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Landi SN, Radke S, Boggess K, Engel SM, Stürmer T, Howe AS, Jonsson Funk M. Comparative effectiveness of metformin versus insulin for gestational diabetes in New Zealand. Pharmacoepidemiol Drug Saf 2019; 28:1609-1619. [DOI: 10.1002/pds.4907] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Suzanne N. Landi
- Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Sarah Radke
- National Institute of Health InnovationUniversity of Auckland Auckland New Zealand
| | - Kim Boggess
- Department of Obstetrics and Gynecology, School of MedicineUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Stephanie M. Engel
- Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Til Stürmer
- Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Anna S. Howe
- Department of General Practice and Primary Health CareUniversity of Auckland Auckland New Zealand
| | - Michele Jonsson Funk
- Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina
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Landi SN, Radke S, Engel SM, Boggess K, Stürmer T, Howe AS, Funk MJ. Association of Long-term Child Growth and Developmental Outcomes With Metformin vs Insulin Treatment for Gestational Diabetes. JAMA Pediatr 2019; 173:160-168. [PMID: 30508164 PMCID: PMC6439608 DOI: 10.1001/jamapediatrics.2018.4214] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 12/28/2022]
Abstract
IMPORTANCE Metformin is an emerging option for treating gestational diabetes (GDM). However, because metformin crosses the placenta, patients and clinicians are concerned with its long-term effect on child health. OBJECTIVE To estimate the association of treating GDM with metformin vs insulin with child growth and development. DESIGN, SETTING, AND PARTICIPANTS Population-based cohort study of New Zealand women treated with metformin or insulin for GDM from 2005 to 2012 and their children. This study linked national health care data to create a cohort of mothers and their children, including data from maternity care, pharmaceutical dispensing, hospitalizations, demographic records, and the B4 School Check (B4SC) preschool health assessment. Women treated pharmacologically with metformin or insulin during pregnancy were included. We excluded pregnancies with evidence of diabetes and deliveries prior to 2013. Liveborn infants were linked to their B4SC results. Data were analyzed between January 2017 and May 2018. EXPOSURES Pharmacologic treatment for GDM with metformin or insulin, measured using pharmaceutical claims data. MAIN OUTCOMES AND MEASURES Child growth (weight and height) and Strengths and Difficulties Questionnaire (SDQ) scores for behavioral development. All outcomes were derived from the B4SC screening program. Linear and log-binomial regression with inverse probability of treatment weighting was used to estimate the association of child growth and psychosocial outcomes with metformin vs insulin treatment for GDM. RESULTS In both treatment groups, the mean (SD) maternal age was 32 (5) years. A large proportion of mothers who were treated with insulin identified as New Zealand European (867 [44.9%]) while 576 mothers who were treated with metformin (28.9%) identified as New Zealand European. Approximately one-third of mothers who were treated with metformin (n = 639) identified as Asian. We identified 3928 pregnancies treated with metformin (n = 1996) or insulin (n = 1932). After adjustment, we observed no meaningful difference in weight for height z scores between children exposed to metformin compared with insulin (mean difference, -0.10; 95% CI, -0.20 to 0.01). Risk of being 85th percentile or greater for weight for height was similar between treatment groups (adjusted risk ratio, 0.92; 95% CI, 0.83-1.02). Mean SDQ scores were not meaningfully different between the treatment groups, Children of metformin-treated mothers were not significantly more likely to have parent-reported SDQ scores of 14 or more (adjusted risk ratio, 1.13; 95% CI, 0.88-1.46) than those of insulin-treated mothers. CONCLUSIONS AND RELEVANCE Our study compares long-term outcomes among school-aged children following maternal use of metformin vs insulin treatment for GDM. Children of metformin-treated mothers were indistinguishable on growth and developmental assessments from those of insulin-treated mothers. These results will help inform future GDM treatment guidelines.
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Affiliation(s)
- Suzanne N. Landi
- Department of Epidemiology, Gillings School of Global
Public Health, University of North Carolina at Chapel Hill
| | - Sarah Radke
- National Institute of Health Innovation, University of
Auckland, Auckland, New Zealand
| | - Stephanie M. Engel
- Department of Epidemiology, Gillings School of Global
Public Health, University of North Carolina at Chapel Hill
| | - Kim Boggess
- Department of Obstetrics and Gynecology, School of
Medicine, University of North Carolina at Chapel Hill
| | - Til Stürmer
- Department of Epidemiology, Gillings School of Global
Public Health, University of North Carolina at Chapel Hill
| | - Anna S. Howe
- Department of General Practice and Primary Health
Care, University of Auckland, Auckland, New Zealand
| | - Michele Jonsson Funk
- Department of Epidemiology, Gillings School of Global
Public Health, University of North Carolina at Chapel Hill
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Griesinger F, Radke S, Lüers A, Deschler-Baier B, Kimmich M, Sebastian M, Schulz C, Brugger W, Wiewrodt R, Pirker R, Früh M, Gautschi O, Wolf J. [Strategies to Overcome Acquired Resistance to EGFR-TKI Therapy Based on T790M Specific Substances using Osimertinib as an Example]. Pneumologie 2018; 72:774-781. [PMID: 30408830 DOI: 10.1055/a-0647-9835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Tyrosine kinase inhibitors (TKIs) of the epidermal growth factor receptor (EGFR) are widely used in non-small cell lung cancer patients harboring activating EGFR mutations. However, resistance mechanisms, particularly the T790 M mutation, hamper longer-term therapeutic success of first and second generation EGFR-TKIs. To address this unmet medical need, EGFR-TKIs of the third generation are under clinical development. Relevant clinical efficacy with mainly mild to moderate class-specific side effects has been shown for third-generation EGFR-TKIs. Molecular testing is of major importance in deciding for treatment with third generation EGFR-TKIs. This article elucidates the developmental state of third generation EGFR-TKIs with its focus on Osimertinib, the first and currently the only compound in this class which is approved in Germany. Additionally, the medical importance of molecular diagnosis using tumor tissue and circulating tumor DNA is discussed.
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Affiliation(s)
- F Griesinger
- Klinik für Hämatologie und Onkologie, Pius-Hospital Oldenburg, Universitätsmedizin Oldenburg, Universitätsklinik Innere Medizin - Onkologie, Oldenburg
| | - S Radke
- AstraZeneca, Medical Affairs, Wedel
| | - A Lüers
- Klinik für Hämatologie und Onkologie, Pius-Hospital Oldenburg, Universitätsmedizin Oldenburg, Universitätsklinik Innere Medizin - Onkologie, Oldenburg
| | - B Deschler-Baier
- Comprehensive Cancer Center Mainfranken, Universitätsklinikum Würzburg, Würzburg
| | - M Kimmich
- Abteilung für Pneumologie und Pneumologische Onkologie, Robert-Bosch-Krankenhaus Klinik Schillerhöhe, Gerlingen
| | - M Sebastian
- Abteilung für Hämatologie und Onkologie, Universitätsklinikum Frankfurt, Frankfurt/Main
| | - C Schulz
- Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg
| | - W Brugger
- Medizinische Klinik II, Hämatologie/Onkologie, Schwarzwald-Baar Klinikum, Akad. Lehrkrankenhaus der Univ. Freiburg, Villingen-Schwenningen
| | - R Wiewrodt
- Medizinische Klinik A, Universitätsklinikum Münster, Münster
| | - R Pirker
- Klinische Abteilung für Onkologie, Allgemeines Krankenhaus-Universitätskliniken Wien
| | - M Früh
- Klinik für Hämatologie/Onkologie, Kantonsspital St. Gallen, St. Gallen
| | - O Gautschi
- Abteilung für Medizinische Onkologie, Kantonsspital Luzern, Luzern
| | - J Wolf
- Klinik I für Innere Medizin, Centrum für Integrierte Onkologie, Uniklinik Köln, Köln
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Shah A, Coyle T, Lalezari S, Fischer K, Kohlstaedde B, Delesen H, Radke S, Michaels LA. BAY 94-9027, a PEGylated recombinant factor VIII, exhibits a prolonged half-life and higher area under the curve in patients with severe haemophilia A: Comprehensive pharmacokinetic assessment from clinical studies. Haemophilia 2018; 24:733-740. [DOI: 10.1111/hae.13561] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - T. Coyle
- TriHealth Cancer Institute; Cincinnati OH USA
| | - S. Lalezari
- Israel National Hemophilia Center; Chaim Sheba Medical Center; Tel-Hashomer, and Sackler School of Medicine; Tel-Aviv University; Israel
| | - K. Fischer
- Van Creveldkliniek; University Medical Center Utrecht; Utrecht University; Utrecht The Netherlands
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Radke S, Seidel EM, Boubela RN, Thaler H, Metzler H, Kryspin-Exner I, Moser E, Habel U, Derntl B. Immediate and delayed neuroendocrine responses to social exclusion in males and females. Psychoneuroendocrinology 2018; 93:56-64. [PMID: 29702443 DOI: 10.1016/j.psyneuen.2018.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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] [Received: 10/19/2017] [Revised: 04/09/2018] [Accepted: 04/09/2018] [Indexed: 01/22/2023]
Abstract
Social exclusion is a complex phenomenon, with wide-ranging immediate and delayed effects on well-being, hormone levels, brain activation and motivational behavior. Building upon previous work, the current fMRI study investigated affective, endocrine and neural responses to social exclusion in a more naturalistic Cyberball task in 40 males and 40 females. As expected, social exclusion elicited well-documented affective and neural responses, i.e., increased anger and distress, as well as increased exclusion-related activation of the anterior insula, the posterior-medial frontal cortex and the orbitofrontal cortex. Cortisol and testosterone decreased over the course of the experiment, whereas progesterone showed no changes. Hormone levels were not correlated with subjective affect, but they were related to exclusion-induced neural responses. Exclusion-related activation in frontal areas was associated with decreases in cortisol and increases in testosterone until recovery. Given that results were largely independent of sex, the current findings have important implications regarding between-sex vs. within-sex variations and the conceptualization of state vs. trait neuroendocrine functions in social neuroscience.
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Affiliation(s)
- S Radke
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany; Jülich Aachen Research Alliance (JARA) - BRAIN Institute 1, Brain Structure-Function Relationships: Decoding the Human Brain at Systemic Levels, Pauwelsstr. 30, 52074 Aachen, Germany.
| | - E M Seidel
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria; Social, Cognitive and Affective Neuroscience Unit, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria
| | - R N Boubela
- MR Centre of Excellence, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna, Austria; Centre for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - H Thaler
- Social, Cognitive and Affective Neuroscience Unit, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria; Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804 Munich, Germany
| | - H Metzler
- Social, Cognitive and Affective Neuroscience Unit, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria; Laboratoire de neurosciences cognitives, Département d'études cognitives, École normale supérieure, INSERM, PSL Research University, 29 rue d'Ulm, 75005 Paris, France
| | - I Kryspin-Exner
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Liebiggasse 5, 1010 Vienna, Austria
| | - E Moser
- MR Centre of Excellence, Medical University of Vienna, Lazarettgasse 14, 1090 Vienna, Austria; Centre for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - U Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany; Jülich Aachen Research Alliance (JARA) - BRAIN Institute 1, Brain Structure-Function Relationships: Decoding the Human Brain at Systemic Levels, Pauwelsstr. 30, 52074 Aachen, Germany
| | - B Derntl
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany; Werner Reichardt Center for Integrative Neuroscience, University of Tübingen, Otfried-Müller-Str. 25, 72076 Tübingen, Germany; LEAD Graduate School, University of Tübingen, Gartenstr. 29, 72074 Tübingen,Germany
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Kettenbach S, Müller T, Radke S, Habel U, Dreher M. Charakterisierung und Visualisierung des Chronic Fatigue Syndrom bei Sarkoidosepatienten. Pneumologie 2018. [DOI: 10.1055/s-0037-1619167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S Kettenbach
- Sektion Pneumologie, Medizinische Klinik I, Medizinische Fakultät der RWTH Aachen
| | - T Müller
- Sektion Pneumologie, Medizinische Klinik I, Medizinische Fakultät der RWTH Aachen
| | - S Radke
- Klinik für Pyschiatrie, Psychotherapie, und Psychosomatik, Medizinische Fakultät der RWTH Aachen
| | - U Habel
- Klinik für Pyschiatrie, Psychotherapie, und Psychosomatik, Medizinische Fakultät der RWTH Aachen
| | - M Dreher
- Sektion Pneumologie, Medizinische Klinik I, Medizinische Fakultät der RWTH Aachen
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Radke S, Petousis-Harris H, Watson D, Gentles D, Turner N. Age-specific effectiveness following each dose of acellular pertussis vaccine among infants and children in New Zealand. Vaccine 2017; 35:177-183. [DOI: 10.1016/j.vaccine.2016.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/17/2016] [Accepted: 11/01/2016] [Indexed: 10/20/2022]
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Schuette W, Eberhardt WEE, Waller C, Schirmacher P, Dietel M, Zirrgiebel U, Radke S, Thomas M. [Subgroup Analysis of the Non-interventional REASON Study: PFS and OS According to Age, Smoking History, Gender, and Histology in NSCLC Patients Treated with Gefitinib or Chemotherapy]. Pneumologie 2016; 70:579-88. [PMID: 27603946 DOI: 10.1055/s-0042-109760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Assessment of several clinical factors on progression-free (PFS) and overall survival (OS) in NSCLC patients (pts.) (stage IV) with mutated epidermal growth factor receptor (EGFRm+) treated with gefitinib (gef) or with chemotherapy (CT) under real-world conditions. METHODS 285 EGFRm+ pts. of the non-interventional REASON study treated with gef (n = 206) or CT (n = 79) as first-line therapy or with gef (n = 213) or CT (n = 61) in any line throughout the course of therapy were analyzed according to age, gender, smoking history and histology. RESULTS Compared with CT, patients treated with gef showed prolongation of PFS and OS in all subgroups. PFS was significantly increased in women and non-smokers. OS was significantly increased in women, non-smokers, (ex)-smokers, patients with adenocarcinoma and elderly patients when treated with gef compared to CT. Female gender turned out to be an independent positive predictive factor for OS in patients treated with gef (HRmale: 1.74, p = 0.0009). CONCLUSION A clinical benefit of gef was shown for all analyzed clinical subgroups of EGFRm+ pts. This was confirmed for the female gender in a multivariate analysis.
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Affiliation(s)
- W Schuette
- Krankenhaus Martha-Maria Halle-Doelau, Klinik für Innere Medizin II, Halle
| | - W E E Eberhardt
- Innere Klinik (Tumorforschung), Ruhrlandklinik, Westdeutsches Tumorzentrum (WTZ), Essen, Universitätsklinikum Essen, Universität Duisburg-Essen
| | - C Waller
- Klinik für Innere Medizin I, Universitätsklinikum Freiburg
| | - P Schirmacher
- Pathologisches Institut, Universitätsklinik Heidelberg
| | - M Dietel
- Pathologisches Institut, Humboldt Universität Berlin
| | | | - S Radke
- Medical Affairs, AstraZeneca, Wedel
| | - M Thomas
- Onkologie der Thoraxtumoren, Thoraxklinik im Universitätsklinikum Heidelberg
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9
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Radke S, Safari N, Schulze J. Toxicity of phosphono compounds – A contested but unknown group of chemicals. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1427] [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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Schuette W, Dietel M, Thomas M, Eberhardt W, Griesinger F, Zirrgiebel U, Radke S, Schirmacher P. [Exon-dependent Subgroup-analysis of the Non-interventional REASON-Study: PFS and OS in EGFR-mutated NSCLC Patients Treated with Gefitinib or Chemotherapy]. Pneumologie 2016; 70:514-21. [PMID: 27512931 DOI: 10.1055/s-0042-109749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To analyze the influence of the localization of mutations in the epidermal growth factor receptor (EGFR) gene on progression-free (PFS) and overall survival (OS) in patients (pts) with locally advanced or metastatic non-small cell lung cancer (NSCLC) treated with gefitinib (gef) or chemotherapy (CT) under real world conditions within the REASON study. METHODS Subgroups of pts with mutations in exon 19 (n = 141), 18/20 (n = 43), and 21 (n = 104) were analyzed for PFS and OS according to gef or CT treatment and compared using the log-rank test. RESULTS Pts with mutations in exon 19 and 18/20 treated with gef as first line therapy showed increased PFS and OS compared to CT. This increase was statistically significant in pts with exon 19 mutation (11.3 vs. 6.5 months), but was not found in pts with exon 21 mutation (9.1 vs. 9.3 months). Also, OS was significantly increased in patients with mutation in exon 19 treated with gef ever over all treatment lines compared to CT (21.8 vs. 10.6 months), whereas this was not found in pts with mutation in exon 21 (14.1 vs. 13.9 months). CONCLUSION Localization and nature of EGFR mutations influences gefitinib treatment outcomes under routine conditions and should therefore be analyzed in detail.
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Affiliation(s)
- W Schuette
- Krankenhaus Martha-Maria Halle-Doelau, Klinik für Innere Medizin II, Halle
| | - M Dietel
- Pathologisches Institut Humboldt Universität Berlin
| | - M Thomas
- Internistische Onkologie der Thoraxtumoren, Thoraxklinik im Universitätsklinikum Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg
| | - W Eberhardt
- Innere Klinik (Tumorforschung), Ruhrlandklinik, Westdeutsches Tumorzentrum (WTZ), Essen, Universitätsklinikum Essen, Universität Duisburg-Essen
| | | | | | - S Radke
- Medical Affairs, AstraZeneca, Wedel
| | - P Schirmacher
- Pathologisches Institut Universitätsklinik Heidelberg
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Schütte W, Eberhardt W, Schirmacher P, Dietel M, Zirrgiebel U, Radke S, Thomas M. REASON: Klinisch-pathologische Faktoren relevant für die klinische Wirksamkeit von Gefitinib bei Patienten mit NSCLC Stadium IIIb/IV und mutiertem EGF Rezeptor (EGFR-M+). Pneumologie 2016. [DOI: 10.1055/s-0036-1572235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Griesinger F, Sebastian M, Serke M, Grohé C, Hillejan L, Passlick B, Reinmuth N, Graeven U, Radke S, Karatas A, Tiemann M, Overbeck T. Induction therapy with intercalated TKI and chemotherapy in NSCLC with activating EGFR mutation in stages II-IIIB: NeoIntercal. Pneumologie 2016. [DOI: 10.1055/s-0036-1572237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Schütte W, Thomas M, Eberhardt W, Zirrgiebel U, Radke S, Dietel M. Zielgerichtete Therapie des NSCLC mit Gefitinib in Abhängigkeit von der Art der EGFR-Mutation: Auswertung der klinischen Wirksamkeit in REASON Exon-Subgruppen. Pneumologie 2016. [DOI: 10.1055/s-0036-1572234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pierse N, Kelly H, Thompson MG, Bissielo A, Radke S, Huang QS, Baker MG, Turner N. Influenza vaccine effectiveness for hospital and community patients using control groups with and without non-influenza respiratory viruses detected, Auckland, New Zealand 2014. Vaccine 2015; 34:503-509. [PMID: 26685091 DOI: 10.1016/j.vaccine.2015.11.073] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [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: 08/12/2015] [Revised: 11/26/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND We aimed to estimate the protection afforded by inactivated influenza vaccine, in both community and hospital settings, in a well characterised urban population in Auckland during 2014. METHODS We used two different comparison groups, all patients who tested negative for influenza and only those patients who tested negative for influenza and had a non-influenza respiratory virus detected, to calculate the vaccine effectiveness in a test negative study design. Estimates were made separately for general practice outpatient consultations and hospitalised patients, stratified by age group and by influenza type and subtype. Vaccine status was confirmed by electronic record for general practice patients and all respiratory viruses were detected by real time polymerase chain reaction. RESULTS 1039 hospitalised and 1154 general practice outpatient consultations met all the study inclusion criteria and had a respiratory sample tested for influenza and other respiratory viruses. Compared to general practice patients, hospitalised patients were more likely to be very young or very old, to be Māori or Pacific Islander, to have a low income and to suffer from chronic disease. Vaccine effectiveness (VE) adjusted for age and other participant characteristics using all influenza negative controls was 42% (95% CI: 16 to 60%) for hospitalised and 56% (95% CI: 35 to 70%) for general practice patients. The vaccine appeared to be most effective against the influenza A(H1N1)pdm09 strain with an adjusted VE of 62% (95% CI:38 to 77%) for hospitalised and 59% (95% CI:36 to 74%) for general practice patients, using influenza virus negative controls. Similar results found when patients testing positive for a non-influenza respiratory virus were used as the control group. CONCLUSION This study contributes to validation of the test negative design and confirms that inactivated influenza vaccines continue to provide modest but significant protection against laboratory-confirmed influenza.
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Affiliation(s)
- Nevil Pierse
- The University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand.
| | - Heath Kelly
- The Australian National University, Canberra 0200, ACT Australia; Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia.
| | - Mark G Thompson
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | - Ange Bissielo
- Institute of Environmental Science and Research, Upper Hutt Wellington, New Zealand.
| | - Sarah Radke
- The University of Auckland, Private Bag 92019, Victoria St West, Auckland, New Zealand.
| | - Q Sue Huang
- Institute of Environmental Science and Research, Upper Hutt Wellington, New Zealand.
| | - Michael G Baker
- The University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand.
| | - Nikki Turner
- The University of Auckland, Private Bag 92019, Victoria St West, Auckland, New Zealand.
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Ostermann H, Ukena D, Radke S, Freitag A, Hörnig S. German Country-Wide Surveys from 2012 and 2014 About EGFR Mutational Testing Algorithms Adopted by Medical Doctors in Patients with Nsclc. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv050.21] [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: 11/13/2022] Open
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Gane E, Kershenobich D, Seguin-Devaux C, Kristian P, Aho I, Dalgard O, Shestakova I, Nymadawa P, Blach S, Acharya S, Anand AC, Andersson MI, Arendt V, Arkkila P, Baatarkhuu O, Barclay K, Ben-Ari Z, Bergin C, Bessone F, Blokhina N, Brunton CR, Choudhuri G, Chulanov V, Cisneros L, Croes EA, Dahgwahdorj YA, Daruich JR, Dashdorj NR, Davaadorj D, de Knegt RJ, de Vree M, Gadano AC, Gower E, Halota W, Hatzakis A, Henderson C, Hoffmann P, Hornell J, Houlihan D, Hrusovsky S, Jarčuška P, Kostrzewska K, Leshno M, Lurie Y, Mahomed A, Mamonova N, Mendez-Sanchez N, Mossong J, Norris S, Nurmukhametova E, Oltman M, Oyunbileg J, Oyunsuren T, Papatheodoridis G, Pimenov N, Prins M, Puri P, Radke S, Rakhmanova A, Razavi H, Razavi-Shearer K, Reesink HW, Ridruejo E, Safadi R, Sagalova O, Sanchez Avila JF, Sanduijav R, Saraswat V, Schréter I, Shah SR, Shevaldin A, Shibolet O, Silva MO, Sokolov S, Sonderup M, Souliotis K, Spearman CW, Staub T, Stedman C, Strebkova EA, Struck D, Sypsa V, Tomasiewicz K, Undram L, van der Meer AJ, van Santen D, Veldhuijzen I, Villamil FG, Willemse S, Zuckerman E, Zuure FR, Prabdial-Sing N, Flisiak R, Estes C. Strategies to manage hepatitis C virus (HCV) infection disease burden - volume 2. J Viral Hepat 2015; 22 Suppl 1:46-73. [PMID: 25560841 DOI: 10.1111/jvh.12352] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [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: 02/06/2023]
Abstract
The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 15 countries, and the relative impact of two scenarios was considered: (i) increased treatment efficacy while holding the treated population constant and (ii) increased treatment efficacy and increased annual treated population. Increasing levels of diagnosis and treatment, in combination with improved treatment efficacy, were critical for achieving substantial reductions in disease burden. In most countries, the annual treated population had to increase several fold to achieve the largest reductions in HCV-related morbidity and mortality. This suggests that increased capacity for screening and treatment will be critical in many countries. Birth cohort screening is a helpful tool for maximizing resources. In most of the studied countries, the majority of patients were born between 1945 and 1985.
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Affiliation(s)
- E Gane
- Auckland Hospital Clinical Studies Unit, Auckland, New Zealand
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Hatzakis A, Chulanov V, Gadano AC, Bergin C, Ben-Ari Z, Mossong J, Schréter I, Baatarkhuu O, Acharya S, Aho I, Anand AC, Andersson MI, Arendt V, Arkkila P, Barclay K, Bessone F, Blach S, Blokhina N, Brunton CR, Choudhuri G, Cisneros L, Croes EA, Dahgwahdorj YA, Dalgard O, Daruich JR, Dashdorj NR, Davaadorj D, de Knegt RJ, de Vree M, Estes C, Flisiak R, Gane E, Gower E, Halota W, Henderson C, Hoffmann P, Hornell J, Houlihan D, Hrusovsky S, Jarčuška P, Kershenobich D, Kostrzewska K, Kristian P, Leshno M, Lurie Y, Mahomed A, Mamonova N, Mendez-Sanchez N, Norris S, Nurmukhametova E, Nymadawa P, Oltman M, Oyunbileg J, Oyunsuren T, Papatheodoridis G, Pimenov N, Prabdial-Sing N, Prins M, Radke S, Rakhmanova A, Razavi-Shearer K, Reesink HW, Ridruejo E, Safadi R, Sagalova O, Sanchez Avila JF, Sanduijav R, Saraswat V, Seguin-Devaux C, Shah SR, Shestakova I, Shevaldin A, Shibolet O, Silva MO, Sokolov S, Sonderup M, Souliotis K, Spearman CW, Staub T, Stedman C, Strebkova EA, Struck D, Sypsa V, Tomasiewicz K, Undram L, van der Meer AJ, van Santen D, Veldhuijzen I, Villamil FG, Willemse S, Zuckerman E, Zuure FR, Puri P, Razavi H. The present and future disease burden of hepatitis C virus (HCV) infections with today's treatment paradigm - volume 2. J Viral Hepat 2015; 22 Suppl 1:26-45. [PMID: 25560840 DOI: 10.1111/jvh.12351] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [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: 12/12/2022]
Abstract
Morbidity and mortality attributable to chronic hepatitis C virus (HCV) infection are increasing in many countries as the infected population ages. Models were developed for 15 countries to quantify and characterize the viremic population, as well as estimate the number of new infections and HCV related deaths from 2013 to 2030. Expert consensus was used to determine current treatment levels and outcomes in each country. In most countries, viremic prevalence has already peaked. In every country studied, prevalence begins to decline before 2030, when current treatment levels were held constant. In contrast, cases of advanced liver disease and liver related deaths will continue to increase through 2030 in most countries. The current treatment paradigm is inadequate if large reductions in HCV related morbidity and mortality are to be achieved.
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Affiliation(s)
- A Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Athens University Medical School, Athens, Greece
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Saraswat V, Norris S, de Knegt RJ, Sanchez Avila JF, Sonderup M, Zuckerman E, Arkkila P, Stedman C, Acharya S, Aho I, Anand AC, Andersson MI, Arendt V, Baatarkhuu O, Barclay K, Ben-Ari Z, Bergin C, Bessone F, Blach S, Blokhina N, Brunton CR, Choudhuri G, Chulanov V, Cisneros L, Croes EA, Dahgwahdorj YA, Dalgard O, Daruich JR, Dashdorj NR, Davaadorj D, de Vree M, Estes C, Flisiak R, Gadano AC, Gane E, Halota W, Hatzakis A, Henderson C, Hoffmann P, Hornell J, Houlihan D, Hrusovsky S, Jarčuška P, Kershenobich D, Kostrzewska K, Kristian P, Leshno M, Lurie Y, Mahomed A, Mamonova N, Mendez-Sanchez N, Mossong J, Nurmukhametova E, Nymadawa P, Oltman M, Oyunbileg J, Oyunsuren T, Papatheodoridis G, Pimenov N, Prabdial-Sing N, Prins M, Puri P, Radke S, Rakhmanova A, Razavi H, Razavi-Shearer K, Reesink HW, Ridruejo E, Safadi R, Sagalova O, Sanduijav R, Schréter I, Seguin-Devaux C, Shah SR, Shestakova I, Shevaldin A, Shibolet O, Sokolov S, Souliotis K, Spearman CW, Staub T, Strebkova EA, Struck D, Tomasiewicz K, Undram L, van der Meer AJ, van Santen D, Veldhuijzen I, Villamil FG, Willemse S, Zuure FR, Silva MO, Sypsa V, Gower E. Historical epidemiology of hepatitis C virus (HCV) in select countries - volume 2. J Viral Hepat 2015; 22 Suppl 1:6-25. [PMID: 25560839 DOI: 10.1111/jvh.12350] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [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: 12/23/2022]
Abstract
Chronic hepatitis C virus (HCV) infection is a leading cause of liver related morbidity and mortality. In many countries, there is a lack of comprehensive epidemiological data that are crucial in implementing disease control measures as new treatment options become available. Published literature, unpublished data and expert consensus were used to determine key parameters, including prevalence, viremia, genotype and the number of patients diagnosed and treated. In this study of 15 countries, viremic prevalence ranged from 0.13% in the Netherlands to 2.91% in Russia. The largest viremic populations were in India (8 666 000 cases) and Russia (4 162 000 cases). In most countries, males had a higher rate of infections, likely due to higher rates of injection drug use (IDU). Estimates characterizing the infected population are critical to focus screening and treatment efforts as new therapeutic options become available.
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Affiliation(s)
- V Saraswat
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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Gane E, Stedman C, Brunton C, Radke S, Henderson C, Estes C, Razavi H. Impact of improved treatment on disease burden of chronic hepatitis C in New Zealand. N Z Med J 2014; 127:61-74. [PMID: 25530333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND We describe the burden of HCV infection and estimate the effect of four different treatment strategies to reduce HCV-related morbidity and mortality. METHODS Baseline model parameters were based upon literature review and expert consensus, focusing on New Zealand data. Four scenarios were modelled: Scenario 1 estimated the impact of increased treatment efficacy, while Scenario 2 estimated the effect of increased treatment efficacy and gradual increases in numbers treated. Scenarios 3 and 4 estimated the impact of deferred introduction of new DAAs for either 1 or 2 years. RESULTS Prevalence of HCV infection peaked in 2010 (50,480 cases). Peak prevalence of cirrhosis and HCC will occur after 2030. Scenario 2 resulted in sizeable decreases in HCV-related morbidity and mortality. The impact of Scenario 1 was smaller. Deferring funding for new DAA treatments for a further 1 or 2 years resulted in an 18-36% increase in liver-related deaths in 2030. CONCLUSIONS While prevalence of chronic HCV infection may have peaked, disease burden continues to grow. Increased treatment uptake and efficacy combined with efforts to reduce disease transmission, will help prevent advanced liver disease and deaths.
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Affiliation(s)
- Edward Gane
- New Zealand Liver Transplant Unit, 15th Floor Support Building, Auckland City Hospital, Grafton, Auckland, New Zealand.
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20
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McNicholas A, Galloway Y, Stehr-Green P, Reid S, Radke S, Sexton K, Kieft C, Macdonald C, Neutze J, Drake R, Isaac D, O'Donnell M, Tatley M, Oster P, O'Hallahan J. Post-Marketing Safety Monitoring of a New Group B Meningococcal Vaccine in New Zealand, 2004-2006. Human Vaccines 2014; 3:196-204. [PMID: 17660718 DOI: 10.4161/hv.3.5.4458] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
New Zealand introduced a new outer membrane vesicle vaccine in 2004 to combat an epidemic of group B meningococcal disease. An Independent Safety Monitoring Board oversaw intensive safety monitoring, which included hospital surveillance, health professional reporting (passive and active) and mortality monitoring. With over three million doses administered to individuals aged under 20 years, the monitoring results provide consistent evidence supporting the vaccine's safety.
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Affiliation(s)
- Anne McNicholas
- Meningococcal Vaccine Strategy, Ministry of Health, Wellington, New Zealand.
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Turner N, Pierse N, Huang QS, Radke S, Bissielo A, Thompson MG, Kelly H. Interim estimates of the effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2014. Euro Surveill 2014; 19:20934. [PMID: 25358042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
We present preliminary results of influenza vaccine effectiveness (VE) in New Zealand using a case test-negative design for 28 April to 31 August 2014. VE adjusted for age and time of admission among all ages against severe acute respiratory illness hospital presentation due to laboratory-confirmed influenza was 54% (95% CI: 19 to 74) and specifically against A(H1N1)pdm09 was 65% (95% CI:33 to 81). For influenza-confirmed primary care visits, VE was 67% (95% CI: 48 to 79) overall and 73% (95% CI: 50 to 85) against A(H1N1)pdm09.
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Affiliation(s)
- N Turner
- The University of Auckland, Auckland, New Zealand
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Turner N, Pierse N, Huang QS, Radke S, Bissielo A, Thompson MG, Kelly H, on behalf of the SHIVERS investigation team C. Interim estimates of the effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2014. Euro Surveill 2014. [DOI: 10.2807/1560-7917.es2014.19.42.20934] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We present preliminary results of influenza vaccine effectiveness (VE) in New Zealand using a case test-negative design for 28 April to 31 August 2014. VE adjusted for age and time of admission among all ages against severe acute respiratory illness hospital presentation due to laboratory-confirmed influenza was 54% (95% CI: 19 to 74) and specifically against A(H1N1)pdm09 was 65% (95% CI:33 to 81). For influenza-confirmed primary care visits, VE was 67% (95% CI: 48 to 79) overall and 73% (95% CI: 50 to 85) against A(H1N1)pdm09.
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Affiliation(s)
- N Turner
- The University of Auckland, Auckland, New Zealand
| | - N Pierse
- University of Otago, Wellington, New Zealand
| | - Q S Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - S Radke
- The University of Auckland, Auckland, New Zealand
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - A Bissielo
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - M G Thompson
- Influenza Division, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - H Kelly
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
- Australian National University, Canberra, Australia
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Turner N, Pierse N, Bissielo A, Huang QS, Radke S, Baker M, Widdowson MA, Kelly H. Effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2013. Euro Surveill 2014; 19:20884. [PMID: 25188614 PMCID: PMC4627593] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
This study reports the first vaccine effectiveness (VE) estimates for the prevention of general practice visits and hospitalisations for laboratory-confirmed influenza from an urban population in Auckland, New Zealand, in the same influenza season (2013). A case test-negative design was used to estimate propensity-adjusted VE in both hospital and community settings. Patients with a severe acute respiratory infection (SARI) or influenza-like illness (ILI) were defined as requiring hospitalisation (SARI) or attending a general practice (ILI) with a history of fever or measured temperature ≥38 °C, cough and onset within the past 10 days. Those who tested positive for influenza virus were cases while those who tested negative were controls. Results were analysed to 7 days post symptom onset and adjusted for the propensity to be vaccinated and the timing during the influenza season. Influenza vaccination provided 52% (95% CI: 32 to 66) protection against laboratory-confirmed influenza hospitalisation and 56% (95% CI: 34 to 70) against presenting to general practice with influenza. VE estimates were similar for all types and subtypes. This study found moderate effectiveness of influenza vaccine against medically attended and hospitalised influenza in New Zealand, a temperate, southern hemisphere country during the 2013 winter season.
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Affiliation(s)
- Nikki Turner
- The University of Auckland, Private Bag 92019, Victoria St West, Auckland, New Zealand
| | - Nevil Pierse
- The University of Otago, Wellington, PO Box 7343 Wellington South 6242, New Zealand
| | - Ange Bissielo
- Institute of Environmental Science and Research, PO Box Box 40-158 Upper Hutt 5140 Wellington, New Zealand
| | - Q Sue Huang
- Institute of Environmental Science and Research, PO Box Box 40-158 Upper Hutt 5140 Wellington, New Zealand
| | - Sarah Radke
- The University of Auckland, Private Bag 92019, Victoria St West, Auckland, New Zealand
| | - Michael Baker
- The University of Otago, Wellington, PO Box 7343 Wellington South 6242, New Zealand
| | | | - Heath Kelly
- The Australian National University, Canberra, ACT 0200 Australia and the Victorian Infectious Diseases Reference Laboratory, 10 Wrecklyn St, North Menbourne VIC 3051 Melbourne, Australia
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Turner N, Pierse N, Bissielo A, Huang QS, Radke S, Baker MG, Widdowson MA, Kelly H, on behalf of the SHIVERS investigation team C. Effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2013. Euro Surveill 2014. [DOI: 10.2807/1560-7917.es2014.19.34.20884] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- N Turner
- The University of Auckland, Auckland, New Zealand
| | - N Pierse
- University of Otago, Wellington, New Zealand
| | - A Bissielo
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - Q S Huang
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - S Radke
- The University of Auckland, Auckland, New Zealand
- Institute of Environmental Science and Research, Wellington, New Zealand
| | - M G Baker
- University of Otago, Wellington, New Zealand
| | - M A Widdowson
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - H Kelly
- Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
- Australian National University, Canberra, Australia
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Gellhaus A, Liu H, Wu Y, Horsch L, Radke S, Giebel B, Köninger A, Kimmig R, Winterhager E. Der angiogene Faktor CCN3 ist an der endothelialen Dysfunktion in der Präeklampsie beteiligt. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347727] [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] Open
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Abu-Khalaf MM, Kim T, Chung GG, DiGiovanna M, Radke S, Cornfeld D, Harris L. A phase I study of biweekly capecitabine and the histone deacetylase inhibitors (HDACi) vorinostat in for advanced breast cancer (BC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e13609] [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: 11/20/2022] Open
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27
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Sexton K, McNicholas A, Galloway Y, Radke S, Kieft C, Stehr-Green P, Reid S, Neutze J, Drake R. Henoch-Schönlein purpura and meningococcal B vaccination. Arch Dis Child 2009; 94:224-6. [PMID: 18650242 DOI: 10.1136/adc.2007.125195] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [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: 11/04/2022]
Abstract
The risk of Henoch-Schönlein purpura (HSP) following vaccination with a group B meningococcal vaccine was assessed through active hospital safety monitoring. There was no increase in the relative incidence of HSP within 30 days after vaccination nor recurrence in HSP cases who received one or more further vaccine doses (re-challenge).
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Affiliation(s)
- K Sexton
- Meningococcal Vaccine Strategy, Ministry of Health, Wellington, New Zealand
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28
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Kapito-Tembo AP, Mwapasa V, Meshnick SR, Samanyika Y, Banda D, Bowie C, Radke S. Prevalence distribution and risk factors for Schistosoma hematobium infection among school children in Blantyre, Malawi. PLoS Negl Trop Dis 2009; 3:e361. [PMID: 19156193 PMCID: PMC2614474 DOI: 10.1371/journal.pntd.0000361] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Accepted: 12/16/2008] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Schistosomiasis is a public health problem in Malawi but estimates of its prevalence vary widely. There is need for updated information on the extent of disease burden, communities at risk and factors associated with infection at the district and sub-district level to facilitate effective prioritization and monitoring while ensuring ownership and sustainability of prevention and control programs at the local level. METHODS AND FINDINGS We conducted a cross-sectional study between May and July 2006 among pupils in Blantyre district from a stratified random sample of 23 primary schools. Information on socio-demographic factors, schistosomiasis symptoms and other risk factors was obtained using questionnaires. Urine samples were examined for Schistosoma hematobium ova using filtration method. Bivariate and multiple logistic regressions with robust estimates were used to assess risk factors for S. hematobium. One thousand one hundred and fifty (1,150) pupils were enrolled with a mean age of 10.5 years and 51.5% of them were boys. One thousand one hundred and thirty-nine (1,139) pupils submitted urine and S. hematobium ova were detected in 10.4% (95%CI 5.43-15.41%). Male gender (OR 1.81; 95% CI 1.06-3.07), child's knowledge of an existing open water source (includes river, dam, springs, lake, etc.) in the area (OR 1.90; 95% CI 1.14-3.46), history of urinary schistosomiasis in the past month (OR 3.65; 95% CI 2.22-6.00), distance of less than 1 km from school to the nearest open water source (OR 5.39; 95% CI 1.67-17.42) and age 8-10 years (OR 4.55; 95% CI 1.53-13.50) compared to those 14 years or older were associated with infection. Using urine microscopy as a gold standard, the sensitivity and specificity of self-reported hematuria was 68.3% and 73.6%, respectively. However, the positive predictive value was low at 23.9% and was associated with age. CONCLUSION The study provides an important update on the status of infection in this part of sub-Saharan Africa and exemplifies the success of deliberate national efforts to advance active participation in schistosomiasis prevention and control activities at the sub-national or sub-district levels. In this population, children who attend schools close to open water sources are at an increased risk of infection and self-reported hematuria may still be useful in older children in this region.
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Affiliation(s)
- Atupele P Kapito-Tembo
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.
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Radke S, Kumar A, Jones L, Tuck DP, Harris LN. Activity and mechanism of action of histone deacetylase inhibitors in trastuzumab resistant breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-3060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #3060
Introduction: The Her2 antibody trastuzumab (T) is the first biological therapy that has proven the value of Her2 blockade in breast cancer. However, not all patients respond to trastuzumab and relapses occur after this treatment. Several studies suggest that histone deacetylase inhibitors (HDACis) are active in Her2-amplified breast cancer but none of them have addressed the role of HDACis in trastuzumab-resistant breast cancer. HDACis act by inhibiting the deacetylation of histones and other non-histone proteins such as Hsp90. Our goal is to study the activity, optimal sequencing and mechanism of action of HDACis in Her2-amplified cell lines, which demonstrate either de novo or acquired resistance to trastuzumab.
 Methods: T-sensitive and Her2-overexpressing BT474 & SkBr3, T-resistant BT474 and de novo T-resistant cell lines MDA-MB361, MDA-MB453, UACC812 and UACC893 were used for all experiments. The HDACi TSA (0-1uM) and trastuzumab at 100ug/mL were used for proliferation assays applying WST1 reagent (Roche). Western-immunoblotting was performed using cell lysates from untreated and treated cells. Proteolytic cleavage of caspase-3 and PARP was analyzed as indicator for apoptosis, Akt expression and phosphorylation for survival, Her2 and Erk1/2 expression and phosphorylation for proliferation and Hsp90 and Hsp70 were analyzed as key enzymes for chaperone activity.
 Results: TSA inhibited proliferation in all cell lines [IC50 100-300 nM]. The addition of trastuzumab was antagonistic in de novo T-resistant cell lines MDA MB 453, UACC 812 and 893 but did not change the effect induced by TSA in acquired T-resistant cells (BT474_H100). Her2 expression decreased in TSA and TSA+T treated cells but not in cells treated with trastuzumab alone. Erk1/2 phosphorylation decreased in TSA and TSA+T treated cells but was not affected by trastuzumab alone. Similar phosphorylation patterns were observed regarding Akt. Of note, Akt, Erk1/2, Hsp90 and Hsp70 levels did not change. Finally, TSA induced caspase-3 and PARP cleavage when given as single agent or in combination with trastuzumab.
 Discussion: This study suggests that HDACis are active in both trastuzumab-sensitive and de novo or acquired trastuzumab-resistant cell lines. However, use of trastuzumab together with TSA may be antagonistic in tumors that are resistant against trastuzumab. Further studies are required in these cell lines in order to elucidate the mechanism of resistance against trastuzumab and the mechanism of the here observed antagonistic effect between trastuzumab and TSA.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3060.
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Affiliation(s)
- S Radke
- 1 Breast Cancer Program, Yale University Comprehensive Cancer Center, New Haven, CT
| | - A Kumar
- 1 Breast Cancer Program, Yale University Comprehensive Cancer Center, New Haven, CT
| | - L Jones
- 1 Breast Cancer Program, Yale University Comprehensive Cancer Center, New Haven, CT
| | - DP Tuck
- 2 Pathology, Yale University School of Medicine, New Haven, CT
| | - LN Harris
- 1 Breast Cancer Program, Yale University Comprehensive Cancer Center, New Haven, CT
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Stehr-Green P, Radke S, Kieft C, Galloway Y, McNicholas A, Reid S. The risk of simple febrile seizures after immunisation with a new group B meningococcal vaccine, New Zealand. Vaccine 2008; 26:739-42. [DOI: 10.1016/j.vaccine.2007.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2007] [Revised: 11/26/2007] [Accepted: 12/02/2007] [Indexed: 01/10/2023]
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Tabe Y, Jin L, Contractor R, Gold D, Ruvolo P, Radke S, Xu Y, Tsutusmi-Ishii Y, Miyake K, Miyake N, Kondo S, Ohsaka A, Nagaoka I, Andreeff M, Konopleva M. Novel role of HDAC inhibitors in AML1/ETO AML cells: activation of apoptosis and phagocytosis through induction of annexin A1. Cell Death Differ 2007; 14:1443-56. [PMID: 17464329 DOI: 10.1038/sj.cdd.4402139] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The chimeric fusion protein AML1-ETO, created by the t(8;21) translocation, recruits histone deacetylase (HDAC) to AML1-dependent promoters, resulting in transcriptional repression of the target genes. We analyzed the transcriptional changes in t(8;21) Kasumi-1 AML cells in response to the HDAC inhibitors, depsipeptide (FK228) and suberoylanilide hydroxamic acid (SAHA), which induced marked growth inhibition and apoptosis. Using cDNA array, annexin A1 (ANXA1) was identified as one of the FK228-induced genes. Induction of ANXA1 mRNA was associated with histone acetylation in ANXA1 promoter and reversal of the HDAC-dependent suppression of C/EBPalpha by AML1-ETO with direct recruitment of C/EBPalpha to ANXA1 promoter. This led to increase in the N-terminal cleaved isoform of ANXA1 protein and accumulation of ANXA1 on cell membrane. Neutralization with anti-ANXA1 antibody or gene silencing with ANXA1 siRNA inhibited FK228-induced apoptosis, suggesting that the upregulation of endogenous ANXA1 promotes cell death. FK228-induced ANXA1 expression was associated with massive increase in cell attachment and engulfment of Kasumi-1 cells by human THP-1-derived macrophages, which was completely abrogated with ANXA1 knockdown via siRNA transfection or ANXA1 neutralization. These findings identify a novel mechanism of action of HDAC inhibitors, which induce the expression and externalization of ANXA1 in leukemic cells, which in turn mediates the phagocytic clearance of apoptotic cells by macrophages.
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MESH Headings
- Acetylation
- Annexin A1/biosynthesis
- Annexin A1/genetics
- Antineoplastic Agents/pharmacology
- Apoptosis/drug effects
- Base Sequence
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Core Binding Factor Alpha 2 Subunit/metabolism
- DNA, Complementary/genetics
- Depsipeptides/pharmacology
- Enzyme Inhibitors/pharmacology
- Histone Deacetylase Inhibitors
- Histones/metabolism
- Humans
- Hydroxamic Acids/pharmacology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Macrophages/physiology
- Oncogene Proteins, Fusion/metabolism
- Phagocytosis/drug effects
- RUNX1 Translocation Partner 1 Protein
- Up-Regulation/drug effects
- Vorinostat
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Affiliation(s)
- Y Tabe
- Section of Molecular Hematology and Therapy, Department of Blood and Marrow Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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32
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Radke S, Battmann A, Jatzke S, Eulert J, Jakob F, Schütze N. Expression of the angiomatrix and angiogenic proteins CYR61, CTGF, and VEGF in osteonecrosis of the femoral head. J Orthop Res 2006; 24:945-52. [PMID: 16609965 DOI: 10.1002/jor.20097] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Angiogenesis and bone repair are closely linked processes. VEGF, CYR61, and CTGF have been identified as signaling factors that control angiogenesis and could be important in fracture healing. The purpose of this study was to investigate the expression of these signaling factors in osteonecrosis of the femoral head. Twenty-one bone cylinders were retrieved from hips of patients with osteonecrosis of the femoral head at different ARCO stages. Immunohistochemistry for CD34, CYR61, CTGF, and VEGF expression was done on each bone cylinder representing the different regions of osteonecrosis (necrosis, fibrosis, transition zone, and edematous area). VEGF, CYR61, and CTGF were expressed in samples with osteonecrosis. Particularly VEGF and CYR61 were highly expressed in the edematous area. CYR61 was also highly expressed in the transition zone. CTGF was expressed mainly in the area of marrow fibrosis and edema. CYR61, CTGF, and VEGF are expressed to different degrees in the different repair zones of osteonecrosis. Particularly, the high expression of VEGF and CYR61 in the edematous area may represent a consequence of hypoxia and indicate a role of these proteins in the repair processes ongoing in osteonecrosis.
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Affiliation(s)
- S Radke
- Orthopaedic Center for Musculoskeletal Research, Molecular Orthopaedics, University of Würzburg, Brettreichstrasse 11, 97074 Würzburg, Germany
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33
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Radke S, Wollmerstedt N, Bischoff A, Eulert J. Knee arthroplasty for spontaneous osteonecrosis of the knee: unicompartimental vs bicompartimental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2005; 13:158-62. [PMID: 15448886 DOI: 10.1007/s00167-004-0551-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2004] [Accepted: 05/17/2004] [Indexed: 10/26/2022]
Abstract
Spontaneous osteonecrosis of the knee (SON) is an osteonecrosis that mainly affects the medial femoral condyle. In endstage SON, knee arthroplasty is the therapy of choice. Because of the unicompartimental nature of the knee, unicondylar knee arthroplasty is considered an ideal implant for treatment of this condition. The purpose of this study was to prove that the long-term results of unicondylar implants are better than the results of bicondylar implants for the treatment of SON. All patients treated for SON between 1984 and 2000 have been recorded. Two groups were formed according to the implant used. In all patients the preoperative radiograph was analyzed according to stage and size of the osteonecrotic lesion and the osteoarthritic changes. Postoperatively, the Knee Society Score and the radiograph were recorded. Thirty-nine patients were included in this study, of which 23 patients were treated by a unicondylar implant and 16 by a bicondylar implant. On a short-term basis, unicondylar implants had better clinical results; however, on a long-term basis bicondylar implants were better. In comparison, only unicondylar implants had to be revised. Radiolucency lines were mainly observed in patients with unicondylar impants and large areas of osteonecrosis. Our long-term results suggest that patients with SON are better treated by bicondylar implants. The reasons for the higher failure rate for unicondylar implants are poor bone stock and secondary arthritic changes.
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Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, König-Ludwig Haus, Julius-Maximilians University Würzburg, Brettreichstr. 11, 97074, Würzburg, Germany,
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34
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Radke S, Vispo-Seara J, Walther M, Kenn W, Kirschner S, Ettl V, Eulert J. [Osteochondral lesions of the talus -- indications for MRI with a contrast agent]. ACTA ACUST UNITED AC 2004; 142:618-24. [PMID: 15472774 DOI: 10.1055/s-2004-820417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM This study aims to establish the indication for a pre- and postoperative MRI examination with an intravenous contrast agent in patients with an osteochondral lesion of the talus. METHODS 20 patients with an osteochondral lesion of the talus in the different stages according to DiPaola were prospectively examined preoperatively and 6 months postoperatively by an MRI investigation with an i. v. contrast agent. The Weber ankle score was determined pre- and postoperatively. A correlation was calculated between MRI and arthroscopic findings of an osteochondral lesion (Spearman-rho). RESULTS There was a significant correlation among the radiological, the MRI and the arthroscopically determined locations. With regard to staging only 12 out of 20 lesions were staged correctly by MRI using arthroscopy as a gold standard. Due to metal artifacts and morphological changes the postoperative MRI could not be used for staging. CONCLUSION A preoperative MRI investigation is indicated in patients with ankle pain of unknown origin, a normal radiograph and a suspected osteochondral lesion of the talus. MRI is not indicated to determine the localization and the stage of an osteochondral lesion. A postoperative MRI is only necessary for the exclusion of a secondary pathology.
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Affiliation(s)
- S Radke
- Orthopädische Klinik, Ludwig-Maximilians-Universität, Würzburg.
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35
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Radke S, Kirschner S, Seipel V, Rader C, Eulert J. Magnetic resonance imaging criteria of successful core decompression in avascular necrosis of the hip. Skeletal Radiol 2004; 33:519-23. [PMID: 15221216 DOI: 10.1007/s00256-004-0811-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2003] [Revised: 08/15/2003] [Accepted: 04/28/2004] [Indexed: 02/02/2023]
Abstract
To identify imaging criteria that determine the outcome of core decompression (CD) in femoral-head avascular necrosis (AVN). Radiographs and magnetic resonance imaging (MRI) of 65 hips with early stage AVN treated by core decompression between January 1990 and December 2000 for AVN were reviewed. All hips were categorized into two groups according to the result of CD using total hip arthroplasty (THA) as an end point. Hips that had no THA at follow-up were allocated to group I; those treated with a THA were allocated to group II. CD results were calculated for each group using THA as an end point. The parameters analyzed were the presence or absence of edema associated with the double-line sign on the preoperative MRI, the type of epiphyseal scar (ES) according to Jing, and the type of necrosis according to Mitchell. On follow-up, 45 hips had no THA (group I); 20 patients had a THA (group II). Patients with a radiographic crescent sign and those with edema associated with the double-line sign progressed to THA significantly more frequently. The extent of the necrosis had less discriminatory effect between the two groups. ES and necrotic tissue types had no prognostic value. In regard to the success of CD, it is important to differentiate on MRI between a double line sign plus bone marrow edema and a double-line sign only.
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Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Julius-Maximilians University, Würzburg, Brettreichstr.11, 97074 Würzburg, Germany.
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36
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Radke S, Kenn W, Eulert J. Transient bone marrow edema syndrome progressing to avascular necrosis of the hip ? a case report and review of the literature. Clin Rheumatol 2004; 23:83-8. [PMID: 14749994 DOI: 10.1007/s10067-003-0820-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2003] [Accepted: 09/29/2003] [Indexed: 10/26/2022]
Abstract
Transient bone marrow edema syndrome (TMES) is a rare disease of unknown etiology. Diagnosis is made by exclusion. There is still controversy as to whether TMES is considered to be a reversible form of avascular necrosis (AVN), a disease entity of its own or a form of non-traumatic algodystrophy. We here describe the extremely rare occurrence of three cases of TMES that progressed to AVN.
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Affiliation(s)
- S Radke
- Department of Orthopedic Surgery, König Ludwig Haus, Julius-Maximilians-Universität Würzburg, Brettreichstr. 11, 97074, Würzburg, Germany.
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37
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Radke S, Walther M, Ettl V, König A. Epidermoid cyst mimicking monoarticular arthritis of the great toe. Rheumatol Int 2003; 24:117-9. [PMID: 14600783 DOI: 10.1007/s00296-003-0345-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2003] [Accepted: 04/25/2003] [Indexed: 10/26/2022]
Abstract
Local swellings of the foot are a common presentation in rheumatological practice. In the following case report, an epidermoid cyst presenting with the typical features of monoarticular arthritis is described in a 27-year-old woman. The differential diagnosis of forefoot swelling is discussed, with particular emphasis on epidermoid cysts and monoarticular arthritis.
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Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Julius Maximilian University, Brettreichstrasse 11, 97074, Würzburg, Germany
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Abstract
We reviewed 34 patients (38 joints) with hallux rigidus treated from 1989 to 1999 with arthrodesis of the first metatarsophalangeal joint. Average patient age at time of surgery was 52 (24-71) years, and the mean follow-up was 54 (18-116) months. There were six superficial infections, and all arthrodeses united. There was a good functional result with a significant pain reduction. The mean postoperative American Orthopaedic Foot and Ankle Society (AOFAS) score was 53 (5-84) points.
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Affiliation(s)
- V. Ettl
- Department of Orthopaedics, Julius-Maximillian University Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
| | - S. Radke
- Department of Orthopaedics, Julius-Maximillian University Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
| | - M. Gaertner
- Department of Orthopaedics, Julius-Maximillian University Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
| | - M. Walther
- Department of Orthopaedics, Julius-Maximillian University Wuerzburg, Brettreichstraße 11, 97074 Wuerzburg, Germany
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39
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Debret R, El Btaouri H, Duca L, Rahman I, Radke S, Haye B, Sallenave JM, Antonicelli F. Annexin A1 processing is associated with caspase-dependent apoptosis in BZR cells. FEBS Lett 2003; 546:195-202. [PMID: 12832039 DOI: 10.1016/s0014-5793(03)00570-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [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: 11/22/2022]
Abstract
Annexins are widely distributed and have been described in lung as well as in other cells and tissues. Annexin I (ANX AI) is a member of the calcium-dependent phospholipid binding protein family. Besides its anti-inflammatory function, ANX AI has been involved in several mechanisms such as the Erk repression pathway or apoptosis. To investigate the role of ANX AI on apoptosis in broncho-alveolar cells, we have constructed a plasmid containing the ANX AI full length cDNA. Transfected BZR cells displayed a higher level of both forms of ANX AI (37 and 33 kDa) as well as a decrease in cell viability (two-fold versus cells transfected with an empty vector). In order to analyse the endogenous ANX AI processing during stimulus-induced apoptosis, BZR cells were treated with a commonly used inducer, i.e. C2 ceramides. In these conditions, microscopic analysis revealed chromatin condensation in dying cells and the Bcl-2, Bcl-x(L)/Bax mRNA balance was altered. Caspase-3 is one of the key executioners of apoptosis, being responsible for the cleavage of many proteins such as the nuclear enzyme poly(ADP-ribose) polymerase (PARP). We demonstrate that caspase-3 was activated after 4 h treatment in the presence of ceramide leading to the cleavage of PARP. Dose-response experiments revealed that cell morphology and viability modifications following ceramide treatment were accompanied by an increase in endogenous ANX AI processing. Interestingly, in both ceramide and transfection experiments, the ANX AI cleaved form was enhanced whereas pre-treatment with the caspase inhibitor Z-VAD-fmk abolished ANX AI cleavage. In conclusion, this study demonstrates a complex regulatory role of caspase-dependent apoptosis where ANX AI is processed at the N-terminal region which could give susceptibility to apoptosis upon ceramide treatment.
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Affiliation(s)
- R Debret
- Laboratoire de Biochimie, CNRS FRE 2534, Université de Reims Champagne-Ardenne, UFR Sciences, Moulin de la Housse, PO Box 1039, 51687 Reims Cedex 2, France
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40
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König A, Radke S, Molzen H, Haase M, Müller C, Drexler D, Natalis M, Krauss M, Behrens N, Irnich D. [Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain - range of motion analysis]. Z Orthop Ihre Grenzgeb 2003; 141:395-400. [PMID: 12928995 DOI: 10.1055/s-2003-41566] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM The aim of this study was to compare the effects of acupuncture on active motion of the cervical spine in patients with chronic neck pain with those of "sham" laser acupuncture and massage. MATERIAL AND METHODS 177 patients with chronic neck pain were included in this prospective, randomized, placebo-controlled study. The patients were allocated by external randomization to five treatments over three weeks with acupuncture, massage and "sham" laser acupuncture. The range of active motion was measured by means of a 3D ultrasound real time motion analyzer. RESULTS The analysis of cervical motion in three directions showed the largest increase in range of motion 14 days after acupuncture. Compared to massage, a significant improvement in total range of motion was seen in those patients treated by acupuncture immediately (p = 0,03) and one week (p = 0,03) weeks after therapy. There was no significant difference in those patients treated by sham laser acupuncture. CONCLUSION The results of the study indicate that acupuncture is superior to conventional massage for improving active range of motion in patients with chronic neck pain. Because of its positive effects, its acceptance among patients and the lack of severe side effects, acupuncture can be recommended for the treatment of chronic neck pain, although there was no significant difference in results between "sham" laser acupuncture and acupuncture.
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Affiliation(s)
- A König
- Orthopädische Klinik, Klinik am Eichert, Göppingen, Germany.
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Radke S, Rader C, Kenn W, Kirschner S, Walther M, Eulert J. Transient marrow edema syndrome of the hip: results after core decompression. A prospective MRI-controlled study in 22 patients. Arch Orthop Trauma Surg 2003; 123:223-7. [PMID: 12739033 DOI: 10.1007/s00402-003-0506-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2002] [Indexed: 10/19/2022]
Abstract
BACKGROUND Transient marrow edema syndrome (TMES) of the hip is a disease of acute onset and severe functional disability. There is histological evidence for an ischemic etiology of TMES of the hip. Core decompression as applied for avascular necrosis (AVN) of the hip is therefore a therapeutic alternative to conservative therapy, the latter leading only to a reduction of symptoms but never a shortening of the course of the disease. METHODS Between January 1998 and June 2000, 22 hips with TMES were treated with core decompression in our department. TMES was diagnosed by exclusion. MRI was done preoperatively and at 6 months postoperatively. The postoperative MRI result was classified into three categories. RESULTS After an average of 7.2 (range 1-30) days, all patients were pain-free after core decompression. In 2 patients, TMES progressed to AVN despite core decompression. All others had no signal alterations of the head of the femur on MRI after 6 months. The postoperative Harris Hip Score (HHS) in patients with TMES was on average 93.7 (range 77-95); in patients with AVN, the postoperative HHS was 47 (range 45-49). CONCLUSION Our results demonstrate that core decompression of the hip significantly shortens the natural course of disease of TMES of the hip.
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Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, Koenig Ludwig Haus, University of Würzburg, Brettreichstr.11, 97074 Würzburg, Germany.
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42
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Radke S, Kirschner S, Seipel V, Rader C, Eulert J. Treatment of transient bone marrow oedema of the hip--a comparative study. Int Orthop 2003; 27:149-52. [PMID: 12799758 PMCID: PMC3458445 DOI: 10.1007/s00264-003-0452-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/18/2003] [Indexed: 11/26/2022]
Abstract
Between 1990 and 2000, we treated 43 patients with transient bone marrow oedema of the hip. Five were treated with nonsteroidal antiinflammatory drugs (NSAIDs) and limited weight bearing, and 38 by core decompression followed by limited weight bearing. At follow-up 2-10 years later, all patients were assessed by a structured interview as well as the Harris hip score (HHS) and the Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC). Both groups reached the same clinical outcome (HHS and WOMAC). Core decompression enabled a significantly faster recovery. There were no complications, but progression to avascular necrosis was seen in both groups. Core decompression induced fast pain relief, making it the preferable treatment.
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Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, Koenig-Ludwig Haus, Julius-Maximilians University Würzburg, Brettreichstr. 11, 97070 Wuerzburg, Germany.
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Abstract
A juxtaarticular ganglion (JAG) is a rare tumor-like lesion of the acetabulum, causing chronic hip disability. Due to its location, a JAG is a special form of an intraosseous ganglion. There is a lack of histological criteria to differentiate a JAG from an osteoarthritic cyst. The clinical findings of a JAG are determined by its proximity to the joint gap and its extraarticular extension. In a case report the necessary diagnostics as well as the therapeutic consequences are discussed.
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Affiliation(s)
- S Radke
- König-Ludwig-Haus, Universität Würzburg, Brettreichstr. 11, 97074 Würzburg
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44
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Rader CP, Baumann B, Rolf O, Radke S, Hendrich C, Schütze N, Seufert J, Jakob F. Detection of differentially expressed genes in particle disease using array-filter analysis. BIOMED ENG-BIOMED TE 2002; 47:111-6. [PMID: 12090138 DOI: 10.1515/bmte.2002.47.5.111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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]
Abstract
UNLABELLED The precise cellular mechanism of osteolysis in particle disease is still unknown. The aim of the study was to screen for new gene products in macrophages during particle contact. METHOD In an established macrophage model THP1-cells (human monocytic cells) were differentiated under the influence of vitamin D3 and GM-CSF into macrophage-like cells (MLC). MLCs were incubated each with different concentrations of polyethylene particles, Lipopolysaccharids (LPS) and controls. Isolated RNA was transcribed into complementary radioactive 32P labeled cDNA. This probe was hybridised on an human cDNA expression array and analysed by autoradiography. To obtain a more reliable method quantifying mRNA, the reverse transcriptase polymerase chain reaction (RT-PCR) was used. RESULTS The arrays showed an upregulation of the following genes by particles: TNF-Rezeptor 2, IL-1 Receptor Antagonist, Bone Morphogenic Protein 4 and HM 145. This was proven three times using RT-PCR and statistically significant in comparison to the controls. LPS induced the same upregulation except for HM145 whereas particles caused downregulation of this mRNA expression. CONCLUSION Our results prove that the model of differentiated THP-1 cells treated with PE particles is a suitable system to analyse differential gene expression patterns, since the induction of the major positive control genes TNF alpha and IL1 beta were detected by this approach. BMP 4 is known as signal protein which mediates ectopic bone formation and can also be interpreted as a contra regulatory gene. HM 145 belongs to the leukocyte chemotactic peptide receptor family. HM 145 seems to be one of the first genes that is enhanced along the septical pathway but less expressed by contact with particles. Analysis of HM 145 expression might help to diagnose septic versus aseptic loosening of prosthesis.
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Affiliation(s)
- Ch P Rader
- Department of Orthopadics, University of Wuerzburg
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46
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Abstract
MRI currently offers the best imaging information for the diagnosis of subacromial pain syndrome, rotator cuff tears and osteoarthritis of the shoulder. The excellent anatomical and tissue specific imaging allows a detailed evaluation of the rotator cuff as well as the adjacent bony structures. If the cause of subacromial pain can not be determined despite extensive clinical, sonographical and radiological examination, MRI is indicated if there is a suspected pathology of the bony structures or the glenohumeral joint that could influence the further therapeutic procedures. In addition, MRI evaluation of muscular atrophy has become an important factor for determining appropriate therapy, particularly in cases of massive rotator cuff tears.
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Affiliation(s)
- S Radke
- Orthopädische Klinik, König Ludwig Haus, Universität Würzburg, Brettreichstrasse 11, 97070 Würzburg
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47
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Abstract
We treated ten patients who on the basis of MRI were suspected to have transient bone marrow oedema. In eight cases the talus was affected, in one the cuboid and in one the navicular bone. All patients had acute onset pain at the ankle. Four were treated with core decompression and had an immediate pain relief. Six were treated conservatively and became also pain-free but with considerable delay.
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Affiliation(s)
- S Radke
- Department of Orthopaedic Surgery, Koenig-Ludwig Haus, University of Würzburg, Würzburg, Germany.
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Walther M, Harms H, Krenn V, Radke S, Faehndrich TP, Gohlke F. Correlation of power Doppler sonography with vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis. Arthritis Rheum 2001. [PMID: 11229463 DOI: 10.1002/1529-0131(200102)44] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine the significance of power Doppler sonography (PDS) in the diagnosis of synovial hypertrophy of the knee joint by verifying and comparing the PDS findings with histopathologic findings of synovial membrane vascularity. METHODS The knee joints of 23 patients who were undergoing arthroplasty of the knee joint because of osteoarthritis or rheumatoid arthritis were examined with ultrasound before arthroplasty. The vascularity of the synovial membrane was classified semiquantitatively using PDS. A sample of synovial tissue was obtained during the arthroplasty, and the vascularity of the synovial tissue was evaluated by immunohistochemistry (factor VIII) and was graded qualitatively by a pathologist who was unaware of the PDS findings. The visual qualitative grading by the examiner was controlled by analyzing PDS images and histologic samples using a digital image evaluation system. RESULTS The correlation between the qualitative PDS results and the qualitative grading of the vascularity by the pathologist was 0.89 by Spearman's rho (P < 0.01). The Pearson correlation coefficient between the digital analysis of the PDS images and the digital analysis of the tissue sections was 0.81 (P < 0.01). Digital image analysis and qualitative grading by the examiner had a correlation of 0.89 by Spearman's p (P < 0.01) for the PDS images. The correlation between the qualitative estimation of vascularity by the pathologist and the digital image analysis was 0.88 by Spearman's rho (P < 0.01). CONCLUSION In the present study, PDS proved to be a reliable diagnostic method for qualitative grading of the vascularity of the synovial tissue. In clinical practice, PDS allows further differentiation of the hypertrophic synovium.
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Ettl V, Kenn W, Radke S, Kirschner S, Goerttler-Krauspe I, Vispo-Seara JL. [The role of MRI in therapy and follow-up after surgical treatment of osteochondrosis dissecans of the talus]. Z Orthop Ihre Grenzgeb 2001; 139:157-62. [PMID: 11386107 DOI: 10.1055/s-2001-15049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AIM Our study was designed to evaluate the use of magnetic resonance imaging (MRI) in the follow-up of surgically treated osteochondrosis dissecans (OCD) of the talus. METHOD We investigated 16 patients (18 joints) with OCD of the talus, surgically treated in our department between 1990 and 1997. All of them had preoperative MRI scans of the affected ankle. The mean follow-up was 40 months (8-82). All patients were evaluated by clinical examination, plain radiography and MRI using a standard protocol. RESULTS The clinical Bray score improved significantly from 58 preoperative to 82 postoperative. Using a visual analogue scale we saw a significant reduction of the patients pain level post-op. In 72% of the patients the preoperative MRI was able to predict the accurate stage of the cartilage. Postoperative MRI showed no more lesion in 3, intact articular cartilage in 11, and disrupted cartilage in 4 joints. There was no correlation between clinical, plain radiographical, and MRI findings postoperative. CONCLUSION Arthroscopy remains the golden standard in evaluating articular cartilage. Using our data, MRI is not the method of choice in the follow-up of surgically treated OCD lesions of the talus. Postoperative use of intravenous contrast media gave no additional information. Postoperative MRI should be reserved only for symptomatic patients to gather additional information about the actual state of the OCD. Afterwards a prompt arthroscopy of the symptomatic ankle should be performed.
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Affiliation(s)
- V Ettl
- Kliniken Dr. Erler, Abt. für Unfallchirurgie, Nürnberg
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Walther M, Harms H, Krenn V, Radke S, Faehndrich TP, Gohlke F. Correlation of power Doppler sonography with vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis. Arthritis Rheum 2001; 44:331-8. [PMID: 11229463 DOI: 10.1002/1529-0131(200102)44:2<331::aid-anr50>3.0.co;2-0] [Citation(s) in RCA: 343] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To examine the significance of power Doppler sonography (PDS) in the diagnosis of synovial hypertrophy of the knee joint by verifying and comparing the PDS findings with histopathologic findings of synovial membrane vascularity. METHODS The knee joints of 23 patients who were undergoing arthroplasty of the knee joint because of osteoarthritis or rheumatoid arthritis were examined with ultrasound before arthroplasty. The vascularity of the synovial membrane was classified semiquantitatively using PDS. A sample of synovial tissue was obtained during the arthroplasty, and the vascularity of the synovial tissue was evaluated by immunohistochemistry (factor VIII) and was graded qualitatively by a pathologist who was unaware of the PDS findings. The visual qualitative grading by the examiner was controlled by analyzing PDS images and histologic samples using a digital image evaluation system. RESULTS The correlation between the qualitative PDS results and the qualitative grading of the vascularity by the pathologist was 0.89 by Spearman's rho (P < 0.01). The Pearson correlation coefficient between the digital analysis of the PDS images and the digital analysis of the tissue sections was 0.81 (P < 0.01). Digital image analysis and qualitative grading by the examiner had a correlation of 0.89 by Spearman's p (P < 0.01) for the PDS images. The correlation between the qualitative estimation of vascularity by the pathologist and the digital image analysis was 0.88 by Spearman's rho (P < 0.01). CONCLUSION In the present study, PDS proved to be a reliable diagnostic method for qualitative grading of the vascularity of the synovial tissue. In clinical practice, PDS allows further differentiation of the hypertrophic synovium.
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