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Gately L, Mesía C, Sepúlveda JM, Del Barco S, Pineda E, Gironés R, Fuster J, Hong W, Dumas M, Gill S, Navarro LM, Herrero A, Dowling A, de Las Peñas R, Vaz MA, Alonso M, Lwin Z, Harrup R, Peralta S, Long A, Perez-Segura P, Ahern E, Garate CO, Wong M, Campbell R, Cuff K, Jennens R, Gallego O, Underhill C, Martinez-Garcia M, Covela M, Cooper A, Brown S, Rosenthal M, Torres J, Collins IM, Gibbs P, Balana C. Correction to: A combined analysis of two prospective randomised studies exploring the impact of extended post-radiation temozolomide on survival outcomes in newly diagnosed glioblastoma. J Neurooncol 2024; 166:417-418. [PMID: 38289531 DOI: 10.1007/s11060-024-04581-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- L Gately
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
- Department of Medical Oncology, Alfred Health, Melbourne, VIC, Australia.
| | - C Mesía
- Medical Oncology Service, Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain
| | - J M Sepúlveda
- Medical Oncology Service, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - S Del Barco
- Medical Oncology Service, Institut Català d'Oncologia Girona, Girona, Spain
| | - E Pineda
- Medical Oncology Service, Hospital Clinic de Barcelona, Barcelona, Spain
| | - R Gironés
- Medical Oncology Service, Hospital Universitario La Fe, Valencia, Spain
| | - J Fuster
- Medical Oncology Service, Hospital Son Espases, Palma de Mallorca, Spain
| | - W Hong
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - M Dumas
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - S Gill
- Department of Medical Oncology, Alfred Health, Melbourne, VIC, Australia
| | - L M Navarro
- Medical Oncology Service, Hospital de Salamanca, Salamanca, Spain
| | - A Herrero
- Medical Oncology Service, Hospital Miguel Servet, Zaragoza, Spain
| | - A Dowling
- Department of Medical Oncology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - R de Las Peñas
- Medical Oncology Service, Hospital Provincial de Castellón, Castellón, Spain
| | - M A Vaz
- Medical Oncology Service, Hospital Ramón y Cajal, Madrid, Spain
| | - M Alonso
- Medical Oncology Service, Hospital Virgen del Rocio, Seville, Spain
| | - Z Lwin
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - R Harrup
- Department of Medical Oncology, Royal Hobart Hospital, Hobart, TAS, Australia
| | - S Peralta
- Medical Oncology Service, Hospital Sant Joan de Reus, Reus, Spain
| | - A Long
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - P Perez-Segura
- Medical Oncology Service, Hospital Clinico San Carlos, Madrid, Spain
| | - E Ahern
- Department of Medical Oncology, Monash Health, Melbourne, VIC, Australia
| | - C O Garate
- Medical Oncology Service, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - M Wong
- Department of Medical Oncology, Westmead Hospital, Westmead, NSW, Australia
| | - R Campbell
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC, Australia
| | - K Cuff
- Department of Medical Oncology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - R Jennens
- Department of Medical Oncology, Epworth Health, Richmond, VIC, Australia
| | - O Gallego
- Medical Oncology Service, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - C Underhill
- Department of Medical Oncology, Border Medical Oncology, East Albury, NSW, Australia
| | | | - M Covela
- Medical Oncology Service, Hospital Lucus Augusti, Lugo, Spain
| | - A Cooper
- Department of Medical Oncology, Liverpool Hospital, Liverpool, NSW, Australia
| | - S Brown
- Department of Medical Oncology, Ballarat Health Services, Ballarat, VIC, Australia
| | - M Rosenthal
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - J Torres
- Department of Medical Oncology, Goulburn Valley Health, Shepparton, VIC, Australia
| | - I M Collins
- Department of Medical Oncology, South West Regional Cancer Centre, Geelong, VIC, Australia
| | - P Gibbs
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - C Balana
- Medical Oncology Service, Institut Català d'Oncologia, Badalona, Spain
- Badalona Applied Research Group in Oncology (B-ARGO), Institut Investigació Germans Trias I Pujol (IGTP), Badalona, Spain
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Gately L, Mesía C, Sepúlveda JM, Del Barco S, Pineda E, Gironés R, Fuster J, Hong W, Dumas M, Gill S, Navarro LM, Herrero A, Dowling A, de Las Peñas R, Vaz MA, Alonso M, Lwin Z, Harrup R, Peralta S, Long A, Perez-Segura P, Ahern E, Garate CO, Wong M, Campbell R, Cuff K, Jennens R, Gallego O, Underhill C, Martinez-Garcia M, Covela M, Cooper A, Brown S, Rosenthal M, Torres J, Collins IM, Gibbs P, Balana C. A combined analysis of two prospective randomised studies exploring the impact of extended post-radiation temozolomide on survival outcomes in newly diagnosed glioblastoma. J Neurooncol 2024; 166:407-415. [PMID: 38153582 DOI: 10.1007/s11060-023-04513-1] [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: 10/11/2023] [Accepted: 11/15/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE The optimal duration of post-radiation temozolomide in newly diagnosed glioblastoma remains unclear, with no published phase III randomised trials. Standard-of-care stipulates 6 months. However, in routine care, it is often extended to 12 months, despite lacking robust supporting data. METHODS GEINO14-01 (Spain) and EX-TEM (Australia) studies enrolled glioblastoma patients without progression at the end of 6 months post-radiation temozolomide. Participants were randomised 1:1 to six additional months of temozolomide or observation. Primary endpoint was 6-month progression free survival from date of randomisation (6mPFS). Secondary endpoints included overall survival (OS) and toxicity. 204 patients were required to detect an improvement in 6mPFS from 50 to 60% (80% power). Neither study recruited sufficient patients. We performed a combined analysis of individual patient data. RESULTS 205 patients were recruited: 159 in GEINO14-01 (2014-2018) and 46 in EX-TEM (2019-2022). Median follow-up was 20.0 and 14.5 months. Baseline characteristics were balanced. There was no significant improvement in 6mPFS (57.2% vs 64.0%, OR0.75, p = 0.4), nor across any subgroups, including MGMT methylated; PFS (HR0.92, p = 0.59, median 7.8 vs 9.7 months); or OS (HR1.03, p = 0.87, median 20.1 vs 19.4 months). During treatment extension, 64% experienced any grade adverse event, mainly fatigue and gastrointestinal (both 54%). Only a minority required treatment changes: 4.5% dose delay, 7.5% dose reduction, 1.5% temozolomide discontinuation. CONCLUSION For glioblastoma patients, extending post-radiation temozolomide from 6 to 12 months is well tolerated but does not improve 6mPFS. We could not identify any subset that benefitted from extended treatment. Six months should remain standard-of-care.
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Affiliation(s)
- L Gately
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
- Department of Medical Oncology, Alfred Health, Melbourne, VIC, Australia.
| | - C Mesía
- Medical Oncology Service, Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain
| | - J M Sepúlveda
- Medical Oncology Service, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - S Del Barco
- Medical Oncology Service, Institut Català d'Oncologia Girona, Girona, Spain
| | - E Pineda
- Medical Oncology Service, Hospital Clinic de Barcelona, Barcelona, Spain
| | - R Gironés
- Medical Oncology Service, Hospital Universitario La Fe, Valencia, Spain
| | - J Fuster
- Medical Oncology Service, Hospital Son Espases, Palma de Mallorca, Spain
| | - W Hong
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - M Dumas
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - S Gill
- Department of Medical Oncology, Alfred Health, Melbourne, VIC, Australia
| | - L M Navarro
- Medical Oncology Service, Hospital de Salamanca, Salamanca, Spain
| | - A Herrero
- Medical Oncology Service, Hospital Miguel Servet, Zaragoza, Spain
| | - A Dowling
- Department of Medical Oncology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia
| | - R de Las Peñas
- Medical Oncology Service, Hospital Provincial de Castellón, Castellón, Spain
| | - M A Vaz
- Medical Oncology Service, Hospital Ramón y Cajal, Madrid, Spain
| | - M Alonso
- Medical Oncology Service, Hospital Virgen del Rocio, Seville, Spain
| | - Z Lwin
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - R Harrup
- Department of Medical Oncology, Royal Hobart Hospital, Hobart, TAS, Australia
| | - S Peralta
- Medical Oncology Service, Hospital Sant Joan de Reus, Reus, Spain
| | - A Long
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - P Perez-Segura
- Medical Oncology Service, Hospital Clinico San Carlos, Madrid, Spain
| | - E Ahern
- Department of Medical Oncology, Monash Health, Melbourne, VIC, Australia
| | - C O Garate
- Medical Oncology Service, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - M Wong
- Department of Medical Oncology, Westmead Hospital, Westmead, NSW, Australia
| | - R Campbell
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC, Australia
| | - K Cuff
- Department of Medical Oncology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - R Jennens
- Department of Medical Oncology, Epworth Health, Richmond, VIC, Australia
| | - O Gallego
- Medical Oncology Service, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - C Underhill
- Department of Medical Oncology, Border Medical Oncology, East Albury, NSW, Australia
| | | | - M Covela
- Medical Oncology Service, Hospital Lucus Augusti, Lugo, Spain
| | - A Cooper
- Department of Medical Oncology, Liverpool Hospital, Liverpool, NSW, Australia
| | - S Brown
- Department of Medical Oncology, Ballarat Health Services, Ballarat, VIC, Australia
| | - M Rosenthal
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - J Torres
- Department of Medical Oncology, Goulburn Valley Health, Shepparton, VIC, Australia
| | - I M Collins
- Department of Medical Oncology, South West Regional Cancer Centre, Geelong, VIC, Australia
| | - P Gibbs
- Personalised Oncology Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
| | - C Balana
- Medical Oncology Service, Institut Català d'Oncologia, Badalona, Spain
- Badalona Applied Research Group in Oncology (B-ARGO), Institut Investigació Germans Trias i Pujol (IGTP), Badalona, Spain
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Carter LE, Bugiel S, Nunnikhoven A, Verster AJ, Petronella N, Gill S, Curran IHA. Comparative genomic analysis of Fischer F344 rat livers exposed for 90 days to 3-methylfuran or its parental compound furan. Food Chem Toxicol 2024; 184:114426. [PMID: 38160780 DOI: 10.1016/j.fct.2023.114426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024]
Abstract
Furan is a naturally forming compound found in heat-processed foods such as coffee, canned meats, and jarred baby food. It is concurrently found with analogues including 2-methylfuran (2-MF) and 3-methylfuran (3-MF), and toxicity studies demonstrate all are potent liver toxins. Toxicity studies found 3-MF is more toxic than either furan, or 2-MF. The present analysis assesses the transcriptional response in liver samples taken from male Fischer (F344) rats exposed to furan or 3-MF from 0 to 2.0 and 0-1.0 mg/kg bw/day, respectively, for 90 days. Transcriptional analyses found decreased liver function and fatty acid metabolism are common responses to both furan and 3-MF exposure. Furan liver injury promotes a ductular reaction through Hippo and TGFB signalling, which combined with increased immune response results in ameliorating perturbed bile acid homeostasis in treated rats. Failure to activate these pathways in 3-MF exposed rats and decreased p53 activity leads to cholestasis, and increased toxicity. Finally, BMD analysis indicate many of the most sensitive pathways affected by furan and 3-MF exposure relate to metabolism - malate dehydrogenase and glucose metabolism with BMDLs of 0.03 and 0.01 mg/kg bw/day for furan and 3-MF exposure, respectively, which agrees with BMDLs previously reported for apical and microarray data.
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Affiliation(s)
- L E Carter
- Bureau of Chemical Safety, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, K1A 0K9, Canada.
| | - S Bugiel
- Bureau of Chemical Safety, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, K1A 0K9, Canada
| | - A Nunnikhoven
- Bureau of Chemical Safety, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, K1A 0K9, Canada
| | - A J Verster
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, K1A 0K9, Canada
| | - N Petronella
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, K1A 0K9, Canada
| | - S Gill
- Bureau of Chemical Safety, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, K1A 0K9, Canada
| | - I H A Curran
- Bureau of Chemical Safety, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, K1A 0K9, Canada
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Luque R, Osborn HP, Leleu A, Pallé E, Bonfanti A, Barragán O, Wilson TG, Broeg C, Cameron AC, Lendl M, Maxted PFL, Alibert Y, Gandolfi D, Delisle JB, Hooton MJ, Egger JA, Nowak G, Lafarga M, Rapetti D, Twicken JD, Morales JC, Carleo I, Orell-Miquel J, Adibekyan V, Alonso R, Alqasim A, Amado PJ, Anderson DR, Anglada-Escudé G, Bandy T, Bárczy T, Barrado Navascues D, Barros SCC, Baumjohann W, Bayliss D, Bean JL, Beck M, Beck T, Benz W, Billot N, Bonfils X, Borsato L, Boyle AW, Brandeker A, Bryant EM, Cabrera J, Carrazco-Gaxiola S, Charbonneau D, Charnoz S, Ciardi DR, Cochran WD, Collins KA, Crossfield IJM, Csizmadia S, Cubillos PE, Dai F, Davies MB, Deeg HJ, Deleuil M, Deline A, Delrez L, Demangeon ODS, Demory BO, Ehrenreich D, Erikson A, Esparza-Borges E, Falk B, Fortier A, Fossati L, Fridlund M, Fukui A, Garcia-Mejia J, Gill S, Gillon M, Goffo E, Gómez Maqueo Chew Y, Güdel M, Guenther EW, Günther MN, Hatzes AP, Helling C, Hesse KM, Howell SB, Hoyer S, Ikuta K, Isaak KG, Jenkins JM, Kagetani T, Kiss LL, Kodama T, Korth J, Lam KWF, Laskar J, Latham DW, Lecavelier des Etangs A, Leon JPD, Livingston JH, Magrin D, Matson RA, Matthews EC, Mordasini C, Mori M, Moyano M, Munari M, Murgas F, Narita N, Nascimbeni V, Olofsson G, Osborne HLM, Ottensamer R, Pagano I, Parviainen H, Peter G, Piotto G, Pollacco D, Queloz D, Quinn SN, Quirrenbach A, Ragazzoni R, Rando N, Ratti F, Rauer H, Redfield S, Ribas I, Ricker GR, Rudat A, Sabin L, Salmon S, Santos NC, Scandariato G, Schanche N, Schlieder JE, Seager S, Ségransan D, Shporer A, Simon AE, Smith AMS, Sousa SG, Stalport M, Szabó GM, Thomas N, Tuson A, Udry S, Vanderburg AM, Van Eylen V, Van Grootel V, Venturini J, Walter I, Walton NA, Watanabe N, Winn JN, Zingales T. A resonant sextuplet of sub-Neptunes transiting the bright star HD 110067. Nature 2023; 623:932-937. [PMID: 38030780 DOI: 10.1038/s41586-023-06692-3] [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: 05/02/2023] [Accepted: 09/28/2023] [Indexed: 12/01/2023]
Abstract
Planets with radii between that of the Earth and Neptune (hereafter referred to as 'sub-Neptunes') are found in close-in orbits around more than half of all Sun-like stars1,2. However, their composition, formation and evolution remain poorly understood3. The study of multiplanetary systems offers an opportunity to investigate the outcomes of planet formation and evolution while controlling for initial conditions and environment. Those in resonance (with their orbital periods related by a ratio of small integers) are particularly valuable because they imply a system architecture practically unchanged since its birth. Here we present the observations of six transiting planets around the bright nearby star HD 110067. We find that the planets follow a chain of resonant orbits. A dynamical study of the innermost planet triplet allowed the prediction and later confirmation of the orbits of the rest of the planets in the system. The six planets are found to be sub-Neptunes with radii ranging from 1.94R⊕ to 2.85R⊕. Three of the planets have measured masses, yielding low bulk densities that suggest the presence of large hydrogen-dominated atmospheres.
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Affiliation(s)
- R Luque
- Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL, USA.
| | - H P Osborn
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A Leleu
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - E Pallé
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - A Bonfanti
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - O Barragán
- Sub-department of Astrophysics, Department of Physics, University of Oxford, Oxford, UK
| | - T G Wilson
- Centre for Exoplanet Science, SUPA School of Physics and Astronomy, University of St Andrews, St Andrews, UK
- Department of Physics, University of Warwick, Coventry, UK
- Centre for Exoplanets and Habitability, University of Warwick, Coventry, UK
| | - C Broeg
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - A Collier Cameron
- Centre for Exoplanet Science, SUPA School of Physics and Astronomy, University of St Andrews, St Andrews, UK
| | - M Lendl
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - P F L Maxted
- Astrophysics Group, Lennard Jones Building, Keele University, Keele, UK
| | - Y Alibert
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - D Gandolfi
- Dipartimento di Fisica, Universita degli Studi di Torino, Torino, Italy
| | - J-B Delisle
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - M J Hooton
- Cavendish Laboratory, University of Cambridge, Cambridge, UK
| | - J A Egger
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
| | - G Nowak
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
- Institute of Astronomy, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Toruń, Poland
| | - M Lafarga
- Department of Physics, University of Warwick, Coventry, UK
- Centre for Exoplanets and Habitability, University of Warwick, Coventry, UK
| | - D Rapetti
- NASA Ames Research Center, Moffett Field, CA, USA
- Research Institute for Advanced Computer Science, Universities Space Research Association, Washington, DC, USA
| | - J D Twicken
- NASA Ames Research Center, Moffett Field, CA, USA
- SETI Institute, Mountain View, CA, USA
| | - J C Morales
- Institut de Ciencies de l'Espai (ICE-CSIC), Bellaterra, Spain
- Institut d'Estudis Espacials de Catalunya (IEEC), Barcelona, Spain
| | - I Carleo
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- INAF - Osservatorio Astrofisico di Torino, Pino Torinese, Italy
| | - J Orell-Miquel
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - V Adibekyan
- Instituto de Astrofísica e Ciências do Espaço, Universidade do Porto, Porto, Portugal
- Departamento de Física e Astronomia, Faculdade de Ciências, Universidade do Porto, Porto, Portugal
| | - R Alonso
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - A Alqasim
- Mullard Space Science Laboratory, University College London, Dorking, UK
| | - P J Amado
- Instituto de Astrofísica de Andalucía (IAA-CSIC), Granada, Spain
| | - D R Anderson
- Department of Physics, University of Warwick, Coventry, UK
- Centre for Exoplanets and Habitability, University of Warwick, Coventry, UK
| | - G Anglada-Escudé
- Institut de Ciencies de l'Espai (ICE-CSIC), Bellaterra, Spain
- Institut d'Estudis Espacials de Catalunya (IEEC), Barcelona, Spain
| | - T Bandy
- European Space Research and Technology Centre (ESTEC), European Space Agency (ESA), Noordwijk, The Netherlands
| | | | | | - S C C Barros
- Instituto de Astrofisica e Ciencias do Espaco, Universidade do Porto, Porto, Portugal
- Departamento de Fisica e Astronomia, Faculdade de Ciencias, Universidade do Porto, Porto, Portugal
| | - W Baumjohann
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - D Bayliss
- Department of Physics, University of Warwick, Coventry, UK
| | - J L Bean
- Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL, USA
| | - M Beck
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - T Beck
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
| | - W Benz
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - N Billot
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - X Bonfils
- Université Grenoble Alpes, CNRS, IPAG, Grenoble, France
| | - L Borsato
- INAF - Osservatorio Astronomico di Padova, Padova, Italy
| | - A W Boyle
- Department of Astronomy, California Institute of Technology, Pasadena, CA, USA
| | - A Brandeker
- Department of Astronomy, Stockholm University, AlbaNova University Center, Stockholm, Sweden
| | - E M Bryant
- Department of Physics, University of Warwick, Coventry, UK
- Mullard Space Science Laboratory, University College London, Dorking, UK
| | - J Cabrera
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
| | - S Carrazco-Gaxiola
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
- Department of Physics and Astronomy, Georgia State University, Atlanta, GA, USA
- RECONS Institute, Chambersburg, PA, USA
| | - D Charbonneau
- Center for Astrophysics | Harvard & Smithsonian, Cambridge, MA, USA
| | - S Charnoz
- Université de Paris Cité, Institut de Physique du Globe de Paris, CNRS, Paris, France
| | - D R Ciardi
- Department of Astronomy, California Institute of Technology, Pasadena, CA, USA
| | - W D Cochran
- McDonald Observatory, The University of Texas, Austin, TX, USA
- Center for Planetary Systems Habitability, The University of Texas, Austin, TX, USA
| | - K A Collins
- Center for Astrophysics | Harvard & Smithsonian, Cambridge, MA, USA
| | - I J M Crossfield
- Department of Physics and Astronomy, University of Kansas, Lawrence, KS, USA
| | - Sz Csizmadia
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
| | - P E Cubillos
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
- INAF - Osservatorio Astrofisico di Torino, Pino Torinese, Italy
| | - F Dai
- Department of Astronomy, California Institute of Technology, Pasadena, CA, USA
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA, USA
| | - M B Davies
- Centre for Mathematical Sciences, Lund University, Lund, Sweden
| | - H J Deeg
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - M Deleuil
- Aix Marseille Univ., CNRS, CNES, LAM, Marseille, France
| | - A Deline
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - L Delrez
- Astrobiology Research Unit, Université de Liège, Liège, Belgium
- Space sciences, Technologies and Astrophysics Research (STAR) Institute, Université de Liège, Liège, Belgium
| | - O D S Demangeon
- Instituto de Astrofisica e Ciencias do Espaco, Universidade do Porto, Porto, Portugal
- Departamento de Fisica e Astronomia, Faculdade de Ciencias, Universidade do Porto, Porto, Portugal
| | - B-O Demory
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - D Ehrenreich
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
- Centre Vie dans l'Univers, Faculté des sciences, Université de Genève, Genève 4, Switzerland
| | - A Erikson
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
| | - E Esparza-Borges
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - B Falk
- Space Telescope Science Institute, Baltimore, MD, USA
| | - A Fortier
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - L Fossati
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - M Fridlund
- Leiden Observatory, University of Leiden, Leiden, The Netherlands
- Onsala Space Observatory, Department of Space, Earth and Environment, Chalmers University of Technology, Onsala, Sweden
| | - A Fukui
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Komaba Institute for Science, The University of Tokyo, Tokyo, Japan
| | - J Garcia-Mejia
- Center for Astrophysics | Harvard & Smithsonian, Cambridge, MA, USA
| | - S Gill
- Department of Physics, University of Warwick, Coventry, UK
| | - M Gillon
- Astrobiology Research Unit, Université de Liège, Liège, Belgium
| | - E Goffo
- Dipartimento di Fisica, Universita degli Studi di Torino, Torino, Italy
- Thüringer Landessternwarte Tautenburg, Tautenburg, Germany
| | - Y Gómez Maqueo Chew
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - M Güdel
- Department of Astrophysics, University of Vienna, Vienna, Austria
| | - E W Guenther
- Thüringer Landessternwarte Tautenburg, Tautenburg, Germany
| | - M N Günther
- European Space Research and Technology Centre (ESTEC), European Space Agency (ESA), Noordwijk, The Netherlands
| | - A P Hatzes
- Thüringer Landessternwarte Tautenburg, Tautenburg, Germany
| | - Ch Helling
- Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - K M Hesse
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - S B Howell
- NASA Ames Research Center, Moffett Field, CA, USA
| | - S Hoyer
- Aix Marseille Univ., CNRS, CNES, LAM, Marseille, France
| | - K Ikuta
- Department of Multi-Disciplinary Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - K G Isaak
- European Space Research and Technology Centre (ESTEC), European Space Agency (ESA), Noordwijk, The Netherlands
| | - J M Jenkins
- NASA Ames Research Center, Moffett Field, CA, USA
| | - T Kagetani
- Department of Multi-Disciplinary Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - L L Kiss
- Konkoly Observatory, HUN-REN Research Centre for Astronomy and Earth Sciences, Budapest, Hungary
- Institute of Physics, ELTE Eötvös Loránd University, Budapest, Hungary
| | - T Kodama
- Komaba Institute for Science, The University of Tokyo, Tokyo, Japan
| | - J Korth
- Lund Observatory, Division of Astrophysics, Department of Physics, Lund University, Lund, Sweden
| | - K W F Lam
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
| | - J Laskar
- IMCCE, UMR8028 CNRS, Observatoire de Paris, PSL Univ., Sorbonne Univ., Paris, France
| | - D W Latham
- Center for Astrophysics | Harvard & Smithsonian, Cambridge, MA, USA
| | - A Lecavelier des Etangs
- Institut d'Astrophysique de Paris, UMR7095 CNRS, Université Pierre & Marie Curie, Paris, France
| | - J P D Leon
- Department of Multi-Disciplinary Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - J H Livingston
- Astrobiology Center, Tokyo, Japan
- National Astronomical Observatory of Japan, Tokyo, Japan
- Department of Astronomical Science, The Graduate University for Advanced Studies, SOKENDAI, Tokyo, Japan
| | - D Magrin
- INAF - Osservatorio Astronomico di Padova, Padova, Italy
| | - R A Matson
- United States Naval Observatory, Washington, DC, USA
| | - E C Matthews
- Max Planck Institute for Astronomy, Heidelberg, Germany
| | - C Mordasini
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
- Center for Space and Habitability, University of Bern, Bern, Switzerland
| | - M Mori
- Department of Multi-Disciplinary Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - M Moyano
- Instituto de Astronomía, Universidad Católica del Norte, Antofagasta, Chile
| | - M Munari
- INAF - Osservatorio Astrofisico di Catania, Catania, Italy
| | - F Murgas
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - N Narita
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Komaba Institute for Science, The University of Tokyo, Tokyo, Japan
- Astrobiology Center, Tokyo, Japan
| | - V Nascimbeni
- INAF - Osservatorio Astronomico di Padova, Padova, Italy
| | - G Olofsson
- Department of Astronomy, Stockholm University, AlbaNova University Center, Stockholm, Sweden
| | - H L M Osborne
- Mullard Space Science Laboratory, University College London, Dorking, UK
| | - R Ottensamer
- Department of Astrophysics, University of Vienna, Vienna, Austria
| | - I Pagano
- INAF - Osservatorio Astrofisico di Catania, Catania, Italy
| | - H Parviainen
- Instituto de Astrofisica de Canarias, La Laguna, Tenerife, Spain
- Departamento de Astrofisica, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - G Peter
- Institute of Optical Sensor Systems, German Aerospace Center (DLR), Berlin, Germany
| | - G Piotto
- INAF - Osservatorio Astronomico di Padova, Padova, Italy
- Dipartimento di Fisica e Astronomia "Galileo Galilei", Universita degli Studi di Padova, Padova, Italy
| | - D Pollacco
- Department of Physics, University of Warwick, Coventry, UK
| | - D Queloz
- Cavendish Laboratory, University of Cambridge, Cambridge, UK
- Department of Physics, ETH Zurich, Zurich, Switzerland
| | - S N Quinn
- Center for Astrophysics | Harvard & Smithsonian, Cambridge, MA, USA
| | - A Quirrenbach
- Landessternwarte, Zentrum für Astronomie der Universität Heidelberg, Heidelberg, Germany
| | - R Ragazzoni
- INAF - Osservatorio Astronomico di Padova, Padova, Italy
- Dipartimento di Fisica e Astronomia "Galileo Galilei", Universita degli Studi di Padova, Padova, Italy
| | - N Rando
- European Space Research and Technology Centre (ESTEC), European Space Agency (ESA), Noordwijk, The Netherlands
| | - F Ratti
- European Space Research and Technology Centre (ESTEC), European Space Agency (ESA), Noordwijk, The Netherlands
| | - H Rauer
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
- Zentrum für Astronomie und Astrophysik, Technische Universität Berlin, Berlin, Germany
- Institut für Geologische Wissenschaften, Freie Universität Berlin, Berlin, Germany
| | - S Redfield
- Astronomy Department, Wesleyan University, Middletown, CT, USA
- Van Vleck Observatory, Wesleyan University, Middletown, CT, USA
| | - I Ribas
- Institut de Ciencies de l'Espai (ICE-CSIC), Bellaterra, Spain
- Institut d'Estudis Espacials de Catalunya (IEEC), Barcelona, Spain
| | - G R Ricker
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A Rudat
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - L Sabin
- Instituto de Astronomía, Universidad Nacional Autónoma de México, Ensenada, Mexico
| | - S Salmon
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - N C Santos
- Instituto de Astrofisica e Ciencias do Espaco, Universidade do Porto, Porto, Portugal
- Departamento de Fisica e Astronomia, Faculdade de Ciencias, Universidade do Porto, Porto, Portugal
| | - G Scandariato
- INAF - Osservatorio Astrofisico di Catania, Catania, Italy
| | - N Schanche
- Center for Space and Habitability, University of Bern, Bern, Switzerland
- Department of Astronomy, University of Maryland, College Park, MD, USA
| | - J E Schlieder
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - S Seager
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - D Ségransan
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - A Shporer
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - A E Simon
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
| | - A M S Smith
- Institute of Planetary Research, German Aerospace Center (DLR), Berlin, Germany
| | - S G Sousa
- Instituto de Astrofisica e Ciencias do Espaco, Universidade do Porto, Porto, Portugal
| | - M Stalport
- Space sciences, Technologies and Astrophysics Research (STAR) Institute, Université de Liège, Liège, Belgium
| | - Gy M Szabó
- Gothard Astrophysical Observatory, ELTE Eötvös Loránd University, Szombathely, Hungary
- HUN-REN-ELTE Exoplanet Research Group, Szombathely, Hungary
| | - N Thomas
- Space Research and Planetary Sciences, Physics Institute, University of Bern, Bern, Switzerland
| | - A Tuson
- Cavendish Laboratory, University of Cambridge, Cambridge, UK
| | - S Udry
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - A M Vanderburg
- Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, USA
- Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - V Van Eylen
- Mullard Space Science Laboratory, University College London, Dorking, UK
| | - V Van Grootel
- Space sciences, Technologies and Astrophysics Research (STAR) Institute, Université de Liège, Liège, Belgium
| | - J Venturini
- Observatoire Astronomique de l'Université de Genève, Versoix, Switzerland
| | - I Walter
- Institute of Optical Sensor Systems, German Aerospace Center (DLR), Berlin, Germany
| | - N A Walton
- Institute of Astronomy, University of Cambridge, Cambridge, UK
| | - N Watanabe
- Department of Multi-Disciplinary Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - J N Winn
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ, USA
| | - T Zingales
- Dipartimento di Fisica e Astronomia "Galileo Galilei", Universita degli Studi di Padova, Padova, Italy
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Kopycka-Kedzierawski D, Billings R, Feng C, Ragusa P, Flint K, Watson G, Wong C, Manning S, Gill S, O’Connor T. A Prospective Longitudinal Study of Early Childhood Caries Onset in Initially Caries-Free Children. JDR Clin Trans Res 2023; 8:394-401. [PMID: 35678084 PMCID: PMC10504875 DOI: 10.1177/23800844221101800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Early childhood caries (ECC) is a complex oral disease that is prevalent in US children. OBJECTIVES The purpose of this 2-y prospective cohort study was to examine baseline and time-dependent risk factors for ECC onset in initially caries-free preschool children. METHODS A cohort of 189 initially caries-free children aged 1 to 3 y was recruited. At each 6-mo study visit, children were examined using the ICDAS index; salivary samples were collected to assess mutans streptococci (MS), lactobacilli, Candida species, salivary cortisol (prior and after a stressor), and salivary IgA. Diet and oral health behavior were assessed from parent report. Child and family stress exposure was assessed from measures of psychological symptoms, stressful life event exposure, family organization and violence exposure, and social support. Sociodemographic factors were also considered. A Kaplan-Meier estimator of survival function of time to ECC and a Cox proportional hazards model were used to identify predictors of ECC onset. RESULTS Onset of ECC was associated with high salivary MS levels at baseline (log-rank test, P < 0.0001). Cox proportional hazards regression showed that the risk of dental caries significantly increased with salivary MS in log scale over the 6-mo period (hazard ratio, 1.08; P = 0.01). Other risk factors in the model did not reach statistical significance. CONCLUSION Our results provide prospective evidence that an increase in salivary MS predicts ECC onset in young, initially caries-free children, confirming that a high salivary MS count likely plays a causal role in ECC onset, independent of covariates. KNOWLEDGE TRANSFER STATEMENT These results suggest that we must focus on reducing salivary MS counts in young children and preventing or delaying MS colonization in infants and young children determined to be at risk for ECC.
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Affiliation(s)
- D.T. Kopycka-Kedzierawski
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - R.J. Billings
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - C. Feng
- Departments of Biostatistics and Computational Biology and Anesthesiology and Perioperative Medicine, University of Rochester, Rochester, NY, USA
| | - P.G. Ragusa
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - K. Flint
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - G.E. Watson
- Departments of Dentistry, Pharmacology and Physiology, and Environmental Medicine, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - C.L. Wong
- Department of Pediatric Dentistry and Pediatrics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - S. Manning
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA
| | - S.R. Gill
- Department of Microbiology and Immunology, University of Rochester, Rochester, NY, USA
| | - T.G. O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
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Gilbert Klaczko C, Alkhars N, Zeng Y, Klaczko M, Gill A, Kopycka-Kedzierawski D, Jusko T, Sohn M, Xiao J, Gill S. The Oral Microbiome and Cross-Kingdom Interactions during Pregnancy. J Dent Res 2023; 102:1122-1130. [PMID: 37431832 PMCID: PMC10552463 DOI: 10.1177/00220345231176459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023] Open
Abstract
Pregnancy initiates a temporary transition in the maternal physiological state, with a shift in the oral microbiome and a potential increase in frequency of oral diseases. The risk of oral disease is higher among populations of Hispanic and Black women and those with lower socioeconomic status (low SES), demonstrating a need for intervention within these high-risk populations. To further our understanding of the oral microbiome of high-risk pregnant women, we characterized the oral microbiome in 28 nonpregnant and 179 pregnant low-SES women during their third trimester living in Rochester, New York. Unstimulated saliva and supragingival plaque samples were collected cross-sectionally, followed by assessment of the bacterial (16S ribosomal RNA) and fungal (18S ITS) microbiota communities. Trained and calibrated dentists performed oral examinations to determine the number of decayed teeth and plaque index. Initially, plaque from 28 nonpregnant women and 48 pregnant women were compared; these data showed significant differences in bacterial abundances based on pregnancy status. To further our understanding of the oral microbiome within the pregnant population, we next examined the oral microbiome within this population based on several variables. Streptococcus mutans, Streptococcus oralis, and Lactobacillus were associated with a greater number of decayed teeth. The composition of fungal communities differed between plaque and saliva, demonstrating 2 distinct "mycotypes" that were represented by a greater abundance of Candida in plaque and Malassezia in saliva. Veillonella rogosae, a common oral bacterium, was negatively associated with both plaque index and salivary Candida albicans colonization by culture data. This was further emphasized by in vitro inhibition of C. albicans by V. rogosae. Identification of interactions between the bacterial or fungal oral communities revealed that V. rogosae was positively associated with the oral commensal Streptococcus australis and negatively with the cariogenic Lactobacillus genus, suggesting V. rogosae as a potential biomarker of a noncariogenic oral microbiome.
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Affiliation(s)
- C. Gilbert Klaczko
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
- Translational Biomedical Science Program, Clinical and Translational Science Institute, University of Rochester School of Medicine & Dentistry, USA
| | - N. Alkhars
- Translational Biomedical Science Program, Clinical and Translational Science Institute, University of Rochester School of Medicine & Dentistry, USA
- Department of General Dental Practice, Faculty of Dentistry, Kuwait University, Kuwait
| | - Y. Zeng
- Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - M.E. Klaczko
- Chemistry Department, University of Rochester, Rochester, NY, USA
| | - A.L. Gill
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - D.T. Kopycka-Kedzierawski
- Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - T.A. Jusko
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - M.B. Sohn
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - J. Xiao
- Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - S.R. Gill
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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Ducreux M, Abou-Alfa GK, Bekaii-Saab T, Berlin J, Cervantes A, de Baere T, Eng C, Galle P, Gill S, Gruenberger T, Haustermans K, Lamarca A, Laurent-Puig P, Llovet JM, Lordick F, Macarulla T, Mukherji D, Muro K, Obermannova R, O'Connor JM, O'Reilly EM, Osterlund P, Philip P, Prager G, Ruiz-Garcia E, Sangro B, Seufferlein T, Tabernero J, Verslype C, Wasan H, Van Cutsem E. The management of hepatocellular carcinoma. Current expert opinion and recommendations derived from the 24th ESMO/World Congress on Gastrointestinal Cancer, Barcelona, 2022. ESMO Open 2023; 8:101567. [PMID: 37263081 PMCID: PMC10245111 DOI: 10.1016/j.esmoop.2023.101567] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 03/12/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 06/03/2023] Open
Abstract
This article summarises expert discussion on the management of patients with hepatocellular carcinoma (HCC), which took place during the 24th World Gastrointestinal Cancer Congress (WGICC) in Barcelona, July 2022. A multidisciplinary approach is mandatory to ensure an optimal diagnosis and staging of HCC, planning of curative and therapeutic options, including surgical, embolisation, ablative strategies, or systemic therapy. Furthermore, in many patients with HCC, underlying liver cirrhosis represents a challenge and influences the therapeutic options.
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Affiliation(s)
- M Ducreux
- Université Paris-Saclay, Gustave Roussy, Villejuif, France.
| | - G K Abou-Alfa
- Memorial Sloan Kettering Cancer Center, New York; Weill Cornell College of Medicine, New York, USA; Trinity College Dublin, Dublin, Ireland
| | | | - J Berlin
- Vanderbilt-Ingram Cancer Center, Nashville, USA
| | - A Cervantes
- INCLIVA, Biomedical Research Institute, Hospital Clínico Universitario, University of Valencia, Valencia, Spain
| | - T de Baere
- Université Paris-Saclay, Gustave Roussy, Villejuif, France
| | - C Eng
- Vanderbilt-Ingram Cancer Center, Nashville, USA
| | - P Galle
- University Medical Center Mainz, Mainz, Germany
| | - S Gill
- BC Cancer/University of British Columbia, Vancouver, Canada
| | - T Gruenberger
- Clinic Favoriten, HPB Center Health Network Vienna and Sigmund Freud University, Medical School, Vienna, Austria
| | - K Haustermans
- University Hospitals Gasthuisbergs, Leuven; Katholieke Universiteit Leuven, Leuven, Belgium
| | - A Lamarca
- Department of Oncology, OncoHealth Institute, Fundación Jiménez Díaz University Hospital, Madrid, Spain; Department of Medical Oncology, The Christie NHS Foundation, Manchester; Division of Cancer Sciences, University of Manchester, Manchester, UK
| | - P Laurent-Puig
- Institut du cancer Paris CARPEM, APHP, Georges Pompidou Hospital, Université Paris Cité, Paris, France
| | - J M Llovet
- Icahn School of Medicine at Mount Sinai, Mount Sinai Liver Cancer Program, New York, USA; Institut d'Investigacions Biomèdiques August Pi i Sunyer Hospital Clínic, Universitat de Barcelona, Barcelona; Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - F Lordick
- University of Leipzig Medical Center, Comprehensive Cancer Center Central Germany, Leipzig, Germany
| | - T Macarulla
- Vall d'Hebron Hospital Campus, Barcelona, Spain; Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - D Mukherji
- American University of Beirut, Beirut, Lebanon
| | - K Muro
- Aichi Cancer Center Hospital, Nagoya, Japan
| | - R Obermannova
- Masaryk Memorial Cancer Institute, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - J-M O'Connor
- Instituto Alexander Fleming, Buenos Aires, Argentina
| | - E M O'Reilly
- Memorial Sloan Kettering Cancer Center, New York; Weill Cornell College of Medicine, New York, USA
| | - P Osterlund
- Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden; Tampere University Hospital, University of Tampere, Tampere, Finland
| | - P Philip
- Henry Ford Cancer Institute, Departments of Oncology and Pharmacology, Wayne State University, Detroit, USA
| | - G Prager
- Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | | | - B Sangro
- Clinica Universidad de Navarra and CIBEREHD, Pamplona, Spain
| | | | - J Tabernero
- Vall d'Hebron Hospital Campus and Institute of Oncology, IOB-Quiron, UVic-UCC, Barcelona, Spain
| | - C Verslype
- University Hospitals Gasthuisbergs, Leuven; Katholieke Universiteit Leuven, Leuven, Belgium
| | - H Wasan
- Hammersmith Hospital, Imperial College London, London, UK
| | - E Van Cutsem
- University Hospitals Gasthuisbergs, Leuven; Katholieke Universiteit Leuven, Leuven, Belgium
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Verdugo Meza A, Gill S, Godovannyi A, Barnett J, Haskey N, Gibson D. A49 TWO NOVEL LIVE BIOTHERAPEUTIC PRODUCTS PROTECT DSS-EXPOSED MICE FROM ACUTE COLITIS WHEN COMPARED TO 5-ASA. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991334 DOI: 10.1093/jcag/gwac036.049] [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 Live biotherapeutic products (LBPs) offer a more rationalized and multitargeted approach to treating gastrointestinal diseases. BioColoniz and BioPersist are two LBPs derived from the parental strains L. reuteri and E. coli Nissle 1917 (EcN), respectively. The parental strains are known to offer some benefit in preventing relapses in IBD patients however the results are heterogeneous. To overcome this, the parental strains were approached as LBPs by introducing traits to thrive under the inflammatory conditions of the colon. Therefore, our aim is to characterize the role of these LBPs in IBD. Purpose To evaluate the therapeutic effect of the LBPs BioColoniz and BioPersist in an acute model of colitis. Method Female C57Bl/6 mice were treated with BioColoniz or BioPersist via oral gavage for three consecutive days prior to DSS challenge. Then mice were exposed to 3.5% DSS via drinking water for seven days. As controls, we also included mice treated with vehicle or the parental strains L. reuteri or EcN. In order to compare the effect of LBPs in the onset of acute colitis to current maintenance therapies for UC, we also exposed another group of mice to DSS and simultaneously administer 5-ASA. Mice were monitored daily for signs of disease and at the end of the experiment, colon tissue was collected for histopathological and molecular analysis. Result(s) The administration of BioColoniz and BioPersist delayed and decreased the colitic phenotype of mice exposed to DSS. Differences in signs of disease, such as diarrhea and weight loss, were evident by day 4 for vehicle or 5-ASA groups, whereas mice in the LBPs groups were still gaining weight. When analyzing the histopathological changes, mice in the LBPs groups presented lower scores when compared to the vehicle and 5-ASA groups. Specifically, mice treated early with BioColoniz or BioPersist presented a more preserved mucosal architecture with visible crypts. Although 5-ASA-treated mice still had vestiges of crypts, the damage in the mucosal architecture was more severe, similar to the observed in mice treated with the parental strains EcN and L. reuteri. We also looked at the expression of proinflammatory cytokines, finding an increase in TNFα, IFNγ, and IL-17a in mice treated with 5-ASA but not in mice treated with LBPs. However, the expression of protective factors such as mucin Muc2 or the antimicrobial peptide Reg3γ was similarly high in 5-ASA and LBP-treated mice when compared to vehicle or parental strains groups, suggesting some therapeutic commonalities between 5-ASA and our LBPs. Conclusion(s) The early administration of the LBPs BioColoniz and BioPersist protect mice from severe acute colitis, being more protective than 5-ASA. Since some differences and similarities were observed between the LBPs- and 5-ASA-treated mice, such as crypt preservation versus increased expression of some protective factors, the next step will aim to identify which mechanisms are specifically triggered by the LBPs. Disclosure of Interest None Declared
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Affiliation(s)
- A Verdugo Meza
- Biology, University of British Columbia, Kelowna, Canada
| | - S Gill
- Biology, University of British Columbia, Kelowna, Canada
| | - A Godovannyi
- Biology, University of British Columbia, Kelowna, Canada
| | - J Barnett
- Biology, University of British Columbia, Kelowna, Canada
| | - N Haskey
- Biology, University of British Columbia, Kelowna, Canada
| | - D Gibson
- Biology, University of British Columbia, Kelowna, Canada
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9
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Hjulmand J, Pries-Heje M, Try Lenz I, Carter-Storch R, Gill S, Bruun NE, Povlsen JA, Christiansen U, Helweg-Larsen J, Fosboel E, Toender N, Moser C, Iversen K, Ihlemann N, Bundgaard H. Long-term impact of persistent vegetations at 6 month followup after treatment of infective endocarditis: a substudy of the Partial Oral vs Intravenous Antibiotic Treatment of Endocarditis (POET) tria. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1670] [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
Our knowledge of changes in vegetation size throughout the course of infective endocarditis (IE) and the impact of persistent vegetations on mortality or embolization after completed antibiotic treatment is sparse. No study has previously investigated the prevalence or clinical impact of persistent vegetations on transthoracic echocardiography (TTE) at 6-months follow-up after ended IE treatment.
Purpose
To investigate the association between persistent vegetations at the 6-months TTE after treatment for IE and long-term prognosis as assessed in the POET trial.
Methods
The POET trial was a nationwide, multicenter RCT, randomizing 400 patients to either partial oral or intravenous (IV) antibiotic treatment of left-sided IE, after initial stabilization of infection using conventional IV therapy.
A persistent vegetation was defined as a vegetation seen on 6-months follow-up TTE (4–7 months) after ended antibiotic treatment for IE. In the POET trial, primary outcome was defined as 1) all-cause mortality, 2) unplanned cardiac surgery, 3) embolic events or 4) relapse of bacteremia, in the 5-year follow-up period. Patients without TTE due to death or lack of available TTE were excluded.
Results
Out of 400 patients, 20 were excluded due to death during 6-months follow-up, and 201 were excluded due to unavailable TTE, leaving 179 TTEs for analysis.
At 6-months follow-up, a persistent vegetation was seen in 30 patients (16.7%, 21 males (70%), mean age 69.6 years (SD 7.7)) (Table 1). Seventeen patients (56.7%) had a persistent vegetation on the aortic valve and 13 patients (43.3%) on the mitral valve. More patients without a persistent vegetation had undergone initial surgical treatment of IE than those with a vegetation (57.7 vs 23.3%, p=0.001). In all surgically treated patients with persistent vegetation at 6-months follow-up, the vegetation was found on another valve than the operated valve.
The composite primary outcome from 6-months follow-up and until 5-year follow-up occurred in 8 patients (26.7%) with a persistent vegetation, compared to 38 patients (25.5%) (p=1.00) without. (Table 2) In patients randomized for peroral treatment, no significant difference in prevalence of persistent vegetation was found (15 patients (50%) with persistent vegetations vs. 74 patients (49.7%) without, p=1.00).
Conclusion
The occurrence of persistent vegetations at 6 months follow-up was 16.7%. There was no association between persistent vegetations at 6-months follow-up and the occurrence of the primary outcome after 5 years follow-up, suggesting that the risk associated with residual vegetations after end of antibiotic treatment is negligible after 6-months.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation
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Affiliation(s)
- J Hjulmand
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - M Pries-Heje
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - I Try Lenz
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | | | - S Gill
- Odense University Hospital , Odense , Denmark
| | - N E Bruun
- Roskilde University Hospital , Roskilde , Denmark
| | - J A Povlsen
- Aarhus University Hospital , Aarhus , Denmark
| | | | - J Helweg-Larsen
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - E Fosboel
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | - N Toender
- Nordsjaellands Hospital , Hilleroed , Denmark
| | - C Moser
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
| | | | - N Ihlemann
- Odense University Hospital , Odense , Denmark
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital , Copenhagen , Denmark
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10
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Dixon JF, Akins R, Miller E, Breslau J, Gill S, Bisi E, Schweitzer JB. Changing Parental Knowledge and Treatment Acceptance for ADHD: A Pilot Study. Clin Pediatr (Phila) 2022; 62:301-308. [PMID: 36171719 PMCID: PMC10108330 DOI: 10.1177/00099228221124676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This pilot study assessed the feasibility and potential effectiveness of a single-session workshop in modifying parental beliefs/knowledge about attention-deficit/hyperactivity disorder (ADHD) in children and impact on treatment acceptance/utilization. Concerns raised by school professionals about lack of treatment follow-through after ADHD diagnosis and parental misinformation about medication usage catalyzed this project. A single-group pre-post quasi-experimental design was used. Sixty-eight parents completed ADHD knowledge/belief scales and stress inventories, and pre-ADHD and post-ADHD information workshop. Follow-up calls were made after the workshop to assess treatment utilization. Parents/caregivers experienced significant knowledge and belief changes regarding medication efficacy, willingness to accept physician treatment recommendations, and rejection of non-empirically based treatments. Follow-up data showed that 41% of contacted participants met with physicians to discuss medication utilization and behavioral treatments. Brief, one-session psycho-educational workshops were feasible and impacted parental beliefs and behaviors regarding scientifically supported interventions for ADHD.
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Affiliation(s)
- J F Dixon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA.,UC Davis MIND Institute, School of Medicine, University of California, Davis, Sacramento, CA, USA
| | - R Akins
- UC Davis MIND Institute, School of Medicine, University of California, Davis, Sacramento, CA, USA.,Department of Pediatrics, University of California, Davis, Sacramento, CA, USA
| | - E Miller
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA
| | - J Breslau
- Rand Corporation, Pittsburgh, PA, USA
| | - S Gill
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA.,Palo Alto University, Palo Alto, CA, USA
| | - E Bisi
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA.,UC Davis MIND Institute, School of Medicine, University of California, Davis, Sacramento, CA, USA
| | - J B Schweitzer
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA.,UC Davis MIND Institute, School of Medicine, University of California, Davis, Sacramento, CA, USA
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11
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Jones L, Colwell B, Hao D, Welch S, Campbell A, Gill S. 505P The impact of COVID-19 on the wellness and resilience of the Canadian medical oncology workforce: A Canadian Association of Medical Oncologists survey. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.633] [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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12
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Beck L, Boguniewicz M, Hata T, Fuxench Z, Simpson E, De Benedetto A, Ko J, Ong P, Yoshida T, Gallo R, Lussier S, David G, Schlievert P, Gill S, Rudman Spergel A, Leung D. 519 Rapid reduction in S. aureus & cytotoxins in dupilumab treated atopic dermatitis subjects. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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13
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Balagopal G, Davidson S, Gill S, Barengo N, De La Rosa M, Sanchez M. The impact of cultural stress and gender norms on alcohol use severity among Latino immigrant men. Ethn Health 2022; 27:1271-1289. [PMID: 33586536 PMCID: PMC8363673 DOI: 10.1080/13557858.2021.1880550] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
Alcohol misuse affects 15 million people in the United States. Compared to White men, Latino men have disproportionately higher rates of both alcohol misuse and negative alcohol-related consequences (e.g. drunk driving, liver disease, alcohol dependence, HIV/AIDS). This cross sectional study examined how cultural stressors [immigration stress and negative context of reception (NCR)] coupled with traditional Latino male gender norms (machismo and caballerismo) influences alcohol use severity (AUS) among adult Latino immigrant men. Data for the present study was collected between 2017 and 2018 from 279 Cuban, Central American, and South American adult Latino men who immigrated to the US approximately 10 years prior. Results from hierarchical multiple regression analysis revealed higher levels of perceived NCR (β = 0.15, p = .01), and machismo (β = 0.16, p = .02) were associated with greater AUS. Significant interaction effects were found between both cultural stressors and machismo [immigration stress x machismo (β = 0.22, p < .001); NCR x machismo (β = 0.22, p < .001)] whereby higher levels of machismo strengthened the association between cultural stress and AUS. Findings from the present study can inform culturally appropriate interventions aimed at mitigating alcohol use among Latino immigrant men.
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Affiliation(s)
- G Balagopal
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - S Davidson
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - S Gill
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - N Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
- Faculty of Medicine, Riga Stradins University, Riga, Latvia
- Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - M De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, USA
| | - M Sanchez
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, USA
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14
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Ward J, Gill S, Armstrong K, Fogarty T, Tan D, Scott A, Yahya A, Dhaliwal S, Jacques A, Tang C. PO-1384 Simethicone use to Reduce Rectal Variability During Prostate Cancer Radiotherapy, a Randomised Trial. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03348-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Shahid AB, Tahir H, Faiz M, Younus A, Larayb H, Aslam S, Gill S. ABO and Rh blood group phenotype frequency in healthy blood donors. Asian J Transfus Sci 2022. [DOI: 10.4103/ajts.ajts_141_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Gill S, Neary E. Anxiety and depression in irritable bowel syndrome (IBS). Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.337] [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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17
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Lee K, Su V, Quon B, Kalyan S, Gill S, Desai S. 213: Impact of nitrogen-bisphosphonate on vitamin E and D status in adult cystic fibrosis (CF) patients. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01638-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Moriarty TF, Muthukrishnan G, Daiss JL, Xie C, Nishitani K, Morita Y, Awad H, de Mesy Bentley KL, Masters E, Bui T, Yan M, Owen J, Mooney B, Gill S, Puetzler J, Wenke JC, Morgenstern M, Metsemakers WJ, Noll C, Joeris A, Richards RG, Schwarz EM, Kates SL. Bone infection: a clinical priority for clinicians, scientists and educators. Eur Cell Mater 2021; 42:312-333. [PMID: 34661245 DOI: 10.22203/ecm.v042a21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Bone infection has received increasing attention in recent years as one of the main outstanding clinical problems in orthopaedic-trauma surgery that has not been successfully addressed. In fact, infection may develop across a spectrum of patient types regardless of the level of perioperative management, including antibiotic prophylaxis. Some of the main unknown factors that may be involved, and the main targets for future intervention, include more accurate and less invasive diagnostic options, more thorough and accurate debridement protocols, and more potent and targeted antimicrobials. The underlying biology dominates the clinical management of bone infections, with features such as biofilm formation, osteolysis and vascularisation being particularly influential. Based on the persistence of this problem, an improved understanding of the basic biology is deemed necessary to enable innovation in the field. Furthermore, from the clinical side, better evidence, documentation and outreach will be required to translate these innovations to the patient. This review presents the findings and progress of the AO Trauma Clinical Priority Program on the topic of bone infection.
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Affiliation(s)
- T F Moriarty
- AO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos Platz,
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19
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Chandrashekar P, Rashdan L, Dale Z, Warner S, Gill S, Fischer K, Kim M, Nazer B, Masri A. Phenotypic presentation trends of transthyretin amyloid cardiomyopathy: are we getting better? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1813] [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
Transthyretin amyloid cardiomyopathy (ATTR-CM) is being increasingly recognized due to recent advances in non-invasive imaging notably bone scintigraphy and newer effective therapies - particularly tafamidis, which was shown to improve survival and decrease heart failure hospitalizations in the ATTR-ACT trial. Earlier tafamidis use appeared to be more beneficial, as reflected by NYHA class I and II patients being associated with lower mortality and hospitalizations compared to NYHA class III. Increased awareness will likely lead to an increasing number of ATTR-CM patients being diagnosed with concerns regarding applicability of ATTR-ACT criteria on these patients.
Purpose
To investigate ATTR-CM phenotypic presentation trends based on initial clinical, biomarkers and transthoracic echocardiographic (TTE) data.
Methods
From 2005–2020, 116 ATTR-CM patients were seen at our amyloidosis center, who were stratified into 3 time periods based on the date of diagnosis: Early (21 patients, pre-2016), Mid (46 patients, 2016–2018), and Recent (49 patients, 2018–2020). ATTR-CM diagnosis was established based on the standard criteria of confirmed ATTR variant + typical TTE features; histological confirmation endomyocardial biopsy; or typical diffuse cardiac tracer uptake on bone scintigraphy while ruling out light chain amyloidosis. With less typical imaging, cardiac MRI typically served as a confirmatory test prior to pursuing histological confirmation. Demographics, cardiac biomarkers, diagnostic method used, and TTE variables that raise the suspicion of ATTR-CM were compared across time periods using one-way ANOVA test and Fischer's exact test.
Results
There was a significant change in the predominant method of diagnosis with the majority of patients in the Early time period diagnosed by endomyocardial biopsy, whereas in the Recent time period the majority of patients were diagnosed via pyrophosphate scintigraphy (Figure). Despite increasing number of patients being diagnosed, the clinical phenotype at diagnosis did not change significantly with similar proportion of patients NYHA class I/II, median daily diuretic dose, biomarkers, having at least one heart failure hospitalization prior to diagnosis, and similar TTE phenotype (Table). Only the age at diagnosis significantly increased across time periods. Women represented the minority of patients across all time periods.
Conclusion
Despite the increased awareness of ATTR-CM, there have been no major changes in the clinical, cardiac biomarker, or TTE phenotype on presentation in patients referred to our center for suspicion or a diagnosis of ATTR-CM. Our findings challenge the assumption that patients with ATTR-CM are being identified earlier with milder phenotypes. Women with ATTR-CM likely remain largely undiagnosed in our community. Continued education and knowledge dissemination are essential to identify ATTR-CM patients earlier to achieve better outcomes in this population.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Pranav Chandrashekar is supported by an educational grant from Pfizer, Inc paid to Oregon Health and Science University. Table 1
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Affiliation(s)
- P Chandrashekar
- Oregon Health and Science University, Knight Cardiovascular Institute, Portland, United States of America
| | - L Rashdan
- Oregon Health and Science University, Knight Cardiovascular Institute, Portland, United States of America
| | - Z Dale
- Oregon Health and Science University, Knight Cardiovascular Institute, Portland, United States of America
| | - S Warner
- Oregon Health and Science University, Knight Cardiovascular Institute, Portland, United States of America
| | - S Gill
- Oregon Health and Science University, Knight Cardiovascular Institute, Portland, United States of America
| | - K Fischer
- Oregon Health and Science University, Knight Cardiovascular Institute, Portland, United States of America
| | - M Kim
- Oregon Health and Science University, Knight Cardiovascular Institute, Portland, United States of America
| | - B Nazer
- Oregon Health and Science University, Knight Cardiovascular Institute, Portland, United States of America
| | - A Masri
- Oregon Health and Science University, Knight Cardiovascular Institute, Portland, United States of America
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Banerjee S, Leary A, Lheureux S, Stewart J, Attygalle A, Vroobel K, Gill S, Ali Z, Tai J, Toms C, Natrajan R, Lord C, Porta N, Bliss J. 815TiP ENGOT/GYN1/NCRI: ATR inhibitor in combination with olaparib in gynaecological cancers with ARID1A loss or no loss (ATARI). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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21
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Siva S, Bressel M, Mai T, Le H, Vinod S, de Silva H, Macdonald S, Skala M, Hardcastle N, Rezo A, Pryor D, Gill S, Higgs B, Wagenfuehr K, Montgomery R, Awad R, Chesson B, Eade T, Wong W, Sasso G, De Abreu Lourenco R, Kron T, Ball D, Neeson P. OC-0335 Final results of TROG 13.01 SAFRON II: Single vs multi-fraction SABR for pulmonary oligometastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06868-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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22
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Fung AS, Graham DM, Chen EX, Stockley TL, Zhang T, Le LW, Albaba H, Pisters KM, Bradbury PA, Trinkaus M, Chan M, Arif S, Zurawska U, Rothenstein J, Zawisza D, Effendi S, Gill S, Sawczak M, Law JH, Leighl NB. A phase I study of binimetinib (MEK 162), a MEK inhibitor, plus carboplatin and pemetrexed chemotherapy in non-squamous non-small cell lung cancer. Lung Cancer 2021; 157:21-29. [PMID: 34052705 DOI: 10.1016/j.lungcan.2021.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION MEK inhibition is a potential therapeutic strategy in non-small cell lung cancer (NSCLC). This phase I study evaluates the MEK inhibitor binimetinib plus carboplatin and pemetrexed in stage IV non-squamous NSCLC patients (NCT02185690). METHODS A standard 3 + 3 dose-escalation design was used. Binimetinib 30 mg BID (dose level 1 [DL1]) or 45 mg BID (dose level 2 [DL2]) was given with standard doses of carboplatin and pemetrexed using an intermittent dosing schedule. The primary outcome was determination of the recommended phase II dose (RP2D) and safety of binimetinib. Secondary outcomes included efficacy, pharmacokinetics, and an exploratory analysis of response based on mutation subtype. RESULTS Thirteen patients (6 DL1, 7 DL2) were enrolled: 7 KRAS, 5 EGFR, and 1 NRAS mutation. The RP2D was binimetinib 30 mg BID. Eight patients (61.5%) had grade 3/4 adverse events, with dose limiting toxicities in 2 patients at DL2. Twelve patients were evaluated for response, with an investigator-assessed objective response rate (ORR) of 50% (95% CI 21.1%-78.9%; ORR 33.3% by independent-review, IR), and disease control rate 83.3% (95% CI 51.6%-97.9%). Median progression free survival (PFS) was 4.5 months (95% CI 2.6 months-NA), with a 6-month and 12-month PFS rate of 38.5% (95% CI 19.3%-76.5%) and 25.6% (95% CI 8.9%-73.6%), respectively. In an exploratory analysis, KRAS/NRAS-mutated patients had an ORR of 62.5% (ORR 37.5% by IR) vs. 25% in KRAS/NRAS wild-type patients. In MAP2K1-mutated patients, the ORR was 42.8%. CONCLUSION The addition of binimetinib to carboplatin and pemetrexed appears to have manageable toxicity with evidence of activity in advanced non-squamous NSCLC.
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Affiliation(s)
- A S Fung
- Department of Oncology, Queen's University, Canada; Princess Margaret Cancer Centre, University Health Network, Canada
| | - D M Graham
- Princess Margaret Cancer Centre, University Health Network, Canada; Division of Medical Oncology, University of Toronto, Canada; The Christie NHSFoundation Trust, Manchester, UK
| | - E X Chen
- Princess Margaret Cancer Centre, University Health Network, Canada; Division of Medical Oncology, University of Toronto, Canada
| | - T L Stockley
- Division of Clinical Laboratory Genetics, University Health Network, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Canada; Advanced Molecular Diagnostics Laboratory, University Health Network, Canada
| | - T Zhang
- Division of Clinical Laboratory Genetics, University Health Network, Canada; Advanced Molecular Diagnostics Laboratory, University Health Network, Canada
| | - L W Le
- Princess Margaret Cancer Centre, University Health Network, Canada
| | - H Albaba
- Princess Margaret Cancer Centre, University Health Network, Canada
| | - K M Pisters
- Princess Margaret Cancer Centre, University Health Network, Canada; MD Anderson Cancer Centre, Houston, TX, United States
| | - P A Bradbury
- Princess Margaret Cancer Centre, University Health Network, Canada; Division of Medical Oncology, University of Toronto, Canada
| | - M Trinkaus
- Division of Medical Oncology, University of Toronto, Canada; Markham Stouffville Hospital, Markham, Canada
| | - M Chan
- Division of Medical Oncology, University of Toronto, Canada; Trillium Health Partners, Mississauga, Canada
| | - S Arif
- Division of Medical Oncology, University of Toronto, Canada; Trillium Health Partners, Mississauga, Canada
| | - U Zurawska
- Division of Medical Oncology, University of Toronto, Canada; St. Joseph's Health Centre, Toronto, Canada
| | - J Rothenstein
- Division of Medical Oncology, University of Toronto, Canada; RS McLaughlin Durham Cancer Centre, Oshawa, Canada
| | - D Zawisza
- Princess Margaret Cancer Centre, University Health Network, Canada
| | - S Effendi
- Princess Margaret Cancer Centre, University Health Network, Canada
| | - S Gill
- Princess Margaret Cancer Centre, University Health Network, Canada
| | - M Sawczak
- Princess Margaret Cancer Centre, University Health Network, Canada
| | - J H Law
- Princess Margaret Cancer Centre, University Health Network, Canada
| | - N B Leighl
- Princess Margaret Cancer Centre, University Health Network, Canada; Division of Medical Oncology, University of Toronto, Canada.
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Forman J, Yoshida T, Lillis J, Gill A, Corbett A, Cahill M, Lockhart A, Simpson E, Boguniewicz M, Hanifin J, De Benedetto A, David G, Leung D, Schlievert P, Gill S, Beck L. 189 Microbial expression of lantibiotics may explain discrepancies between S. aureus culturability and metagenomics in atopic dermatitis subjects and healthy controls. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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24
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Beck L, Boguniewicz M, Hatta T, Chiesa Fuxench Z, Simpson E, De Benedetto A, Ko J, Ong P, Yoshida T, Gallo R, Schlievert P, Gill S, Mosmann T, Berdyshev E, David G, Lussier S, Rudman Spergel A, Leung D. 666 Effect of dupilumab on the host-microbe interface in atopic dermatitis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Tesileanu CMS, van den Bent MJ, Sanson M, Wick W, Brandes AA, Clement PM, Erridge SC, Vogelbaum MA, Nowak AK, Baurain JF, Mason WP, Wheeler H, Chinot OL, Gill S, Griffin M, Rogers L, Taal W, Rudà R, Weller M, McBain C, van Linde ME, Sabedot TS, Hoogstrate Y, von Deimling A, de Heer I, van IJcken WFJ, Brouwer RWW, Aldape K, Jenkins RB, Dubbink HJ, Kros JM, Wesseling P, Cheung KJ, Golfinopoulos V, Baumert BG, Gorlia T, Noushmehr H, French PJ. Prognostic significance of genome-wide DNA methylation profiles within the randomised, phase 3, EORTC CATNON trial on non-1p/19q deleted anaplastic glioma. Neuro Oncol 2021; 23:1547-1559. [PMID: 33914057 PMCID: PMC8408862 DOI: 10.1093/neuonc/noab088] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Survival in patients with IDH1/2-mutant (mt) anaplastic astrocytomas is highly variable. We have used the prospective phase 3 CATNON trial to identify molecular factors related to outcome in IDH1/2mt anaplastic astrocytoma patients. Methods The CATNON trial randomized 751 adult patients with newly diagnosed 1p/19q non-codeleted anaplastic glioma to 59.4 Gy radiotherapy +/− concurrent and/or adjuvant temozolomide. The presence of necrosis and/or microvascular proliferation was scored at central pathology review. Infinium MethylationEPIC BeadChip arrays were used for genome-wide DNA methylation analysis and the determination of copy number variations (CNV). Two DNA methylation-based tumor classifiers were used for risk stratification. Next-generation sequencing (NGS) was performed using 1 of the 2 glioma-tailored NGS panels. The primary endpoint was overall survival measured from the date of randomization. Results Full analysis (genome-wide DNA methylation and NGS) was successfully performed on 654 tumors. Of these, 432 tumors were IDH1/2mt anaplastic astrocytomas. Both epigenetic classifiers identified poor prognosis patients that partially overlapped. A predictive prognostic Cox proportional hazard model identified that independent prognostic factors for IDH1/2mt anaplastic astrocytoma patients included; age, mini-mental state examination score, treatment with concurrent and/or adjuvant temozolomide, the epigenetic classifiers, PDGFRA amplification, CDKN2A/B homozygous deletion, PI3K mutations, and total CNV load. Independent recursive partitioning analysis highlights the importance of these factors for patient prognostication. Conclusion Both clinical and molecular factors identify IDH1/2mt anaplastic astrocytoma patients with worse outcome. These results will further refine the current WHO criteria for glioma classification.
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Affiliation(s)
- C M S Tesileanu
- Neurology Department, Erasmus MC, Rotterdam, the Netherlands
| | | | - M Sanson
- Sorbonne Université, Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | - W Wick
- Neurology Department, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - A A Brandes
- Medical Oncology Department, AUSL-IRCCS Scienze Neurologiche, Bologna, Italy
| | - P M Clement
- Oncology Department, KU Leuven and Medical Oncology Department, UZ Leuven, Leuven, Belgium
| | - S C Erridge
- Neuro-Oncology Centre Edinburgh, Western General Hospital, Edinburgh, UK
| | - M A Vogelbaum
- Neuro-Oncology Department, Moffitt Cancer Center, Tampa, Florida, USA
| | - A K Nowak
- University of Western Australia, Perth, Australia; Co-Operative Group for Neuro-Oncology, University of Sydney, Sydney, Australia; Medical Oncology Department, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - J F Baurain
- Medical Oncology Department, King Albert II Cancer Institute, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - W P Mason
- Princess Margaret Cancer Centre, Toronto, Canada
| | - H Wheeler
- Northern Sydney Cancer Centre, Sydney, Australia
| | - O L Chinot
- Neuro-Oncology Department, Aix-Marseille University, Marseille, France
| | - S Gill
- Medical Oncology Department, Alfred Hospital, Melbourne, Australia
| | - M Griffin
- Clinical Oncology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - L Rogers
- Radiation Oncology Department, Gammawest Cancer Services, Salt Lake City, UT, USA
| | - W Taal
- Neurology Department, Erasmus MC, Rotterdam, the Netherlands
| | - R Rudà
- Neuro-Oncology Department, University of Turin, Turin, Italy
| | - M Weller
- Neurology Department, University Hospital of Zurich, Zurich, Switzerland
| | - C McBain
- Clinical Oncology Department, The Christie NHS FT, Manchester, UK
| | - M E van Linde
- Medical Oncology Department, Amsterdam UMC, Amsterdam, the Netherlands
| | - T S Sabedot
- Neurosurgery Department, Henry Ford Health System, Detroit, MI, USA
| | - Y Hoogstrate
- Neurology Department, Erasmus MC, Rotterdam, the Netherlands
| | - A von Deimling
- Neuropathology Department, Ruprecht-Karls-University and, CCU Neuropathology, German Cancer Institute and Consortium, DKFZ, and DKTK, Heidelberg, Germany
| | - I de Heer
- Neurology Department, Erasmus MC, Rotterdam, the Netherlands
| | | | - R W W Brouwer
- Biomics Center, Erasmus MC, Rotterdam, the Netherlands
| | - K Aldape
- Princess Margaret Cancer Centre, Toronto, Canada
| | - R B Jenkins
- Pathology Department, Mayo Clinic, Rochester, MN, USA
| | - H J Dubbink
- Pathology Department, Erasmus MC, Rotterdam, the Netherlands
| | - J M Kros
- Pathology Department, Erasmus MC, Rotterdam, the Netherlands
| | - P Wesseling
- Pathology Department, Amsterdam UMC, Amsterdam, the Netherlands; Princess Máxima Center, Utrecht, the Netherlands
| | | | | | - B G Baumert
- Radiation-Oncology Department, Maastricht UMC, Maastricht, the Netherlands; Radiation-Oncology Institute, Cantonal Hospital Graubünden, Chur, Switzerland
| | | | - H Noushmehr
- Neurosurgery Department, Henry Ford Health System, Detroit, MI, USA
| | - P J French
- Neurology Department, Erasmus MC, Rotterdam, the Netherlands
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Chawla A, Gill S, Sharma S, Kumar V, Logani A. Endodontic implications of a patient with arteriovenous malformation: a case report and literature review. Int Endod J 2021; 54:975-987. [PMID: 33410128 DOI: 10.1111/iej.13473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 11/29/2022]
Abstract
AIM To present the endodontic management of a patient diagnosed with a high-flow arteriovenous malformation (AVM) requiring root canal treatment and to discuss the relevant endodontic literature for this rare but significant problem. SUMMARY AVM is a complex communication of an artery and a vein in which the oxygenated blood is forced away from the intended tissue. The incidence of its occurrence in the face and neck is rare, and when present, the most common sign is gingival bleeding. Arteriovenous malformation is both a diagnostic and therapeutic challenge for dentists. Also, there is ambiguity regarding the precautions to be taken whilst doing endodontic procedures in such cases. Hence, there is a need to understand the disease process and its implications in order to prevent life-threatening complications during treatment. This case report highlights the successful endodontic management of a cariously exposed right maxillary second premolar in a patient diagnosed with high-flow AVM. On an orthopantomogram, the AVM was spreading in the left submandibular space involving the left ramus area. The clinical findings of limited mouth opening with inter-appointment swelling and trismus during treatment made the case unusual and challenging. This paper addresses the current understanding of the classification, diagnosis, clinical features and endodontic management, together with specific guidelines and recommendations whilst performing endodontic procedures in AVM cases. KEY LEARNING POINTS The classification and oral manifestations of AVM must be known and understood. Practitioners should be aware of the radiographic appearance of AVM. Recommended precautions should be taken when carrying out restorative and endodontic procedures in a patient with AVM. Antibiotic prophylaxis may be considered before endodontic treatment in a patient with AVM. Multidisciplinary treatment planning may be required.
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Affiliation(s)
- A Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - S Gill
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - S Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - V Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - A Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Siva S, Bressel M, Kron T, Mai T, Le H, Montgomery R, Hardcastle N, Rezo A, Gill S, Higgs B, Pryor D, De Abreu Lourenco R, Awad R, Chesson B, Eade T, Skala M, Sasso G, Wong W, Vinod S, Ball D. Stereotactic Ablative Fractionated Radiotherapy versus Radiosurgery for Oligometastatic Neoplasia to the Lung: A Randomized Phase II Trial. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Abstract
Hepatocellular carcinoma (hcc) is the 4th most common cause of cancer-related deaths worldwide1 [...]
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Affiliation(s)
- S Gill
- BC Cancer and University of British Columbia, Vancouver, BC
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Gill S, Sartini C, Uh H, Ghoreishi N, Cardoso V, Bunting K, Gkoutos G, Suzart-Woischnik K, Asselbergs F, Eijkemans M, Kotecha D. Accurate detection of atrial fibrillation using a smartphone remains uncertain: a systematic review and meta-analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3505] [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
Early diagnosis of atrial fibrillation (AF) is essential to reduce complications such as stroke, and improve patient quality of life. Novel screening techniques using smartphone camera photoplethysmography (PPG) can be used for AF detection, but their clinical applicability remains unclear.
Purpose
To assess the diagnostic accuracy of smartphone PPG compared to conventional ECG for AF detection.
Methods
We performed a systematic review of MEDLINE, EMBASE, Cochrane library, and other databases (1980-October 2019), including any study or abstract where smartphone finger-tip PPG was compared with a reference ECG (1, 3 or 12-lead). Outcomes were sensitivity (SE), specificity (SP), positive and negative predictive value (PPV; NPV) and overall accuracy. Bivariate hierarchical random effects meta-analysis was performed for studies with confidence intervals for SE and SP, and funnel plots were used to identify publication bias. Study quality was assessed using the established QUADAS-2 tool by two independent graders.
Results
1350 publications were screened, of which 17 studies were included in the systematic review (7 full text publications and 10 abstracts), providing 21 comparisons of accuracy for AF detection. Most studies were based in secondary care and small (range n=33 to 1095), with a total of 5469 participants including 1384 with AF. Only 4 studies were multicentre. Smartphone applications used were Cardiio Rhythm, Fibricheck, Preventicus and Heartbeats, with 7 studies not specifying the tool used. Overall SE and SP for AF detection were high, ranging from 76 to 100%, and 85 to 100% respectively. PPV ranged from 54 to 100% and NPV from 77 to 100%, with overall accuracy between 61 and 99%. The meta-analysis included 12 comparisons from 10 studies (n=2714; 936 with AF). The pooled SE was 93% (95% CI 90–96%) and SP 97% (95% CI 95–99%); Figure 1A. QUADAS-2 assessment demonstrated poor quality of studies overall, with a high or unclear risk of bias in at least one domain for all studies. There was clear evidence of publication bias; Figure 1B.
Conclusions
PPG offers the potential for large scale, non-invasive, patient-led screening of AF. However, current evidence is limited to biased, low quality studies often with unrealistic results for AF detection. These are insufficient to advise clinicians on the true value of current smartphone PPG technology.
Figure 1. Meta-analysis & publication bias
Funding Acknowledgement
Type of funding source: Public grant(s) – EU funding. Main funding source(s): BigData@Heart EU/EFPIA IMI 116074.
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Affiliation(s)
- S Gill
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | - C Sartini
- Bayer AG, Global epidemiology, Berlin, Germany
| | - H.W Uh
- University Medical Center Utrecht, Utrecht, Netherlands (The)
| | - N Ghoreishi
- Bayer AG, Global epidemiology, Berlin, Germany
| | - V Cardoso
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | - K.V Bunting
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | - G Gkoutos
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | | | - F.W Asselbergs
- University Medical Center Utrecht, Utrecht, Netherlands (The)
| | - M.J.C Eijkemans
- University Medical Center Utrecht, Utrecht, Netherlands (The)
| | - D Kotecha
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
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Bunting K, Gill S, Sitch A, Mehta S, O'Connor K, Hodson J, Lip G, Stanbury M, Kirchhof P, Griffith M, Townend J, Steeds R, Kotecha D. Time saving, simple and reproducible method to quantify left ventricular function in patients with atrial fibrillation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0543] [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
Echocardiography is essential for the management of patients with atrial fibrillation (AF), but current methods are time consuming and lack any evidence of reproducibility.
Purpose
To compare conventional averaging of consecutive beats with an index beat approach, where systolic and diastolic measurements are taken once after two prior beats with a similar RR interval (not more than 60 ms difference).
Methods
Transthoracic echocardiography was performed using a standardized and blinded protocol in patients enrolled into the RAte control Therapy Evaluation in permanent AF randomised controlled trial (RATE-AF; NCT02391337). AF was confirmed in all patients with a preceding 12-lead ECG. A minimum of 30-beat loops were recorded. Left ventricular function was determined using the recommended averaging of 5 and 10 beats and using the index beat method, with observers blinded to clinical details. Complete loops were used to calculate the within-beat coefficient of variation (CV) and intraclass correlation coefficient (ICC) for Simpson's biplane left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) and filling pressure (E/e').
Results
160 patients (median age 75 years (IQR 69–82); 46% female) were included, with median heart rate 100 beats/min (IQR 86–112). For LVEF, the index beat had the lowest CV of 32% compared to 51% for 5 consecutive beats and 53% for 10 consecutive beats (p<0.001). The index beat also had the lowest CV for GLS (26% versus 43% and 42%; p<0.001) and E/e' (25% versus 41% and 41%; p<0.001; see Figure for ICC comparison). Intra-operator reproducibility, assessed by the same operator from two different recordings in 50 patients, was superior for the index beat with GLS bias −0.5 and narrow limits of agreement (−3.6 to 2.6), compared to −1.0 for 10 consecutive beats (−4.0 to 2.0). For inter-operator variability, assessed in 18 random patients, the index beat also showed the smallest bias with narrow confidence intervals (CI). Using a single index beat did not impact on the validity of LVEF, GLS or E/e' measurement when correlated with natriuretic peptides. Index beat analysis substantially shortened analysis time; 35 seconds (95% CI 35 to 39 seconds) for measuring E/e' with the index beat versus 98 seconds (95% CI 92 to 104 seconds) for 10 consecutive beats (see Figure).
Conclusion
Index beat determination of left ventricular function improves reproducibility, saves time and does not compromise validity compared to conventional quantification in patients with heart failure and AF. After independent validation, the index beat method should be adopted into routine clinical practice.
Comparison for measurement of E/e'
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institute of Health Research UK
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Affiliation(s)
- K.V Bunting
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | - S Gill
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | - A Sitch
- University of Birmingham, Institute of applied health, Birmingham, United Kingdom
| | - S Mehta
- University of Birmingham, Institute of applied health, Birmingham, United Kingdom
| | - K O'Connor
- University Hospital Birmingham, Birmingham, United Kingdom
| | - J Hodson
- University Hospital Birmingham, Birmingham, United Kingdom
| | - G.Y.H Lip
- University of Liverpool, Liverpool, United Kingdom
| | - M Stanbury
- University of Birmingham, Lead for the Patient and Public Involvement panel, Birmingham, United Kingdom
| | - P Kirchhof
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
| | - M Griffith
- University Hospital Birmingham, Birmingham, United Kingdom
| | - J.N Townend
- University Hospital Birmingham, Birmingham, United Kingdom
| | - R.P Steeds
- University Hospital Birmingham, Birmingham, United Kingdom
| | - D Kotecha
- University of Birmingham, Institute of Cardiovascular Sciences, Birmingham, United Kingdom
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Pries-Heje M, Hasselbalch R, Ihleman N, Gill S, Bruun N, Elming H, Jensen K, Oestergaard L, Helweg-Larsen J, Fosboel E, Koeber L, Toender N, Moser C, Iversen K, Bundgaard H. Hemoglobin level at stabilization is associated with long-term all-cause mortality in patients with left-sided endocarditis, a POET substudy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2018] [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: 11/15/2022] Open
Abstract
Abstract
Background
Left-sided infectious endocarditis (IE) has a high 1-year mortality. Anemia is a common finding in patients with IE, yet little is known about frequency, severity, and associated outcomes in this setting.
Purpose
To examine the relationship between Hemoglobin (Hgb) level measured at IE stabilization (time of randomization) in the Partial Oral versus intravenous Antibiotic Treatment of Endocarditis (POET) trial - and long-term all-cause mortality.
Methods
In the POET trial, 400 patients with left-sided IE were randomized, after medical and/or surgical stabilization, to conventional antibiotic treatment or partial oral treatment. Only non-surgically treated patients were considered in this study. Patients were divided by quartiles into four groups based on Hgb level at randomization.
Results
We examined 248 patients with non-surgically treated IE. Median time from diagnosis of IE to randomization was 14 days (IQ 12–19). At long-term follow-up (median 3.2 years, IQ 2.18–4.60), 71 patients had died (28.6%). Patients in the lowest quantile (Hgb ≤6.0 mmol) had a HR of 4.17 (95% CI 1.81–9.61, p<0.001) for death compared to patients in the highest quantile (Hgb >7.5 mmol/L). This association remained significant after multivariable adjustment for age, sex, renal disease, C-Reactive Protein, and Prosthetic heart valve (HR 2.69, 95% CI 1.11–6.50); p=0.028).
Conclusion
Low Hemoglobin level at stabilization in patients with IE was associated with an increased risk of long-term mortality. Whether intensified treatment of anemia in patients with IE could improve long-term outcome requires investigation.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The Danish Heart Foundation, The Capital Regions Research Council
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Affiliation(s)
- M Pries-Heje
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | | | - N Ihleman
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - S Gill
- Odense University Hospital, Department of Cardiology, Odense, Denmark
| | - N.E Bruun
- Zealand University Hospital, Department of Cardiology, Roskilde, Denmark
| | - H Elming
- Zealand University Hospital, Department of Cardiology, Roskilde, Denmark
| | - K Jensen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - L Oestergaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - J Helweg-Larsen
- Rigshospitalet - Copenhagen University Hospital, Department of Infectious Diseases, Copenhagen, Denmark
| | - E.L Fosboel
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - L Koeber
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - N Toender
- Hillerod Hospital, Department of Cardiology, Hillerod, Denmark
| | - C Moser
- Rigshospitalet - Copenhagen University Hospital, Department of Clinical Microbiology, Copenhagen, Denmark
| | - K Iversen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
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Singh R, Safri HS, Singh S, Ubhi BS, Singh G, Alg GS, Randhawa G, Gill S. Under-mask beard cover (Singh Thattha technique) for donning respirator masks in COVID-19 patient care. J Hosp Infect 2020; 106:782-785. [PMID: 33022336 PMCID: PMC7532752 DOI: 10.1016/j.jhin.2020.09.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Abstract
Tight-fitting filtering facepiece (FFP3) face masks are essential respiratory protective equipment during aerosol-generating procedures in the coronavirus disease 2019 (COVID-19) environment, and require a fit test to assess mask–face seal competency. Facial hair is considered to be an impediment for achieving a competent seal. We describe an under-mask beard cover called the Singh Thattha technique, which obtained a pass rate of 25/27 (92.6%) by qualitative and 5/5 (100%) by quantitative fit test in full-bearded individuals. Sturdier versions of FFP3 were more effective. For individuals for whom shaving is not possible, the Singh Thattha technique could offer an effective solution to safely don respirator masks.
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Affiliation(s)
- R Singh
- Sikh Doctors & Dentists Association, UK.
| | - H S Safri
- Sikh Doctors & Dentists Association, UK
| | - S Singh
- Sikh Doctors Association, UK
| | - B S Ubhi
- British Sikh Dental Association, UK
| | - G Singh
- British Sikh Dental Association, UK
| | - G S Alg
- British Sikh Doctors Organisation, UK
| | | | - S Gill
- Sikh Doctors & Dentists Association, UK
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Bawany F, Gill S, Beck L, Yoshida T. 344 Longitudinal changes in skin microbial populations as a function of atopic dermatitis severity. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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34
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Gill S, Hao D, Hirte H, Campbell A, Colwell B. Impact of COVID-19 on Canadian medical oncologists and cancer care: Canadian Association of Medical Oncologists survey report. ACTA ACUST UNITED AC 2020; 27:71-74. [PMID: 32489248 DOI: 10.3747/co.27.6643] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background The covid-19 pandemic has presented unprecedented professional and personal challenges for the oncology community. Under the auspices of the Canadian Association of Medical Oncologists, we conducted an online national survey to better understand the impact of the pandemic on the medical oncology community in Canada. Methods An English-language multiple-choice survey, including questions about demographics, covid-19 risk, use of personal protective equipment (ppe), personal challenges, and chemotherapy management was distributed to Canadian medical oncologists. The survey was open from 30 March to 4 April 2020, and attracted 159 responses. Results More than 70% of medical oncologists expressed moderate-to-extreme concern about personally contracting covid-19 and about family members or patients (or both) contracting covid-19 from them. Despite that high level of concern, considerable variability in the use of ppe in direct cancer care was reported at the time of this survey, with 33% of respondents indicating no routine ppe use at their institutions and 69% indicating uncertainty about access to adequate ppe. Of the respondents, 54% were experiencing feelings of nervousness or anxiety on most days, and 52% were having feelings of depression or hopelessness on at least some days. Concern about aging parents or family and individual wellness represented the top personal challenges identified. The management of cancer patients has been affected, with adoption of telemedicine reported by 82% of respondents, and cessation of clinical trial accrual reported by 54%. The 3 factors deemed most important for treatment decision-making were■ cancer prognosis and anticipated benefit from treatment,■ risk of treatment toxicity during scarce health care access, and■ patient risk of contracting covid-19. Conclusions This report describes the results of the first national survey assessing the impact of the covid-19 on Canadian medical oncologists and how they deliver systemic anticancer therapies. We hope that these data will provide a framework to address the challenges identified.
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Affiliation(s)
- S Gill
- BC Cancer and University of British Columbia, Vancouver, BC
| | - D Hao
- Tom Baker Cancer Centre and Cumming School of Medicine, University of Calgary, Calgary, AB
| | - H Hirte
- Juravinski Cancer Centre, Hamilton, ON
| | - A Campbell
- Canadian Association of Medical Oncologists, Ottawa, ON
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Abstract
Immunotherapy has been described as the "fourth pillar" of oncology treatment, in conjunction with surgery, chemotherapy, and radiotherapy. However, the role of immunotherapy in gastrointestinal tumours is still evolving. Data for checkpoint inhibition in esophagogastric, hepatocellular, colorectal, and anal squamous cell carcinomas are expanding. In phase iii trials in the second-line setting, PD-1 inhibitors have demonstrated positive results for the subset of esophageal cancers that are positive for PD-L1 at a combined positive score of 10 or more. Based on results of phase ii trials, PD-1 inhibitors were approved in North America for use in PD-L1-positive chemorefractory gastric cancers, in hepatocellular carcinoma after sorafenib exposure, and in treatment-refractory deficient mismatch repair (dmmr) or high microsatellite instability (msi-h) tumours, regardless of tissue site. Combination use of PD-1 and ctla-4 inhibitors has been approved by the U.S. Food and Drug Administration for chemorefractory dmmr or msi-h colorectal cancer. Responses to checkpoint inhibition are durable, particularly in the dmmr or msi-h colorectal cancer cohort. As trials of combination immunotherapy, immunotherapy in combination with other systemic therapies, and immunotherapy in combination with other treatment modalities move forward in multiple tumour sites, cautious optimism is called for. The treatment landscape is continually changing, and expanded indications are likely to be just around the corner.
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Affiliation(s)
- S Mendis
- Medical Oncology, BC Cancer, Vancouver, BC
| | - S Gill
- Medical Oncology, BC Cancer, Vancouver, BC
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Gill S. Are we finally moving toward personalized therapy in colorectal cancer? Curr Oncol 2019; 26:S5-S6. [PMID: 31819704 PMCID: PMC6878936 DOI: 10.3747/co.26.5943] [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: 11/15/2022] Open
Abstract
Colorectal cancer (crc) will represent 12% of all new cancer cases and 12% of all cancer deaths in 2019, with more than 26,300 Canadians being diagnosed and 9500 Canadians dying of crc this year1.[...]
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Gill S, Kumara VMR. Detecting Neurodevelopmental Toxicity of Domoic Acid and Ochratoxin A Using Rat Fetal Neural Stem Cells. Mar Drugs 2019; 17:md17100566. [PMID: 31590222 PMCID: PMC6835907 DOI: 10.3390/md17100566] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 12/12/2022] Open
Abstract
Currently, animal experiments in rodents are the gold standard for developmental neurotoxicity (DNT) investigations; however, testing guidelines for these experiments are insufficient in terms of animal use, time, and costs. Thus, alternative reliable approaches are needed for predicting DNT. We chose rat neural stem cells (rNSC) as a model system, and used a well-known neurotoxin, domoic acid (DA), as a model test chemical to validate the assay. This assay was used to investigate the potential neurotoxic effects of Ochratoxin A (OTA), of which the main target organ is the kidney. However, limited information is available regarding its neurotoxic effects. The effects of DA and OTA on the cytotoxicity and on the degree of differentiation of rat rNSC into astrocytes, neurons, and oligodendrocytes were monitored using cell-specific immunofluorescence staining for undifferentiated rNSC (nestin), neurospheres (nestin and A2B5), neurons (MAP2 clone M13, MAP2 clone AP18, and Doublecortin), astrocytes (GFAP), and oligodendrocytes (A2B5 and mGalc). In the absence of any chemical exposure, approximately 46% of rNSC differentiated into astrocytes and neurons, while 40% of the rNSC differentiated into oligodendrocytes. Both non-cytotoxic and cytotoxic concentrations of DA and OTA reduced the differentiation of rNSC into astrocytes, neurons, and oligodendrocytes. Furthermore, a non-cytotoxic nanomolar (0.05 µM) concentration of DA and 0.2 µM of OTA reduced the percentage differentiation of rNSC into astrocytes and neurons. Morphometric analysis showed that the highest concentration (10 μM) of DA reduced axonal length. These indicate that low, non-cytotoxic concentrations of DA and OTA can interfere with the differentiation of rNSC.
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Affiliation(s)
- S Gill
- Regulatory Toxicology Research Division, Health Products and Food Branch, Tunney's Pasture, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, ON K1A 0K9, Canada.
| | - V M Ruvin Kumara
- Regulatory Toxicology Research Division, Health Products and Food Branch, Tunney's Pasture, Health Canada, 251 Sir Frederick Banting Driveway, Ottawa, ON K1A 0K9, Canada.
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Ostergaard L, Bruun NE, Voldstedlund M, Schonheyder HC, Rosenvinge F, Valeur N, Sogaard P, Skov R, Chen M, Iversen K, Gill S, Lauridsen TK, Dahl A, Povlsen JA, Moser C. P3665Prevalence of infective endocarditis in patients with positive blood cultures: a Danish nationwide study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0520] [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
Increasing attention has been given to the risk of infective endocarditis (IE) in patients with certain blood stream infections (BSI). Previous studies have been conducted on selected patient cohorts, yet unselected data are sparse.
Purpose
To investigate the nationwide prevalence of diagnosed IE in BSIs with bacteria typically associated with IE.
Methods
By crosslinking nationwide registries from 2010–2016, we identified patients with BSIs typically associated with IE: Enterococcus faecalis, Staphylococcus, Streptococcus spp., and coagulase negative staphylococci (CoNS) and examined the concurrent IE prevalence. A trend test was used to examine temporal changes in the prevalence of IE.
Results
In total 60,119 BSIs, distributed with 15,407, 16,790, and 27,922 BSIs were identified in the periods of 2010–2011, 2012–2013, and 2014–2016, respectively.
Patients with E. Faecalis had the highest prevalence of diagnosed IE (16.3%) followed by S. aureus (10.2%), Streptococcus spp. (7.3%), and CoNS (1.6%) (Figure). During the study period, the prevalence of IE among patients with E. faecalis increased significantly (p=0.003), Male patients had higher prevalence of IE for all microorganisms investigated compared with females. A significant increase in the prevalence of IE was seen for E. faecalis, Streptococcus spp., and CoNS with increasing age.
Percent with endocarditis
Conclusion
For E. faecalis BSI, 1 in 6 had IE, for S. aureus BSI 1 in 10 had IE, and for Streptococcus spp. 1 in 14 had IE. Our results support screening for IE in patients with E. faecalis, S. aureus, or Streptococcus spp. BSI in order to offer appropriate therapy.
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Affiliation(s)
- L Ostergaard
- Rigshospitalet - Copenhagen University Hospital, The Heart Centre, Copenhagen, Denmark
| | - N E Bruun
- University Hospital, Department of cardiology, Roskilde, Denmark
| | - M Voldstedlund
- Statens Serum Institut, Department of epidemiology, Copenhagen, Denmark
| | - H C Schonheyder
- Aalborg University Hospital, Department of clinical microbiology, Aalborg, Denmark
| | - F Rosenvinge
- Odense University Hospital, Department of clinical microbiology, Odense, Denmark
| | - N Valeur
- Bispebjerg University Hospital, Cardiology, Copenhagen, Denmark
| | - P Sogaard
- Aalborg University Hospital, Department of cardiology, Aalborg, Denmark
| | - R Skov
- Statens Serum Institut, Department of epidemiology, Copenhagen, Denmark
| | - M Chen
- Hospital of Southern Jutland, Department of clinical microbiology, Sonderborg, Denmark
| | - K Iversen
- Herlev Hospital, Department of cardiology, Herlev, Denmark
| | - S Gill
- Odense University Hospital, Department of cardiology, Odense, Denmark
| | - T K Lauridsen
- Gentofte University Hospital, Department of cardiology, Copenhagen, Denmark
| | - A Dahl
- Bispebjerg University Hospital, Cardiology, Copenhagen, Denmark
| | - J A Povlsen
- Aarhus University Hospital, Department of cardiology, Aarhus, Denmark
| | - C Moser
- Rigshospitalet - Copenhagen University Hospital, Department of clinical microbiology, Copenhagen, Denmark
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Ostergaard L, Voldstedlund M, Andersen CO, Schonheyder HC, Lemming L, Valeur N, Sogaard P, Andersen PS, Skov R, Gill S, Torp-Pedersen C, Mortensen RN, Lauridsen TK, Dahl A, Kober L. P3663Prevalence of infective endocarditis in patients with a left-sided heart valve prosthesis: a nationwide study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0518] [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
Increasing attention has been given to patients with blood stream infection (BSI) and the concurrent prevalence of infective endocarditis (IE). However, there exist a gap in knowledge on the prevalence of IE among patients with a left-sided heart valve prosthesis and BSI.
Purpose
To examine the prevalence between different BSI and IE in patients with a left-sided heart valve prosthesis.
Methods
By linking Danish nationwide registries, we were able to identify patients with a left-sided prosthetic heart valve and first-time BSI of interest (Enterococcus faecalis, Staphylococcsus aureus, streptococci species (spp.), and coagulase negative staphylococci [CoNS]) in the period of 2010–2016. Concurrent admission for IE was identified from the Danish National Patient Registry in a period of up to 14 days after the BSI.
Results
A total of 1,465 patients with BSI were included (1,319 patients with an aortic valve prosthesis [82.6% bioprosthetic] and 146 patients with a mitral valve prosthesis [48.6% bioprosthetic]). Among the included patients, 244 had E. faecalis (median age: 78.3 years, 77.0% male), 301 had S. aureus (median age: 76.9 years, 69.1% male), 401 had streptococci spp. (median age: 78.0 years, 69.1% male) and 519 had CoNS (median age: 76.4 years, 64.2% male). The percentage of patients with a diagnosis of IE in relation to the BSI was 44.3%, 33.6%, 34.4%, and 7.9% for E. faecalis, S. aureus, streptococci spp., and CoNS, respectively. No difference in the overall results was seen by type of valve prosthesis, sex, or age group.
Percentage of patients with endocarditis
Conclusion
In patients with a left-sided heart valve prosthesis, IE was diagnosed in almost half of the patients with E. faecalis, in 1/3 with S. aureus or streptococci spp. and in 1 in 12 with CoNS BSI. Future studies may try to explain why some microbes are more likely to cause prosthetic heart valve endocarditis, than others are.
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Affiliation(s)
- L Ostergaard
- Rigshospitalet - Copenhagen University Hospital, The Heart Centre, Copenhagen, Denmark
| | - M Voldstedlund
- Statens Serum Institut, Department of epidemiology, Copenhagen, Denmark
| | - C O Andersen
- Hvidovre University Hospital, Department of clinical microbiology, Hvidovre, Denmark
| | - H C Schonheyder
- Aalborg University Hospital, Department of clinical microbiology, Aalborg, Denmark
| | - L Lemming
- Aarhus University Hospital, Department of clinical microbiology, Aarhus, Denmark
| | - N Valeur
- Bispebjerg University Hospital, Cardiology, Copenhagen, Denmark
| | - P Sogaard
- Aalborg University Hospital, Department of cardiology, Aalborg, Denmark
| | - P S Andersen
- Statens Serum Institut, Department of epidemiology, Copenhagen, Denmark
| | - R Skov
- Statens Serum Institut, Department of epidemiology, Copenhagen, Denmark
| | - S Gill
- Odense University Hospital, Department of cardiology, Odense, Denmark
| | - C Torp-Pedersen
- Aalborg University Hospital, Department of clinical epidemiology and biostatistics, Aalborg, Denmark
| | - R N Mortensen
- Aalborg University Hospital, Department of clinical epidemiology and biostatistics, Aalborg, Denmark
| | - T K Lauridsen
- Gentofte University Hospital, Department of cardiology, Copenhagen, Denmark
| | - A Dahl
- Bispebjerg University Hospital, Cardiology, Copenhagen, Denmark
| | - L Kober
- Rigshospitalet - Copenhagen University Hospital, The Heart Centre, Copenhagen, Denmark
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Moody WE, Holloway B, Gill S, Boivin C, Wahid Y, Ferguson J, Steeds RP. 248Prognostic value of single photon emission computed tomography among liver transplantation candidates. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez150.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- W E Moody
- Royal Brompton Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - B Holloway
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
| | - S Gill
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
| | - C Boivin
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
| | - Y Wahid
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
| | - J Ferguson
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
| | - R P Steeds
- University of Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom of Great Britain & Northern Ireland
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Cummins K, Salas-McKee J, Kulikovskaya I, Gohil M, Nobles C, Bushman F, Lacey S, Gill S. Optimization of CRISPR-Cas9 knock-out of CD33 in human hematopoietic stem / progenitor cells for allogeneic transplantation in patients with acute myeloid leukemia. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.585] [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: 10/26/2022]
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Ko YJ, Abdelsalam M, Kavan P, Lim H, Tang PA, Vincent M, Wong R, Kish M, Gill S. What is a clinically meaningful survival benefit in refractory metastatic colorectal cancer? ACTA ACUST UNITED AC 2019; 26:e255-e259. [PMID: 31043834 DOI: 10.3747/co.26.4753] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Assessment of the clinical benefit of cancer treatments can be highly subjective, influenced by both perspective and context. Such assessments are required in regulatory and policy decision-making, but consistency between jurisdictions is often lacking. Clear and consistent standards for determining when a treatment offers a meaningful benefit, relative to the current standard of care, can help to address issues of equity and transparency in health technology assessment. For metastatic colorectal cancer (mcrc), no standardized Canadian definition of clinically meaningful benefit has yet been proposed. Colorectal Cancer Canada therefore convened a group of medical oncologists expert in colorectal cancer to review the literature about clinical significance. The resulting consensus is intended to apply to any therapeutic agent being considered in the setting of chemotherapy-refractory mcrc. It was agreed that overall survival is the appropriate measure of clinical efficacy in chemorefractory mcrc. As quantitative targets for efficacy, an improvement of 2 months or more in median overall survival or a hazard ratio for survival of 0.75 or lower (or both) are proposed as the threshold for clinically meaningful benefit. That threshold could be influenced by a treatment's effect on quality of life. Treatment toxicity is also relevant to the assessment of clinical benefit in this setting, specifically when significant differences in treatment tolerability are evident.
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Affiliation(s)
- Y J Ko
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON
| | - M Abdelsalam
- Division of Medical Oncology, Department of Medicine, Dalhousie University, Halifax, NS
| | - P Kavan
- Department of Oncology, McGill University, Montreal, QC
| | - H Lim
- Division of Medical Oncology, Faculty of Medicine, University of British Columbia, Vancouver, BC
| | - P A Tang
- Department of Oncology, Tom Baker Cancer Centre, Cumming School of Medicine, University of Calgary, Calgary, AB
| | - M Vincent
- Division of Medical Oncology, London Regional Cancer Program, London, ON
| | - R Wong
- CancerCare Manitoba, Department of Hemato-Oncology, University of Manitoba, Winnipeg, MB
| | - M Kish
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON
| | - S Gill
- BC Cancer, University of British Columbia, Vancouver, BC
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Sud S, O'Callaghan C, Jonker C, Karapetis C, Price T, Tebbutt N, Shapiro J, Van Hazel G, Pavlakis N, Gibbs P, Jeffrey M, Siu L, Gill S, Wong R, Jonker D, Tu D, Goodwin R. Hypertension as a predictor of advanced colorectal cancer outcome and cetuximab treatment response. ACTA ACUST UNITED AC 2018; 25:e516-e526. [PMID: 30607118 DOI: 10.3747/co.25.4069] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Adrenergic receptor stimulation is involved in the development of hypertension (htn) and has been implicated in cancer progression and dissemination of metastases in various tumours, including colon cancer. Adrenergic antagonists such as beta-blockers (bbs) demonstrate inhibition of invasion and migration in colon cancer cell lines and have been associated with decreased mortality in colorectal cancer (crc). We examined the association of baseline htn and bb use with overall (os) and progression-free survival (pfs) in patients with pretreated, chemotherapy refractory, metastatic crc (mcrc). We also examined baseline htn as a predictor of cetuximab efficacy. Methods Using data from the Canadian Cancer Trials Group co.17 study [cetuximab vs. best supportive care (bsc)], we coded baseline htn and use of anti-htn medications, including bbs, for 572 patients. The chi-square test was used to assess the associations between those variables and baseline characteristics. Cox regression models were used for univariate and multivariate analyses of os and pfs by htn diagnosis and bb use. Results Baseline htn, bb use, and anti-htn medication use were not found to be prognostic for improved os. Baseline htn and bb use were not significant predictors of cetuximab benefit. Conclusions In chemorefractory mcrc, neither baseline htn nor bb use is a significant prognostic factor. Baseline htn and bb use are not predictive of cetuximab benefit. Further investigation to determine whether baseline htn or bb use have a similarly insignificant impact on prognosis in patients receiving earlier lines of treatment remains warranted.
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Affiliation(s)
- S Sud
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON
| | - C O'Callaghan
- ncic Clinical Trials Group, Queen's University, Kingston, ON
| | - C Jonker
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON
| | - C Karapetis
- Flinders University and Flinders Medical Centre, Flinders Centre for Innovation in Cancer, Bedford Park, SA
| | - T Price
- The Queen Elizabeth and University of Adelaide, Adelaide, SA
| | | | - J Shapiro
- Department of Medical Oncology, Monash University, Melbourne, VIC
| | | | - N Pavlakis
- Royal North Shore Hospital, Northern Clinical School, University of Sydney, St. Leonards, NSW
| | - P Gibbs
- Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - M Jeffrey
- Oncology Service, Christchurch Hospital, Christchurch, N.Z
| | - L Siu
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON
| | - S Gill
- University of British Columbia, BC Cancer, Vancouver, BC
| | - R Wong
- CancerCare Manitoba, Winnipeg, MB
| | - D Jonker
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON
| | - D Tu
- ncic Clinical Trials Group, Queen's University, Kingston, ON
| | - R Goodwin
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON
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Liu S, Loree J, Renouf D, Jones M, Yip S, Marra M, Jones S, Nelson J, Laskin J, Lim H, Gill S. Clinical benefit of whole genome and transcriptome analysis (WGTA) in metastatic colorectal cancer (MCRC): Results from the personalized oncogenomics program (POG). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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45
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Gill S, Kim D. Effects of obesity and knee osteoarthritis on gait and postural stability in pre-bariatric surgery candidates. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dashti HS, Jones S, Lane JM, Wang H, Song Y, Patel K, Gill S, Gottlieb D, Tiemeier H, Ray DW, Frayling TM, Rutter MK, Weedon MN, Saxena R. 0013 Genome-wide Association Analysis Identifies >75 Genetic Loci Associated With Sleep Duration In UK Biobank Participants. Sleep 2018. [DOI: 10.1093/sleep/zsy061.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- H S Dashti
- Massachusetts General Hospital, Boston, MA
| | - S Jones
- University of Exeter Medical School, Exeter, UNITED KINGDOM
| | - J M Lane
- Massachusetts General Hospital, Boston, MA
| | - H Wang
- Brigham and Women’s Hospital, Boston, MA
| | - Y Song
- Massachusetts General Hospital, Boston, MA
| | - K Patel
- Massachusetts General Hospital, Boston, MA
| | - S Gill
- Massachusetts General Hospital, Boston, MA
| | - D Gottlieb
- Brigham and Women’s Hospital, Boston, MA
| | - H Tiemeier
- Harvard Chan School of Public Health, Boston, MA
| | - D W Ray
- The University of Manchester, Manchester, UNITED KINGDOM
| | - T M Frayling
- University of Exeter Medical School, Exeter, UNITED KINGDOM
| | - M K Rutter
- The University of Manchester, Manchester, UNITED KINGDOM
| | - M N Weedon
- University of Exeter Medical School, Exeter, UNITED KINGDOM
| | - R Saxena
- Massachusetts General Hospital, Boston, MA
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Gill S, Kavanagh M, Cherry W, Bourque C, Caldwell D, Wang G, Bondy G. A 90-day subchronic gavage toxicity study in Fischer 344 rats with 3-methylfuran. Food Chem Toxicol 2018; 111:341-355. [DOI: 10.1016/j.fct.2017.10.055] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 10/20/2017] [Accepted: 10/30/2017] [Indexed: 12/31/2022]
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Brücke T, Jain R, Van Dyck N, Chen L, Thun P, Seijo F, Suarez San Martin E, Visser-Vandewalle V, Barbe M, Gill S, Whone A, Porta M, Servello D, Timmermann L, Alesch F. Long term results of the VANTAGE study: A prospective multicenter trial evaluating deep brain stimulation with a multiple source, constant current system in Parkinson’s disease. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gill S, Gandhidasan S, Kron T, Ball D, Shaw M, Chander S, Bressel M, Chesson B, David S, Siva S. Ablation of oligometastasis cancer with stereotactic ablative body radiotherapy exploiting the stepwise theory of metastasis: A retrospective review of a single institution series. Respir Med 2017. [DOI: 10.1016/j.rmed.2017.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kouli O, Khalil M, Fathi A, Gill S, Headon E, Love G. Total Hip Replacement (THR) In Intracapsular Neck of Femur (NOF) Fracture Management in Ninewells Hospital. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.413] [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: 11/30/2022]
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