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Ko J, Tsao A, Kim R, Perry C, Oyoyo U, Kwon SR. Effect of Various Toothpaste Tablets on Gloss and Surface Roughness of Resin-based Composite Materials. Oper Dent 2024:500014. [PMID: 38632854 DOI: 10.2341/23-120-l] [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] [Accepted: 10/23/2023] [Indexed: 04/19/2024]
Abstract
OBJECTIVES To evaluate the effect of various toothpaste tablets on gloss and surface roughness of resin-based composite. METHODS AND MATERIALS Sixty-four resin-based composite specimens were divided into four groups of 16 specimens each. Gloss and roughness were measured before and after simulated brushing with three types of toothpaste tablets and one conventional toothpaste: CT: Chewtab Toothpaste Tablets; AT: Anticavity Toothpaste Tablets; HC: Charcoal Toothpaste Tablets; CP: Cavity Protection toothpaste. The Kruskal- Wallis procedure was performed to compare the differences by groups. Post-hoc comparisons were conducted with Bonferroni corrections (α=0.05). RESULTS There was a significant drop in gloss for all groups. CT and AT maintained the highest gloss with means of 81.6 GU and 74.1 GU, respectively. The lowest gloss of 24.5 GU was observed for HC. There was a significant increase in roughness for all groups except for CT. CT had the lowest roughness with a mean of 0.034 μm, while HC had the highest roughness with a mean of 0.074 μm. There was a significant correlation between post-brushing gloss and post-brushing roughness (p<0.001, r=-0.884). CONCLUSION Chewtab Toothpaste Tablets had the least effect on gloss and roughness, while Charcoal Toothpaste Tablets had the most negative effect on the surface properties of resin-based composites.
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Affiliation(s)
- J Ko
- Julia Ko, BSc, Department of Biomedical Science La Sierra University, Riverside, CA, USA
| | - A Tsao
- Adam Tsao, BSc, Department of Biomedical Science La Sierra University, Riverside, CA, USA
| | - R Kim
- Raymond Kim, BSc, Department of Biomedical Science La Sierra University, Riverside, CA, USA
| | - C Perry
- Christopher Perry, PhD, Department of Biochemistry, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - U Oyoyo
- Udochukwu Oyoyo, MPH, Dental Education Services, Loma Linda University School of Dentistry, Loma Linda, CA, USA
| | - S R Kwon
- *So Ran Kwon, DDS, MS, PhD, MS, professor, Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA, USA
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Hale SJM, Kim R, Douglas RG. Topical anaesthesia and decongestion in rhinology. Rhinology 2024; 62:143-151. [PMID: 37942998 DOI: 10.4193/rhin23.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Topical anaesthesia and decongestion of the sinonasal mucosa are used commonly in rhinology practice to facilitate nasal endoscopy, as well as debridement and biopsies. Topical agents used for sinonasal anaesthesia include lignocaine, tetracaine and cocaine. Unlike lignocaine and tetracaine, cocaine also has a decongestant effect. Phenylephrine, oxymetazoline, xylometazoline or adrenaline are usually added to lignocaine and tetracaine to provide decongestion. Several studies have been performed seeking to identify the optimal nasal preparation for nasal endoscopy in the clinic setting. However, there remains no clear consensus in the literature resulting in ongoing wide variation between anaesthetic-decongestant preparations used in clinical practice. Indeed, some authors have argued that no anaesthetic is required at all for flexible nasendoscopy despite the apparent consensus that nasal instrumentation is generally uncomfortable, inferred by the persistence of ongoing research in this area. This review provides a practical summary of local anaesthetic and decongestant pharmacology as it relates to rhinologic practice and summarises the literature to date, with the goal of identifying current gaps in the literature and guiding future research efforts.
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Affiliation(s)
- S J M Hale
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Grafton, Auckland, New Zealand
| | - R Kim
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Grafton, Auckland, New Zealand
| | - R G Douglas
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Grafton, Auckland, New Zealand
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Saing CH, Ung M, Suy S, Oy S, Dary C, Yam ELY, Chhorn S, Nagashima-Hayashi M, Khuon D, Mam S, Kim R, Saphonn V, Yi S. i-MoMCARE: Innovative Mobile Technology for Maternal and Child Health Care in Cambodia-study protocol of a cluster randomized controlled trial. Trials 2023; 24:692. [PMID: 37880782 PMCID: PMC10601211 DOI: 10.1186/s13063-023-07724-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND The Government of Cambodia established the village health support groups (VHSGs) in 2003 to facilitate primary healthcare activities, including maternal and child health (MCH) services. However, VHSGs face several challenges that hinder them from performing optimally, including a lack of regular structured training and remuneration and limited and inconsistent support and supervision from the health centers (HCs). This implementation research aims to develop, implement, and evaluate a digital health intervention to improve the performance of VHSGs through better support and supervision and increase the MCH service coverage in rural Cambodia. METHODS i-MoMCARE, a two-arm cluster randomized controlled trial, will be conducted between 2022 and 2025. Five operational districts (ODs) have been randomized to an intervention arm and the other five ODs to the control arm. The intervention will last for 24 months. Around 200 VHSGs in the intervention arm will be equipped with a mobile application as a job aid and 20 HC staff with a web interface to improve support and supervision of VHSGs. The potential beneficiaries will include pregnant women, mothers, and children under 2 years old. We will measure the outcomes at baseline and endline. The primary outcomes will consist of a composite MCH index constructed from maternal and newborn care indicators, child immunization, and treatment of under-two children. Secondary outcomes will include coverage of selected MCH services. We will conduct the intention-to-treat and per-protocol analyses. We will conduct qualitative interviews with selected beneficiaries and stakeholders to evaluate the intervention's acceptability, feasibility, and scalability. We will also conduct a cost-effective analysis using decision-analytic modeling incorporating a societal perspective that explores different time horizons, intervention effects, and when scaled up to the national level. DISCUSSION i-MoMCARE is expected to increase MCH service access and coverage in rural Cambodia. It will contribute to advancing digital health use in primary healthcare interventions, which remains in its infancy in the country. Furthermore, the study findings will be a valuable addition to a growing body of literature on the effectiveness and feasibility of mobile health to improve coverage of MCH services in rural low- and middle-income country settings. TRIAL REGISTRATION ClinicalTrial.gov NCT05639595. Registered on 06 December 2022.
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Affiliation(s)
- Chan Hang Saing
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Mengieng Ung
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | | | - Sreymom Oy
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | | | - Esabelle Lo Yan Yam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
- College of Health and Medicine, Australian National University, Canberra, Australia
| | | | - Michiko Nagashima-Hayashi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Dyna Khuon
- University of Health Sciences, Phnom Penh, Cambodia
| | - Sovatha Mam
- University of Health Sciences, Phnom Penh, Cambodia
| | - Rattana Kim
- National Maternal and Child Health Center, Phnom Penh, Cambodia
| | | | - Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore.
- KHANA Center for Population Health Research, Phnom Penh, Cambodia.
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, CA, USA.
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Christou A, Mbishi J, Matsui M, Beňová L, Kim R, Numazawa A, Iwamoto A, Sokhan S, Ieng N, Delvaux T. Stillbirth rates and their determinants in a national maternity hospital in Phnom Penh, Cambodia in 2017-2020: a cross-sectional assessment with a nested case-control study. Reprod Health 2023; 20:157. [PMID: 37865789 PMCID: PMC10590507 DOI: 10.1186/s12978-023-01703-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/15/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND In Cambodia, stillbirths and their underlying factors have not been systematically studied. This study aimed to assess the proportion and trends in stillbirths between 2017 and 2020 in a large maternity referral hospital in the country and identify their key determinants to inform future prevention efforts. METHODS This was a retrospective cross-sectional analysis with a nested case-control study of women giving birth at the National Maternal and Child Health Centre (NMCHC) in Phnom Penh, 2017-2020. We calculated percentages of singleton births at ≥ 22 weeks' gestation resulting in stillbirth and annual stillbirth rates by timing: intrapartum (fresh) or antepartum (macerated). Multivariable logistic regression was used to explore factors associated with stillbirth, where cases were all women who gave birth to a singleton stillborn baby in the 4-year period. One singleton live birth immediately following each case served as an unmatched control. Multiple imputation was used to handle missing data for gestational age. RESULTS Between 2017 and 2020, 3.2% of singleton births ended in stillbirth (938/29,742). The stillbirth rate increased from 24.8 per 1000 births in 2017 to 38.1 per 1000 births in 2020, largely due to an increase in intrapartum stillbirth rates which rose from 18.8 to 27.4 per 1000 births in the same period. The case-control study included 938 cases (stillbirth) and 938 controls (livebirths). Factors independently associated with stillbirth were maternal age ≥ 35 years compared to < 20 years (aOR: 1.82, 95%CI: 1.39, 2.38), extreme (aOR: 3.29, 95%CI: 2.37, 4.55) or moderate (aOR: 2.45, 95%CI: 1.74, 3.46) prematurity compared with full term, and small-for-gestational age (SGA) (aOR: 2.32, 1.71, 3.14) compared to average size-for-age. Breech/transverse births had nearly four times greater odds of stillbirth (aOR: 3.84, 95%CI: 2.78, 5.29), while caesarean section reduced the odds by half compared with vaginal birth (aOR: 0.50, 95%CI: 0.39, 0.64). A history of abnormal vaginal discharge increased odds of stillbirth (aOR: 1.42, 95%CI: 1.11, 1.81) as did a history of stillbirth (aOR: 3.08, 95%CI: 1.5, 6.5). CONCLUSIONS Stillbirth prevention in this maternity referral hospital in Cambodia requires strengthening preterm birth detection and management of SGA, intrapartum care, monitoring women with stillbirth history, management of breech births, and further investigation of high-risk referral cases.
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Affiliation(s)
- Aliki Christou
- Department of Public Health, Sexual and Reproductive Health Unit, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
| | | | - Mitsuaki Matsui
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
| | - Lenka Beňová
- Department of Public Health, Sexual and Reproductive Health Unit, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Rattana Kim
- National Maternal and Child Health Center, Phnom Penh, Cambodia
| | - Ayako Numazawa
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
| | - Azusa Iwamoto
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sophearith Sokhan
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
| | - Nary Ieng
- Nagasaki University School of Tropical Medicine and Global Health, Nagasaki, Japan
| | - Thérèse Delvaux
- Department of Public Health, Sexual and Reproductive Health Unit, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
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Naito YT, Fukuzawa R, Ganchimeg T, Afulani PA, Aiga H, Kim R, Katsumata AT. Validation of the person-centered maternity care scale at governmental health facilities in Cambodia. PLoS One 2023; 18:e0288051. [PMID: 37410783 DOI: 10.1371/journal.pone.0288051] [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: 01/14/2023] [Accepted: 06/18/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Women's childbirth experience of interpersonal care is a significant aspect of quality of care. Due to the lack of a reliable Cambodian version of a measurement tool to assess person-centered maternity care, the present study aimed to adapt the "Person-Centered Maternity Care (PCMC) scale" to the Cambodian context and further determine its psychometric properties. METHODS The PCMC scale was translated into Khmer using the team translation approach. The Khmer version of PCMC (Kh-PCMC) scale was pretested among 20 Cambodian postpartum women using cognitive interviewing. Subsequently, the Kh-PCMC scale was administered in a survey with 300 Cambodian postpartum women at two governmental health facilities. According to the COnsensus-based Standards for the Selection of health status Measurement Instruments (COSMIN) standard, we performed psychometric analysis, including content validity, construct validity, criterion validity, cross-cultural validity, and internal consistency. RESULTS The preliminary processes of Kh-PCMC scale development including cognitive interviewing and expert review ensured appropriate levels of content validity and acceptable levels of cross-cultural validity of the Kh-PCMC scale with four-point frequency responses. The Scale-level Content Validity Index, Average (S-CVI/Avg) of 30-item Kh-PCMC scale was 0.96. Twenty items, however, performed optimally in the psychometric analysis from the data in Cambodia. The 20-item Kh-PCMC scale produced Cronbach's alpha of 0.86 for the full scale and 0.76-0.91 for the subscales, indicating adequately high internal consistency. Hypothesis testing found positive correlations between the 20-item Kh-PCMC scale and reference measures, which implies acceptable criterion validity. CONCLUSIONS The present study produced the Kh-PCMC scale that enables women's childbirth experiences to be quantitatively measured. The Kh-PCMC scale can identify intrapartum needs from women's perspectives for quality improvement in Cambodia. However, dynamic changes in and diverse differences of cultural context over time across provinces in Cambodia require the Kh-PCMC scale to be regularly reexamined and, when needed, to be further adjusted.
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Affiliation(s)
- Yuko Takahashi Naito
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Rieko Fukuzawa
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Patience A Afulani
- Departments of Epidemiology & Biostatistics and Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, United States of America
| | - Hirotsugu Aiga
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Rattana Kim
- National Maternal and Child Health Center, Phnom Penh, Cambodia
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Meyer C, Larghero P, Almeida Lopes B, Burmeister T, Gröger D, Sutton R, Venn NC, Cazzaniga G, Corral Abascal L, Tsaur G, Fechina L, Emerenciano M, Pombo-de-Oliveira MS, Lund-Aho T, Lundán T, Montonen M, Juvonen V, Zuna J, Trka J, Ballerini P, Lapillonne H, Van der Velden VHJ, Sonneveld E, Delabesse E, de Matos RRC, Silva MLM, Bomken S, Katsibardi K, Keernik M, Grardel N, Mason J, Price R, Kim J, Eckert C, Lo Nigro L, Bueno C, Menendez P, Zur Stadt U, Gameiro P, Sedék L, Szczepański T, Bidet A, Marcu V, Shichrur K, Izraeli S, Madsen HO, Schäfer BW, Kubetzko S, Kim R, Clappier E, Trautmann H, Brüggemann M, Archer P, Hancock J, Alten J, Möricke A, Stanulla M, Lentes J, Bergmann AK, Strehl S, Köhrer S, Nebral K, Dworzak MN, Haas OA, Arfeuille C, Caye-Eude A, Cavé H, Marschalek R. The KMT2A recombinome of acute leukemias in 2023. Leukemia 2023; 37:988-1005. [PMID: 37019990 PMCID: PMC10169636 DOI: 10.1038/s41375-023-01877-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 04/07/2023]
Abstract
Chromosomal rearrangements of the human KMT2A/MLL gene are associated with de novo as well as therapy-induced infant, pediatric, and adult acute leukemias. Here, we present the data obtained from 3401 acute leukemia patients that have been analyzed between 2003 and 2022. Genomic breakpoints within the KMT2A gene and the involved translocation partner genes (TPGs) and KMT2A-partial tandem duplications (PTDs) were determined. Including the published data from the literature, a total of 107 in-frame KMT2A gene fusions have been identified so far. Further 16 rearrangements were out-of-frame fusions, 18 patients had no partner gene fused to 5'-KMT2A, two patients had a 5'-KMT2A deletion, and one ETV6::RUNX1 patient had an KMT2A insertion at the breakpoint. The seven most frequent TPGs and PTDs account for more than 90% of all recombinations of the KMT2A, 37 occur recurrently and 63 were identified so far only once. This study provides a comprehensive analysis of the KMT2A recombinome in acute leukemia patients. Besides the scientific gain of information, genomic breakpoint sequences of these patients were used to monitor minimal residual disease (MRD). Thus, this work may be directly translated from the bench to the bedside of patients and meet the clinical needs to improve patient survival.
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Affiliation(s)
- C Meyer
- DCAL/Institute of Pharm. Biology, Goethe-University, Frankfurt/Main, Germany
| | - P Larghero
- DCAL/Institute of Pharm. Biology, Goethe-University, Frankfurt/Main, Germany
| | - B Almeida Lopes
- DCAL/Institute of Pharm. Biology, Goethe-University, Frankfurt/Main, Germany
- Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil
| | - T Burmeister
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Dept. of Hematology, Oncology and Tumor Immunology, Berlin, Germany
| | - D Gröger
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Dept. of Hematology, Oncology and Tumor Immunology, Berlin, Germany
| | - R Sutton
- Molecular Diagnostics, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia
| | - N C Venn
- Molecular Diagnostics, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia
| | - G Cazzaniga
- Tettamanti Research Center, Pediatrics, University of Milano-Bicocca/Fondazione Tettamanti, Monza, Italy
| | - L Corral Abascal
- Tettamanti Research Center, Pediatrics, University of Milano-Bicocca/Fondazione Tettamanti, Monza, Italy
| | - G Tsaur
- Regional Children's Hospital, Ekaterinburg, Russian Federation; Research Institute of Medical Cell Technologies, Ekaterinburg, Russian Federation
| | - L Fechina
- Regional Children's Hospital, Ekaterinburg, Russian Federation; Research Institute of Medical Cell Technologies, Ekaterinburg, Russian Federation
| | - M Emerenciano
- Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil
| | | | - T Lund-Aho
- Laboratory of Clinical Genetics, Fimlab Laboratories, Tampere, Finland
| | - T Lundán
- Department of Clinical Chemistry and Laboratory Division, University of Turku and Turku University Hospital, Turku, Finland
| | - M Montonen
- Department of Clinical Chemistry and Laboratory Division, University of Turku and Turku University Hospital, Turku, Finland
| | - V Juvonen
- Department of Clinical Chemistry and Laboratory Division, University of Turku and Turku University Hospital, Turku, Finland
| | - J Zuna
- CLIP, Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - J Trka
- CLIP, Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - P Ballerini
- Biological Hematology, AP-HP A. Trousseau, Pierre et Marie Curie University, Paris, France
| | - H Lapillonne
- Biological Hematology, AP-HP A. Trousseau, Pierre et Marie Curie University, Paris, France
| | - V H J Van der Velden
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - E Sonneveld
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - E Delabesse
- Institut Universitaire du Cancer de Toulouse, Toulouse Cedex 9, France
| | - R R C de Matos
- Cytogenetics Department, Bone Marrow Transplantation Unit, National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | - M L M Silva
- Cytogenetics Department, Bone Marrow Transplantation Unit, National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | - S Bomken
- Wolfson Childhood Cancer Research Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - K Katsibardi
- Division of Pediatric Hematology-Oncology, First Department of Pediatrics, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - M Keernik
- Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia
| | - N Grardel
- Department of Hematology, CHU Lille, France
| | - J Mason
- Northern Institute for Cancer Research, Newcastle University and the Great North Children's West Midlands Regional Genetics Laboratory, Birmingham Women's and Children's NHS Foundation Trust, Mindelsohn Way, Birmingham, United Kingdom
| | - R Price
- Northern Institute for Cancer Research, Newcastle University and the Great North Children's West Midlands Regional Genetics Laboratory, Birmingham Women's and Children's NHS Foundation Trust, Mindelsohn Way, Birmingham, United Kingdom
| | - J Kim
- DCAL/Institute of Pharm. Biology, Goethe-University, Frankfurt/Main, Germany
- Department of Laboratory Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - C Eckert
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Pediatric Oncology/Hematology, Berlin, Germany
| | - L Lo Nigro
- Centro di Riferimento Regionale di Ematologia ed Oncologia Pediatrica, Azienda Policlinico "G. Rodolico", Catania, Italy
| | - C Bueno
- Josep Carreras Leukemia Research Institute. Barcelona, Spanish Network for Advanced Therapies (RICORS-TERAV, ISCIII); Spanish Collaborative Cancer Network (CIBERONC. ISCIII); University of Barcelona, Barcelona, Spain
- Josep Carreras Leukemia Research Institute. Barcelona, Spanish Network for Advanced Therapies (RICORS-TERAV, ISCIII); Spanish Collaborative Cancer Network (CIBERONC. ISCIII); Department of Biomedicine. University of Barcelona; and Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - P Menendez
- Centro di Riferimento Regionale di Ematologia ed Oncologia Pediatrica, Azienda Policlinico "G. Rodolico", Catania, Italy
| | - U Zur Stadt
- Pediatric Hematology and Oncology and CoALL Study Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Gameiro
- Instituto Português de Oncologia, Departament of Hematology, Lisbon, Portugal
| | - L Sedék
- Department of Pediatric Hematology and Oncology, Medical University of Silesia, Zabrze, Poland
| | - T Szczepański
- Department of Pediatric Hematology and Oncology, Medical University of Silesia, Zabrze, Poland
| | - A Bidet
- Laboratoire d'Hématologie Biologique, CHU Bordeaux, Bordeaux, France
| | - V Marcu
- Hematology Laboratory, Sheba Medical Center, Tel-Hashomer, Israel
| | - K Shichrur
- Molecular Oncology Laboratory, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - S Izraeli
- Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - H O Madsen
- Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - B W Schäfer
- Division of Oncology and Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland
| | - S Kubetzko
- Division of Oncology and Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland
| | - R Kim
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, INSERM/CNRS U944/UMR7212, Institut de recherche Saint-Louis, Paris, France
| | - E Clappier
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, INSERM/CNRS U944/UMR7212, Institut de recherche Saint-Louis, Paris, France
| | - H Trautmann
- Laboratory for Specialized Hematological Diagnostics, Medical Department II, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Brüggemann
- Laboratory for Specialized Hematological Diagnostics, Medical Department II, University Hospital Schleswig-Holstein, Kiel, Germany
| | - P Archer
- Bristol Genetics Laboratory, North Bristol NHS Trust, Bristol, United Kingdom
| | - J Hancock
- Bristol Genetics Laboratory, North Bristol NHS Trust, Bristol, United Kingdom
| | - J Alten
- Department of Pediatrics, University Hospital Schleswig-Holstein, Kiel, Germany
| | - A Möricke
- Department of Pediatrics, University Hospital Schleswig-Holstein, Kiel, Germany
| | - M Stanulla
- Department of Pediatrics, MHH, Hanover, Germany
| | - J Lentes
- Institute of Human Genetics, Medical School Hannover, Hannover, Germany
| | - A K Bergmann
- Institute of Human Genetics, Medical School Hannover, Hannover, Germany
| | - S Strehl
- St. Anna Children's Cancer Research Institute (CCRI), Vienna, Austria
| | - S Köhrer
- St. Anna Children's Cancer Research Institute (CCRI), Vienna, Austria
- Labdia Labordiagnostik, Vienna, Austria
| | - K Nebral
- St. Anna Children's Cancer Research Institute (CCRI), Vienna, Austria
- Labdia Labordiagnostik, Vienna, Austria
| | - M N Dworzak
- St. Anna Children's Cancer Research Institute (CCRI), Vienna, Austria
- Labdia Labordiagnostik, Vienna, Austria
- St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - O A Haas
- St. Anna Children's Cancer Research Institute (CCRI), Vienna, Austria
- Labdia Labordiagnostik, Vienna, Austria
- St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - C Arfeuille
- Genetics Department, AP-HP, Hopital Robert Debré, Paris, France
| | - A Caye-Eude
- Genetics Department, AP-HP, Hopital Robert Debré, Paris, France
- Université Paris Cité, Inserm U1131, Institut de recherche Saint-Louis, Paris, France
| | - H Cavé
- Genetics Department, AP-HP, Hopital Robert Debré, Paris, France
- Université Paris Cité, Inserm U1131, Institut de recherche Saint-Louis, Paris, France
| | - R Marschalek
- DCAL/Institute of Pharm. Biology, Goethe-University, Frankfurt/Main, Germany.
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E B, Ko K, Kim R, Nagashima S, Ouoba S, Hussain MRA, Sato T, Chuon C, Abe K, Sugiyama A, Takahashi K, Akita T, Tung R, Ork V, Hossain MS, Saphonn V, Tanaka J. Residual risk of mother-to-child transmission of HBV despite timely Hepatitis B vaccination: a major challenge to eliminate hepatitis B infection in Cambodia. BMC Infect Dis 2023; 23:261. [PMID: 37101167 PMCID: PMC10131410 DOI: 10.1186/s12879-023-08249-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/13/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND In countries with intermediate or high hepatitis B virus (HBV) endemicity, mother-to-child transmission (MTCT) represents the main route of chronic HBV infection. There is a paucity of information on HBV MTCT in Cambodia. This study aimed to investigate the prevalence of HBV infection among pregnant women and its MTCT rate in Siem Reap, Cambodia. METHODS This longitudinal study included two parts, study-1 to screen HBsAg among pregnant women and study-2 to follow up babies of all HBsAg-positive and one-fourth of HBsAg-negative mothers at their delivery and six-month post-partum. Serum or dried blood spot (DBS) samples were collected to examine HBV sero-markers by chemiluminescent enzyme immunoassay (CLEIA), and molecular analyses were performed on HBsAg-positive samples. Structured questionnaires and medical records were used to examine the risk factors for HBV infection. MTCT rate was calculated by HBsAg positivity of 6-month-old babies born to HBsAg-positive mothers and ascertained by the homology of HBV genomes in mother-child pair at 6-month-old. RESULTS A total of 1,565 pregnant women were screened, and HBsAg prevalence was 4.28% (67/1565). HBeAg positivity was 41.8% and was significantly associated with high viral load (p < 0.0001). Excluding subjects who dropped out due to restrictions during COVID-19, one out of 35 babies born to HBsAg-positive mothers tested positive for HBsAg at 6 months of age, despite receiving timely HepB birth dose and HBIG, followed by 3 doses of HepB vaccine. Hence the MTCT rate was 2.86%. The mother of the infected baby was positive for HBeAg and had a high HBV viral load (1.2 × 109 copies/mL). HBV genome analysis showed 100% homology between the mother and the child. CONCLUSIONS Our findings illustrate the intermediate endemicity of HBV infection among pregnant women in Siem Reap, Cambodia. Despite full HepB vaccination, a residual risk of HBV MTCT was observed. This finding supports the recently updated guidelines for the prevention of HBV MTCT in 2021, which integrated screening and antiviral prophylaxis for pregnant women at risk of HBV MTCT. Furthermore, we strongly recommend the urgent implementation of these guidelines nationwide to effectively combat HBV in Cambodia.
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Affiliation(s)
- Bunthen E
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
- Payment Certification Agency (PCA), Ministry of Health, Phnom Penh, Cambodia
| | - Ko Ko
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Rattana Kim
- National Maternal and Child Health Center (NMCHC), Ministry of Health, Phnom Penh, Cambodia
| | - Shintaro Nagashima
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Serge Ouoba
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
- Unité de Recherche Clinique de Nanoro (URCN), Institut de Recherche en Sciences de La Santé (IRSS), Nanoro, Burkina Faso
| | - Md Razeen Ashraf Hussain
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Tomoki Sato
- Hiroshima City Funairi Citizens Hospital, Hiroshima, Japan
| | - Channarena Chuon
- Doctor Alliance of Union of Youth Federation of Cambodia (DAUYFC), Phnom Penh, Cambodia
| | - Kanon Abe
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Aya Sugiyama
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Kazuaki Takahashi
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Tomoyuki Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | | | - Vichit Ork
- National Immunization Program (NIP), Ministry of Health, Phnom Penh, Cambodia
| | - Md Shafiqul Hossain
- Expanded Program On Immunization, World Health Organization Country Office, Phnom Penh, Cambodia
| | | | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
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Premananthan C, Rowe G, Gill G, Chen Q, Malas J, Zubair M, Emerson D, Kim R, Bowdish M, Chikwe J. Bicaval Versus Biatrial Heart Transplantation in Pediatric Recipients: A United Network for Organ Sharing Database Analysis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1344] [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: 04/05/2023] Open
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Taylor D, Donovan L, Choi J, Kim R, Schwarz U, Wilson A. A174 A NOVEL MECHANISM OF CROHN’S DISEASE SEVERITY IN WOMEN: EVALUATING THE IMPACT OF AN ESTROGEN-FARNESOID X RECEPTOR INTERACTION ON INTESTINAL BARRIER FUNCTION. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991304 DOI: 10.1093/jcag/gwac036.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Crohn’s disease (CD) is associated with deficits in intestinal barrier function. Activation of bile acid-sensing nuclear receptor Farnesoid X receptor (NR1H4, FXR) is associated with protective effects against reduced intestinal barrier function; namely through promoting tight junction complex genes (TJCGs) and reducing expression of inflammatory cytokines. The FXR -1G>T variant is associated with decreased FXR activation and increased risk of, and early progression to, CD-related surgery in females only. It is hypothesized an estrogen-FXR interaction is mediating this effect. Purpose We aimed to assess the combined effect of estrogen and FXR genetic variation on intestinal barrier function using a cell-based model and its impact in a clinical cohort. Method Caco-2 cells were characterized for expression of TJCGs (zonula occludens-1, occludin, junctional adhesion molecule A, and claudin-1 and claudin-2), FXR, and nuclear estrogen receptors (ERα, ERβ) by qPCR. The influence of FXR activation on TJCGs was characterized by incubation of Caco-2 cells with chenodeoxycholic acid (CDCA). FXR-knockout stable Caco-2 line was developed using CRISPR-Cas9 methods and verified by qPCR and genotyping. The effect of estradiol on expression of TJCGs in FXR-knockout and wildtype Caco-2 cell monolayers was compared by qPCR. Future experiments include comparison of FXR-knockout and wildtype monolayer permeability with estrogen exposure by transwell permeability assay. The effect of FXR genotype and exogenous estrogen CD severity (surgery, hospitalization, fistulizing disease) was evaluated in our female cohort by multivariate analysis. Result(s) Increased expression of TJCGs was seen in native Caco-2 monolayers incubated with CDCA. FXR-knockout cell line was then successfully created and confirmed. FXR-knockout cells showed decreased expression of TJCGs with the exception of zonula occludens-1. Estradiol exposure resulted in a dose-dependent decline in TJCGs expression in the wildtype Caco-2 cell line, however this effect was lost in the FXR-knockout cell line. Preliminary analysis of patient cohort data (n=359) showed exogenous estrogen was associated with lower surgery risk (OR = 0.603, 95% CI= 0.373–0.964, p < 0.05; Fischer’s exact test) and trended towards decreasing fistulizing disease risk in a multiple logistic regression model which included FXR genotype. The association of FXR genotype with increased surgery risk was also confirmed in this logistic regression model. Conclusion(s) Herein, we show that FXR activity affects expression of TJCGs, and this effect is attenuated by estrogen interactions. Our patient cohort preliminary analysis confirmed an increased CD severity risk associated with FXR genotype and demonstrated a trend of decreasing CD severity with exogenous estrogen exposure. Further studies will assess the mechanisms by which FXR and estrogen interact to influence intestinal permeability. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding; Department of Medicine, Western University Disclosure of Interest D. Taylor: None Declared, L. Donovan: None Declared, J. Choi: None Declared, R. Kim: None Declared, U. Schwarz: None Declared, A. Wilson Consultant of: Consulting fees from Fresenius Kabi, Speakers bureau of: Speaking fees from Takeda and Pfizer
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Affiliation(s)
- D Taylor
- Department of Physiology & Pharmacology
| | - L Donovan
- Schulich School of Medicine & Dentistry
| | - J Choi
- Department of Physiology & Pharmacology
| | - R Kim
- Department of Medicine, Western University, London, Canada
| | - U Schwarz
- Department of Physiology & Pharmacology
| | - A Wilson
- Department of Medicine, Western University, London, Canada
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Delvaux T, Ouk V, Samreth S, Yos S, Tep R, Pall C, Keo V, Deng S, Khin Cho WH, Hul S, Chhorn S, Tuot S, Kim R. Challenges and outcomes of implementing a national syphilis follow-up system for the elimination of congenital syphilis in Cambodia: a mixed-methods study. BMJ Open 2023; 13:e063261. [PMID: 36627153 PMCID: PMC9835872 DOI: 10.1136/bmjopen-2022-063261] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES We aimed to describe the challenges and outcomes of implementing a national syphilis follow-up system to improve syphilis management in maternal and child health (MCH) services in Cambodia. DESIGN Operational study; quantitative cohort data and cross sectional qualitative data. SETTING Public health facilities at national level and in four provinces with high syphilis prevalence in Cambodia. PARTICIPANTS Pregnant women screened for syphilis; MCH health care providers and managers. METHODS We conducted an operational research using syphilis screening and treatment data collected from a national follow-up system (cohort data) and reported in the health management information system (HMIS) between 2019 and 2020. We also conducted indepth interviews with 16 pregnant women and focus group discussions with 37 healthcare providers and managers. Descriptive statistics and thematic content analysis were used. OUTCOME MEASURES Syphilis testing and treatment results and perceptions regarding these services. RESULTS A total of 470 pregnant women who tested positive in rapid syphilis testing were recorded in the national syphilis follow-up system in 2019-2020. Of these, 71% (332 of 470) received a rapid plasma reagin (RPR) test and 95% (n=315) tested positive; 78% (246 of 315) received any syphilis treatment and only 28% (88 of 315) were treated adequately with benzathine penicillin G (BPG). Data from four provinces with high syphilis prevalence (more closely monitored) showed higher testing and treatment rates than at the national level. HMIS aggregated data reported a higher number of pregnant women screened and treated for syphilis than the follow-up system during the same period. Barriers to syphilis testing and treatment included late antenatal care, long distance to RPR testing and treatment, partners' lack of support to reach the health facility, BPG stockout and poor adherence to oral treatment in the absence of BPG. Providers and managers reported a lack of communication across services, insufficient skills to treat infants and absence of clear guidance regarding the revised follow-up system. Study findings contributed to changes in operating procedures nationwide to facilitate access to syphilis testing and adequate treatment and a systematic follow-up of pregnant women and exposed infants. CONCLUSIONS Study results contributed to informing improvements to syphilis management in MCH services in Cambodia.
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Affiliation(s)
- Thérèse Delvaux
- Department of Publich Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Vichea Ouk
- National Centre for HIV/AIDS Dermatology and STD, Phnom Penh, Cambodia
| | | | - Socheata Yos
- National Maternal and Child Health Center, Phnom Penh, Cambodia
| | | | - Chamroen Pall
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | | | | | | | - Sivantha Hul
- Clinton Health Access Initiative, Phnom Penh, Cambodia
| | - Somnang Chhorn
- National Maternal and Child Health Center, Phnom Penh, Cambodia
| | - Sovannary Tuot
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Rattana Kim
- National Maternal and Child Health Center, Phnom Penh, Cambodia
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Naito YT, Fukuzawa R, Afulani PA, Kim R, Aiga H. Cultural adaptation of the person-centered maternity care scale at governmental health facilities in Cambodia. PLoS One 2023; 18:e0265784. [PMID: 36595538 PMCID: PMC9810154 DOI: 10.1371/journal.pone.0265784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 12/10/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In Cambodia, the importance of valuing women's childbirth experiences in improving quality of care has been understudied. This is largely because of absence of reliable Khmer tools for measuring women's intrapartum care experiences. Generally, cross-cultural development of those tools often involves translation from a source language into a target language. Yet, few earlier studies considered Cambodian cultural context. Thus, we developed the Cambodian version of the Person-Centered Maternity Care (PCMC) scale, by culturally adapting its original to Cambodian context for ensuring cultural equivalence and content validity. METHODS Three rounds of cognitive interviewing with 20 early postpartum women were conducted at two governmental health facilities in Cambodia. Cognitive interviewing was composed of structured questionnaire pretesting and qualitative probing. The issues identified in the process of transcribing and translating audio-recorded cognitive interviews were iteratively discussed among study team members, and further analyzed. RESULTS A total of 14 issues related to cultural adaptations were identified in the 31 translated questions for the Cambodian version of the PCMC scale. Our study identified three key findings: (i) discrepancies between the WHO recommendations on intrapartum care and Cambodian field realities; (ii) discrepancies in recognition on PCMC between national experts and local women; and (iii) challenges in correctly collecting and interpreting less-educated women's views on intrapartum care. CONCLUSION Not only women's verbal data but also their non-verbal data and cultural contexts should be comprehensively counted, when reflecting Cambodian women's intrapartum practice realities in the translated version. This is the first study that attempted to develop the tool for measuring Cambodian women's experiences during childbirth, by addressing cross-cultural issues.
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Affiliation(s)
- Yuko Takahashi Naito
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
- * E-mail:
| | - Rieko Fukuzawa
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Patience A. Afulani
- Departments of Epidemiology & Biostatistics & Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, California, United States of America
| | - Rattana Kim
- National Maternal and Child Health Center, Phnom Penh, Cambodia
| | - Hirotsugu Aiga
- School of Tropical Medicine and Global Health, University of Nagasaki, Nagasaki, Japan
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Movassaghi M, Lou JJ, Wright S, Silva J, Leavy K, Kim R, Monuki ES, Perez-Rosendahl M, Head E, Yong WH. Lewy Body Pathology and Alzheimer Disease in Down Syndrome. Am J Clin Pathol 2022. [DOI: 10.1093/ajcp/aqac126.059] [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: 11/11/2022] Open
Abstract
Abstract
Introduction/Objective
Aging adults with Down syndrome (DS) develop Alzheimer disease neuropathology (AD) by the age of 40 years, primarily due to the overexpression of the amyloid precursor protein on chromosome 21. Lewy bodies (LBs), containing alpha-synuclein protein, are observed in 7-60% of AD patients in the amygdala and in cortex. Prior DS studies (n=20-56 cases) find the frequency of LB pathology to range between 8-50% of cases being affected. We hypothesized that LB pathology would also be present in DS brain with similar locations and prevalence to AD. Thus, we evaluated the frequency of LB in our UCI cohort of DS cases that we have collected over the past 25 years.
Methods/Case Report
Neuropathology reports from 55 cases with DS from the UCI-ADRC were included in this study. Cases were stained for beta-amyloid, phosphor-tau, alpha-synuclein and TDP-43 as per NACC protocols (one case each v7,8,9 and three v11).
Results (if a Case Study enter NA)
We identified 6 cases (10.9%), all male, with a mean age of 57 years (SD=3) that showed LB and/or Lewy neurites. LB pathology was classified as amygdala predominant in 3 cases, brainstem predominant in one, intermediate/transitional in one, and diffuse/neocortical in one. Five cases were BRAAK stage 6 and one was stage 5. Five cases had CERAD neuritic plaque score C and one case had a B score. Two of 3 cases were Thal phase 5, and one was phase 4. The case with diffuse/neocortical LB pathology demonstrated hippocampal sclerosis.
Conclusion
The observation that all our LB positive cases were male may reflect a sample bias. In our study, Lewy pathology was most common in amygdala but other sites of involvement are seen similar to a prior DS study and AD studies. Prior DS studies (n=20-56 cases) find the frequency of LB pathology to range between 8-50% of cases being affected. The prevalence of LB in our DS cohort (10.9%) is in the low end of the range seen in other DS and AD studies.
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Affiliation(s)
- M Movassaghi
- Pathology, University of California- Irvine School of Medicine , Irvine, California , United States
| | - J J Lou
- Pathology, University of California- Irvine School of Medicine , Irvine, California , United States
| | - S Wright
- Pathology, University of California- Irvine School of Medicine , Irvine, California , United States
| | - J Silva
- Pathology, University of California- Irvine School of Medicine , Irvine, California , United States
| | - K Leavy
- Pathology, University of California- Irvine School of Medicine , Irvine, California , United States
| | - R Kim
- Pathology, University of California- Irvine School of Medicine , Irvine, California , United States
| | - E S Monuki
- Pathology, University of California- Irvine School of Medicine , Irvine, California , United States
| | - M Perez-Rosendahl
- Pathology, University of California- Irvine School of Medicine , Irvine, California , United States
| | - E Head
- Pathology, University of California- Irvine School of Medicine , Irvine, California , United States
| | - W H Yong
- Pathology, University of California- Irvine School of Medicine , Irvine, California , United States
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Park J, Wai Meng D, Hollebecque A, Borad M, Goyal L, Schram A, Cassier P, Kamath S, Dotan E, Kim R, Sahai V, Liao CY, Millward M, Roda Perez D, Blakesley R, Wolf B, Subbiah V, Kelley R, Oh DY. 76MO Efficacy of RLY-4008, a highly selective FGFR2 inhibitor in patients (pts) with an FGFR2-fusion or rearrangement (f/r), FGFR inhibitor (FGFRi)-naïve cholangiocarcinoma (CCA): ReFocus trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Schram A, Borad M, Sahai V, Kamath S, Kim R, Liao C, Oh D, Ponz-Sarvisé M, Yachnin J, Shell S, Cassier P, Dotan E, Florou V, Moreno V, Park J, Tai D, Schmidt-Kittler O, Ferté C, Goyal L, Subbiah V. Identifying FGFR2 fusions/rearrangements in cholangiocarcinoma patients using a novel cfDNA algorithm for treatment with RLY-4008, a highly selective irreversible FGFR2 inhibitor. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01110-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Naing A, Ferrando-Martinez S, Wolfarth A, Xu M, Goon J, Ware M, Haymaker C, Raso M, Chaney M, Ezeanya U, Dhar S, Lee H, Lee T, Adebanjo T, Fan J, Yang S, Lee B, Kim R. 1674P NT-I7 plus pembrolizumab combination treatment enhances infiltration of PD-1+ T cells and provides a more immunogenic tumor microenvironment: Biomarker data from the NIT-110 study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Hollebecque A, Borad M, Goyal L, Schram A, Park J, Cassier P, Kamath S, Meng DW, Dotan E, Kim R, Sahai V, Oh DY, Liao CY, Millward M, Perez DR, Ferté C, Blakesley R, Wolf B, Subbiah V, Kelley R. LBA12 Efficacy of RLY-4008, a highly selective FGFR2 inhibitor in patients (pts) with an FGFR2-fusion or rearrangement (f/r), FGFR inhibitor (FGFRi)-naïve cholangiocarcinoma (CCA): ReFocus trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Segeral O, Dim B, Durier C, Nhoueng S, Chhim K, Sovann S, Yom S, Vong C, Yin S, Ros B, Ky V, Pech S, Nem B, Hout K, Guillebaud J, Ear E, Caroupaye-Caroupin L, Rekacewicz C, Fernandez L, Laurent D, Yay C, Kim R, Meyer L, Chhun S. Immunoglobulin-free strategy to prevent HBV mother-to-child transmission in Cambodia (TA-PROHM): a single-arm, multicentre, phase 4 trial. Lancet Infect Dis 2022; 22:1181-1190. [PMID: 35643089 DOI: 10.1016/s1473-3099(22)00206-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/12/2022] [Accepted: 03/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Prevention of mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is based on administration of vaccine and immunoglobulins (HBIg) to newborns at birth and maternal antiviral prophylaxis for those with an HBV-DNA viral load of at 5·3 log10 IU/mL or more. Many low-income and middle-income countries face difficulty in accessing HBIg and HBV-DNA quantification. The aim of this study was to evaluate the effectiveness of an HBIg-free strategy to prevent MTCT of HBV. METHODS TA-PROHM was a single-arm, multicentre, phase 4 trial done in five maternity units in Cambodia. Pregnant women who were positive for hepatitis B surface antigen (HBsAg), aged 18 years or older were included. Women who were HCV or HIV positive, had creatinine clearance of less than 30 mL/min, severe gravid disease, and planned to give birth outside the study sites were excluded. From Oct 4, 2017, to Jan 9, 2019, HBsAg positive pregnant women who tested positive for hepatitis B e antigen (HBeAg) with a rapid diagnostic test were eligible to receive tenofovir disoproxil fumarate. From Jan 9, 2019, women who were HBeAg negative with an alanine aminotransferase concentration of ≥40 IU/L were also eligible to receive tenofovir disoproxil fumarate. Women in the tenofovir disoproxil fumarate eligible group received 300 mg of tenofovir disoproxil fumarate orally once a day from the 24th week of gestation until 6 weeks postpartum. The primary outcome was the overall proportion of infants who were HBsAg positive at 6 months of life, confirmed by positive HBV DNA quantification. For the primary outcome, the proportion (95% CI) of infants with HBsAg at 6 months was stratified according to infant's HBIg status, duration of maternal tenofovir disoproxil fumarate treatment (>4 weeks and ≤4 weeks), and study period (before and after the change in therapeutic algorithm) and was measured in a modified intention-to-treat analysis, which excluded infants lost to follow-up or who were withdrawn before 6 months. The study is registered with ClinicalTrials.gov, NCT02937779. FINDINGS From Oct 4, 2017, to Nov 27, 2020, 21 251 pregnant women were screened for HBsAg, of whom 1194 (6%) were enrolled in the study: 338 (28%) were eligible to receive tenofovir disoproxil fumarate. For the tenofovir disoproxil fumarate eligible group, four (1% [95% CI 0·34-3·20]) of 317 infants had HBV infection at 6 months; in the subgroup of 271 children who did not receive HBIg, four (1% [0·40-3·74]) had HBV infection at 6 months. In absence of HBIg, MTCT HBV transmission occurred in none (0% [0-1·61]) of 227 women who received tenofovir disoproxil fumarate for more than 4 weeks before giving birth and three (8% [1·75-22·47]) of 36 women who received tenofovir disoproxil fumarate for less than 4 weeks. In the tenofovir disoproxil fumarate ineligible group, seven (1% [0·40-2·02]) of 712 infants had HBV infection at 6 months; in the subgroup of 567 children who did not receive HBIg, six (1% [0·39-2·30]) had HBV infection at 6 months. INTERPRETATION An immunoglobulin-free strategy using an HBeAg rapid diagnosis test and alanine aminotransferase-based algorithm to assess eligibility for tenofovir, is effective at preventing MTCT of HBV when tenofovir was initiated at least 4 weeks before birth. FUNDING French Agency for Research on AIDS and Viral Hepatitis and Emerging Infectious diseases. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Olivier Segeral
- Grant Management Office, University of Health Sciences, Phnom Penh, Cambodia; French Agency for Research on AIDS, Viral Hepatitis and Emerging Infectious diseases (ANRS-MIE), Phnom Penh, Cambodia.
| | - Bunnet Dim
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Christine Durier
- INSERM US19, SC10 Essais Thérapeutiques et Maladies Infectieuses, Villejuif, France
| | - Sovann Nhoueng
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Kearena Chhim
- Maternity Department, Calmette hospital, Phnom Penh, Cambodia
| | - Saren Sovann
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Sophal Yom
- Maternity Department, Jayavarman VII hospital, Siem Reap, Cambodia
| | - Chanlina Vong
- Hepatology Department, Calmette hospital, Phnom Penh, Cambodia
| | - Song Yin
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Bandith Ros
- Maternity Department, Jayavarman VII hospital, Siem Reap, Cambodia
| | - Vutha Ky
- Hepatology Department, Calmette hospital, Phnom Penh, Cambodia
| | - Sothy Pech
- National Maternal and Child Health Center, Phnom Penh, Cambodia
| | - Bunthoeun Nem
- Maternity Department, Kompong Cham Provincial Hospital, Kompong Cham, Cambodia
| | - Kay Hout
- Maternity Department, Takeo Referral Hospital, Takeo, Cambodia
| | - Julia Guillebaud
- Virology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Eamkim Ear
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | | | - Claire Rekacewicz
- INSERM-Centre d'Investigation Clinique-Cochin-Hôtel Dieu, Paris France
| | | | - Denis Laurent
- Direction Department, Foundation Children's Hospital Kantha Bopha, Dr med Beat Richner, Phnom Penh, Cambodia
| | - Chantana Yay
- Direction Department, Foundation Children's Hospital Kantha Bopha, Dr med Beat Richner, Phnom Penh, Cambodia
| | - Rattana Kim
- National Maternal and Child Health Center, Phnom Penh, Cambodia
| | - Laurence Meyer
- University Paris Saclay, Assistance Publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France
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Telfort J, Lickert C, Xie L, Bell G, Ansani N, Kim R. P-739 Social and treatment characteristics of women with Uterine Fibroid (UF) with/without Heavy Menstrual Bleeding (HMB), in a commercially insured US population. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.685] [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: 11/15/2022] Open
Abstract
Abstract
Study question
Are there differences in patient’s social demographic, clinical and treatment characteristics among patients diagnosed with HMB and/or UF?
Summary answer
Baseline characteristics were similar across all UF-status defined-groups. Differences were observed in education, net-worth and 12-monthfollow-up characteristics. Nearly 60% were prescribed pain meds pre-diagnosis.
What is known already
Uterine leiomyomas (or fibroids) are benign neoplasm that affect women of reproductive age1. In the US, treatment for UF is individualized, dependent on size and location of the fibroids, patient profile, symptom severity and type of diagnosis. Patients may be diagnosed with HMB before UF (HMB-UF), diagnosed with UF first and then HMB (UF-HMB), diagnosed with only HMB (HMB-Only) or UF only (UF-Only). Previous studies indicated that the majority (70%) of women received no prescription medications regardless of surgery status and 40% had pain at time of diagnosis.2,3
Study design, size, duration
Our retrospective real-world observational study included 295,400 women across four cohorts between 10/1/2012 -12/31/2020. The majority (96,961; 44%) had HMB-Only, 46,763 (21%) UF-Only, 35,421 (16%) HMB-UF, and 40,806 (19%) UF-HMB. Patients required 12 months continuous enrollment before index date (earlier of HMB or UF diagnosis date based on cohorts) and 12-months of follow-up unless hysterectomy was observed before 12 months. Surgical and pharmacologic agents explored were based on ACOG guidelines for UF.
Participants/materials, setting, methods
Optum® Socio-Economic Status claims database was used to identify newly diagnosed women 18-55 years old with UF and/or HMB claims, without history of conservative/radical surgery or non-dermatological cancers.
Descriptive analyses were performed for patients’ social demographics and treatment characteristics during pre- and post-index period.
Main results and the role of chance
Across all cohorts,
During the 12-month follow-up, nearly 80% of patients used at least 1 prescribed pain medication compared to nearly 60% at baseline. The increase in pain medication use was mainly driven by increase in NSAIDs, opioids, analgesics, and anti-migraine in all cohorts except HMB-O (Opioids: baseline 24-30% to follow up 41-55%; NSAIDs: 20-21% to 44-53%; analgesics: 6-8% to 19%-33%; anti-migraine: 8-11% to 16-29%).
Limitations, reasons for caution
True incidence of index claims are difficult to estimate. Over-the-counters medications or claims made outside the study period are not captured. Pain medication may be unrelated to UF-associated pain.
Findings only reflect the commercially insured population and may not be generalizable. Claims data provide limited clinical profile and prescribing rationales.
Wider implications of the findings
The majority of the patients in these cohorts experienced pain and were prescribed opioids. Determining the link between the use of pain medication and symptoms of UF and HMB is important, as pain medications do not address HMB.
Trial registration number
Not applicable
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Affiliation(s)
- J Telfort
- Pfizer Inc, Patient & Health and Impact , New York, U.S.A
| | - C Lickert
- Myovant Sciences Inc., Medical Managed Markets & RWE , Brisbane, U.S.A
| | - L Xie
- Pfizer Inc, Patient & Health and Impact , New York, U.S.A
| | - G Bell
- Pfizer Inc, Global Product Development , New York, U.S.A
| | - N Ansani
- Pfizer Inc, Internal Medicine - North America Medical Affairs , New York, U.S.A
| | - R Kim
- Pfizer Inc, Patient & Health and Impact , New York, U.S.A
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Maculaitis M, Hunsche E, Cislo P, Ansani N, Virro J, Will O, Peck E, Kopenhafer L, Olsen P, Hauber A, Beusterien K, Kim R. P-315 The importance of treatment features beyond pain reduction associated with gonadotropin-releasing hormone analogues from the patient perspective. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.300] [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: 11/14/2022] Open
Abstract
Abstract
Study question
Beyond reducing pain, how do women with moderate-severe-endometriosis pain prioritize treatment features and outcomes associated with gonadotropin-releasing hormone (GnRH) analogues?
Summary answer
Moderate-severe-endometriosis patients prioritized safe long-term treatment, feeling treatment-effects within a few cycles, being able to maintain employment, reducing fatigue, depression, and headaches, and improving libido.
What is known already
The importance of pain management in endometriosis treatment is well-established. Poor health-related quality of life has been attributed to endometriosis pain, with greater impact as the number of endometriosis symptoms and symptom severity increase. Endometriosis treatment options include analgesics for acute pain episodes and surgery in more severe cases, as well as hormone therapies, including GnRH analogues. The potential risks, benefits, and outcomes associated with currently available GnRH analogues for endometriosis treatment can vary. Data are lacking on the patient perspective with respect to potential treatment features and outcomes beyond just pain reduction.
Study design, size, duration
Treatment-naïve patients with moderate-severe-endometriosis pain (rating scale ≥4 for menstrual pain) in the United States completed a cross-sectional online survey. Best-worst scaling (BWS) was used to assess preferences for key non-pain treatment attributes that were identified based on the literature. Cognitive pre-test interviews were conducted to confirm content validity of the questionnaire. Data collection for this ongoing survey was initiated in December 2021.
Participants/materials, setting, methods
Patients (English-speaking, premenopausal, 18-50 years-old) were recruited via healthcare research panel. Eligible patients self-reported laparoscopy-confirmed-endometriosis, no endometriosis/other gynecological surgery in past 3 months, no osteoporosis/bone disease/uterine fibroids history, and healthcare coverage for previous 3 years. Treatment features in the BWS exercise included dosage flexibility, short treatment onset, reversibility of side effects, reducing fatigue, depression, headache, impact on libido, impact on sleep, ability to maintain employment, duration of treatment, and additional need for contraceptive use.
Main results and the role of chance
Overall, 115 patients (31.1±7.5 years-old) were included in the analyses. On a 0 (no pain) to 10 (pain as bad as you can imagine) scale, the mean worst menstrual and non-menstrual pelvic pain (during past month) were 7.7±1.6 and 5.4±2.7, respectively. The most common endometriosis treatments ever used included over-the-counter pain medications (90.4%) and prescription contraceptives (74.8%).
Of 11 BWS features tested, patients prioritized:
“You can safely take the treatment for a long period of time” (relative importance=11.4%) “Your ability to get or maintain a job” (11.1%) “When starting a treatment, you will begin to feel the treatment’s effects within the first few menstrual cycles” (10.9%) “You will be less depressed” (10.8%) “Your interest in sex will not be affected” (10.7%) “Any side-effects you may experience are resolved quickly after treatment stops” (10.1%) “You will be less fatigued or tired” (9.5%) “You will have fewer headaches or migraines” (8.6%)
Least important to patients were:
“Your sleep will not be affected” (6.8%) “Your doctor offers different options for the dose strength and how often you take it, as appropriate to your needs” (5.9%) “You are not required to take additional contraceptives along with the treatment” (4.0%)
Limitations, reasons for caution
The preferences of patients who participated may differ from those who did not participate, thereby reducing the ability to generalize results. All data were self-reported; diagnosis and treatment could not be independently confirmed. The BWS exercise cannot include all possible attributes and outcomes relevant to patients.
Wider implications of the findings
Beyond pain reduction, patients most highly valued having safe long-term treatment, feeling treatment effects within a few cycles, rapid resolution of side effects, being able to work, maintaining libido, and reducing fatigue, depression, and headaches. These factors can help physicians to better align endometriosis treatment decision-making with patient preferences.
Trial registration number
Not applicable
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Affiliation(s)
- M Maculaitis
- Cerner Enviza, RWE Data & Analytics , Malvern, U.S.A
| | - E Hunsche
- Myovant Sciences- GmBH, Global Market Access & HEOR , Basel, Switzerland
| | - P Cislo
- Pfizer Inc, Statistical Research & Data Science Center , New York, U.S.A
| | - N Ansani
- Pfizer Inc, Medical Affairs , New York, U.S.A
| | - J Virro
- Myovant Sciences Inc, Medical Affairs , Brisbane, U.S.A
| | - O Will
- Cerner Enviza, RWE Data & Analytics , Malvern, U.S.A
| | - E Peck
- Cerner Enviza, RWE Data & Analytics , Malvern, U.S.A
| | - L Kopenhafer
- Cerner Enviza, RWE Data & Analytics , Malvern, U.S.A
| | - P Olsen
- Cerner Enviza, RWE Data & Analytics , Malvern, U.S.A
| | - A Hauber
- Pfizer Inc, Statistical Research & Data Science Center , New York, U.S.A
| | - K Beusterien
- Cerner Enviza, RWE Data & Analytics , Malvern, U.S.A
| | - R Kim
- Pfizer Inc, Patient & Health Impact , New York, U.S.A
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Naing A, Mamdani H, Barve M, Johnson M, Wolff R, Kim D, Yang S, Lee B, Adebanjo T, Georgevitch R, Ferrando-Martinez S, Haymaker C, Chaney M, Fan J, Kim R, Pant S. P-48 Phase 2a study of NT-I7, a long-acting interleukin-7, plus pembrolizumab: Cohort of subjects with checkpoint inhibitor-naïve advanced pancreatic cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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21
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Kim R, Mamdani H, Barve M, Johnson M, Sahin I, Kopetz S, Yang S, Lee B, Adebanjo T, Georgevitch R, Ferrando-Martinez S, Chaney M, Fan J, Naing A. P-54 Phase 2a study of NT-I7, a long-acting interleukin-7, plus pembrolizumab: Cohort of subjects with checkpoint inhibitor-naïve advanced MSS-colorectal cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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22
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Kis B, Shridhar R, Mhaskar R, Frakes J, El-Haddad G, Choi J, Kim R, Hoffe S. Abstract No. 4 ▪ ABSTRACT OF THE YEAR Radioembolization with yttrium-90 glass microspheres as first-line treatment for unresectable intrahepatic cholangiocarcinoma: a prospective phase 2 clinical trial. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.077] [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] Open
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23
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Rowe G, Gill G, Chen Q, Zubair M, Roach A, Alhossan A, Peiris A, Thomas J, Emerson D, Kim R, Chikwe J. Repeat Pediatric Heart Transplantation in the United States: United Network for Organ Sharing Database Analysis. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.403] [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] Open
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24
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Cohen N, Kim R, Bucknor A, Sarabanchong V, Huntly J, Nentin F, Ascher-Walsh C. Increasing access to in-office hysteroscopy for patients with public insurance at an academic medical center. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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25
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Clark R, Lajkosz L, Ken M, Thain E, Kim R, Fleshner N. Lifetime risk of prostate cancer death among high-risk germline mutation carriers. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00595-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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26
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Kim R, Mishra C, Sen S. The use of teleconsultation and technology by the Aravind Eye Care System, India. Community Eye Health 2022; 35:10. [PMID: 36035096 PMCID: PMC9412088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- R Kim
- Chief Medical Officer: Retina Vitreous Services; Director: Informational Technology & Systems, Aravind Eye Hospital, Madurai, India
| | - Chitaranjan Mishra
- Medical Consultant: Department of Vitreo-Retina, Aravind Eye Hospital, Madurai, India
| | - Sagnik Sen
- Fellow: Department of Vitreo-Retina, Aravind Eye Hospital, Madurai, India
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27
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Kim R, Kwon M, An M, Kim ST, Smith SA, Loembé AB, Mortimer PGS, Armenia J, Lukashchuk N, Shah N, Dean E, Park WY, Lee J. Phase II study of ceralasertib (AZD6738) in combination with durvalumab in patients with advanced/metastatic melanoma who have failed prior anti-PD-1 therapy. Ann Oncol 2021; 33:193-203. [PMID: 34710570 DOI: 10.1016/j.annonc.2021.10.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Modulating the DNA damage response and repair (DDR) pathways is a promising strategy for boosting cancer immunotherapy. Ceralasertib (AZD6738) is an oral inhibitor of the serine/threonine protein kinase ataxia telangiectasia and Rad3-related protein, which is crucial for DDR. PATIENTS AND METHODS This phase II trial evaluated ceralasertib plus durvalumab for the treatment of patients with metastatic melanoma who had failed anti-programmed cell death protein 1 therapy. RESULTS Among the 30 patients, we observed an overall response rate of 31.0% and a disease control rate of 63.3%. Responses were evident across patients with acral, mucosal, and cutaneous melanoma. The median duration of response was 8.8 months (range, 3.8-11.7 months). The median progression-free survival was 7.1 months (95% confidence interval, 3.6-10.6 months), and the median overall survival was 14.2 months (95% confidence interval, 9.3-19.1 months). Common adverse events were largely hematologic and manageable with dose interruptions and reductions. Exploratory biomarker analysis suggested that tumors with an immune-enriched microenvironment or alterations in the DDR pathway were more likely to respond to the study treatment. CONCLUSION We conclude that ceralasertib in combination with durvalumab has promising antitumor activity among patients with metastatic melanoma who have failed anti-programmed cell death protein 1 therapy, and constitute a population with unmet needs.
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Affiliation(s)
- R Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M Kwon
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - M An
- Samsung Advanced Institute of Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S A Smith
- Oncology R&D, AstraZeneca, Cambridge, UK
| | - A B Loembé
- Oncology R&D, AstraZeneca, Cambridge, UK
| | | | - J Armenia
- Oncology R&D, AstraZeneca, Cambridge, UK
| | | | - N Shah
- Oncology R&D, AstraZeneca, Cambridge, UK
| | - E Dean
- Oncology R&D, AstraZeneca, Cambridge, UK
| | - W-Y Park
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Geninus Inc., Seoul, Korea
| | - J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Korea.
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Liu W, Oh Y, Yin W, Kim R, Zhou Y, Zhang X, Mo R, Puviindran V, Sriranjan S, van Eede M, Henkelman M, Bruneau B, Hui C, Kim K. THE COMBINATORIAL ROLE OF IROQUOIS HOMEOBOX GENES 3 AND 4 IN THE COMPACTION OF THE VENTRICULAR MYOCARDIUM. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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29
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Bilen M, Xi A, Wong A, Schroeder A, Kim R, Liu F, Peng J, Robinson S, Bhanegaonkar A. 701P Real-world (RW) treatment (Tx) patterns and clinical outcomes in patients (pts) with metastatic urothelial carcinoma (mUC) receiving first-line (1L) Tx: Results from IMPACT UC. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.097] [Citation(s) in RCA: 1] [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: 11/16/2022] Open
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30
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Ajmera M, Chang J, Hitchens A, Kearney M, Esterberg E, Kim R, Cappelleri J, Devgan G, Costa N, Candrilli S. 706P Real-world study assessing physician rationale for initiating first-line (1L) immuno-oncology (IO) therapy for patients with advanced urothelial cancer (aUC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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31
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Park EA, Kang KY, Lee JH, Lee JY, Kim HS, Choi HS, Song GY, Moon EH, Shiin MY, Hur YJ, Yu EJ, Kim R, Koong MK, Lee KA, Kim MJ. P–153 Comparison outcome of vitrified human embryos stored in vapor phase liquid nitrogen (LN2) and direct LN2. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Is vapor cryopreserved LN2 storage beneficial for clinical outcomes of vitrified human embryos that are frozen compared to vitrified human embryos having direct contact with LN2.
Summary answer
There are no significant differences compared to clinical outcomes of human embryos stored in LN2 vapor and direct store in LN2.
What is known already
There has been concerned about potential cross-contamination and biohazard issues of embryos for long term storage using direct LN2. This study aimed to compare clinical outcomes of human embryos transfer between vapor phase and liquid LN2.
Study design, size, duration
The embryo has undergone vitrification for long term storage with vapor or direct contact in LN2. After the thawing of the embryo, we checked on the survival rates. We transferred only one or two embryos per patient and kept analyzing the implantation and pregnancy rates
Participants/materials, setting, methods
This retrospective study was carried out from January 2018 to December 2019 with 3272cycles 4713embryos; vitrified for long term storage in vapor phase or direct contact with LN2. We compared the clinical outcomes of frozen embryo transfer cycles using vitrified for long term storage in vapor phase and direct contact with LN2. Clinical outcomes monitored were embryo survival, subsequent implantation and pregnancy after single or double embryo transfer
Main results and the role of chance
A total of 4713 fertilized human embryos are vitrified and then stored in LN2 vapor (n = 2520 cycles) or direct contact LN2 (n = 752 cycles). The study showed that the blastocyst stored in vapor able to retain full development. Survival was 97.8% (vapor) and 97.6% (direct contact LN2), and the vapor storage of human embryos had no significant difference in survival rates after a long term storage. For single blastocyst transfer, pregnancy and implantation rates were 51.5%, 52.4% in vapor, 54.6%, 54.9% in direct LN2; respectively (p=NS). In double blastocyst transfer, the pregnancy and implantation rates were 61.8%, 42.0% in vapor and 64.7%, 44.5% in direct LN2; respectively (p=NS). There were also no significant differences between two groups.
Limitations, reasons for caution
The study showed that the blastocyst stored in vapor can retain full development. A vapor storage system thus is safe and effective for long term vapor storage of vitrified human embryos.Within the limits of this study, there was no detection of an adverse effect of vapor storage.
Wider implications of the findings: Vapor storage systems thus represent a useful alternative for safe and effective long-term storage of vitrified human embryos that can avoid cross contamination chances from having direct contact with LN2.
Trial registration number
Not applicable
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Affiliation(s)
- E A Park
- CHA Fertility Center Seoul Station, Fertility laboratory, Seoul, Korea- South
| | - K Y Kang
- CHA Fertility Center Seoul Station, Fertility laboratory, Seoul, Korea- South
| | - J H Lee
- CHA Fertility Center Seoul Station, Fertility laboratory, Seoul, Korea- South
| | - J Y Lee
- CHA Fertility Center Seoul Station, Fertility laboratory, Seoul, Korea- South
| | - H S Kim
- CHA Fertility Center Seoul Station, Fertility laboratory, Seoul, Korea- South
| | - H S Choi
- CHA Fertility Center Seoul Station, Fertility laboratory, Seoul, Korea- South
| | - G Y Song
- CHA Fertility Center Seoul Station, Fertility laboratory, Seoul, Korea- South
| | - E H Moon
- CHA Fertility Center Seoul Station, Fertility laboratory, Seoul, Korea- South
| | - M Y Shiin
- CHA Fertility Center Seoul Station, Fertility laboratory, Seoul, Korea- South
| | - Y J Hur
- CHA Fertility Center Seoul Station, Department of Obstetrics and Gynecology, Seoul, Korea- South
| | - E J Yu
- CHA Fertility Center Seoul Station, Department of Obstetrics and Gynecology, Seoul, Korea- South
| | - R Kim
- CHA Fertility Center Seoul Station, Department of Obstetrics and Gynecology, Seoul, Korea- South
| | - M K Koong
- CHA Fertility Center Seoul Station, Department of Obstetrics and Gynecology, Seoul, Korea- South
| | - K A Lee
- CHA University, Department of Biomedical Science- College of Life Science, Seoul, Korea- South
| | - M J Kim
- CHA Fertility Center Seoul Station, Department of Obstetrics and Gynecology, Seoul, Korea- South
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Goyal L, Subbiah V, Mahipal A, Kamath S, Mody K, Borad M, El-Khoueiry A, Sahai V, Kim R, Kelley R, Schmidt-Kittler O, Shen J, Jen K, Deary A, Padval M, Sherwin C, Wolf B, Schram A. P-70 First-in-human study of highly selective FGFR2 inhibitor, RLY-4008, in patients with intrahepatic cholangiocarcinoma and other advanced solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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33
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Wilson A, Wang M, Ponich T, Gregor JC, Chande N, Yan B, Sey M, Beaton MD, Kim R. A12 PRE-TREATMENT HLADQA1-HLADRB1 TESTING FOR THE PREVENTION OF AZATHIOPRINE-INDUCED PANCREATITIS IN INFLAMMATORY BOWEL DISEASE: A PROSPECTIVE COHORT STUDY. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Azathioprine (AZA) therapy has a long history of use in IBD. The need to promote its safe use in this population is ensured by governmental health policy requiring IBD patients to fail low cost drugs, such as AZA, prior to approving funding for more potent biologic therapies. AZA-induced pancreatitis is an idiosyncratic and unpredictable response, occurring in up to 7% of AZA-exposed patients that can lead to patient morbidity, hospitalization, delay in effective IBD management, as well as result in substantial additional health-related costs. There are no tools in clinical practice to identify individuals at risk of AZA-induced pancreatitis. Genetic variation in the HLADQA1-HLADRB1*07:01 haplotype is strongly associated with azathioprine (AZA)-induced pancreatitis in inflammatory bowel disease (IBD).
Aims
To evaluate whether HLA DQA1-HLADRB1*07:01A>C pre-treatment genotype testing in an adult IBD population prior to AZA therapy to guide AZA selection would result in a lower incidence of AZA-induced pancreatitis.
Methods
Participants with IBD (n=599) were screened for HLADQA1-HLADRB1*07:01A>C and participants with a variant genotype were excluded from azathioprine treatment (n=271). Wildtype participants (n=328) were started on azathioprine and followed for 3 months. The incidence of pancreatitis was compared to unscreened historical controls (n=373).
Results
The minor allele frequency of HLADQA1-HLADRB1*07:01 was 30.4% and 30.0% in the screened and unscreened populations respectively. Up to 45.2% of participants were excluded from AZA therapy based on genotype in the HLADQA1-HLADRB1*07:01A>C screened cohort. HLADQA1-HLADRB1*07:01A>C screening resulted in an 11-fold reduction in the odds of azathioprine-induced pancreatitis (0.30% versus 3.4%, OR=0.085, 95%CI=0.011–0.651, p=0.002).
Conclusions
HLA DQA1-HLADRB1*07:01A>C screening substantially reduced the risk of pancreatitis during AZA treatment in patients with IBD. However, using this strategy as a tool for guiding the use of AZA therapy in IBD may eliminate a large proportion of patients from being eligible for treatment with AZA. In regions, where there is access to other IBD therapies, and given the short and long term toxicities associated with AZA, HLA DQA1-HLADRB1*07:01A>C screening may be a clinically-relevant strategy for enhancing the safe use of AZA in IBD. Additionally, cost-effectiveness analyses are needed to further solidify the utility of HLA DQA1-HLADRB1*07:01A>C-screening in IBD populations.
Funding Agencies
Academic Medical Organization of Southwestern Ontario Innovation Fund
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Affiliation(s)
- A Wilson
- Gastroenterology, University of Western Ontario, London, ON, Canada
| | - M Wang
- Gastroenterology, University of Western Ontario, London, ON, Canada
| | - T Ponich
- Gastroenterology, University of Western Ontario, London, ON, Canada
| | - J C Gregor
- Gastroenterology, University of Western Ontario, London, ON, Canada
| | - N Chande
- Gastroenterology, University of Western Ontario, London, ON, Canada
| | - B Yan
- Gastroenterology, University of Western Ontario, London, ON, Canada
| | - M Sey
- Gastroenterology, University of Western Ontario, London, ON, Canada
| | - M D Beaton
- Gastroenterology, University of Western Ontario, London, ON, Canada
| | - R Kim
- Gastroenterology, University of Western Ontario, London, ON, Canada
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Hardy J, Sperry A, Hartmann H, Goldfaden R, Ashchi M, Kim R, Huston J, Niman S, Choksi R. Abelacimab. Anti-factor XI/XIa monoclonal antibody, Treatment of atrial fibrillation, Treatment of thrombotic disorders. DRUG FUTURE 2021. [DOI: 10.1358/dof.2021.46.12.3349024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Romano S, Dell'atti D, Judd R, Kim R, Weinsaft J, Kim J, Heitner J, Farzaneh-Far A. Right ventricular longitudinal strain measured using feature-tracking cardiac magnetic resonance is an independent predictor of all cause mortality in patients with severe tricuspid regurgitation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Tricuspid regurgitation imposes a volume overload on the right ventricle (RV) that can lead to progressive RV dilation and dysfunction. Overt RV dysfunction is associated with poor prognosis and increased operative risk. Abnormalities of myocardial strain may provide the earliest evidence of ventricular dysfunction. CMR feature-tracking techniques now allow assessment of strain from routine cine-images, without specialized pulse sequences. Whether abnormalities of RV strain measured using CMR feature-tracking have prognostic value in patients with tricuspid regurgitation is unknown
Purpose
To evaluate the prognostic value of CMR feature-tracking derived RV free wall longitudinal strain (RVFWLS) in a large multicenter population of patients with severe tricuspid regurgitation.
Methods
Consecutive patients with severe tricuspid regurgitation undergoing CMR at four US medical centers were included in this study. Feature-tracking RVFWLS was calculated from 4 chamber cine-views (Figure-left panel). The primary endpoint was all-cause death. Cox proportional hazards regression modeling was used to examine the independent association between RVFWLS and death. The incremental prognostic value of RVFWLS was assessed in nested models.
Results
Of the 406 patients in this study,115 died during a median follow-up of 8.8 years. By Kaplan-Meier-analysis, patients with RVFWLS ≥median (−16%) had significantly reduced event free survival compared to those with RVFWLS < median (log-rank p<0.001) (Figure-right panel). By Cox multivariable regression modeling, each 1% worsening in RVFWLS was associated with a 13% increased risk-of-death after adjustement for clinical and imaging risk factors (HR=1.13 per %; p<0.001). Addition of RVFWLS in this model resulted in significant-improvement in the global-chi-square (26 to 65; p<0.0001).
Conclusions
CMR feature-tracking derived RVFWLS is an independent predictor of mortality in patients with severe tricuspid regurgitation, incremental to common clinical and imaging risk factors.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Romano
- University of Verona, Verona, Italy
| | | | - R Judd
- Duke University, Division of cardiology, Department of Medicine, Durham, United States of America
| | - R Kim
- Duke University, Division of cardiology, Department of Medicine, Durham, United States of America
| | - J Weinsaft
- Weill Cornell Medical College, Division of cardiology, New York, United States of America
| | - J Kim
- Weill Cornell Medical College, Division of cardiology, New York, United States of America
| | - J Heitner
- New York Methodist hospital, Cardiology, New York, United States of America
| | - A Farzaneh-Far
- University of Illinois at Chicago, Cardiology, Chicago, United States of America
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Cowey C, Liu F, Kim R, Boyd M, Fulcher N, Krulewicz S, Smith J, Bhanegaonkar A. 1090P Real-world (RW) clinical outcomes in patients (pts) with locally advanced (LA) or metastatic Merkel cell carcinoma (mMCC) treated in United States (US) oncology clinical practices: Results from SPEAR-Merkel. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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37
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George S, Zheng Y, Bell E, Engel-Nitz N, White J, Lal L, Kim R, Krulewicz S, Smith J, Liu F. 1611P Healthcare resource utilization (HCRU) and costs in patients (pts) with advanced cancer treated with immune checkpoint inhibitors (ICIs) who experienced select immune-related adverse events (irAEs). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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38
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Tan E, Kim D, Imanirad I, Carballido E, Zhou J, Schell M, Jimenez MM, Kim R. P-47 A phase I/II study of pembrolizumab in combination with ibrutinib for advanced, refractory microsatellite stable colorectal cancers. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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39
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Kim R, Do Y, Park K, Park H, Kim D, Heo S. Abstract No. 682 Updates for extremity arteriovenous malformations involving the bone: approach for embolization and its therapeutic outcomes. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.741] [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] Open
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Wilson A, Wang Q, Almousa A, Jansen L, Choi Y, Schwarz UI, Kim R. A214 GENETIC VARIATION IN THE FARNESOID X RECEPTOR PREDICTS CROHN’S DISEASE SEVERITY IN FEMALE PATIENTS. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Crohn’s disease (CD) is an immune-mediated inflammatory bowel disease defined by episodes of intestinal inflammation. There is now an increasing appreciation of the bile acid-sensing nuclear receptor, FXR, as an important regulator of intestinal inflammation, intestinal permeability and response to bacterial overgrowth. Many of these processes are dysregulated in CD. It is unclear how genetic variation in FXR impacts on CD severity. FXR deficiency is rare. Loss of function mutations in FXR as contributors to CD are unlikely; however, partial loss of function of FXR may contribute to CD progression or severity. Our group demonstrated that FXR-1G>T, a SNV adjacent to the ATG start codon, is linked to reduced transactivation of FXR gene targets. We hypothesized that changes in the intestinal barrier as a result of reduced FXR expression among those who harbor the FXR-1T allele are more likely to exhibit a severe CD phenotype compared to G (reference) allele carriers, and thereby experience a more rapid progression to surgery. Alterations in FXR activity may in part be secondary to genetic variation in the FXR gene.
Aims
To evaluate FXR-1G>T as a genomic biomarker of severity in CD and propose a plausible molecular mechanism.
Methods
A retrospective study (n=542) was conducted in a Canadian cohort of CD patients. Blood samples were obtained for genotypic analysis (FXR-1G>T), as well as determination of the FXR downstream product, fibroblast growth factor (FGF) 19. Primary outcomes included risk and time to first CD-related surgery. To better elucidate a potential molecular basis for the observed effect of FXR-1G>T genotype on CD prognosis (more frequent and early surgery) in female CD patients, we explored a connection between the estrogen receptor (ER)-mediated pathway and genetic variation in FXR using a cell-based model. .
Results
The FXR-1GT genotype was associated with the risk of (odds ratio, OR=3.34, 95%CI=1.58–7.05, p=0.002) and early progression to surgery (hazard ratio, HR=3.00, 95%CI=1.86–4.83, p<0.0001) in CD. Female carriers of the FXR-1GT genotype had the greatest risk of surgery (OR=14.87 95%CI=4.22–52.38, p<0.0001) and early progression to surgery (HR=6.28, 95%CI=3.62–10.90, p<0.0001). Furthermore, women carriers of FXR-1GT polymorphism had a nearly three-fold lower FGF19 plasma concentration compared to women with wildtype FXR-1GG genotype (p<0.0001). In HepG2 cells cotransfected with estrogen receptors (ERα and β) and FXR, presence of estradiol further attenuated variant FXR activity.
Conclusions
FXR-1GT is deleterious to women with CD through ER-mediated attenuation of FXR activation. Female CD FXR-1GT carriers should be considered for more aggressive medical management.
Funding Agencies
CAG, CCC, CIHR
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Affiliation(s)
- A Wilson
- Gastroenterology, University of Western Ontario, London, ON, Canada
| | - Q Wang
- Lawson Health Research Insitute, London, ON, Canada
| | - A Almousa
- Division of Clinical Pharmacology, University of Western Ontario, London, ON, Canada
| | - L Jansen
- Lawson Health Research Insitute, London, ON, Canada
| | - Y Choi
- Department of Epidemiology & Biostatistics, University of Western Ontario, London, ON, Canada
| | - U I Schwarz
- Division of Clinical Pharmacology, University of Western Ontario, London, ON, Canada
| | - R Kim
- Division of Clinical Pharmacology, University of Western Ontario, London, ON, Canada
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Peel C, Wang Q, Pananos A, Kim R, Wilson A. A208
HLA-DQA1*05 GENOTYPE PREDICTS ANTI-DRUG ANTIBODY FORMATION AND LOSS OF RESPONSE DURING INFLIXIMAB THERAPY FOR INFLAMMATORY BOWEL DISEASE. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The underlying mechanism for immunogenicity in anti-TNFa-exposed patients with inflammatory bowel disease is poorly understood. Anti-drug antibodies are a leading contributor to infliximab loss of response and adverse drug events. Currently, it is not feasible to identify patients at risk of antibody formation prior to initiating infliximab. The genetic variation HLADQA1*05(rs2097432) has been linked to infliximab antibody formation in a cohort of patients with Crohn’s disease.
Aims
Due to the wide variation in the frequency of HLADQA1* 05 across ethnic groups, we aim to independently evaluate the association between HLADQA1*05and infliximab antibody formation, infliximab loss of response, treatment discontinuation and adverse drug events, in a Canadian inflammatory bowel disease cohort.
Methods
In a retrospective cohort study, infliximab-exposed patients with inflammatory bowel disease (n=262) were screened for the genetic variation, HLADQA1*05A>G(rs2097432). The risk of infliximab anti-drug antibody formation, infliximab loss of response, adverse events, and discontinuation were assessed in wild type (GG) and variant-carrying (AG or AA) individuals.
Results
Forty percent of all participants were HLADQA1*05A>Gvariant carriers, with 79% of participants with infliximab antibodies carrying at least one variant allele. The risk of infliximab antibody formation was higher in HLADQA1*05A>Gvariant carriers in an IBD population (adjusted HR=7.29, 95%CI=2.97–17.191, p=1.46x10-5) independent of age, sex, weight, dose and co-immunosuppression with an immunomodulator. Variant carrier status was associated with an increased risk of infliximab loss of response (adjusted HR=2.34, 95%CI=1.41–3.88, p=0.001) and discontinuation (adjusted HR=2.27, 95%CI=1.46–3.43, p=2.53x10-4) though not with infliximab-associated adverse drug events.
Conclusions
HLADQA1*05 is independently associated with a high risk of infliximab antibody formation in addition to infliximab loss of response and treatment discontinuation. As a result, we propose that pre-emptive genetic screening for the HLADQA1* 05A>Gvariant would be useful in order to predict individuals at risk of developing immunogenicity. There may be a role for genotype-guided application of combination therapy in inflammatory bowel disease.
Funding Agencies
NoneWolfe Medical Research Chair in Pharmacogenomics (MOP-89753 to RBK), the Academic Medical Organization of Southwestern Ontario (INN18-005 to RBK and AW; S17-004 to AW), and Lawson Health Research Institute (IRF-05-19 to AW)
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Affiliation(s)
- C Peel
- Western University, London, ON, Canada
| | - Q Wang
- Schulich School of Medicine and Dentistry, London, ON, Canada
| | - A Pananos
- Department of Epidemiology and Biostatistics, London, ON, Canada
| | - R Kim
- Divisions of Clinical Pharmacology, London, ON, Canada
| | - A Wilson
- Divisions of Clinical Pharmacology, London, ON, Canada
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Ugonabo N, Kim R, Chen L, Meehan S, Weed J. Erythroderma with circulating atypical T-cells, likely Sézary syndrome. Dermatol Online J 2019; 25:13030/qt8980h67z. [PMID: 32045168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023] Open
Abstract
The erythrodermic patient is often challenging and requires careful evaluation. Work-up should include an extensive and careful medication history, histological and laboratory testing, and if necessary, molecular studies for the evaluation of underlying malignancy. Herein, we present an erythrodermic patient with repeated biopsies demonstrating a spongiotic process who was found to have circulating atypical T-cells concerning for an underlying erythrodermic T-cell leukemia, most closely related to Sézary syndrome.
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Affiliation(s)
- N Ugonabo
- Ronald O. Perelman Department of Dermatology, NYU School of Medicine, NYU Langone Medical Center, New York, NY.
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Jun JS, Kim R, Byun JI, Seok J, Kim TJ, Sunwoo JS, Yang K, Jung KY. Emotional dysregulation in idiopathic rem sleep behavior disorder: a prospective cross-sectional multicenter study. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wang C, Schroeder IS, Cazales AS, Kim R, Albert A, Elwood C, Van Schalkwyk J. Management of fever in labor after institution of a standardized order set at a maternity quaternary care center. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.10.041] [Citation(s) in RCA: 2] [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: 11/30/2022]
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Schoch S, Verzhbinsky I, Kim R, Sejnowski T, Kurth S. Improved automatic classification of sleep stages in infants using high-density EEG recordings. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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46
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Zanotti G, Kim R, Krulewicz S, Hall J, Leith A, Bailey A, Liu F, Kearney M. Treatment (TX) Patterns Of Patients with Advanced Renal Cell Carcinoma (aRCC) Receiving First-Line (1L) TX: Results from a Cross-Sectional Real-World Study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz450.008] [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: 11/14/2022] Open
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Kim R, Dmello M, Clark NV, Ajao M, Einarsson JI, Cohen SL. 2538 Current Methods of Tissue Extraction in Minimally Invasive Surgical Treatment of Uterine Fibroids. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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48
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Kim R, Pepin K, Einarsson JI. Laparoscopic Excision of Transmural Rectal Endometriosis. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kim R, Chaves J, Kavan P, Fakih M, Kortmansky J, Spencer K, Wong L, Tehfe M, Li J, Lee M, Mayo C, Marinello P, Chiorean E. Pembrolizumab (pembro) plus mFOLFOX or FOLFIRI in patients with metastatic colorectal cancer (mCRC): KEYNOTE-651 cohorts B and D. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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50
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George S, Zheng Y, Kim R, Yu T, Dreyfus J, Gayle J, Wassel C, Phatak H. Real world outcomes of immune-related adverse events (irAEs) among patients receiving immune checkpoint inhibitors (ICIs) in hospital settings. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.109] [Citation(s) in RCA: 2] [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: 11/13/2022] Open
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