Chapel Hill NC USA
| | - M. Skinner
- Institute for Policy Advancement Ltd.; Washington DC USA
| | - R. Curtis
- Factor VIII Computing; Berkeley CA USA
| | | | - C. Kessler
- Georgetown University; Washington DC USA
| | - S. J. Lane
- McMaster Centre for Transfusion Research McMaster University; Hamilton ON Canada
| | - M. Makris
- Department of Infection, Immunity and Cardiovascular Disease; University of Sheffield; Sheffield UK
| | - E. Riker
- National Hemophilia Foundation; New York NY USA
| | - N. Santesso
- Department of Clinical Epidemiology and Biostatistics; McMaster University; Hamilton ON Canada
| | - J. M. Soucie
- Centers for Disease Control and Prevention; National Center for Birth Defects and Developmental Disabilities; Division of Blood Disorders; Atlanta GA USA
| | - C. H. T. Yeung
- Department of Clinical Epidemiology and Biostatistics; McMaster University; Hamilton ON Canada
| | - A. Iorio
- Department of Medicine; McMaster University; Hamilton ON Canada
- Department of Clinical Epidemiology and Biostatistics; McMaster University; Hamilton ON Canada
| | - H. J. Schünemann
- Department of Clinical Epidemiology and Biostatistics; McMaster University; Hamilton ON Canada
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9
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Gierach GL, Curtis RE, Pfeiffer RM, Mullooly M, Hoover RN, Nyante SJ, Feigelson HS, Glass AG, Berrington de Gonzalez A. Abstract P5-12-01: Adjuvant endocrine therapy and risk of contralateral breast cancer among a cohort of U.S. women with breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-12-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The increasing incidence of estrogen receptor (ER)-positive breast cancer in the U.S. in concert with the aging population and improved survival have resulted in an increased number of women at risk of developing a second contralateral primary breast cancer. Results from randomized clinical trials have suggested a reduced risk of contralateral breast cancer among women taking tamoxifen or aromatase inhibitors. However, little is known about the duration of beneficial effects of endocrine therapy within the context of real life treatment scenarios, where gaps in treatment and varying durations of use may influence risk.
Methods: We assessed contralateral breast cancer risk associated with adjuvant tamoxifen treatment among a cohort of 7,541 women, ages 24-85 years, who were members of Kaiser Permanente (KP) Northwest or Colorado, and were diagnosed with invasive breast cancer between 1990 and 2008 and remained at risk of contralateral breast cancer for at least one year. We also assessed risk in relation to aromatase inhibitor use, though statistical power was somewhat limited due to the relatively recent introduction of aromatase inhibitors in this older cohort. Use of tamoxifen, aromatase inhibitors and other treatments was ascertained from KP prescription and medical records. Relative risks (RR) and 95% confidence intervals (CI) were estimated using multivariable Poisson regression adjusting for study site, age at and year of diagnosis, stage at diagnosis, ER status, chemotherapy, and radiotherapy.
Results: Over a median (range) of 6.3 (1.0-20.9) years of follow-up, 248 women developed contralateral breast cancer. Among patients surviving at least five years (n=4,668), 58% were prescribed tamoxifen with a median (range) duration of use of 4.2 (0.25-16.2) years. In models evaluating joint effects of tamoxifen duration and time since last use, we observed a statistically significant reduced risk of contralateral breast cancer among current tamoxifen users (RR=0.47, 95% CI: 0.30, 0.74) and among former users with 4+ years of tamoxifen (RR=0.39, 95% CI: 0.24, 0.63) as compared with women not treated with tamoxifen. Former users with 1-4 years of tamoxifen demonstrated a suggestive reduction in risk (RR=0.71, 95% CI: 0.45, 1.10), but there was no evidence of risk reduction for former users with <1 year of tamoxifen (RR=0.96, 95% CI: 0.56, 1.64). The reduced risks associated with 4+ years of tamoxifen persisted among patients surviving at least 7 years but were attenuated among those with more than 10 years since their first primary diagnosis. Aromatase inhibitor use was also associated with reduced contralateral breast cancer risk (RR=0.46, 95% CI: 0.22, 0.97). In subgroup analyses restricted to women whose first primary cancer was ER-positive (n=5,951), findings were consistent with those observed in the overall cohort.
Conclusions: Adjuvant tamoxifen and aromatase inhibitor therapy considerably reduce the risk of contralateral breast cancer. Furthermore, our data suggest that tamoxifen protects against contralateral breast cancer while women are being treated and that the protective effect appears to continue after cessation with longer durations of use.
Citation Format: Gierach GL, Curtis RE, Pfeiffer RM, Mullooly M, Hoover RN, Nyante SJ, Feigelson HS, Glass AG, Berrington de Gonzalez A. Adjuvant endocrine therapy and risk of contralateral breast cancer among a cohort of U.S. women with breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-12-01.
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Affiliation(s)
- GL Gierach
- National Cancer Institute, Bethesda, MD; University of North Carolina at Chapel Hill, Chapel Hill, NC; Kaiser Permanente Institute for Health Research, Denver, CO; Kaiser Permanente Northwest Center for Health Research, Portland, OR
| | - RE Curtis
- National Cancer Institute, Bethesda, MD; University of North Carolina at Chapel Hill, Chapel Hill, NC; Kaiser Permanente Institute for Health Research, Denver, CO; Kaiser Permanente Northwest Center for Health Research, Portland, OR
| | - RM Pfeiffer
- National Cancer Institute, Bethesda, MD; University of North Carolina at Chapel Hill, Chapel Hill, NC; Kaiser Permanente Institute for Health Research, Denver, CO; Kaiser Permanente Northwest Center for Health Research, Portland, OR
| | - M Mullooly
- National Cancer Institute, Bethesda, MD; University of North Carolina at Chapel Hill, Chapel Hill, NC; Kaiser Permanente Institute for Health Research, Denver, CO; Kaiser Permanente Northwest Center for Health Research, Portland, OR
| | - RN Hoover
- National Cancer Institute, Bethesda, MD; University of North Carolina at Chapel Hill, Chapel Hill, NC; Kaiser Permanente Institute for Health Research, Denver, CO; Kaiser Permanente Northwest Center for Health Research, Portland, OR
| | - SJ Nyante
- National Cancer Institute, Bethesda, MD; University of North Carolina at Chapel Hill, Chapel Hill, NC; Kaiser Permanente Institute for Health Research, Denver, CO; Kaiser Permanente Northwest Center for Health Research, Portland, OR
| | - HS Feigelson
- National Cancer Institute, Bethesda, MD; University of North Carolina at Chapel Hill, Chapel Hill, NC; Kaiser Permanente Institute for Health Research, Denver, CO; Kaiser Permanente Northwest Center for Health Research, Portland, OR
| | - AG Glass
- National Cancer Institute, Bethesda, MD; University of North Carolina at Chapel Hill, Chapel Hill, NC; Kaiser Permanente Institute for Health Research, Denver, CO; Kaiser Permanente Northwest Center for Health Research, Portland, OR
| | - A Berrington de Gonzalez
- National Cancer Institute, Bethesda, MD; University of North Carolina at Chapel Hill, Chapel Hill, NC; Kaiser Permanente Institute for Health Research, Denver, CO; Kaiser Permanente Northwest Center for Health Research, Portland, OR
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10
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Curtis R. Auditing safe sedation practice nationally. Anaesthesia 2015; 70:885-6. [DOI: 10.1111/anae.13125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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11
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Beach L, Fetterplace K, Edbrooke L, Parry S, Curtis R, Rechnitzer T, Berney S, Denehy L. Low physical activity levels and poorer muscle strength are associated with reduced physical function at intensive care unit discharge: An observational study. Aust Crit Care 2015. [DOI: 10.1016/j.aucc.2014.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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12
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Hauptmann M, Fossa SD, Stovall M, van Leeuwen FE, Johannesen TB, Rajaraman P, Gilbert ES, Smith SA, Weathers RE, Aleman BMP, Andersson M, Curtis RE, Dores GM, Fraumeni JF, Hall P, Holowaty EJ, Joensuu H, Kaijser M, Kleinerman RA, Langmark F, Lynch CF, Pukkala E, Storm HH, Vaalavirta L, van den Belt-Dusebout AW, Travis LB, Morton LM. Increased stomach cancer risk following radiotherapy for testicular cancer. Br J Cancer 2015; 112:44-51. [PMID: 25349972 PMCID: PMC4453604 DOI: 10.1038/bjc.2014.552] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 10/02/2014] [Accepted: 10/04/2014] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Abdominal radiotherapy for testicular cancer (TC) increases risk for second stomach cancer, although data on the radiation dose-response relationship are sparse. METHODS In a cohort of 22,269 5-year TC survivors diagnosed during 1959-1987, doses to stomach subsites were estimated for 92 patients who developed stomach cancer and 180 matched controls. Chemotherapy details were recorded. Odds ratios (ORs) were estimated using logistic regression. RESULTS Cumulative incidence of second primary stomach cancer was 1.45% at 30 years after TC diagnosis. The TC survivors who received radiotherapy (87 (95%) cases, 151 (84%) controls) had a 5.9-fold (95% confidence interval (CI) 1.7-20.7) increased risk of stomach cancer. Risk increased with increasing stomach dose (P-trend<0.001), with an OR of 20.5 (3.7-114.3) for ⩾50.0 Gy compared with <10 Gy. Radiation-related risks remained elevated ⩾20 years after exposure (P<0.001). Risk after any chemotherapy was not elevated (OR=1.1; 95% CI 0.5-2.5; 14 cases and 23 controls). CONCLUSIONS Radiotherapy for TC involving parts of the stomach increased gastric cancer risk for several decades, with the highest risks after stomach doses of ⩾30 Gy. Clinicians should be aware of these excesses when previously irradiated TC survivors present with gastrointestinal symptoms and when any radiotherapy is considered in newly diagnosed TC patients.
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Affiliation(s)
- M Hauptmann
- Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - S D Fossa
- Department of Oncology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - M Stovall
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - F E van Leeuwen
- Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | | | - P Rajaraman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - E S Gilbert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - S A Smith
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - R E Weathers
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - B M P Aleman
- Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M Andersson
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | - R E Curtis
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - G M Dores
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
- Department of Veterans Affairs Medical Center, Oklahoma City, OK, USA
| | - J F Fraumeni
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - P Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E J Holowaty
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - H Joensuu
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
| | - M Kaijser
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - R A Kleinerman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | | | - C F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - E Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - H H Storm
- Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark
| | - L Vaalavirta
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
| | - A W van den Belt-Dusebout
- Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - L B Travis
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - L M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
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Roberts D, Keeling R, Tracka M, van der Walle CF, Uddin S, Warwicker J, Curtis R. Specific Ion and Buffer Effects on Protein–Protein Interactions of a Monoclonal Antibody. Mol Pharm 2014; 12:179-93. [DOI: 10.1021/mp500533c] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- D. Roberts
- School
of Chemical Engineering and Analytical Science, The University of Manchester, Sackville Street, Manchester M13 9PL, U.K
| | - R. Keeling
- School
of Chemical Engineering and Analytical Science, The University of Manchester, Sackville Street, Manchester M13 9PL, U.K
| | - M. Tracka
- Formulation
Sciences, MedImmune, Ltd., Aaron Klug Building, Granta Park, Cambridge CB21 6GH, U.K
| | - C. F. van der Walle
- Formulation
Sciences, MedImmune, Ltd., Aaron Klug Building, Granta Park, Cambridge CB21 6GH, U.K
| | - S. Uddin
- Formulation
Sciences, MedImmune, Ltd., Aaron Klug Building, Granta Park, Cambridge CB21 6GH, U.K
| | - J. Warwicker
- School
of Chemical Engineering and Analytical Science, The University of Manchester, Sackville Street, Manchester M13 9PL, U.K
| | - R. Curtis
- School
of Chemical Engineering and Analytical Science, The University of Manchester, Sackville Street, Manchester M13 9PL, U.K
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14
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Dores GM, Curtis RE, van Leeuwen FE, Stovall M, Hall P, Lynch CF, Smith SA, Weathers RE, Storm HH, Hodgson DC, Kleinerman RA, Joensuu H, Johannesen TB, Andersson M, Holowaty EJ, Kaijser M, Pukkala E, Vaalavirta L, Fossa SD, Langmark F, Travis LB, Fraumeni JF, Aleman BM, Morton LM, Gilbert ES. Pancreatic cancer risk after treatment of Hodgkin lymphoma. Ann Oncol 2014; 25:2073-2079. [PMID: 25185241 PMCID: PMC4176454 DOI: 10.1093/annonc/mdu287] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [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: 03/09/2014] [Revised: 07/19/2014] [Accepted: 07/20/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Although elevated risks of pancreatic cancer have been observed in long-term survivors of Hodgkin lymphoma (HL), no prior study has assessed the risk of second pancreatic cancer in relation to radiation dose and specific chemotherapeutic agents. PATIENTS AND METHODS We conducted an international case-control study within a cohort of 19 882 HL survivors diagnosed from 1953 to 2003 including 36 cases and 70 matched controls. RESULTS Median ages at HL and pancreatic cancer diagnoses were 47 and 60.5 years, respectively; median time to pancreatic cancer was 19 years. Pancreatic cancer risk increased with increasing radiation dose to the pancreatic tumor location (Ptrend = 0.005) and increasing number of alkylating agent (AA)-containing cycles of chemotherapy (Ptrend = 0.008). The odds ratio (OR) for patients treated with both subdiaphragmatic radiation (≥10 Gy) and ≥6 AA-containing chemotherapy cycles (13 cases, 6 controls) compared with patients with neither treatment was 17.9 (95% confidence interval 3.5-158). The joint effect of these two treatments was significantly greater than additive (P = 0.041) and nonsignificantly greater than multiplicative (P = 0.29). Especially high risks were observed among patients receiving ≥8400 mg/m(2) of procarbazine with nitrogen mustard or ≥3900 mg/m(2) of cyclophosphamide. CONCLUSION Our study demonstrates for the first time that both radiotherapy and chemotherapy substantially increase pancreatic cancer risks among HL survivors treated in the past. These findings extend the range of nonhematologic cancers associated with chemotherapy and add to the evidence that the combination of radiotherapy and chemotherapy can lead to especially large risks.
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Affiliation(s)
- G M Dores
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda; Department of Veterans Affairs Medical Center, Oklahoma City, USA.
| | - R E Curtis
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - F E van Leeuwen
- Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M Stovall
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston,USA
| | - P Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - C F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, USA
| | - S A Smith
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston,USA
| | - R E Weathers
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston,USA
| | - H H Storm
- Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark
| | - D C Hodgson
- Department of Radiation Oncology, University of Toronto, Toronto,Canada
| | - R A Kleinerman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - H Joensuu
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
| | | | - M Andersson
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | - E J Holowaty
- Dalla Lana School of Public Health, University of Toronto, Toronto,Canada
| | - M Kaijser
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - E Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki and School of Health Sciences, University of Tampere, Tampere, Finland
| | - L Vaalavirta
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
| | - S D Fossa
- Department of Oncology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | | | - L B Travis
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester,USA
| | - J F Fraumeni
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - B M Aleman
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - L M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
| | - E S Gilbert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
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Fetterplace K, Beach L, Edbrooke L, Parry S, Curtis R, Rechnitzer T, Berney S, Denehy L. PP028-SUN: Associations between Cumulative Calorie Debt (CCD) in Intensive Care (ICU), The Diagnosis of Intensive Care Unit Acquired Weakness (ICUAW) and Length of Stay (LOS). Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50070-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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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Fetterplace K, Beach L, Edbrooke L, Parry S, Curtis R, Rechnitzer T, Berney S, Denehy L. PP038-SUN: Measured Energy Expenditure Compared with Estimated Energy Requirments and Accelerometry in Intensive Care. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50080-5] [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: 10/24/2022]
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Niu X, Poon JL, Riske B, Zhou ZY, Ullman M, Lou M, Baker J, Koerper M, Curtis R, Nichol MB. Physical activity and health outcomes in persons with haemophilia B. Haemophilia 2014; 20:814-21. [PMID: 25156277 DOI: 10.1111/hae.12485] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2014] [Indexed: 11/30/2022]
Abstract
Regular participation in physical activity helps to prevent damage and maintain joint health in persons with haemophilia. This study describes self-reported physical activity participation among a sample of people with haemophilia B in the US and measures its association with health-related quality of life (HRQoL). Data on 135 participants aged 5-64 years were abstracted from Hemophilia Utilization Group Study Part Vb. The International Physical Activity Questionnaire assessed physical activity among participants aged 15-64 years, and the Children's Physical Activity Questionnaire abstracted from the Canadian Community Health Survey was used for participants aged 5-14 years. SF-12 was used to measure HRQoL and the EuroQol (EQ-5D-3L) was used to measure health status for participants older than 18 years of age. PedsQL was used to measure HRQoL in children aged 5-18 years. Sixty-two percent of participants in the 15-64 year-old age cohort reported a high level of physical activity, 29% reported moderate activity and 9% reported low activity. For children aged 5-14 years, 79% reported participating in physical activity for at least 4 days over a typical week. Based on the 2008 Physical Activity Guidelines for Americans, 79% of adults achieved the recommended physical activity level. Multivariable regression models indicated that adults who engaged in a high level of physical activity reported EQ-5D Visual Analogue Scale (VAS) scores that were 11.7 (P = 0.0726) points greater than those who engaged in moderate/low activity, indicating better health outcomes. Among children, no statistically significant differences in health outcomes were found between high and moderate or low activity groups.
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Affiliation(s)
- X Niu
- University of Southern California, Los Angeles, CA, USA
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Caneba CA, Yang L, Baddour J, Curtis R, Win J, Hartig S, Marini J, Nagrath D. Nitric oxide is a positive regulator of the Warburg effect in ovarian cancer cells. Cell Death Dis 2014; 5:e1302. [PMID: 24967964 PMCID: PMC4611736 DOI: 10.1038/cddis.2014.264] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/14/2014] [Accepted: 05/16/2014] [Indexed: 01/25/2023]
Abstract
Ovarian cancer (OVCA) is among the most lethal gynecological cancers leading to high mortality rates among women. Increasing evidence indicate that cancer cells undergo metabolic transformation during tumorigenesis and growth through nutrients and growth factors available in tumor microenvironment. This altered metabolic rewiring further enhances tumor progression. Recent studies have begun to unravel the role of amino acids in the tumor microenvironment on the proliferation of cancer cells. One critically important, yet often overlooked, component to tumor growth is the metabolic reprogramming of nitric oxide (NO) pathways in cancer cells. Multiple lines of evidence support the link between NO and tumor growth in some cancers, including pancreas, breast and ovarian. However, the multifaceted role of NO in the metabolism of OVCA is unclear and direct demonstration of NO's role in modulating OVCA cells' metabolism is lacking. This study aims at indentifying the mechanistic links between NO and OVCA metabolism. We uncover a role of NO in modulating OVCA metabolism: NO positively regulates the Warburg effect, which postulates increased glycolysis along with reduced mitochondrial activity under aerobic conditions in cancer cells. Through both NO synthesis inhibition (using L-arginine deprivation, arginine is a substrate for NO synthase (NOS), which catalyzes NO synthesis; using L-Name, a NOS inhibitor) and NO donor (using DETA-NONOate) analysis, we show that NO not only positively regulates tumor growth but also inhibits mitochondrial respiration in OVCA cells, shifting these cells towards glycolysis to maintain their ATP production. Additionally, NO led to an increase in TCA cycle flux and glutaminolysis, suggesting that NO decreases ROS levels by increasing NADPH and glutathione levels. Our results place NO as a central player in the metabolism of OVCA cells. Understanding the effects of NO on cancer cell metabolism can lead to the development of NO targeting drugs for OVCAs.
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Affiliation(s)
- C A Caneba
- 1] Laboratory for Systems Biology of Human Diseases, Rice University, Houston, TX, USA [2] Department of Bioengineering, Rice University, Houston, TX, USA
| | - L Yang
- 1] Laboratory for Systems Biology of Human Diseases, Rice University, Houston, TX, USA [2] Department of Chemical and Biomolecular Engineering, Rice University, Houston, TX, USA
| | - J Baddour
- 1] Laboratory for Systems Biology of Human Diseases, Rice University, Houston, TX, USA [2] Department of Chemical and Biomolecular Engineering, Rice University, Houston, TX, USA
| | - R Curtis
- 1] Laboratory for Systems Biology of Human Diseases, Rice University, Houston, TX, USA [2] Department of Chemical and Biomolecular Engineering, Rice University, Houston, TX, USA
| | - J Win
- 1] Laboratory for Systems Biology of Human Diseases, Rice University, Houston, TX, USA [2] Department of Chemical and Biomolecular Engineering, Rice University, Houston, TX, USA
| | - S Hartig
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - J Marini
- 1] Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA [2] Pediatric Critical Care Medicine and USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - D Nagrath
- 1] Laboratory for Systems Biology of Human Diseases, Rice University, Houston, TX, USA [2] Department of Bioengineering, Rice University, Houston, TX, USA [3] Department of Chemical and Biomolecular Engineering, Rice University, Houston, TX, USA
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Roberts D, Keeling R, Tracka M, van der Walle CF, Uddin S, Warwicker J, Curtis R. The role of electrostatics in protein-protein interactions of a monoclonal antibody. Mol Pharm 2014; 11:2475-89. [PMID: 24892385 DOI: 10.1021/mp5002334] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Understanding how protein-protein interactions depend on the choice of buffer, salt, ionic strength, and pH is needed to have better control over protein solution behavior. Here, we have characterized the pH and ionic strength dependence of protein-protein interactions in terms of an interaction parameter kD obtained from dynamic light scattering and the osmotic second virial coefficient B22 measured by static light scattering. A simplified protein-protein interaction model based on a Baxter adhesive potential and an electric double layer force is used to separate out the contributions of longer-ranged electrostatic interactions from short-ranged attractive forces. The ionic strength dependence of protein-protein interactions for solutions at pH 6.5 and below can be accurately captured using a Deryaguin-Landau-Verwey-Overbeek (DLVO) potential to describe the double layer forces. In solutions at pH 9, attractive electrostatics occur over the ionic strength range of 5-275 mM. At intermediate pH values (7.25 to 8.5), there is a crossover effect characterized by a nonmonotonic ionic strength dependence of protein-protein interactions, which can be rationalized by the competing effects of long-ranged repulsive double layer forces at low ionic strength and a shorter ranged electrostatic attraction, which dominates above a critical ionic strength. The change of interactions from repulsive to attractive indicates a concomitant change in the angular dependence of protein-protein interaction from isotropic to anisotropic. In the second part of the paper, we show how the Baxter adhesive potential can be used to predict values of kD from fitting to B22 measurements, thus providing a molecular basis for the linear correlation between the two protein-protein interaction parameters.
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Affiliation(s)
- D Roberts
- School of Chemical Engineering and Analytical Science, The University of Manchester , Sackville Street, Manchester M13 9PL, U.K
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Lee C, Lee C, Lamart S, Simon SL, Curtis RE, Inskip P. SU-E-T-285: Use of Computational Human Phantoms Combined with a Treatment Planning System to Study the Sensitivity of Reconstructed Normal Tissue Dose to Patient Size and Assumptions On Second Tumor Location. Med Phys 2013. [DOI: 10.1118/1.4814719] [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: 11/07/2022] Open
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21
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Curtis R. Tracheal intubation with a camera embedded in the tube tip. Anaesthesia 2013; 68:428. [DOI: 10.1111/anae.12202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Robert A, Curtis R, Flath D, Gray A, Sikorski M, Song S, Srinivasan V, Stefanescu D. The X-ray Correlation Spectroscopy instrument at the Linac Coherent Light Source. ACTA ACUST UNITED AC 2013. [DOI: 10.1088/1742-6596/425/21/212009] [Citation(s) in RCA: 11] [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: 11/11/2022]
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Morton LM, Gilbert ES, Hall P, Andersson M, Joensuu H, Vaalavirta L, Dores GM, Stovall M, Holowaty EJ, Lynch CF, Curtis RE, Smith SA, Kleinerman RA, Kaijser M, Storm HH, Pukkala E, Weathers RE, Linet MS, Rajaraman P, Fraumeni JF, Brown LM, van Leeuwen FE, Fossa SD, Johannesen TB, Langmark F, Lamart S, Travis LB, Aleman BMP. Risk of treatment-related esophageal cancer among breast cancer survivors. Ann Oncol 2012; 23:3081-3091. [PMID: 22745217 PMCID: PMC3501231 DOI: 10.1093/annonc/mds144] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [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: 07/26/2011] [Revised: 04/10/2012] [Accepted: 04/16/2012] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Radiotherapy for breast cancer may expose the esophagus to ionizing radiation, but no study has evaluated esophageal cancer risk after breast cancer associated with radiation dose or systemic therapy use. DESIGN Nested case-control study of esophageal cancer among 289 748 ≥5-year survivors of female breast cancer from five population-based cancer registries (252 cases, 488 individually matched controls), with individualized radiation dosimetry and information abstracted from medical records. RESULTS The largest contributors to esophageal radiation exposure were supraclavicular and internal mammary chain treatments. Esophageal cancer risk increased with increasing radiation dose to the esophageal tumor location (P(trend )< 0.001), with doses of ≥35 Gy associated with an odds ratio (OR) of 8.3 [95% confidence interval (CI) 2.7-28]. Patients with hormonal therapy ≤5 years preceding esophageal cancer diagnosis had lower risk (OR = 0.4, 95% CI 0.2-0.8). Based on few cases, alkylating agent chemotherapy did not appear to affect risk. Our data were consistent with a multiplicative effect of radiation and other esophageal cancer risk factors (e.g. smoking). CONCLUSIONS Esophageal cancer is a radiation dose-related complication of radiotherapy for breast cancer, but absolute risk is low. At higher esophageal doses, the risk warrants consideration in radiotherapy risk assessment and long-term follow-up.
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Affiliation(s)
- L M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA.
| | - E S Gilbert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - P Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - M Andersson
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | - H Joensuu
- Department of Oncology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - L Vaalavirta
- Department of Oncology, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - G M Dores
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA; US Department of Veterans Affairs Medical Center, Oklahoma City
| | - M Stovall
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - E J Holowaty
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - C F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, USA
| | - R E Curtis
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - S A Smith
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - R A Kleinerman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - M Kaijser
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - H H Storm
- Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, Denmark
| | - E Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - R E Weathers
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M S Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - P Rajaraman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - J F Fraumeni
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - L M Brown
- Statistics & Epidemiology, RTI International, Rockville, USA
| | - F E van Leeuwen
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S D Fossa
- Department of Oncology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | | | | | - S Lamart
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, USA
| | - L B Travis
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, USA
| | - B M P Aleman
- Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Little MP, Rajaraman P, Curtis RE, Devesa SS, Inskip PD, Check DP, Linet MS. Mobile phone use and glioma risk: comparison of epidemiological study results with incidence trends in the United States. BMJ 2012; 344:e1147. [PMID: 22403263 PMCID: PMC3297541 DOI: 10.1136/bmj.e1147] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2012] [Indexed: 12/23/2022]
Abstract
OBJECTIVE In view of mobile phone exposure being classified as a possible human carcinogen by the International Agency for Research on Cancer (IARC), we determined the compatibility of two recent reports of glioma risk (forming the basis of the IARC's classification) with observed incidence trends in the United States. DESIGN Comparison of observed rates with projected rates of glioma incidence for 1997-2008. We estimated projected rates by combining relative risks reported in the 2010 Interphone study and a 2011 Swedish study by Hardell and colleagues with rates adjusted for age, registry, and sex; data for mobile phone use; and various latency periods. SETTING US population based data for glioma incidence in 1992-2008, from 12 registries in the Surveillance, Epidemiology, and End Results (SEER) programme (Atlanta, Detroit, Los Angeles, San Francisco, San Jose-Monterey, Seattle, rural Georgia, Connecticut, Hawaii, Iowa, New Mexico, and Utah). PARTICIPANTS Data for 24,813 non-Hispanic white people diagnosed with glioma at age 18 years or older. RESULTS Age specific incidence rates of glioma remained generally constant in 1992-2008 (-0.02% change per year, 95% confidence interval -0.28% to 0.25%), a period coinciding with a substantial increase in mobile phone use from close to 0% to almost 100% of the US population. If phone use was associated with glioma risk, we expected glioma incidence rates to be higher than those observed, even with a latency period of 10 years and low relative risks (1.5). Based on relative risks of glioma by tumour latency and cumulative hours of phone use in the Swedish study, predicted rates should have been at least 40% higher than observed rates in 2008. However, predicted glioma rates based on the small proportion of highly exposed people in the Interphone study could be consistent with the observed data. Results remained valid if we used either non-regular users or low users of mobile phones as the baseline category, and if we constrained relative risks to be more than 1. CONCLUSIONS Raised risks of glioma with mobile phone use, as reported by one (Swedish) study forming the basis of the IARC's re-evaluation of mobile phone exposure, are not consistent with observed incidence trends in US population data, although the US data could be consistent with the modest excess risks in the Interphone study.
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Affiliation(s)
- M P Little
- Radiation Epidemiology Branch, National Cancer Institute, Rockville, MD 20852-7238, USA.
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Zhou ZY, Wu J, Baker J, Curtis R, Forsberg A, Huszti H, Koerper M, Lou M, Miller R, Parish K, Riske B, Shapiro A, Ullman M, Johnson K. Haemophilia utilization group study - Part Va (HUGS Va): design, methods and baseline data. Haemophilia 2011; 17:729-36. [PMID: 21689212 DOI: 10.1111/j.1365-2516.2011.02595.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
To describe the study design, procedures and baseline characteristics of the Haemophilia Utilization Group Study - Part Va (HUGS Va), a US multi-center observational study evaluating the cost of care and burden of illness in persons with factor VIII deficiency. Patients with factor VIII level ≤ 30%, age 2-64 years, receiving treatment at one of six federally supported haemophilia treatment centres (HTCs) were enrolled in the study. Participants completed an initial interview including questions on socio-demographical characteristics, health insurance status, co-morbidities, access to care, haemophilia treatment regimen, factor utilization, self-reported joint pain and motion limitation and health-related quality of life. A periodic follow-up survey collected data regarding time lost from usual activities, disability days, health care utilization and outcomes of care. HTC clinicians documented participants' baseline clinical characteristics and pharmacy dispensing records for 2 years. Between July 2005 and July 2007, 329 participants were enrolled. Average age was 9.7 years for children and 33.5 years for adults; two-thirds had severe haemophilia. The distributions of age, marital status, education level and barriers to haemophilia care were relatively consistent across haemophilic severity categories. Differences were found in participants' employment status, insurance status and income. Overall, children with haemophilia had quality of life scores comparable to healthy counterparts. Adults had significantly lower physical functioning than the general US population. As one of the largest economic studies of haemophilia care, HUGS Va will provide detailed information regarding the burden of illness and health care utilization in the US haemophilia A population.
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Affiliation(s)
- Z-Y Zhou
- University of Southern California, Los Angeles, CA, USA
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Colman R, Curtis R, Nelson J, Barkley J, Beal A, Edelman J, Efferen L, Hadjiliadis D, Levine D, Meyer K, Padilla M, Strek M, Varkey B, Wille K, Singer L. 62 Barriers to Optimal Palliative Care of Lung Transplant Candidates. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.069] [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] Open
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Lee C, Lamart S, Curtis R, Inskip P. SU-GG-T-406: A Feasibility Study on Monte Carlo-Based Organ Dose Reconstructions for Patients Treated by External Beam Radiotherapy. Med Phys 2010. [DOI: 10.1118/1.3468803] [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: 11/07/2022] Open
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Berrington de Gonzalez A, Curtis RE, Gilbert E, Berg CD, Smith SA, Stovall M, Ron E. Second solid cancers after radiotherapy for breast cancer in SEER cancer registries. Br J Cancer 2009; 102:220-6. [PMID: 19935795 PMCID: PMC2813734 DOI: 10.1038/sj.bjc.6605435] [Citation(s) in RCA: 172] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Radiotherapy for breast cancer reduces disease recurrence and breast cancer mortality. However, it has also been associated with increased second cancer risks in exposed sites. Methods: We evaluated long-term second cancer risks among 182 057 5-year survivors of locoregional invasive breast cancer diagnosed between 1973 and 2000 and reported to US NCI-SEER Program cancer registries. Multivariate Poisson regression was used to estimate the relative risk (RR) and excess cases of second cancer in women who had surgery and radiotherapy, compared with those who had surgery alone. Second cancer sites were grouped according to doses received from typical tangential breast fields. Results: By the end of 2005 (median follow-up=13.0 years), 15 498 second solid cancers had occurred, including 6491 contralateral breast cancers. The RRs for radiotherapy were 1.45 (95% confidence interval (CI)=1.33–1.58) for high-dose second cancer sites (1+ Gy: lung, oesophagus, pleura, bone and soft tissue) and 1.09 (1.04–1.15) for contralateral breast cancer (≈1 Gy). These risks decreased with increasing age and year of treatment. There was no evidence of elevated risks for sites receiving medium (0.5–0.99 Gy, RR=0.89 (0.74–1.06)) or low doses (<0.5 Gy, RR=1.01 (0.95–1.07)). The estimated excess cases of cancer in women treated with radiotherapy were as follows: 176 (95% CI=69–284) contralateral breast cancers or 5% (2–8%) of the total in all 1+year survivors, and 292 (222–362) other solid cancers or 6% (4–7%) of the total. Conclusions: Most second solid cancers in breast cancer survivors are not related to radiotherapy.
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Affiliation(s)
- A Berrington de Gonzalez
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20814, USA.
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Pyo G, Curtis K, Curtis R, Markwell S. A validity study of the Working Group's Orientation Test for individuals with moderate to severe intellectual disability. J Intellect Disabil Res 2009; 53:780-786. [PMID: 19627423 DOI: 10.1111/j.1365-2788.2009.01191.x] [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: 05/28/2023]
Abstract
BACKGROUND Decline in orientation skill has been reported as an early indicator of Dementia of Alzheimer's Type (DAT). Orientation subtest of the Working Group's Test Battery was examined whether this test is useful to identify DAT patients among adults with moderate to severe ID. METHODS Sixteen DAT patients and 35 non-demented normal controls with moderate to severe ID were followed for a year using Orientation Test. The scores on the baseline evaluation and the longitudinal changes over a 1-year period among the DAT patients and the normal controls were compared. The effects of age and etiologies of ID on the performance of Orientation were also examined. RESULTS The DAT group's score was significantly poorer than that of the normal control group on the baseline evaluation. The score changes over the 1-year period were not significantly different between the groups. However, there was a considerable overlap between the score distributions of the two groups. The effects of age and etiologies of ID on the performance of Orientation were not significant. CONCLUSIONS Screening DAT patients based only on the score of the Orientation Test of the Working Group's Test Battery may produce a large number of diagnostic errors.
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Affiliation(s)
- G Pyo
- Department of Psychiatry, Southern Illinois University School of Medicine, Illinois, USA.
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Affiliation(s)
- R. Curtis
- a Comparative Ophthalmology Unit , Animal Health Trust , Lanwades Park, Kennett, Newmarket, Suffolk, CB8 7PN, England
| | - J.R. Baker
- b Department of Veterinary Pathology , University of Liverpool Veterinary Field Station Leahurst , Neston, South Wirral, L64 7TE, England
| | - P.E. Curtis
- c Department of Veterinary Clinical Science , University of Liverpool Veterinary Field Station , Leahurst, Neston, South Wirral, L64 7TE, England
| | - A. Johnston
- c Department of Veterinary Clinical Science , University of Liverpool Veterinary Field Station , Leahurst, Neston, South Wirral, L64 7TE, England
- d The Veterinary Surgery , Salisbury Road, York, YO2 4YW, England
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Gisep A, Curtis R, Flütsch S, Suhm N. Augmentation of osteoporotic bone: effect of pulsed jet-lavage on injection forces, cement distribution, and push-out strength of implants. J Biomed Mater Res B Appl Biomater 2007; 78:83-8. [PMID: 16333851 DOI: 10.1002/jbm.b.30472] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Demographic change in the population leads to higher incidence of fragility fractures. Fracture fixation with standard implants may lead to implant cut-out due to reduced purchase. Augmentation of the bone stock with bone cements might overcome this problem. However, cancellous bone infiltration with the viscous cement dough reveals problems of fat embolism or high pressures during application of the cement. This study investigates the improved quality of bovine cancellous bone augmentation when pulsed jet-lavage is used for fat and marrow removal. Parameters such as injection forces, cement dough distribution through cannulated implants and mechanical strength of the fixation were applied for quantification. Injection of 5 mL of acrylic bone cement required significantly lower forces in the lavaged as compared to the untreated bone (50 N vs. > 300 N). Cement distribution was much more homogeneous and push-out forces significantly higher in the pretreated bone group (8.33 +/- 1.41 kN vs. 1.66 +/- 0.63 kN). The application of pulsed jet-lavage for fat removal prior to acrylic cement augmentation led to much more controlled outcomes of the augmentation. This seems to be a relevant step towards safe and efficient injection of bone cements into cancellous bone structures.
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Affiliation(s)
- A Gisep
- AO Development Institute, Clavadelerstrasse, Davos Platz 7270, Switzerland.
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Pyo G, Kripakaran K, Curtis K, Curtis R, Markwell S. A preliminary study of the validity of memory tests recommended by the Working Group for individuals with moderate to severe intellectual disability. J Intellect Disabil Res 2007; 51:377-86. [PMID: 17391254 DOI: 10.1111/j.1365-2788.2006.00886.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Normal aging and Dementia of Alzheimer's Type (DAT) among higher functioning individuals with intellectual disability (ID) have been relatively well studied using a variety of cognitive tests. However, cognitive studies for lower functioning individuals with ID are scarce in the literature. The Working Group recommended the Test Battery for the Diagnosis of Dementia in Individuals with various level of ID. Few studies have investigated whether the Test Battery is useful to study dementia among individuals with moderate to severe ID. The purpose of this study is to investigate whether the memory subtests of the Test Battery are useful for measuring memory function and studying DAT in individuals with moderate to severe ID. METHODS We compared performances on the memory subtests in the Test Battery between 31 normal controls and 13 DAT patients with moderate to severe ID. Performance on the Picture Recognition Test was also compared between five normal controls and five DAT patients. This test was designed by our team to measure memory functions of individuals with moderate to severe ID. RESULTS Among the memory subtests of the Test Battery, the Autobiographical Memory and the Orientation were found to be useful for studying normal and abnormal aging among individuals with moderate to severe ID. Preliminary data for the Picture Recognition Test demonstrated that these individuals properly responded to this test and the majority of DAT patients could be differentiated from the normal controls based on their performance. CONCLUSIONS Further studies are necessary to improve usefulness of the memory subtests of the Test Battery for lower functioning individuals with ID. While the results suggest that the Picture Recognition Test may be more effective in discriminating individuals with DAT, given the very small sample sizes, a study with larger sample sizes should be undertaken to validate these findings.
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Affiliation(s)
- G Pyo
- Department of Psychiatry, Southern Illinois University, School of Medicine, Springfield, IL, USA.
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Li H, Watson TF, Sherriff M, Curtis R, Bartlett DW. The Influence of Fluoride Varnish on the Attrition of Dentine. Caries Res 2007; 41:219-22. [PMID: 17426403 DOI: 10.1159/000099322] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2006] [Accepted: 11/24/2006] [Indexed: 11/19/2022] Open
Abstract
Previous investigations have shown the potential for fluoride to be protective in an abrasion/erosion laboratory model. The aim of this study was to investigate the effect of high concentrations of fluoride delivered in a varnish on attrition of dentine. Fifteen caries-free, intact lower third molar teeth were sectioned and the enamel removed by a water-cooled diamond disc. Polished dentine surfaces were divided into 8 areas, 4 of which were randomly covered with a high-concentration fluoride varnish for 24 h. The samples were subjected to 5,000 cycles of attrition bathed under artificial saliva. Microhardness testing adjacent to the wear scars showed no statistical difference between the fluoride-treated (71.42 KHN, SD 10.52) and control surfaces (72.66 KHN, SD 9.69). The volume of the wear scar was statistically greater for the fluoride-treated surface at 9.6 microm(3) (SD 4.92) and 8.13 microm(3) (SD 5.54) for the control areas (p = 0.029). The low pH of the fluoride varnish appears to have increased the amount of wear from attrition in this laboratory study.
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Affiliation(s)
- H Li
- Department of TMJ (Orthodontics), West China College of Stomatology, Sichuan University, Chengdu, China
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Baboolal NS, Lalla S, Chai M, Curtis R, Nandwani C, Olivier L, Smith C. Childhood sexual abuse among outpatients attending adult psychiatric outpatient clinics: a case-control study. W INDIAN MED J 2007; 56:152-8. [PMID: 17910146 DOI: 10.1590/s0043-31442007000200009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
UNLABELLED Only a few studies have focussed on the importance of routine investigation of childhood sexual abuse in outpatients attending adult psychiatric outpatient clinics. The aim of this study is to explore the association between having a history of childhood sexual abuse (CSA) and attending adult Psychiatric Outpatient Clinics in Trinidad. METHODS This was a case-control study conducted in twelve psychiatric outpatient clinics located throughout Trinidad A questionnaire covering demographic, social, and sexual abuse components was administered by semi-structured interview to 566 participants, of whom 242 were cases, 239 were controls and 85 had incomplete questionnaires. The cases were 242 patients attending psychiatric outpatient clinics in Trinidad and the controls were 239 non-physician staffmembers at the clinics. Results were analyzed using the Stastistical Package for the Social Sciences (SPSS) version 10. RESULTS Chi-square analyses revealed several significant differences between the cases and control group. Sixty-three (26%) cases and 29 (12.1%) controls experienced CSA (p < 0.000). Twenty-five (39.7%) of the CSA cases had their experiences between the ages of 4 to 8 years and 13 (44.8%) of the CSA controls had their experiences between the ages of 9 to 12 (p < 0.01). Twenty-six (41.3%) of the cases and 3 (10.3%) of the controls had been abused at least 5 times (p < 0.000). Seventeen (58.6%) abused CSA controls reported having been sexually abused as a child only once. CSA with both force and manipulation was reported by 30 (47.6%) CSA cases while 6 (20.7%) CSA controls experienced CSA with force and manipulation (p < 0. 025). The abused CSA cases reported having a smaller social network of 2 persons compared to the abused CSA controls who had a social network of more than 4 persons (p < 0. 05). Of the 92 abused participants, 73.9% were women, and only 52.2% had told someone about the CSA. For the majority of CSA cases and CSA controls, the abuse involved one abuser. CONCLUSION A positive correlation was established between earlier onset of CSA, repeated abuse (occurring more than 5 times), a limited social network in patients who had CSA and attending adult psychiatric outpatient clinics. Identifying CSA in psychiatric outpatients may lead to early intervention and aid patient management.
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Affiliation(s)
- N S Baboolal
- Psychiatry Unit, Department of Clinical Medical Sciences, Faculty of Medical Sciences, St Augustine, The University of the West Indies.
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Chopra V, Smith BJ, Preiskel HW, Palmer RM, Curtis R. Breakaway forces of flat and domed surfaced Magfit implant magnet attachments. Eur J Prosthodont Restor Dent 2007; 15:7-12. [PMID: 17378452] [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: 05/14/2023]
Abstract
The aim of this in vitro study was to compare the resistance to separation (breakaway force) of flat (Magfit-IP-BF) and domed (Magfit-IP-BD) implant magnet attachments subjected to non-axial forces. The separating forces were applied by an Instron Universal Testing Instrument to single magnet attachments at angles of 0 degrees, 2 degrees, 5 degrees 10 degrees, and 20 degrees from the axial line of the components (angle of pull) and at crosshead speeds of 0.5 mn/min and 5 degrees mm/min. The breakaway forces were significantly (p < 0.0001) inversely related to the angle of pull for both flat magnets and for domed magnets. At the slow crosshead speed, the breakaway forces recorded for the domed magnets were significantly greater than those recorded for the flat magnets for angles of pull greater than 5 degrees. At the faster crosshead speed, the breakaway forces recorded for the domed magnets were significantly greater than those recorded for the flat magnets for angles of pull greater than 2 degrees. This apparent superiority of domed magnets under non-axially directed separating forces could influence the choice of magnet attachment for implant overdentures as intraoral displacing forces are multidirectional. Domed magnets may also be advantageous where implants are not parallel.
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Bellenger NG, Wells T, Hitchcock R, Watkins M, Duffet C, Jewell D, Palliser D, Shapland L, Curtis R, Scrase S, Burns R, Curzen N. Reducing transfer times for coronary angiography in patients with acute coronary syndromes: one solution to a national problem. Postgrad Med J 2006; 82:411-3. [PMID: 16754712 PMCID: PMC2563751 DOI: 10.1136/pgmj.2005.040162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Patients with acute coronary syndrome (ACS) are at high risk of further cardiac events and benefit from early intervention, as reflected by international guidelines recommending early transfer to interventional centres. The current average waiting time of up to 21 days contravenes evidence based early intervention, creates geographical inequity of access, wastes bed days, and is unsatisfactory for patients. METHODS A regional transfer unit (RTU) was created to expatriate access of ACS patients referred from other centres to the revascularisation service. By redesigning the care pathway patients arriving on the RTU undergo angiography within 24 hours, and then leave the RTU the following day, allowing other ACS patients to be treated. RESULTS During the first six months of the RTU, the mean waiting time from referral to procedure decreased from 20 (SD 15) days (range 0-51) to 8 (SD 3) days (range 0-21) for 365 patients transferred from a district general hospital. Ninety seven per cent of patients underwent angiography within 24 hours, 61% having undergone percutaneous coronary intervention at the same sitting, and 78% were discharged home within 24 hours. CONCLUSIONS Delivering standards laid out in the National Service Framework, reducing inequalities of care across the region, and facilitating evidence based strategies of care represents a challenging and complex issue. For high risk patients suffering ACS who need early invasive investigation, a coordinated network wide approach together with the creation of an RTU resulted in a 62% reduction in waiting times for no extra resources. Further improvements can be expected through increased capacity of this verified strategy.
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Affiliation(s)
- N G Bellenger
- Wessex Cardiac Unit, Southampton University Hospitals NHS Trust, Southampton SO16 6YD, UK.
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Gisep A, Curtis R, Hänni M, Suhm N. Augmentation of implant purchase with bone cements: Anin vitro study of injectability and dough distribution. J Biomed Mater Res B Appl Biomater 2006; 77:114-9. [PMID: 16245286 DOI: 10.1002/jbm.b.30421] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Vertebroplasty is widely used to treat (augment) osteoporotic fractures of the spine. This technique--with or without metallic implants--might have more widespread indications, if the mechanics of the injection and distribution of the cement dough through cannulated instruments and implants were better understood. This study was performed to investigate injectability of calcium phosphate and acrylic bone cements through implant prototypes, which featured different perforated sleeve designs. Using a custom-made capillary rheometer, the forces needed to inject 10 mL of the cement dough through standard cannulas were measured in the first series of experiments. In the second series, plastic sleeves were attached to the rheometer, simulating the implant. In both series, the dough was injected into ambient laboratory atmosphere, and in the second series, cement distribution was analyzed by means of an optical system. Injection of cement dough through the cannulas required forces between 50 and 400 N in the case of acrylic cements and between 40 and 500 N in case of the calcium phosphate cements. Using different sleeves did not have a significant influence on the distribution of the cement dough around the sleeve. The amount of cement dough injected was reduced when a perforated implant was attached to the cannula. More material was delivered through the proximal holes of the implant, leading to a V-shaped distribution of the cement dough. Among topics to be investigated in future studies is determination of the injectability of cement dough into trabecular bone or bone-like structures.
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Affiliation(s)
- A Gisep
- AO Development Institute, Clavadelerstrasse, CH-7270, Davos Platz, Switzerland.
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Curtis R, Goldhahn J, Schwyn R, Regazzoni P, Suhm N. Fixation principles in metaphyseal bone--a patent based review. Osteoporos Int 2005; 16 Suppl 2:S54-64. [PMID: 15536538 DOI: 10.1007/s00198-004-1763-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [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] [Received: 07/26/2004] [Accepted: 09/09/2004] [Indexed: 11/30/2022]
Abstract
Osteoporotic changes start in cancellous bone due to the underlying pathophysiology. Consequently, the metaphyses are at a higher risk of "osteoporotic" fracture than the diaphysis. Furthermore, implant purchase to fix these fractures is also affected by the poor bone quality. In general, researchers and developers have worked on three different approaches to address the problem of fractures to osteoporotic bone: adapted anchoring techniques, improved load distribution as well as transfer with angular stable screws, and augmentation techniques using bone substitutes. A patent-based review was performed to evaluate which ideas were utilized to improve fixation in osteoporotic, metaphyseal bone, especially in the proximal femur, and to analyze whether the concept had entered clinical use. Anchoring devices that are either extramedullary or intramedullary have a long clinical history. However, demanding surgical techniques and complications, especially in poor quality bone, are justification that such implants and their corresponding surgical techniques need to be improved upon. Expanding elements have been evaluated in the laboratory. The results are promising and the potential of this approach has yet to be fully exploited in the clinics. Internal fixators with angular stable screws open the door for many new anchorage ideas and have great potential for further optimization of load distribution and transfer. Augmentation techniques may improve anchorage in osteoporotic bone. However, the properties of bone substitute materials will need to be modified and improved upon in order to meet the demanding requirements. If we summarise the development process and the clinical use of implants to date, we have to clearly state that more factors than simply biomechanical advantage will determine the clinical success of a new fixation principle or a new implant. Instead, fracture treatment of patients with osteoporosis really needs an interdisciplinary approach!
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Affiliation(s)
- R Curtis
- AO Development Institute, Davos, Switzerland
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Akhkha A, Curtis R, Kennedy M, Kusel J. The potential signalling pathways which regulate surface changes induced by phytohormones in the potato cyst nematode (Globodera rostochiensis). Parasitology 2004; 128:533-9. [PMID: 15180321 DOI: 10.1017/s0031182004004810] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
It has been demonstrated that the surface lipophilicity of the plant-parasitic nematode Globodera rostochiensis decreases when infective larvae are exposed to the phytohormones indole-3-acetic acid (auxin) or kinetin (cytokinin). In the present study, it was shown that inhibition of phospholipase C (PLC) or phosphatidylinositol 3 kinase (PI3-kinase) reversed the effect of phytohormones on surface lipophilicity. The signalling pathway(s) involved in surface modification were investigated using 'caged' signalling molecules and stimulators or inhibitors of different signalling enzymes. Photolysis of the 'caged' signalling molecules, NPE-caged Ins 1,4,5-P3, NITR-5/AM or caged-cAMP to liberate IP3, Ca2+ or cAMP respectively, decreased the surface lipophilicity. Activation of adenylate cyclase also decreased the surface lipophilicity. In contrast, inhibition of PI3-kinase using Wortmannin, LY-294002 or Quercetin, and inhibition of PLC using U-73122 all increased the surface lipophilicity. Two possible signalling pathways involved in phytohormone-induced surface modification are proposed.
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Affiliation(s)
- A Akhkha
- Davidson Building, Division of Biochemistry and Molecular Biology, University of Glasgow, Glasgow G12 8QQ, UK.
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Abstract
OBJECTIVES To examine the role and relative impact of illness perceptions, coping strategies and clinical disease indicators on adjustment in patients with rheumatoid arthritis. METHOD Participants were 75 women with rheumatoid arthritis. The Illness Perception Questionnaire (IPQ), the COPE questionnaire and the Arthritis Impact Measurement Scale (AIMS) were administered during a semistructured interview. Disease status was indicated by physician ratings of joint involvement and by the laboratory indices of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). RESULTS Statistically significant correlations (P<0.01) were in the expected direction. Various aspects of adjustment (good physical function, low pain and depression) were associated with perceptions of low illness identity, high control/cure, more serious illness consequences and long illness timeline. Low disease activity was related to good physical function. Depression was associated with high use of coping by denial and with less frequent use of five COPE strategies: active coping, planning, seeking instrumental social support, positive reinterpretation and growth, and acceptance. In hierarchical regression analysis, disease status explained variance in physical function (15%). Illness perceptions accounted for variance in all three adjustment outcomes, ranging from 22 to 27%. Coping variables did not add to the explanation of variance on adjustment. CONCLUSIONS Illness perceptions have significant implications for adaptation to illness and they outweigh the impact of medical disease status on depression, physical function and pain. Health interventions based on understanding and modifying perceptions of illness may prove useful in facilitating patient well-being.
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Affiliation(s)
- A Groarke
- Department of Psychology, National University of Ireland, University Road, Galway, Ireland.
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Cash A, Curtis R, Garrigia-Majo D, McDonald F. A comparative study of the static and kinetic frictional resistance of titanium molybdenum alloy archwires in stainless steel brackets. Eur J Orthod 2004; 26:105-11. [PMID: 14994890 DOI: 10.1093/ejo/26.1.105] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This ex vivo study compared the static and kinetic frictional resistance of eight different archwires tested in a single, stainless steel, zero base 0.022 x 0.028 inch (0.56 x 0.711 mm) slot standard edgewise bracket. The archwires evaluated were 0.019 x 0.025 inch (0.483 x 0.636 mm) in dimension, manufactured from the following alloys: beta titanium (TMA), 'low friction' coloured beta titanium (aqua, honeydew, purple and violet), ion-implanted beta titanium, Timolium and a stainless steel control. Prior to friction testing, bracket and archwire dimensions were measured by direct digital imaging via a desktop computer linked to a binocular light microscope. Frictional force was evaluated using an Instron universal testing machine. All experiments were carried out at room temperature, with no ligation, in the dry state with 20 degrees of added torque. The results demonstrated that static and kinetic friction were statistically significant (P < 0.001) for all archwire types. Ion-implanted and standard TMA archwires were found to have no significant advantage over stainless steel. The archwire alloys may be ranked as follows: stainless steel produced the lowest frictional resistance followed by honeydew, ion-implanted TMA and Timolium, with aqua, purple and violet producing frictional resistance values as high as standard TMA. It was also found that the percentage difference between the archwire and bracket slot dimensions claimed by the manufacturers and those measured in this experiment produced tolerances ranging from +5.37 to -6.67 per cent.
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Affiliation(s)
- A Cash
- Department of Orthodontics, GKT Dental Institute, Kings College, London, UK
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Gilbert ES, Stovall M, Gospodarowicz M, Van Leeuwen FE, Andersson M, Glimelius B, Joensuu T, Lynch CF, Curtis RE, Holowaty E, Storm H, Pukkala E, van't Veer MB, Fraumeni JF, Boice JD, Clarke EA, Travis LB. Lung cancer after treatment for Hodgkin's disease: focus on radiation effects. Radiat Res 2003; 159:161-73. [PMID: 12537521 DOI: 10.1667/0033-7587(2003)159[0161:lcatfh]2.0.co;2] [Citation(s) in RCA: 175] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Aspects of radiation-induced lung cancer were evaluated in an international study of Hodgkin's disease. The study population consisted of 227 patients with lung cancer and 455 matched controls. Unique features included dose determinations to the specific location in the lung where each cancer developed and quantitative data on both chemotherapy and tobacco use obtained from medical records. The estimated excess relative risk (ERR) per Gy was 0.15 (95% CI: 0.06-0.39), and there was little evidence of departure from linearity even though lung doses for the majority of Hodgkin's disease patients treated with radiotherapy exceeded 30 Gy. The interaction of radiation and chemotherapy that included alkylating agents was almost exactly additive, and a multiplicative relationship could be rejected (P = 0.017). Conversely, the interaction of radiation and smoking was consistent with a multiplicative relationship, but not with an additive relationship (P < 0.001). The ERR/Gy for males was about four times that for females, although the difference was not statistically significant. There was little evidence of modification of the ERR/Gy by time since exposure (after a 5-year minimum latent period), age at exposure, or attained age. Because of the very high radiation doses received by Hodgkin's disease patients and the immunodeficiency inherent to this lymphoma and that associated with chemotherapy, generalizing these findings to other populations receiving considerably lower doses of radiation should be done cautiously.
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Affiliation(s)
- E S Gilbert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda Maryland 20852-7238, USA.
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Fioretti L, Porter A, Haydock PJ, Curtis R. Monoclonal antibodies reactive with secreted-excreted products from the amphids and the cuticle surface of Globodera pallida affect nematode movement and delay invasion of potato roots. Int J Parasitol 2002; 32:1709-18. [PMID: 12464417 DOI: 10.1016/s0020-7519(02)00178-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This paper describes Excreted-secreted proteins (ES) proteins that were immunolocalised in the cuticle, amphids and subventral glands of second stage juveniles of the two species of potato cyst nematodes (Globodera pallida and Globodera rostochiensis). Monoclonal antibodies reactive with these ES proteins were used in a bioassay to investigate their effect on nematode movement and on their ability to invade potato roots. Antibodies recognising the nematode cuticle surface and the amphids affected nematode movement and delayed nematode penetration of roots. These effects were temporary, since the nematodes were able to recover and infect potato roots. Movement of second stage juveniles treated with the antibodies was impaired for the first 30 min after inoculation: the juveniles remained close to the point of introduction and moved slowly and abnormally. They recovered normal movement after 1-2 h, possibly because the turnover rate of the secreted proteins meant that they were no longer blocked by the monoclonal antibodies. No effect was observed on second stage juveniles treated with an antibody reactive with secretions from the oesophageal glands. Nematodes treated with antibodies reactive with the nematode cuticle surface were notably more affected than those treated with other antibodies; nematodes failed to recover movement when in continuous contact with the antibodies. It is possible that the physical presence of the antibodies on the nematode surface affected their motility. Nematodes treated with antibodies reactive with secretions from the amphids were temporarily unable to move towards potato roots and their exploratory behaviour was greatly affected by the antibody treatment. Whether these antibodies were able to inhibit temporarily the function of the amphids or this effect was due to physical presence of the antibodies blocking the amphidial pore remains to be determined.
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Affiliation(s)
- L Fioretti
- Nematode Interaction Unit, Rothamsted Research, Harpenden, Hertfordshire AL5 2JQ, UK
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Kääb MJ, Rahn BA, Weiler A, Curtis R, Perren SM, Schneider E. Osseous integration of poly-(L-co-D/L-lactide) 70/30 and titanium suture anchors: an experimental study in sheep cancellous bone. Injury 2002; 33 Suppl 2:B37-42. [PMID: 12161318 DOI: 10.1016/s0020-1383(02)00131-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- M J Kääb
- AO-Research Institute, Davos, Switzerland.
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Abstract
The direct effects of phytohormones (auxin and kinetin) and root diffusates on the surface lipophilicity of the plant parasitic nematodes Globodera rostochiensis and Meloidogyne incognita were investigated. The fluorescent lipid probe AF18 (5-N(octodecanoyl) aminofluorescein) was used to detect surface changes. Root diffusates increased AF18 uptake by G. rostochiensis while it had no effect on M. incognita. Kinetin and auxin decreased AF18 uptake in G. rostochiensis, while they had the opposite effect on M. incognita. Auxin/kinetin ratio was also found to be important in triggering the surface changes, especially at high concentrations. Whether plant nematodes have auxin and/or kinetin binding proteins is discussed as well as the mechanism behind the surface lipophilicity changes due to root diffusates and phytohormones.
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Affiliation(s)
- A Akhkha
- Division of Biochemistry and Molecular Biology, University of Glasgow, UK.
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