1
|
El Naamani K, Morse C, Ghanem M, Barbera J, Amllay A, Severance G, Ruiz R, Sweid A, Gooch MR, Herial NA, Jabbour P, Rosenwasser RH, Nyquist GG, Tjoumakaris S. Endovascular Embolization for Epistaxis: A Single Center Experience and Meta-Analysis. J Clin Med 2023; 12:6958. [PMID: 38002574 PMCID: PMC10672438 DOI: 10.3390/jcm12226958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/03/2023] [Accepted: 11/05/2023] [Indexed: 11/26/2023] Open
Abstract
The optimal treatment for intractable epistaxis is still controversial. Various studies have demonstrated high success rates and low complication rates for endovascular embolization. Herein, the authors report an institutional experience and meta-analysis in terms of efficacy and safety of endovascular embolization of intractable epistaxis. This was a retrospective observational study of 35 patients with epistaxis who underwent 40 embolization procedures between 2010 and 2023. The primary outcome was immediate success defined by immediate cessation of epistaxis at the end of the procedure. Immediate success was achieved in most of the procedures (39, 97.5%). During follow-up, three (7.5%) patients experienced a rebleed. Forty-one studies from 3595 articles were identified for inclusion in the meta-analysis and comprised 1632 patients. The mean pooled age was 57.5 years (95% CI: 57.2-57.8) and most patients were males (mean: 70.4, 95% CI: 69.8-71.0). Immediate success was achieved at a pooled mean of 90.9% (95% CI: 90.4-91.4) and rebleeding was observed at a pooled mean of 17% (95% CI: 16.5-17.5). In conclusion, endovascular embolization proved to be both safe and effective in treating intractable epistaxis carrying a low risk of post-operative stroke.
Collapse
Affiliation(s)
- Kareem El Naamani
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; (K.E.N.); (C.M.); (J.B.); (G.S.); (R.R.); (A.S.); (M.R.G.); (N.A.H.); (P.J.); (R.H.R.)
| | - Charles Morse
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; (K.E.N.); (C.M.); (J.B.); (G.S.); (R.R.); (A.S.); (M.R.G.); (N.A.H.); (P.J.); (R.H.R.)
| | - Marc Ghanem
- School of Medicine, Lebansese American University, Beirut 1102-2801, Lebanon;
| | - Julie Barbera
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; (K.E.N.); (C.M.); (J.B.); (G.S.); (R.R.); (A.S.); (M.R.G.); (N.A.H.); (P.J.); (R.H.R.)
| | - Abdelaziz Amllay
- School of Medicine, Hassan II University, Casablanca 8118, Morocco;
| | - Grace Severance
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; (K.E.N.); (C.M.); (J.B.); (G.S.); (R.R.); (A.S.); (M.R.G.); (N.A.H.); (P.J.); (R.H.R.)
| | - Ramon Ruiz
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; (K.E.N.); (C.M.); (J.B.); (G.S.); (R.R.); (A.S.); (M.R.G.); (N.A.H.); (P.J.); (R.H.R.)
| | - Ahmad Sweid
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; (K.E.N.); (C.M.); (J.B.); (G.S.); (R.R.); (A.S.); (M.R.G.); (N.A.H.); (P.J.); (R.H.R.)
| | - Michael R. Gooch
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; (K.E.N.); (C.M.); (J.B.); (G.S.); (R.R.); (A.S.); (M.R.G.); (N.A.H.); (P.J.); (R.H.R.)
| | - Nabeel A. Herial
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; (K.E.N.); (C.M.); (J.B.); (G.S.); (R.R.); (A.S.); (M.R.G.); (N.A.H.); (P.J.); (R.H.R.)
| | - Pascal Jabbour
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; (K.E.N.); (C.M.); (J.B.); (G.S.); (R.R.); (A.S.); (M.R.G.); (N.A.H.); (P.J.); (R.H.R.)
| | - Robert H. Rosenwasser
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; (K.E.N.); (C.M.); (J.B.); (G.S.); (R.R.); (A.S.); (M.R.G.); (N.A.H.); (P.J.); (R.H.R.)
| | - Gurston G. Nyquist
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA;
| | - Stavropoula Tjoumakaris
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA; (K.E.N.); (C.M.); (J.B.); (G.S.); (R.R.); (A.S.); (M.R.G.); (N.A.H.); (P.J.); (R.H.R.)
| |
Collapse
|
2
|
Salinas CE, Patey OV, Murillo C, Gonzales M, Espinoza V, Mendoza S, Ruiz R, Vargas R, Perez Y, Montaño J, Toledo-Jaldin L, Badner A, Jimenez J, Peñaranda J, Romero C, Aguilar M, Riveros L, Arana I, Giussani DA. Preeclampsia and risk of maternal pulmonary hypertension at high altitude in Bolivia. J Dev Orig Health Dis 2023; 14:523-531. [PMID: 37497575 DOI: 10.1017/s2040174423000193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Women with a history of preeclampsia (PE) have a greater risk of pulmonary arterial hypertension (PAH). In turn, pregnancy at high altitude is a risk factor for PE. However, whether women who develop PE during highland pregnancy are at risk of PAH before and after birth has not been investigated. We tested the hypothesis that during highland pregnancy, women who develop PE are at greater risk of PAH compared to women undergoing healthy highland pregnancies. The study was on 140 women in La Paz, Bolivia (3640m). Women undergoing healthy highland pregnancy were controls (C, n = 70; 29 ± 3.3 years old, mean±SD). Women diagnosed with PE were the experimental group (PE, n = 70, 31 ± 2 years old). Conventional (B- and M-mode, PW Doppler) and modern (pulsed wave tissue Doppler imaging) ultrasound were applied for cardiovascular íííassessment. Spirometry determined maternal lung function. Assessments occurred at 35 ± 4 weeks of pregnancy and 6 ± 0.3 weeks after birth. Relative to highland controls, highland PE women had enlarged right ventricular (RV) and right atrial chamber sizes, greater pulmonary artery dimensions and increased estimated RV contractility, pulmonary artery pressure and pulmonary vascular resistance. Highland PE women had lower values for peripheral oxygen saturation, forced expiratory flow and the bronchial permeability index. Differences remained 6 weeks after birth. Therefore, women who develop PE at high altitude are at greater risk of PAH before and long after birth. Hence, women with a history of PE at high altitude have an increased cardiovascular risk that transcends the systemic circulation to include the pulmonary vascular bed.
Collapse
Affiliation(s)
- C E Salinas
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - O V Patey
- Department of Physiology, Development & Neuroscience, University of Cambridge, Cambridge, UK
| | - C Murillo
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - M Gonzales
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - V Espinoza
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - S Mendoza
- Centro de Salud Tembladerani, La Paz, Bolivia
| | - R Ruiz
- Hospital Materno Infantil, La Paz, Bolivia
| | - R Vargas
- Hospital de la Mujer, La Paz, Bolivia
| | - Y Perez
- Hospital de la Mujer, La Paz, Bolivia
| | - J Montaño
- Hospital de la Mujer, La Paz, Bolivia
| | | | - A Badner
- Hospital Materno Infantil, La Paz, Bolivia
| | - J Jimenez
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | | | - C Romero
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - M Aguilar
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - L Riveros
- Instituto Boliviano de Biología de Altura (IBBA), UMSA, La Paz, Bolivia
| | - I Arana
- Grupo Premio Nobel, La Paz, Bolivia
| | - D A Giussani
- Department of Physiology, Development & Neuroscience, University of Cambridge, Cambridge, UK
- BHF Centre for Research Excellence, University of Cambridge, Cambridge, UK
- Strategic Research Initiative in Reproduction, University of Cambridge, Cambridge, UK
| |
Collapse
|
3
|
Arana Iñiguez I, Recreo Baquedano A, Ruiz R, Ariceta López A, Ramírez Cervera JL, Piñera A, Talavera Utrera G, Pérez Otermin I, Otegi Altolagirre I, Blázquez Lautre L. P-104 A STEP-UP APPROACH FROM IPOM + IN MINIMALLY INVASIVE ABDOMINAL WALL SURGERY. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
To compare the early outcomes of two different techniques for ventral hernia repair in our abdominal wall surgery unit.
Materials and Methods
A prospective non-randomized review was perfomed including patients who underwent laparoscopic hernia repair from January 2018 to April 2022. All patients were followed-up for 1 month and the hernia orifice was closed in all cases. Patients and hernias characteristics, operative data and early complications were reviewed. Postoperative pain was defined as ≥4 value in Visual Analogue Scale.
We compared 2 laparoscopic techniques: intraperitoneal mesh fixed with a double crown of resorbable tackers (IPOM+) and self gripping sublay positioned mesh (preperitoneal –PREP- or retromuscular –RIVES- position).
Outcomes
During the study period, 44 patients were assigned into 2 groups: 31 (70%) in IPOM+ group and 13 (30%) in Rives/Preperitoneal group. No differences were found in risk factors, population and hernia data between both groups. 6 patients (19%) from IPOM+ group presented postoperative pain and only 1 patient (7,7%) in Rives/Prep group (p: 0,30). There was no differences in other complications, length of stay or operative time.
Conlusion
Early outcomes of sublay techniques (Rives or preperitoneal) do not report more complications during perioperative time, but they could help reducing immediately postoperatorive pain.
Collapse
Affiliation(s)
- I Arana Iñiguez
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - A Recreo Baquedano
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - R Ruiz
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - A Ariceta López
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - J L Ramírez Cervera
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - A Piñera
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - G Talavera Utrera
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - I Pérez Otermin
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - I Otegi Altolagirre
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| | - L Blázquez Lautre
- Abdominal wall surgery, Hospital Universitario de Navarra , Pamplona , Spain
| |
Collapse
|
4
|
Ruiz-Casado A, Hijos M, Ruiz R, Romero J. Orbital metastasis from oesophageal cancer. When the ophtalmologist meets gastrointestinal specialists. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:594-595. [PMID: 35879175 DOI: 10.1016/j.oftale.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Affiliation(s)
- A Ruiz-Casado
- Departamento de Oncología Médica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
| | - M Hijos
- Departamento de Oftalmología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - R Ruiz
- Departamento de Radiología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - J Romero
- Departamento de Radioterapia, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| |
Collapse
|
5
|
Xiao H, Chen C, Shiu J, Ruiz R, Caldwell M, Lander A, Ganesan A. 079 Identifying signaling networks in melanoma tumors that promote the uncontrolled growth of BRAF mutant melanocytes. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.014] [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: 10/17/2022]
|
6
|
Weinberg JH, Sweid A, Asada A, Schaefer J, Ruiz R, Kang K, Gooch MR, Herial NA, Tjoumakaris S, Zarzour H, Rosenwasser RH, Jabbour P. Access Site Complications and Management of the Transradial Approach for Neurointerventions. Neurosurgery 2022; 91:339-346. [DOI: 10.1227/neu.0000000000002022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/07/2022] [Indexed: 11/19/2022] Open
|
7
|
Abbas R, El Naamani K, Sweid A, Birkenstock L, Ruiz R, Tjoumakaris S, Gooch MR, Herial NA, Rosenwasser RH, Jabbour P. Retreatment Strategies in Aneurysm Woven Endobridge Recurrences: A Case Series. Oper Neurosurg (Hagerstown) 2022; 22:201-207. [PMID: 35240675 DOI: 10.1227/ons.0000000000000115] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The treatment of wide-necked and bifurcation aneurysms has become a common indication for the Woven Endobridge (WEB) device. In many instances, WEB embolization fails and retreatment strategies for the recanalized aneurysms have not been established and may be challenging. OBJECTIVE To report an experience with retreatment strategies after WEB failure in 7 cases involving various aneurysm shapes, sizes, and location using multiple strategies including endovascular modalities and microsurgical clip ligation. METHODS Data were retrospectively collected from 1 high-volume cerebrovascular center for 7 patients treated with a WEB device for an aneurysm who subsequently required retreatment for that same aneurysm from 2015 through January 2021. RESULTS We identified 7 patients with WEB recurrences over a period of 6 years. Four patients initially presented with incidental findings, whereas 3 patients presented with subarachnoid hemorrhage. One patient was lost to follow-up and presented with a rerupture, whereas the 6 other patients were diagnosed with routine follow-up. Two patients received clip ligation, 2 had simple coil embolization, 1 had stent-assisted coil embolization, 1 had a flow-diverting stent, and 1 patient required 2 retreatments; he received stent-assisted coil embolization for the first retreatment and a simple coil embolization for the second retreatment. All patients had excellent angiographic outcomes and no complications. CONCLUSION The authors conclude that aneurysm recurrence after WEB is very diverse, and no single modality can properly address all recurrences. Rather, an individualized approach based on aneurysm features, neurointerventionalist expertise, and patient preference should be implemented.
Collapse
Affiliation(s)
- Rawad Abbas
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Kareem El Naamani
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Ahmad Sweid
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Lyena Birkenstock
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ramon Ruiz
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Stavropoula Tjoumakaris
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - M Reid Gooch
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Nabeel A Herial
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Robert H Rosenwasser
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Pascal Jabbour
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| |
Collapse
|
8
|
Richardson IJ, Wager LE, Recker MJ, Reynolds R, Ruiz R, Markiewicz MR. Morbidity Associated With Anterior Versus Posterior Cranial Vault Expansion for Early Treatment of Syndromic Craniosynostosis: A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg 2021; 80:651-661. [PMID: 34863645 DOI: 10.1016/j.joms.2021.10.022] [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] [Received: 06/29/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this systematic review and meta-analysis was to estimate and compare rates of unplanned reoperation and complications after undergoing either fronto-orbital advancement (anterior cranial vault expansion) or posterior cranial vault expansion as an early surgery in the management of syndromic craniosynostosis. MATERIALS AND METHODS A literature search was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant articles were identified in 2 electronic databases (PubMed and EMBASE) from the time of electronic publication to November 2020. Quality assessment and risk of bias were appraised using the Grading of Recommendations Assessment, Development and Evaluation system. A meta-analysis was performed comparing rates of reoperation and complications between participants who underwent anterior or posterior cranial vault expansion as an early surgery. RESULTS Of 1,373 screened records, 7 met inclusion criteria. Six were included in the meta-analysis. The studies that met inclusion criteria reported on 103 patients treated with anterior techniques and 72 patients treated with a posterior approach. Anterior cranial vault expansion was associated with significantly higher rates of reoperation (Peto odds ratio = 2.83; 95% confidence interval = 1.19, 6.74, P = .02) and complications (Peto odds ratio = 2.61; 95% confidence interval = 1.12, 6.12, P = .03) than posterior cranial vault expansion. CONCLUSIONS Both anterior and posterior approaches are suitable options in the treatment of syndromic craniosynostosis depending on patient-specific factors. Anterior cranial vault expansion was associated with higher rates of unplanned reoperation and complications than posterior techniques in this analysis. Because of the paucity of literature which met inclusion criteria, this study was not able to assess critical outcome variables such as distance distracted/volumetric expansion, estimated blood loss, and cost. Larger studies evaluating both techniques under multiple institutions with long-term follow-up are indicated.
Collapse
Affiliation(s)
- Ian J Richardson
- Resident, Department of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Louisiana State University, New Orleans, LA; Former predoctoral student, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY
| | - Lauren E Wager
- Resident, Department of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, University of Florida, College of Medicine- Jacksonville, Jacksonville, FL; Former predoctoral student, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY
| | - Matthew J Recker
- Resident in training, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Renée Reynolds
- Assistant professor and Residency Program Director, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Ramon Ruiz
- Director, Pediatric Craniomaxillofacial Surgery, Arnold Palmer Hospital for Children, Orlando, FL
| | - Michael R Markiewicz
- Professor and Chair, Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, Clinical Professor, Department of Neurosurgery, Division of Pediatric Surgery, Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, Attending Surgeon, Roswell Park Comprehensive Cancer Center, Co-Director, Craniofacial Center of Western New York, John Oishei Children's Hospital, Buffalo, NY.
| |
Collapse
|
9
|
Ruiz R, Galvez-Nino M, Roque K, Montes J, Nuñez M, Raez L, Sánchez-Gambetta S, Jauregui S, Viale S, Smith E, Mas L, Pinto J. P59.30 Genomic Landscape of Lung Cancer in the Young. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
10
|
Galvez-Nino M, Ruiz R, Lozano S, Roque K, Coanqui O, Valdivieso N, Olivera M, Mas L. P07.02 Real World data of Advanced Non-Small Cell Lung Cancer Patients EGFR Mutated from a Peruvian Cohort. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.291] [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: 11/28/2022]
|
11
|
Paytan T, Ruiz R, Araujo J, Juarez D, Gutierrez J, Morante Z, Aguilar A, Mas L. P09.24 Real-World Data in Non-Small Cell Lung Cancer Treated with Checkpoint Inhibitors in a Latin American Institution. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
12
|
Gutierrez J, Araujo J, Ruiz R, Pinto J, Flores C, Morante Z, Amorin E, Mas L. P33.21 Epidemiological Characteristics and Survival in Patients With Lung Cancer in a Peruvian Private Institution Between 2011-2014. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.690] [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: 11/28/2022]
|
13
|
Juarez D, Ruiz R, Gutierrez J, Mas L, Morante Z, Aguilar A, Flores C, Paytan T. P76.32 Real-World Data in Non-Small Cell Lung Cancer with Activating EGFR Mutation Treated with First and Second Generation TKI. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
14
|
Pino L, Triana I, Mejia J, Camelo M, Galvez-Nino M, Ruiz R, Roque K, Moreno J, Olivera M, Valdiviezo N, Coanqui O, Mas L. P09.14 Predictive Analytics in Real-World Data from Peru: The New Models for Personalized Oncology. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
15
|
Japaridze M, Markby J, Ruiz R, Khonelidze I, Danelia M, Gabisonia I, Adamia E, Shilton S. Novel approach to near POC testing for HCV RNA; integration of HCV RNA testing into existing near POC machines used in National TB program, Georgia. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
16
|
de Otálora XD, Ruiz R, Goiri I, Rey J, Atxaerandio R, San Martin D, Orive M, Iñarra B, Zufia J, Urkiza J, García-Rodríguez A. valorisation of spent coffee grounds as functional feed ingredient improves productive performance of Latxa dairy ewes. Anim Feed Sci Technol 2020. [DOI: 10.1016/j.anifeedsci.2020.114461] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
17
|
Allareddy V, Bruun R, MacLaine J, Markiewicz MR, Ruiz R, Miller MA. Orthodontic Preparation for Secondary Alveolar Bone Grafting in Patients with Complete Cleft Lip and Palate. Oral Maxillofac Surg Clin North Am 2020; 32:205-217. [DOI: 10.1016/j.coms.2020.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
18
|
Galvez-Nino M, Ruiz R, Roque K, Moreno J, Valdivieso N, Olivera M, Miranda Y, Maquera G, Cabero O, Guillen M, Rojas V, Amorin E, Mas L. P2.05 Real World Data on Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors Use in Advanced Non-small Cell Lung Cancer from a Latin American Cohort. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.168] [Citation(s) in RCA: 1] [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: 10/25/2022]
|
19
|
Mas L, Patane A, Arrieta O, Soria T, Cardona A, Martín C, Ruiz-Patiño A, Ruiz R, Rioja P, Lozano S, Barron LZ, Barrón F, Corassa M, Freitas H, De Lima VC, Corrales-Rodriguez L, Sotelo C, Rodríguez J, Ricaurte L, Ávila J, Mayorga D, Bravo M, Archila P, Otero J, Carranza H, Vargas C, Rosell R, Remon J. P1.12 Real World Characterization and Treatment Patterns of Patients with Thymic Carcinoma: Lessons from a Latin American Collaborative Study (CLICaP-LATimus). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
20
|
Raez L, Saravia D, Sumarriva D, Ruiz R, Izquierdo P, Cress D, Hunis B, Mas L, Lopes G, Kaen D. P2.16-15 Survival and Clinical Immunotherapy Outcomes in Hispanic Patients vs Non-Hispanic White Patients with Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1882] [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: 11/28/2022]
|
21
|
Mas L, Patané A, Arrieta O, Soria T, Cardona A, Martin C, Ruiz-Patiño A, Rojas L, Ruiz R, Rioja P, Lozano S, Barrón ZZ, Corassa M, Freitas H, De Lima VC, Corrales L, Sotelo C, Rodriguez J, Ricaurte L, Ávila J, Mayorga D, Bravo M, Archila P, Otero J, Carranza H, Vargas C, Rosell R, Remon J. EP1.15-28 Survival of Thymoma Is Extensive in Latin-American Patients: Results from Over 10 Years of Experience (CLICaP-LATimus). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2363] [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: 11/28/2022]
|
22
|
Cardona A, Ruiz-Patiño A, Arrieta O, Martin C, Raez L, Barrón ZZ, Barrón F, Ricaurte L, Bravo-Garzón M, Mas L, Corrales L, Rojas L, Lupinacci L, Perazzo F, Bas C, Carranza O, Puparelli C, Rizzo M, Ruiz R, Rolfo C, Archila P, Rodriguez J, Sotelo C, Vargas C, Carranza H, Otero J, Pino L, Ortiz C, Laguado P, Rosell R. EP1.04-46 Immunotherapy at Any Line Improves Survival in Hispanic Patients with Advanced Metastatic NSCLC Compared to Chemotherapy (Quijote-CLICaP). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
23
|
Ruiz R, Morante Z, Namuche F, Urrunaga D, Leon M, Ziegler G, Aguilar A, Chavez Mac Gregor M, Gomez H. Abstract P3-08-18: Clinicopathological characteristics associated with intermediate and high-risk ODx RS. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The gene expression profiling assay OncotypeDx (ODx) prognosticates the risk of estrogen receptor positive (ER+) breast cancer (BC) recurrence and assesses the likely benefit from adjuvant chemotherapy in addition to endocrine therapy. There have been several attempts to develop algorithms that provide similar outcome prediction to the ODx assay with the use of routine clinicopathological characteristics. These models appear to predict high-risk ODx RS but are unable to reliably rule out the presence of patients with intermediate-risk disease. Our objective was to identify the clinicopathological factors associated with intermediate and high-risk categories.
Methods: We retrospectively reviewed the electronic medical records of patients with early-stage ER+ BC for whom ODx recurrence score (RS) was available. Patients were diagnosed and treated at 3 specialized cancer centers between 2010 and 2017. Two multinomial logistic regression models (crude and adjusted) were constructed to assess the association between clinicopathological characteristics and ODx RS as a categorical variable. The adjusted model included the following variables: ODx RS, age, tumor size, node status, grade, lymphovascular invasion and hormonal receptors. The reported association measure was the relative prevalence ratio (RPR) with its respective 95%CI.
Results: A total of 551 patients were included. Patients had a mean age of 56.2 ± 11.9 (SD) (range: 26-89). 9.6% (n=53) of patients were≤40 years old.The size of the tumors ranged from 0.1 cm to 7.2 cm (median = 1.5 cm; IQR 1.0-2.2cm). A minority of patients had lymph node involvement (5.8%, n=32). By subtype, carcinomas were mostly ductal (83.5%, n=460), followed by lobular (10.0%, n=55) and mucinous (3.5%, n=19). The majority of tumor exhibited an intermediate histological grade (71.6%, n=386). Ki 67 was available in 58.8% patients (n= 324), with a median Ki67 of 20 (IQR 10-30). In the adjusted multinomial logistic regression model, factors associated with ODx intermediate-risk category were grade 3 (RPR=4.78; 95%CI: 2.01-11.39) and having either ER or PR <50 (RPR=2.80; 95%CI: 1.83-4.27). Factors associated with ODx high-risk category were grade 3 (RPR=15.89; 95%CI: 3.23-78.19), having either ER or PR <50 (RPR=4.58; 95%CI: 2.37-8.87), age≤40 (RPR=2.96; 95%CI: 1.20-7.29) and T2-3 (RPR=2.20; 95%CI: 1.13-4.32).
Conclusion: Grade 3, ER o PR <50, age ≤40 years and T2-3 are clinicopathological characteristics strongly associated with high-risk ODx RS. The associations with intermediate-risk ODx RS are weaker. The way these factors could be integrated into a clinicopathologic risk prediction model to identify high-risk patients needs further analysis.
Citation Format: Ruiz R, Morante Z, Namuche F, Urrunaga D, Leon M, Ziegler G, Aguilar A, Chavez Mac Gregor M, Gomez H. Clinicopathological characteristics associated with intermediate and high-risk ODx RS [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-18.
Collapse
Affiliation(s)
- R Ruiz
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - Z Morante
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - F Namuche
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - D Urrunaga
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - M Leon
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - G Ziegler
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - A Aguilar
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - M Chavez Mac Gregor
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - H Gomez
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad San Martin de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
24
|
Ruiz R, Namuche F, Morante Z, Aguilar A, Urrunaga D, Ziegler G, Chavez Mac Gregor M, Leon M, Gomez H. Abstract P3-08-16: Age's importance in early breast cancer: Oncotype Dx results in patients ≤40 years. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-16] [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 21-gene recurrence score (RS) predicts the benefit of adjuvant chemotherapy (CT) in ER-positive HER2-negative breast cancer (BC) and has been validated in population where women under 40 are underrepresented.Young BC pts are more likely to receive adjuvant chemotherapy (CT) in addition to endocrine therapy (ET). Our objective was to assess the RS results in young (≤40 yo) vs older (>40 yo) pts and evaluate the impact of age on clinical decision-making according to RS categories.
Methods
We retrospectively reviewed electronic medical files of all patients with early stage hormone receptor BC for whom RS was available between 2007 and 2017 in 3 specialized cancer centers. We used the Mann-Whitney and Chi-squared tests to assess differences between age group. Similarly, we evaluated the association between age groups and treatment, within each ODx category. To determine if age was associated with CT use in the low risk category, a logistic regression model was constructed.
Results
A total of 551 pts were included, 53 (9.6%) ≤40 yo and 498 (90.4%) >40 yo. No statistical differences were found between the younger and older groups in T (p=0.874), N (p=0.794), stage (p=0.188), or grade (p=0.791). Young patients underwent radical surgery more frequently than their older counterparts (41.5 vs 25.7%, p=0.014). Statistically significant differences were also observed in ER mean, which was lower in the younger group (80 vs 90%, p<0.001). The median RS result was significantly higher in the younger group (19 vs 16, p=0.009). Also, high-risk recurrence score category was significantly more frequent in the younger group (22.6 vs 9.2%, p=0.009). In the intermediate-risk category there were no differences in the proportion of patients who received CT according to age groups (p=0.484). In the low-risk category, 28.0% of patients ≤40 years vs 11.3% of patients >40 years received CT (p=0.037).
Conclusions
Our results indicate that RS tends to be higher in patients with BC ≤ 40 yo and that the frequency of high-risk RS is significantly higher in the younger group, suggesting biological differences between groups. 28% of young patients with low-risk RS from our cohort are overtreated. Based on these results, it should be considered to develop a test adjusted to the age of the patients.
Citation Format: Ruiz R, Namuche F, Morante Z, Aguilar A, Urrunaga D, Ziegler G, Chavez Mac Gregor M, Leon M, Gomez H. Age's importance in early breast cancer: Oncotype Dx results in patients ≤40 years [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-16.
Collapse
Affiliation(s)
- R Ruiz
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - F Namuche
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - Z Morante
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - A Aguilar
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - D Urrunaga
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - G Ziegler
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - M Chavez Mac Gregor
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - M Leon
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| | - H Gomez
- Oncosalud, Lima, Peru; INEN, Lima, Peru; Clínica Ricardo Palma, Lima, Peru; MD Anderson, Houston, TX
| |
Collapse
|
25
|
Namuche F, Ruiz R, Morante Z, Aguilar A, Gomez H. Abstract P3-08-22: Oncotype Dx recurrence score risk groups according to Ki67, a predictor to be considered. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-22] [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 gene expression profiling assay OncotypeDx (ODx) prognosticates the risk of estrogen receptor positive (ER+) breast cancer (BC) recurrence and assesses the likely benefit from adjuvant chemotherapy in addition to endocrine therapy. There have been several attempts to develop algorithms that provide similar outcome prediction to the ODx assay with the use of routine clinicopathological characteristics. Ki67 is frequently incorporated into these assessments, although there is no standard cut-off for its use.
Methods
We retrospectively reviewed the electronic medical records of 330 patients with early stage ER+ BC for whom ODx recurrence score (RS) was available. Patients were diagnosed and treated at two specialized cancer centers between 2014 and 2017.
Our objective was to determine the ki67's median differences between ODx risk groups.
We used Spearman rho for the correlation between Ki67 and ODx score and used Kruskal-Wallis test for compare medians, pairwaise comparison for the intergroup relations.
Results
Mean age at diagnosis was 57.42 years (range 28-89). Mean tumor diameter was 15.67 mm. 78.9% were intermediate histologic grade and 9.7% patients had lymph node involvement. Median expression of ER and PR were 90% (5-100) and 70% (0-100), respectively. We assessed the correlation between Ki67 and ODx score, with a pearson r:0.31, p<0.001. The data showed a directly proportional trend between Ki67 and ODx score.
Median Ki67 was 20 (1-100). According to ODX RS, 61.5% of tumors were low risk, 30.3% were intermediate risk and, 8.2% were high risk. Median Ki67 within each category group is as follows: low: 15 (IQR:15), intermediate: 20 (IQR:18) and high: 40 (IQR:35), with a statistically significant difference between medians (p<0.001). In the Pairwise comparison intergroup the data showed: Low-Intermediate (p<0.05), Low-High (p<0.001), Intermediate-High (p<0.001).
Conclusions
The data showed directly proportional trend between Ki67 and ODx score. In our population there is a statistically significant difference between Ki67 medians according to ODx risk groups.
Citation Format: Namuche F, Ruiz R, Morante Z, Aguilar A, Gomez H. Oncotype Dx recurrence score risk groups according to Ki67, a predictor to be considered [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-22.
Collapse
Affiliation(s)
- F Namuche
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - R Ruiz
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - Z Morante
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - A Aguilar
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - H Gomez
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| |
Collapse
|
26
|
Ruiz R, Morante Z, Namuche F, Urrunaga D, Aguilar A, Schwarz J, Leon M, Ziegler G, Chavez Mac Gregor M, Gomez H. Abstract P3-08-17: Evaluation of Oncotype DX testing and subsequent treatment choices in the Latin American setting. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-08-17] [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 gene expression profiling assay OncotypeDx (ODx) prognosticates the risk of estrogen receptor positive (ER+) breast cancer (BC) recurrence and assesses the likely benefit from adjuvant chemotherapy in addition to endocrine therapy. Numerous clinical utility studies have shown that acknowledging the RS impacts on clinical decision making, leading to a decrease in chemotherapy (CT) use. However, the cost of the assay limits it widespread use, especially in low and middle-income countries. Our objective was to determine the patterns of use of ODx, its results and the subsequent treatment choices in a large Latin American cohort.
Methods: We retrospectively reviewed the electronic medical records of patients with early-stage ER+ BC for whom ODx recurrence score (RS) was available. Patients were diagnosed and treated at 3 specialized Peruvian cancer centers between 2007 and 2017. Descriptive results for numeric variables were presented as means with standard deviation (SD) or medians with interquartile range (IQR), depending on their distributions; otherwise, we expressed the qualitative variables as numbers with percentages. We evaluated the association between ODx RS category and treatment using the Chi-squared test.
Results: A total of 551 patients were included. Patients had a mean age of 56.2 ± 11.9 (SD) (range: 26-89). 9.6% (n=53) of patients were ≤40 years old. The size of the tumors ranged from 0.1 cm to 7.2 cm (median = 1.5 cm; IQR 1.0-2.2cm). 36 (6.5%) patients had tumors ≤ 0.5cm and 7 (1%) had tumors > 5cm. A minority of patients had lymph node involvement (5.8%, n=32). ODx was ordered in 55 cases (10%) of lobular carcinoma and in 23 cases (4%) of favorable histology tumors (19 mucinous, 4 tubular). Most tumors exhibited an intermediate histological grade (71.6%, n=386). Ki67 was available in 58.8% patients (n= 324), with a median Ki67 of 20 (IQR 10-30). Using commercial cutoffs RS was distributed as follows: low (0–17) = 316 (57.4%), intermediate (18–30) = 177 (32.1%), and high (≥31) = 58 (10.5%). In general, 57.5% (n=317) of patients received endocrine therapy (ET) as their only systemic treatment and 42.5% (n=234), also received CT (ET + CT). In the low-risk category, 87.3% (n=276) of patients received ET and 12.7% (n=40), ET + CT. Within the intermediate-risk category, most patients received ET + CT (77.4%, n=137). Only one patient in the high-risk category did not receive CT. There was a significant association between the RS group and treatment choice (p<0.001).
Impact of ODx RS results on treatment recommendations Oncotype risk categories LowIntermediateHighp valueTreatmentn%n%n%<0.001Endocrine therapy27687.34022.611.7 Chemotherapy + Endocrine therapy4012.713777.45798.3
Conclusion: ODx significantly influenced treatment decisions in our cohort, however an overutilization of CT was found in low-risk patients. Further data analysis is needed to explain the higher than expected use of CT. Also, there is room for improvement in the selection of cases that undergo ODx testing.
Citation Format: Ruiz R, Morante Z, Namuche F, Urrunaga D, Aguilar A, Schwarz J, Leon M, Ziegler G, Chavez Mac Gregor M, Gomez H. Evaluation of Oncotype DX testing and subsequent treatment choices in the Latin American setting [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-08-17.
Collapse
Affiliation(s)
- R Ruiz
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - Z Morante
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - F Namuche
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - D Urrunaga
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - A Aguilar
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - J Schwarz
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - M Leon
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - G Ziegler
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - M Chavez Mac Gregor
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| | - H Gomez
- ONCOSALUD - AUNA, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Clinica Ricardo Palma, Lima, Peru; Universidad de San Martín de Porres, Lima, Peru; MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
27
|
Morral A, Urrútia G, Gich I, Ruiz R, Bonfill X. Radial extracorporeal shock wave device appearance does not influence clinical outcomes: A randomized controlled trial. J Rehabil Med 2019; 51:201-208. [DOI: 10.2340/16501977-2516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
28
|
Galvez Nino M, Ruiz R, Pinto J, Raez L, Mas Lopez L. P2.15-07 Lung Cancer in the Young. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
29
|
Raez L, Saravia D, Munoz-Antonia T, Ruiz R, Cress D, Chiappori A, Hunis B, Sumarriva D, Powery H, Mas Lopez L, Lopes G, Izquierdo P, Antonia S. P2.15-23 Are there Ethnic Disparities in the Clinical Outcomes of Non-Small Cell Lung Cancer Hispanic Patients Treated with Immunotherapy? J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1465] [Citation(s) in RCA: 1] [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: 11/26/2022]
|
30
|
Saravia D, Raez L, Ruiz R, Munoz-Antonia T, Sumarriva D, Cress D, Hunis B, Chiappori A, Powery H, Izquierdo P, Mas L, Lopes G, Antonia S. PS4 Clinical Outcomes in Hispanic Patients Treated with Checkpoint Inhibitors. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.07.023] [Citation(s) in RCA: 1] [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: 11/30/2022]
|
31
|
Rodríguez-Pintó I, Espinosa G, Erkan D, Shoenfeld Y, Cervera R, Cervera R, Espinosa G, Rodríguez-Pintó I, Shoenfeld Y, Erkan D, Piette JC, Jacek M, Roca B, Tektonidou M, Moutsopoulos H, Boffa J, Chapman J, Stojanovich L, Veloso MP, Praprotnik S, Traub B, Levy R, Daryl T, Daryl T, Boffa MC, Makatsaria A, Ruano M, Allievi A, You W, Khamastha M, Hughes S, Menendez Suso J, Pacheco J, Boriotti MF, Dias C, Pangtey G, Miller S, Policepatil S, Larissa L, Marjatta S, Carolyn S, Noortje T, Reiner K, Arteaga S, Leilani T, Langsford D, Niedzwiecki M, Queyrel V, Moroti-Constantinescu R, Romero C, Jeremic K, Urbano A, Hurtado-García R, Kumar Das A, Costedoat-Chalumeau N, Yngvar F, Gomez-Puerta JA, de Meigs E, Smith JP, Zakharova E, Nayer A, Douglas W, Lyndsey R, Blanco V, Vicent C, Natalya K, Damian L, Valentini E, Giula B, Casal Moura M, Araújo Loperena O, Ritter Susan Y, Guettrot Imbert G, Almasri H, Hospach T, Mouna B, Robles A, Wilson H, Guisado P, Ruiz R, Rodriguez J. The effect of triple therapy on the mortality of catastrophic anti-phospholipid syndrome patients. Rheumatology (Oxford) 2018; 57:1264-1270. [DOI: 10.1093/rheumatology/key082] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/28/2018] [Indexed: 01/19/2023] Open
Affiliation(s)
| | - Gerard Espinosa
- Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain
| | - Doruk Erkan
- Barbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery, New York, NY, USA
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Aviv, Israel
| | - Ricard Cervera
- Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Ruiz R, Brygo A, Nicot R, Ferri J. Sialolithiasis removal under general anesthesia: A descriptive retrospective study in the maxillofacial surgery department in Lille University Hospital. Journal of Stomatology, Oral and Maxillofacial Surgery 2018; 119:97-101. [DOI: 10.1016/j.jormas.2017.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 10/01/2017] [Accepted: 11/02/2017] [Indexed: 11/29/2022]
|
33
|
Ruiz R, Namuche F, Flores C, Aguilar A, Gomez HL. Abstract P1-06-12: Optimizing the use of oncotype Dx in early breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-06-12] [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: Oncotype Dx (ODX) prognosticates the risk of recurrence and predicts the benefit of adjuvant chemotherapy in estrogen-receptor-positive breast cancer (BC). However, its cost makes it prohibitive for many health care systems. Our objective was to develop a model that uses routine clinical and pathological parameters to identify ODX high risk patients which require adjuvant chemotherapy.
Methods: We retrospectively reviewed ODX and pathology reports from 190 early BC patients treated between 2014 and 2016 in a specialized cancer center. Our population was divided into a training (n:133) and validation set (n:57). In the training set, among available clinico-pathological variables (age, T, ER, PR, Ki67, Elston-Ellis grade) a multiple linear regression model was carried out to select those significantly associated with ODX. Coefficients of statistically significant variables were used to build an equation. The equation was applied in the training set. These results were confronted to ODX categories. The best threshold for selecting high risk patients was identified in the training set and tested in the validation set.
Results: Among the tested variables, tumor size (pT), progesterone receptor (PR), Ki67 and Ellston-Ellis grade were significantly associated with ODX RS (Table 1). The linear predictor is: (0.2544 x pT) – (0.0739 x PR) + (0.0861 x Ki67) + (5.4232 x Elston grade). The threshold score for this equation was set on 14 to discriminate high from low-intermediate risk patients. The test was able to correctly classify high risk patients with a sensitivity of 78%, a specificity of 72% and a negative predictive value of 98%.
Conclusion: With further refinement ODX could be omitted in patients classified as high risk by our predictor therefore restricting and optimizing the use of ODX to a smaller population of patients. The observed ODX distribution in our patients is similar to previously reported series suggesting that this equation could be informative in similar clinical settings. Additional external testing using new datasets is ongoing.
Citation Format: Ruiz R, Namuche F, Flores C, Aguilar A, Gomez HL. Optimizing the use of oncotype Dx in early breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-06-12.
Collapse
Affiliation(s)
- R Ruiz
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - F Namuche
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - C Flores
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - A Aguilar
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - HL Gomez
- Oncosalud, Lima, Peru; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| |
Collapse
|
34
|
Namuche F, Ruiz R, Flores C, Gomez HL, Aguilar A. Abstract P6-09-11: Ki67 cut offs and oncotype DX recurrence score in early breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-09-11] [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 gene expression profiling assay OncotypeDx (ODX) predicts the likelihood of estrogen receptor (ER) positive breast cancer (BC) recurrence and assesses the likely benefit from both hormonal therapy and chemotherapy. Many clinical scores that estimate the risk category of ODX are being tested. Ki67 is frequently incorporated into these assessments, although there is no standard cut-off for its use.
Methods: We retrospectively reviewed the electronic medical records of 190 patients with early stage ER+ BC for whom ODX recurrence score (RS) was available. Patients were diagnosed and treated at a specialized cancer center between 2014 and 2016. Our objective was to find out the degree to which an optimal ki67 cut-off correlates with ODX risk category. We also aim to determine an association between classical clinicopathological variables (St. Gallen (SG) 2015) could predict ODX risk category. Chi square test was used.
Results: The characteristics of patients according to ODX risk category are shown in Table 2. Mean age at diagnosis was 59 years (range 28-89). Mean tumor diameter was 15mm, 84.2% were intermediate grade and 4.7% patients had lymph node involvement. Mean expression of ER, PR and Ki67 were 87%, 53% and 22%, respectively. According to ODX 62.1% patients were low risk, 30.5% were intermediate risk and 7.4% were high risk. An overall concordance of 46.8% (73/190) was found between SG 2015 and the risk category of ODX (75.7% for low, 33.3% for intermediate and 23.9% for high RS). When changing SG Ki67 cutoffs to ≤20% (for low Ki67) and ≥30% (for high Ki67), an overall concordance of 56.3% (107/190) was found (69.6% for low, 47.3% for intermediate and 23.9% for high RS) and this was statistically significant (p=0.00) (Table 3).
Conclusion: In our population there is no a direct correlation between classical clinicopathological variables and ODX score. Despite being a specialized center, the utility of classical clinicopathological variables for predicting ODX risk category is limited.
Citation Format: Namuche F, Ruiz R, Flores C, Gomez HL, Aguilar A. Ki67 cut offs and oncotype DX recurrence score in early breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-09-11.
Collapse
Affiliation(s)
- F Namuche
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - R Ruiz
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - C Flores
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - HL Gomez
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| | - A Aguilar
- Oncosalud, Lima, Peru; INEN, Lima, Peru
| |
Collapse
|
35
|
Pineda-Quiroga C, Atxaerandio R, Ruiz R, García-Rodríguez A. Effects of dry whey powder alone or combined with calcium butyrate on productive performance, duodenal morphometry, nutrient digestibility, and ceca bacteria counts of broiler chickens. Livest Sci 2017. [DOI: 10.1016/j.livsci.2017.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
36
|
Gorostidi M, Villalain C, Ruiz R, Jaunarena I, Lekuona A. Technique for precaval and laterocaval nodes excision at extraperitoneal paraaortic lymphadenectomy. Gynecol Oncol 2017; 148:233-234. [PMID: 29137810 DOI: 10.1016/j.ygyno.2017.10.030] [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] [Received: 09/02/2017] [Revised: 10/17/2017] [Accepted: 10/24/2017] [Indexed: 10/18/2022]
Abstract
STUDY OBJECTIVE To describe our technique for excision of the pre-caval and laterocaval nodes using an extraperitoneal approach. This technique was developed to make the dissection and excision of the less accessible nodes in an easier and safer way by minimizing the risk of great vessels injury and bleeding. DESIGN Step-by-step description of the surgical procedure using video (Canadian Task Force classification III). SETTING The procedure was performed at a teaching hospital, Hospital Universitario Donostia (Spain). PATIENTS A 52-year-old woman with a body mass index of 33 underwent endoscopic extraperitoneal paraaortic lymphadenectomy for advanced high grade cervical adenocarcinoma FIGO IIB. INTERVENTIONS The patient underwent an endoscopic extraperitoneal para-aortic lymphadenectomy. An anatomical dissection is being performed being the upper limit of the dissection the left renal vein. Focus of the video involves the challenging dissection of the right nodes. MEASUREMENTS AND MAIN RESULTS Firstly we complete a dissection of all the anatomical aortic limits until the renal vein and exeresis of aortic nodes. A plane just above the cava vein is carefully developed by pushing all the lymph nodes to the roof of the dissection. Special care must be taken close to the aortic bifurcation due to the perforating vessels that can be found more frequently in this location. Once all this space is dissected, nodes attached to the roof are easily pushed down. It is useful to use a clip in the upper part, close to the renal vein, to prevent lymphorrhea. Nodes are excised in four blocks, supramesenteric and inframesenteric aortic and precaval nodes. The proximity to the peritoneal roof and the chance for a peritoneal hole and loss of pneumoperitoneum can be less problematic if the right dissection is performed at the end of the procedure. CONCLUSION A complete para-aortic retroperitoneal dissection can be achieved with this extraperitoneal approach. Benefits of this technique are based on the absence of the bowel or other intraperitoneal structures invading the operative field given the barrier-free nature of the retroperitoneal space. Despite the challenge of the access to the right nodes in a retroperitoneal paraaortic lymphadenectomy they can be successfully excised reaching the renal vein including obese patients.
Collapse
Affiliation(s)
- M Gorostidi
- Hospital Universitario Donostia, San Sebastián, Spain.
| | | | - R Ruiz
- Hospital Universitario Donostia, San Sebastián, Spain
| | - I Jaunarena
- Hospital Universitario Donostia, San Sebastián, Spain
| | - A Lekuona
- Hospital Universitario Donostia, San Sebastián, Spain
| |
Collapse
|
37
|
Barg A, Ruiz R, Hintermann B. [Triple arthrodesis for correction of cavovarus deformity]. Oper Orthop Traumatol 2017; 29:461-472. [PMID: 29052742 DOI: 10.1007/s00064-017-0519-3] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 07/01/2017] [Accepted: 07/12/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim is to correct the underlying cavovarus deformity and to achieve a pain-free and stable hindfoot. INDICATIONS Rigid neurologic, posttraumatic, congenital, and idiopathic cavovarus deformities. CONTRAINDICATIONS General surgical or anesthesiological risks, infections, critical soft tissue conditions, neurovascular impairment of the lower extremity, noncompliance, patients with severely reduced bone quality, insulin-dependent diabetes mellitus, smoking. SURGICAL TECHNIQUE The talonavicular and subtalar joints are exposed using a single medial approach. Joint cartilage is carefully debrided. Hindfoot reposition with complete correction of cavovarus deformity in all three planes. Joints are stabilized using cannulated screws, followed by wound closure. POSTOPERATIVE MANAGEMENT A soft wound dressing is used. Thromboprophylaxis is recommended. Patient mobilization starts on postoperative day 1 using a stabilizing walking boot or cast for 6 weeks with 15 kg partial weight bearing. Clinical and radiographic follow-up 6 weeks postoperatively to assess osseous consolidation at the arthrodesis site. Following clinical and radiographic follow-up at 6 weeks, full weight bearing is gradually initiated. RESULTS Between January 2012 and July 2014, triple arthrodesis was performed in 11 patients with a mean age of 62 ± 14 years due to cavovarus deformity. The mean follow-up was 34 ± 8 months (range 24-48 months). In all patients, the cavovarus deformity was substantially corrected. Significant pain relief from 7.1 ± 2.2 (range 5-10) to 1.8 ± 1.5 (range 0-4) on the visual analogue scale was observed.
Collapse
Affiliation(s)
- A Barg
- Orthopädische Klinik, Universität Utah, 590 Wakara Way, 84108, Salt Lake City, UT, USA.
- Harold K. Dunn Orthopädisches Forschungslabor, Orthopädische Klinik, Universität Utah, Salt Lake City, UT, USA.
| | - R Ruiz
- Klinik für Orthopädie und Traumatologie des Bewegungsapparates, Kantonsspital Baselland, Liestal, Schweiz
| | - B Hintermann
- Klinik für Orthopädie und Traumatologie des Bewegungsapparates, Kantonsspital Baselland, Liestal, Schweiz
| |
Collapse
|
38
|
Mingo J, Luna S, Gaafar A, Ruiz R, Carracedo A, Guerra I, López J, Pulido R. The relevance of precision epitope mapping for accurate oncologic diagnostic based on PTEN protein expression in tumours. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx508.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
39
|
Averós X, Beltrán de Heredia I, Ruiz R, Estevez I. 004 Influence of pre- and postnatal stress on the social motivation and fear response in lambs. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
40
|
Sommerville R, Ruiz R, Averós X. A meta-analysis on the effects of the housing environment on the behaviour, mortality, and performance of growing rabbits. Anim Welf 2017. [DOI: 10.7120/09627286.26.2.223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
41
|
Ruiz R, Tedeschi L, Sepúlveda A. Investigation of the effect of pegbovigrastim on some periparturient immune disorders and performance in Mexican dairy herds. J Dairy Sci 2017; 100:3305-3317. [DOI: 10.3168/jds.2016-12003] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 01/29/2023]
|
42
|
St. Louis J, Bukowski A, Paulino E, Ferreyra ME, Nunes J, Mejia G, Duarte C, Ruiz R, Touya D, Polo S, Chavarri-Guerra Y, Moreno J, Georgieva N, Tsolko T, Obayedullah Baki M, Luna HC, Goss PE. Abstract P4-17-03: Global Cancer Institute online tumor boards to improve global patterns of clinical practice for breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-17-03] [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 Global Cancer Institute (GCI) breast cancer multi-disciplinary tumor boards (MTBs) are live, online telemedicine discussions of breast cancer patient case scenarios between breast cancer specialists in low- and middle-income countries (LMICs) and expert breast cancer specialists in the United States (US). In the US MTBs are routinely held in most cancer centers and have been shown to improve patient outcomes and patient and family quality of life. GCI launched breast cancer MTBs in 2012 with the goals to improve breast cancer patient care in underserved populations globally, to establish an online platform to allow live communication and collaboration among oncologists, and to serve as an educational tool for oncologists.
Methods: During our MTBs case scenarios are presented by global oncologists for discussion and input by a panel of both community/tertiary care expert breast oncologists from our global network. During each MTB, three cancer centers present challenging breast cancer patient scenarios. Patient scenarios are presented in English, according to a standard PowerPoint template. After presentation guideline - or clinical trial-based discussions are held for each case. As the patient cases originate from oncologists in LMICs, optimal and best locally available clinical care in rural and remote settings are discussed. For educational purposes the MTBs and the associated YouTube panel discussions are archived online and can subsequently be viewed by practicing oncologists and trainees globally. Links to relevant international guidelines, published and ongoing clinical trials, and other educational resources are also provided to all MTB attendees.
Results: Since its initiation in 2012, the GCI MTBs have engaged a network of 370 oncologists in LMICs and 20 expert panelists from nine cancer centers in the United States. Together the oncologists in LMICs represent 28 tertiary cancer centers and 116 community oncologists in 19 countries across Latin America, Eastern Europe, Asia, and Africa.
Conclusions: GCI breast cancer MTBs are a powerful educational and networking tool for oncologists in LMICs to improve their patterns of clinical practice, conduct multi-disciplinary discussions and access research collaborations. GCI invites oncologists throughout Latin America, Europe, Asia, and Africa to join our tumor boards and further expansion of its MTB network. GCI currently surveys oncologists in our network before and after attendance of MTBs to measure modifications in oncologists' practice and adherence to international clinical practice guidelines.
Citation Format: St. Louis J, Bukowski A, Paulino E, Ferreyra ME, Nunes J, Mejia G, Duarte C, Ruiz R, Touya D, Polo S, Chavarri-Guerra Y, Moreno J, Georgieva N, Tsolko T, Obayedullah Baki M, Luna HC, Goss PE. Global Cancer Institute online tumor boards to improve global patterns of clinical practice for breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-17-03.
Collapse
Affiliation(s)
- J St. Louis
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - A Bukowski
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - E Paulino
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - ME Ferreyra
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - J Nunes
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - G Mejia
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - C Duarte
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - R Ruiz
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - D Touya
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - S Polo
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - Y Chavarri-Guerra
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - J Moreno
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - N Georgieva
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - T Tsolko
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - M Obayedullah Baki
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - HC Luna
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| | - PE Goss
- The Global Cancer Institute, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil; Harvard Medical School, Boston, MA; Marie Curie Hospital, Buenos Aires, Argentina; Hospital Erasto Gaertner, Curitiba, Brazil; Hospital Clinico Viedma, Cochabamba, Bolivia; Institution Nacional de Cancerologia, Bogota, Colombia; Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru; Hospital de Clinicas, Montevideo, Uruguay; INCAN, Guatemala City, Guatemala; Instituto Nacional de Ciencias y Nutrition Salvador Zubiran, Mexico D.F., Mexico; Instituto Oncologico Nacional, Panama City, Panama; MHAT Nadezhda, Sofia, Bulgaria; Lviv State Oncological Regional Centre, Lviv, Ukraine; Obayedullah-Ferdousi Cancer Foundation, Dhaka, Bangladesh; National Kidney and Transplant Institute, Quezon City, Manila, Philippines
| |
Collapse
|
43
|
Pineda-Quiroga C, Atxaerandio R, Zubiria I, Gonzalez-Pozuelo I, Hurtado A, Ruiz R, Garcia-Rodriguez A. Productive performance and cecal microbial counts of floor housed laying hens supplemented with dry whey powder alone or combined with Pediococcus acidilactici in the late phase of production. Livest Sci 2017. [DOI: 10.1016/j.livsci.2016.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
44
|
Ostrowsky B, Ruiz R, Brown S, Chung P, Koppelman E, van Deusen Lukas C, Guo Y, Jalon H, Sumer Z, Araujo C, Sirtalan I, Brown C, Riska P, Currie B. Lessons learned from implementing Clostridium difficile-focused antibiotic stewardship interventions. Infect Control Hosp Epidemiol 2016; 35 Suppl 3:S86-95. [PMID: 25222903 DOI: 10.1086/677828] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine whether controlling the prescription of targeted antibiotics would translate to a measurable reduction in hospital-onset Clostridium difficile infection (CDI) rates. DESIGN A multicenter before-and-after intervention comparative study. SETTING/PARTICIPANTS Ten medical centers in the greater New York region. Intervention group comprised of 6 facilities with early antimicrobial stewardship programs (ASPs). The 4 facilities without ASPs made up the nonintervention group. INTERVENTIONS/METHODS Intervention facilities identified target antibiotics using case-control studies and implemented ASP-based strategies to control their use. Pre- and postintervention hospital-onset CDI rates and antibiotic consumption were compared for a 20-month period from June 2010 to January 2012. Antibiotic usage was compared using defined daily dose, days of therapy, and number of courses prescribed. Comparisons used bivariate and regression techniques. RESULTS Intervention facilities identified piperacillin/tazobactam, fluoroquinolones, or cefepime (odds ratio, 2.0-9.8 in CDI case patients compared with those without CDI) as intervention targets and selected several interventions (all included a component of audit and feedback). Varying degrees of success were observed in reducing antibiotic consumption over time. Total target antibiotic use significantly decreased (P < .05) when measured by days of therapy and number of courses but not by defined daily dose. Intravenous moxifloxacin and oral ciprofloxacin use showed significant reduction when measured by defined daily dose and days of therapy (P ≤ .01). Number of courses with all forms of these antibiotics was reduced (P < .005). Intervention hospitals reported fewer hospital-onset CDI cases (2.8 rate point difference) compared with nonintervention hospitals; however, we were unable to show statistically significant decreases in aggregate hospital-onset CDI either between intervention and nonintervention groups or within the intervention group over time. CONCLUSIONS Although decreases in target antibiotic consumption did not translate into reductions of hospital-onset CDI in this study, many valuable lessons (including implementation strategies and antibiotic consumption measures) were learned. The findings can inform potential policy decisions regarding incorporating control of CDI and ASP as healthcare quality measures.
Collapse
|
45
|
Abstract
IntroductionIt is known that antipsychotic drugs can increase prolactinaemia, we report a case in which the use of aripiprazole after treatment with paliperidone helped regaining normality levels.Case reportDuring treatment with PALiperidone12 mg/day the patient, a 27-year-old female diagnosed with borderline personality disorder, developed hyperprolactinaemia with galactorrhea and menstrual disorders. During hospitalization, aripiprazole is introduced while paliperidone is progressively decreased. Antipsychotic were prescribed because delusions of reference and auditory pseudo-hallucinations arose suddenly in a woman without history of previous psychotic breaks. Before treatment with aripiprazole, prolactinaemia was 156,96 ng/mL (pregnancy test was negative) and after stopping, paliperidone was 23,60 ng/mL.DiscussionIf hyperprolactinaemia symptoms appeared (galactorrhea…), aripiprazole is a good option if antipsychotic treatment is required. In this case, paliperidone was decreased slowly, while aripiprazole was increased, until minimum effective dose was reached.ConclusionsHyperprolactinaemia is a common side effect in antipsychotic treatments and if symptoms appeared aripiprazole is a good option.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
46
|
Markiewicz MR, Bell RB, Bui TG, Dierks EJ, Ruiz R, Gelesko S, Pirgousis P, Fernandes R. Survival of microvascular free flaps in mandibular reconstruction: A systematic review and meta-analysis. Microsurgery 2015; 35:576-87. [DOI: 10.1002/micr.22471] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 07/26/2015] [Accepted: 08/03/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Michael R. Markiewicz
- Division of Head Neck Surgery, Department of Oral & Maxillofacial Surgery, Division of Surgical Oncology; University of Florida College of Medicine; Jacksonville FL
| | - R. Bryan Bell
- Oral, Head and Neck Cancer Program; Providence Cancer Center; Portland OR
- Department of Oral and Maxillofacial Surgery; Oregon Health and Science University; Portland OR
- Head and Neck Institute; Portland OR
| | - Tuan G. Bui
- Oral, Head and Neck Cancer Program; Providence Cancer Center; Portland OR
- Department of Oral and Maxillofacial Surgery; Oregon Health and Science University; Portland OR
- Head and Neck Institute; Portland OR
| | - Eric J. Dierks
- Oral, Head and Neck Cancer Program; Providence Cancer Center; Portland OR
- Department of Oral and Maxillofacial Surgery; Oregon Health and Science University; Portland OR
- Head and Neck Institute; Portland OR
| | - Ramon Ruiz
- Department of Pediatric Craniomaxillofacial Surgery; Arnold Palmer Hospital for Children University of Central Florida; Orlando FL
| | - Savannah Gelesko
- Department of Oral and Maxillofacial Surgery; Oregon Health and Science University; Portland OR
| | - Phillip Pirgousis
- Division of Head Neck Surgery, Department of Oral & Maxillofacial Surgery, Division of Surgical Oncology; University of Florida College of Medicine; Jacksonville FL
| | - Rui Fernandes
- Division of Head Neck Surgery, Department of Oral & Maxillofacial Surgery, Division of Surgical Oncology; University of Florida College of Medicine; Jacksonville FL
| |
Collapse
|
47
|
Woods T, Jennings NB, Fernandez HT, Onaca N, Carlile BK, Levy MF, Gould DL, Ruiz R. Renal Autotransplantation in Lynch Syndrome: A Viable Option in a Patient With Contralateral Metachronous Ureteral Cancer. Am J Transplant 2015; 15:2507-10. [PMID: 25847116 DOI: 10.1111/ajt.13279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 02/18/2015] [Accepted: 02/22/2015] [Indexed: 01/25/2023]
Abstract
The success of human kidney allotransplantation was realized over six decades ago. First described 50 years ago, renal autotransplantation has been utilized sparingly as a salvage procedure for patients at risk of losing renal function, either from a benign or malignant condition. While classically associated with colorectal malignancies, Lynch syndrome also carries a small yet significant risk for the development of ureteral carcinoma. For these patients who develop chronic kidney disease, allotransplantation may not be an option due to the lifelong risk of several malignancies. We report the first known case of renal autotransplantation in a patient with metachronous ureteral cancer due to Lynch syndrome.
Collapse
Affiliation(s)
- T Woods
- Annette C. and Harold C. Simmons Transplant Institute, Baylor All Saints Medical Center at Fort Worth, Fort Worth, TX
| | - N B Jennings
- Annette C. and Harold C. Simmons Transplant Institute, Baylor All Saints Medical Center at Fort Worth, Fort Worth, TX
| | - H T Fernandez
- Annette C. and Harold C. Simmons Transplant Institute, Baylor All Saints Medical Center at Fort Worth, Fort Worth, TX
| | - N Onaca
- Annette C. and Harold C. Simmons Transplant Institute, Baylor All Saints Medical Center at Fort Worth, Fort Worth, TX
| | - B K Carlile
- Annette C. and Harold C. Simmons Transplant Institute, Baylor All Saints Medical Center at Fort Worth, Fort Worth, TX
| | - M F Levy
- Annette C. and Harold C. Simmons Transplant Institute, Baylor All Saints Medical Center at Fort Worth, Fort Worth, TX
| | - D L Gould
- Annette C. and Harold C. Simmons Transplant Institute, Baylor All Saints Medical Center at Fort Worth, Fort Worth, TX
| | - R Ruiz
- Annette C. and Harold C. Simmons Transplant Institute, Baylor All Saints Medical Center at Fort Worth, Fort Worth, TX
| |
Collapse
|
48
|
Limon R, Ruiz R, Serrano M, Lopez A, Alvarez M, Marrufo C, Luis M, Valdiviezo N. 2725 Single institution experience with neoadjuvant chemotherapy in stage IB2 cervical cancer. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31492-7] [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: 10/22/2022]
|
49
|
Ruiz R, Peinado MJ, Aranda-Olmedo I, Abecia L, Suárez-Pereira E, Ortiz Mellet C, García Fernández JM, Rubio LA. Effects of feed additives on ileal mucosa–associated microbiota composition of broiler chickens1. J Anim Sci 2015; 93:3410-20. [DOI: 10.2527/jas.2015-8905] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R. Ruiz
- Depto. de Fisiología y Bioquímica de la Nutrición Animal (INAN, EEZ, CSIC), Profesor Albareda, 1, 18008 Granada, Spain
| | - M. J. Peinado
- Depto. de Fisiología y Bioquímica de la Nutrición Animal (INAN, EEZ, CSIC), Profesor Albareda, 1, 18008 Granada, Spain
| | - I. Aranda-Olmedo
- Depto. de Fisiología y Bioquímica de la Nutrición Animal (INAN, EEZ, CSIC), Profesor Albareda, 1, 18008 Granada, Spain
| | - L. Abecia
- Depto. de Fisiología y Bioquímica de la Nutrición Animal (INAN, EEZ, CSIC), Profesor Albareda, 1, 18008 Granada, Spain
| | - E. Suárez-Pereira
- Depto. de Química Orgánica, Facultad de Química, Univ. de Sevilla, Apdo. 1203, E-41071 Sevilla, Spain
| | - C. Ortiz Mellet
- Depto. de Química Orgánica, Facultad de Química, Univ. de Sevilla, Apdo. 1203, E-41071 Sevilla, Spain
| | - J. M. García Fernández
- Instituto de Investigaciones Químicas (IIQ, CSIC and Univ. de Sevilla), Américo Vespucio 49, Isla de la Cartuja, E-41092 Sevilla, Spain
| | - L. A. Rubio
- Depto. de Fisiología y Bioquímica de la Nutrición Animal (INAN, EEZ, CSIC), Profesor Albareda, 1, 18008 Granada, Spain
| |
Collapse
|
50
|
Ruiz R, Taxa L, Casanova L, Ruiz E, Montenegro P. P-243 Clinicopathologic features and survival outcomes of colorectal cancer in young patients: Experience from a cancer institute in Peru. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.240] [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: 01/03/2023] Open
|