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Fredericksen RJ, Fitzsimmons E, Drumright LN, Loo S, Dougherty S, Brown S, Pearce J, Nance RM, Whitney BM, Ruderman S, O'Cleirigh C, Cropsey K, Mayer KH, Mugavero MJ, Delaney JAC, Crane HM, Hahn A. Vaporized nicotine use among patients in HIV care who smoke tobacco: perceived health effects and effectiveness as a smoking cessation tool. AIDS Care 2023; 35:1741-1748. [PMID: 36912767 PMCID: PMC10497704 DOI: 10.1080/09540121.2023.2180476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 01/13/2023] [Indexed: 03/14/2023]
Abstract
Evidence suggests adverse health effects from vaporized nicotine (VN) use, such as electronic "e" cigarettes, and limited efficacy to aid tobacco cessation. People with HIV (PWH) smoke tobacco at higher rates than the general population, with greater morbidity, highlighting the necessity of effective tobacco cessation tools. PWH may be more vulnerable to adverse effects of VN. Using semi-structured 1:1 interviews, we examined health beliefs regarding VN, patterns of use, and perceived effectiveness for tobacco cessation among PWH in HIV care at three geographically diverse U.S. sites. PWH (n = 24) had limited understanding of VN product content or health effects, presuming VN less harmful than tobacco cigarettes (TC). VN failed to adequately replicate the psychoactive effects or desired ritual of smoking TC. Concurrent TC use, and continuous VN use throughout the day, was common. Satiety using VN was elusive, and consumption quantity was difficult to track. VN had limited desirability and durability as a TC cessation tool among the interviewed PWH.
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Affiliation(s)
| | - E Fitzsimmons
- Department of Medicine, University of Washington, Seattle, USA
| | - L N Drumright
- Department of Medicine, University of Washington, Seattle, USA
| | - S Loo
- Fenway Community Health, Boston, USA
| | - S Dougherty
- Department of Medicine, University of Alabama-Birmingham, Birmingham, AL, USA
| | - S Brown
- Department of Medicine, University of Washington, Seattle, USA
| | - J Pearce
- Department of Medicine, University of Washington, Seattle, USA
| | - R M Nance
- Department of Medicine, University of Washington, Seattle, USA
| | - B M Whitney
- Department of Medicine, University of Washington, Seattle, USA
| | - S Ruderman
- Department of Medicine, University of Washington, Seattle, USA
| | | | - K Cropsey
- Fenway Community Health, Boston, USA
| | - K H Mayer
- Fenway Community Health, Boston, USA
| | - M J Mugavero
- Department of Medicine, University of Alabama-Birmingham, Birmingham, AL, USA
| | - J A C Delaney
- Department of Medicine, University of Washington, Seattle, USA
| | - H M Crane
- Department of Medicine, University of Washington, Seattle, USA
| | - A Hahn
- Department of Medicine, University of Washington, Seattle, USA
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2
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Fredericksen RJ, Nance RM, Whitney BM, Harding BN, Fitzsimmons E, Del Rio C, Eron J, Feaster DJ, Kalokhe AS, Mathews WC, Mayer KH, Metsch LR, Mugavero MJ, Potter J, O'Cleirigh C, Napravnik S, Rodriguez B, Ruderman S, Jac D, Crane HM. Correlates of psychological intimate partner violence with HIV care outcomes on patients in HIV care. BMC Public Health 2021; 21:1824. [PMID: 34627181 PMCID: PMC8502266 DOI: 10.1186/s12889-021-11854-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/24/2021] [Indexed: 11/27/2022] Open
Abstract
Background Among people living with HIV (PLWH), physical intimate partner violence (IPV) is associated with poor virologic, psychiatric, and behavioral outcomes. We examined non-physical, psychological intimate partner violence (psy-IPV) and HIV care outcomes using data from two U.S. consortia. Methods We conducted multivariable analyses with robust standard errors to compare patients indicating/not indicating psy-IPV. Results Among PLWH (n = 5950), 9.5% indicated psy-IPV; these individuals were younger (− 3; 95% CI [− 2,-4], p-value < 0.001), less likely to be on antiretroviral treatment (ART) (0.73 [0.55,0.97], p = 0.03), less adherent to ART (− 4.2 [− 5.9,-2.4], p < 0.001), had higher odds of detectable viral load (1.43 [1.15,1.78], p = 0.001) and depression (2.63 [2.18,3.18], p < 0.001), and greater use of methamphetamines/crystal [2.98 (2.30,3.87),p < 0.001], cocaine/crack [1.57 (1.24,1.99),p < 0.001], illicit opioids [1.56 (1.13,2.16),p = 0.007], and marijuana [1.40 (1.15,1.70), p < 0.001]. Conclusion Psychological IPV, even in the absence of physical or sexual IPV, appears to be associated with HIV care outcomes and should be included in IPV measures integrated into routine HIV care. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11854-x.
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Affiliation(s)
- R J Fredericksen
- Department of Medicine, University of Washington, Seattle, Washington, USA.
| | - R M Nance
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - B M Whitney
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - B N Harding
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - E Fitzsimmons
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - C Del Rio
- Department of Global Health, Emory University, Atlanta, Georgia
| | - J Eron
- School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - D J Feaster
- Department of Public Health Sciences, University of Miami, Miami, Florida, USA
| | - A S Kalokhe
- Department of Medicine, Emory University, Atlanta, Georgia
| | - W C Mathews
- Department of Medicine, University of California - San Diego, San Diego, California, USA
| | - K H Mayer
- The Fenway Institute, Boston, MA, USA
| | - L R Metsch
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
| | - M J Mugavero
- Department of Medicine, University of Alabama - Birmingham, Birmingham, AL, USA
| | - J Potter
- Department of Medicine, Harvard University, Cambridge, MA, USA
| | - C O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - S Napravnik
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - B Rodriguez
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - S Ruderman
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Delaney Jac
- College of Pharmacy, University of Manitoba, Winnipeg, Manitoba, USA
| | - H M Crane
- Department of Medicine, University of Washington, Seattle, Washington, USA
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3
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Ruderman S, Eshein A, Valuckaite V, Dougherty U, Almoghrabi A, Gomes A, Singh A, Pabla B, Roy HK, Hart J, Bissonnette M, Konda V, Backman V. Early increase in blood supply (EIBS) is associated with tumor risk in the Azoxymethane model of colon cancer. BMC Cancer 2018; 18:814. [PMID: 30103733 PMCID: PMC6090821 DOI: 10.1186/s12885-018-4709-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 07/31/2018] [Indexed: 01/20/2023] Open
Abstract
Background The present study aimed to investigate the role of blood supply in early tumorigenesis in colorectal cancer. We leveraged the renin angiotensin system (RAS) to alter colonic blood supply and determine the effect on tumor initiation and progression. Methods To test the effect of blood supply on tumorigenesis, 53 male A/J mice were randomly assigned to one of three RAS modulation groups and one of two AOM treatments. The RAS modulation groups were I) water (RAS-unmodulated) as a control group, II) angiotensin-II and III) the angiotensin receptor blocker, Losartan. The mice in each group were then randomly split into either the saline control condition or the AOM-treated condition in which tumors were induced with a standard protocol of serial azoxymethane (AOM) injections. To monitor microvascular changes in the rectal mucosa during the study, we used confocal laser endomicroscopy (CLE) with FITC-Dextran for in-vivo imaging of vessels and polarization-gated spectroscopy (PGS) to quantify rectal hemoglobin concentration ([Hb]) and blood vessel radius (BVR). Results At 12 weeks post-AOM injections and before tumor formation, CLE images revealed many traditional hallmarks of angiogenesis including vessel dilation, loss of co-planarity, irregularity, and vessel sprouting in the pericryptal capillaries of the rectal mucosa in AOM-Water tumor bearing mice. PGS measurements at the same time-point showed increased rectal [Hb] and decreased BVR. At later time points, CLE images showed pronounced angiogenic features including irregular networks throughout the colon. Notably, the AOM-Losartan mice had significantly lower tumor multiplicity and did not exhibit the same angiogenic features observed with CLE, or the increase in [Hb] or decrease in BVR measured with PGS. The AOM-AngII mice did not have any significant trends. Conclusion In-vivo PGS measurements of rectal colonic blood supply as well as CLE imaging revealed angiogenic disruptions to the capillary network prior to tumor formation. Losartan demonstrated an effective way to mitigate the changes to blood supply during tumorigenesis and reduce tumor multiplicity. These effects can be used in future studies to understand the early vessel changes observed.
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Affiliation(s)
- Sarah Ruderman
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Adam Eshein
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Vesta Valuckaite
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Urszula Dougherty
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Anas Almoghrabi
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Andrew Gomes
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Ajaypal Singh
- Department of Gastroenterology, Rush University, Chicago, IL, 60612, USA
| | - Baldeep Pabla
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Hemant K Roy
- Department of Gastroenterology, Boston Medical Center, Boston, MA, 02118, USA
| | - John Hart
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Marc Bissonnette
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Vani Konda
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Vadim Backman
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA.
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Patel M, Gomes A, Ruderman S, Hardee D, Crespo S, Raimondo M, Woodward T, Backman V, Roy H, Wallace M. Polarization gating spectroscopy of normal-appearing duodenal mucosa to detect pancreatic cancer. Gastrointest Endosc 2014; 80:786-93.e1-2. [PMID: 24861243 PMCID: PMC4241379 DOI: 10.1016/j.gie.2014.03.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 11/18/2013] [Accepted: 03/18/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND According to the field effect theory, by detecting microvasculature changes such as early increase in blood supply (EIBS) in the surrounding tissue, neoplastic lesions can be identified from a distance. OBJECTIVE To determine the feasibility and efficacy of a fiberoptic probe containing novel polarization gating spectroscopy technology to identify patients with pancreatic adenocarcinoma (PAC) by the field effect theory. DESIGN Prospective cohort (pilot) study. SETTING Outpatient tertiary care center. PATIENTS Adult (≥ 18 years) patients undergoing EGD-EUS were screened. Patients with PAC were included in the "cancer" group and patients without PAC were included in the "control" group. We excluded patients with other known malignancies and gastroduodenal premalignant lesions. INTERVENTIONS AND MAIN OUTCOME MEASURES Spectroscopic measurements of EIBS variables, such as deoxyhemoglobin concentration (DHb) and mean blood vessel radius (BVR), were obtained from 5 periampullary locations. The Mann-Whitney rank sum test was used for the statistical analysis (P ≤ .05). RESULTS Fourteen patients (mean age 72 years, 79% male) in the cancer group and 15 patients (mean age 63 years, 60% male) in the control group were included in the final analysis. At the ampullary site, both DHb (P = .001) and BVR (P = .03) were higher in PAC patients than in the control subjects. The DHb alone (92% sensitivity, 86% specificity) or in combination with BVR (92% sensitivity, 79% specificity) can differentiate PAC from control subjects with high accuracy. LIMITATIONS Small sample size, unmatched control subjects. CONCLUSIONS Spectroscopic measurements of EIBS by fiberoptic probes are feasible. Preliminary evidence suggests that in vivo measurement of normal-appearing duodenal tissue can differentiate PAC patients from a distance with high accuracy.
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Affiliation(s)
- Mihir Patel
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Andrew Gomes
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
| | - Sarah Ruderman
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
| | - Darla Hardee
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Sergio Crespo
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Massimo Raimondo
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Timothy Woodward
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Vadim Backman
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
| | - Hemant Roy
- Department of Gastroenterology, Boston University Medical Center, Boston, Massachusetts
| | - Michael Wallace
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
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5
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Konda V, Becker V, Ruderman S, Dougherty U, Hart J, Ruiz M, Valuckaite V, Kulkarni A, Fichera A, Waxman I, Bissonnette M. In Vivo Assessment of Tumor Vascularity Using Confocal Laser Endomicroscopy in Murine Models of Colon Cancer. ACTA ACUST UNITED AC 2013. [DOI: 10.2174/221155281120100007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Ruderman S, Mueller S, Gomes A, Rogers J, Backman V. Method of detecting tissue contact for fiber-optic probes to automate data acquisition without hardware modification. Biomed Opt Express 2013; 4:1401-12. [PMID: 24010002 PMCID: PMC3756576 DOI: 10.1364/boe.4.001401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 07/15/2013] [Accepted: 07/17/2013] [Indexed: 05/20/2023]
Abstract
We present a novel algorithm to detect contact with tissue and automate data acquisition. Contact fiber-optic probe systems are useful in noninvasive applications and real-time analysis of tissue properties. However, applications of these technologies are limited to procedures with visualization to ensure probe-tissue contact and individual user techniques can introduce variability. The software design exploits the system previously designed by our group as an optical method to automatically detect tissue contact and trigger acquisition. This method detected tissue contact with 91% accuracy, detected removal from tissue with 83% accuracy and reduced user variability by > 8%. Without the need for additional hardware, this software algorithm can easily integrate into any fiber-optic system and expands applications where visualization is difficult.
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Affiliation(s)
- Sarah Ruderman
- Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208,
USA
| | - Scott Mueller
- American BioOptics, 1801 Maple Ave Evanston, IL 60201,
USA
| | - Andrew Gomes
- Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208,
USA
| | - Jeremy Rogers
- Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208,
USA
| | - Vadim Backman
- Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208,
USA
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7
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Gomes AJ, Turzhitsky V, Ruderman S, Backman V. Monte Carlo model of the penetration depth for polarization gating spectroscopy: influence of illumination-collection geometry and sample optical properties. Appl Opt 2012; 51:4627-37. [PMID: 22781238 PMCID: PMC3557942 DOI: 10.1364/ao.51.004627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Polarization-gating has been widely used to probe superficial tissue structures, but the penetration depth properties of this method have not been completely elucidated. This study employs a polarization-sensitive Monte Carlo method to characterize the penetration depth statistics of polarization-gating. The analysis demonstrates that the penetration depth depends on both the illumination-collection geometry [illumination-collection area (R) and collection angle (θ(c))] and on the optical properties of the sample, which include the scattering coefficient (μ(s)), absorption coefficient (μ(a)), anisotropy factor (g), and the type of the phase function. We develop a mathematical expression relating the average penetration depth to the illumination-collection beam properties and optical properties of the medium. Finally, we quantify the sensitivity of the average penetration depth to changes in optical properties for different geometries of illumination and collection. The penetration depth model derived in this study can be applied to optimizing application-specific fiber-optic probes to target a sampling depth of interest with minimal sensitivity to the optical properties of the sample.
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Affiliation(s)
- Andrew J. Gomes
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois 60218, USA
| | - Vladimir Turzhitsky
- Biomedical Imaging and Spectroscopy Laboratory, Departments of Medicine and Obstetrics and Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center, Harvard University, Boston, Massachusetts 02215, USA
| | - Sarah Ruderman
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois 60218, USA
| | - Vadim Backman
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois 60218, USA
- Corresponding author:
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8
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Gomes AJ, Ruderman S, DelaCruz M, Wali RK, Roy HK, Backman V. In vivo measurement of the shape of the tissue-refractive-index correlation function and its application to detection of colorectal field carcinogenesis. J Biomed Opt 2012; 17:047005. [PMID: 22559696 PMCID: PMC3382344 DOI: 10.1117/1.jbo.17.4.047005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Polarization-gated spectroscopy is an established method to depth-selectively interrogate the structural properties of biological tissue. We employ this method in vivo in the azoxymethane (AOM)-treated rat model to monitor the morphological changes that occur in the field of a tumor during early carcinogenesis. The results demonstrate a statistically significant change in the shape of the refractive-index correlation function for AOM-treated rats versus saline-treated controls. Since refractive index is linearly proportional to mass density, these refractive-index changes can be directly linked to alterations in the spatial distribution patterns of macromolecular density. Furthermore, we found that alterations in the shape of the refractive-index correlation function shape were an indicator of both present and future risk of tumor development. These results suggest that noninvasive measurement of the shape of the refractive-index correlation function could be a promising marker of early cancer development.
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Affiliation(s)
- Andrew J. Gomes
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois 60218
| | - Sarah Ruderman
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois 60218
| | - Mart DelaCruz
- NorthShore University Health System, Department of Internal Medicine, Evanston, Illinois 60218
| | - Ramesh K. Wali
- NorthShore University Health System, Department of Internal Medicine, Evanston, Illinois 60218
| | - Hemant K. Roy
- NorthShore University Health System, Department of Internal Medicine, Evanston, Illinois 60218
| | - Vadim Backman
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois 60218
- Address all correspondence to: Vadim Backman, Northwestern University, Department of Biomedical Engineering, 2145 Sheridan Road, BME-E310, Evanston, Illinois 60218. Tel: +847 4913536; Fax: +847 4914928; E-mail:
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9
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Tiwari AK, Crawford SE, Radosevich A, Wali RK, Stypula Y, Kunte DP, Mutyal N, Ruderman S, Gomes A, Cornwell ML, De La Cruz M, Brasky J, Gibson TP, Backman V, Roy HK. Neo-angiogenesis and the premalignant micro-circulatory augmentation of early colon carcinogenesis. Cancer Lett 2011; 306:205-13. [PMID: 21493000 DOI: 10.1016/j.canlet.2011.03.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 03/07/2011] [Accepted: 03/11/2011] [Indexed: 12/23/2022]
Abstract
Spectroscopic techniques have demonstrated that in the microscopically normal mucosa, there is an increase in mucosal micro-circulation in patients harboring neoplasia elsewhere in the colon (i.e. marker of field carcinogenesis). However, the physiological and molecular basis of this early increase in blood supply (EIBS) has not been elucidated. We, therefore, investigated the microvessel density (MVD) and angiogenic gene expression in the premalignant colonic mucosa from the well-validated azoxymethane (AOM)-treated rat experimental model of colon carcinogenesis. Fisher 344 rats were treated with AOM (15 mg/kg i.p.) or saline and euthanized 14 weeks later (a time-point that precedes carcinoma development). Colon sections were studied for MVD via immunohistochemical assessment for CD31 and location was compared with optical assessment of mucosal hemoglobin with low-coherence enhanced backscattering spectroscopy (LEBS). Finally, we performed a pilot real-time PCR angiogenesis microarray (84 genes) from the microscopically normal colonic mucosa of AOM and age-matched saline treated rats. AOM treatment increased MVD in both the mucosa and submucosa of the rats (125% increase in mucosa; p<0.007, and 96% increase in submucosa; p<0.02) but the increase was most pronounced at the cryptal base consistent with the LEBS data showing maximal hemoglobin augmentation at 200-225 μm depth. Microarray analysis showed striking dysregulation of angiogenic and anti-angiogenic factors. We demonstrate, for the first time, that neo-angiogenesis occurs in the microscopically normal colonic mucosa and was accentuated at the bottom of the crypt. This finding has potential implications as a biomarker for risk-stratification and target for chemoprevention.
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Affiliation(s)
- Ashish K Tiwari
- Department of Medicine, NorthShore University HealthSystem, Evanston, IL, USA
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Ruderman S, Gomes AJ, Stoyneva V, Rogers JD, Fought AJ, Jovanovic BD, Backman V. Analysis of pressure, angle and temporal effects on tissue optical properties from
polarization-gated spectroscopic probe measurements. Biomed Opt Express 2010; 1:489-499. [PMID: 21258484 PMCID: PMC3017986 DOI: 10.1364/boe.1.000489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 07/24/2010] [Accepted: 08/02/2010] [Indexed: 05/03/2023]
Abstract
Noninvasive optical techniques for tissue characterization, in particular, light scattering properties and blood supply quantification of mucosa, is useful in a wide variety of applications. However, fiber-optic probes that require contact with the tissue surface can present a challenging problem in the variability of in vivo measurements due the nature of interactions, for example affects due to variations in pressure applied to the probe tip. We present an in vivo evaluation of pressure, angle, and temporal effects on tissue properties for polarization-gated spectroscopy at superficial depths (within 100 to 200 microns of tissue surface) for oral mucosa.
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Affiliation(s)
- Sarah Ruderman
- Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Rd, Evanston, IL 60208, USA
| | - Andrew J. Gomes
- Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Rd, Evanston, IL 60208, USA
| | - Valentina Stoyneva
- Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Rd, Evanston, IL 60208, USA
| | - Jeremy D. Rogers
- Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Rd, Evanston, IL 60208, USA
| | - Angela J. Fought
- Department of Preventative Medicine, Northwestern University Medical School, 680 North Lake Shore Drive,
Suite 1400, Evanston, IL 60208, USA
| | - Borko D. Jovanovic
- Department of Preventative Medicine, Northwestern University Medical School, 680 North Lake Shore Drive,
Suite 1400, Evanston, IL 60208, USA
| | - Vadim Backman
- Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Rd, Evanston, IL 60208, USA
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Roy HK, Gomes AJ, Ruderman S, Bianchi LK, Goldberg MJ, Stoyneva V, Rogers JD, Turzhitsky V, Kim Y, Yen E, Jameel M, Bogojevic A, Backman V. Optical measurement of rectal microvasculature as an adjunct to flexible sigmoidosocopy: gender-specific implications. Cancer Prev Res (Phila) 2010; 3:844-51. [PMID: 20570881 DOI: 10.1158/1940-6207.capr-09-0254] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Flexible sigmoidoscopy is a robust, clinically validated, and widely available colorectal cancer screening technique that is currently sanctioned by major guideline organizations. Given that endoscopic visualization is generally limited to the distal third of the colon and women tend to have a proclivity for proximal lesions, the flexible sigmoidoscopy performance is markedly inferior in women than in men. Our group has shown that by using a novel light-scattering approach, we were able to detect an early increase in blood supply (EIBS) in the distal colonic mucosa, which served as a marker of field carcinogenesis and, hence, proximal neoplasia. Therefore, we sought to ascertain whether rectal EIBS would improve flexible sigmoidoscopy, especially in women. A polarization-gated spectroscopy fiber-optic probe was used to assess EIBS in the endoscopically normal rectum (n = 366). When compared with gender-matched neoplasia-free controls, females with advanced proximal neoplasia (n = 10) had a robust (60%; P = 0.002) increase in rectal mucosal oxyhemoglobin content whereas the effect size in males was less marked (33%; P = 0.052). In women, addition of rectal oxyhemoglobin tripled the sensitivity for advanced neoplasia over flexible sigmoidoscopy alone. Indeed, the performance characteristics seemed to be excellent (sensitivity, 100%; specificity, 76.8%; positive predictive value, 32.6%; and negative predictive value, 100%). A variety of nonneoplastic factors were assessed and did not confound the relationship between rectal EIBS and advanced neoplasia. Therefore, using rectal EIBS in combination with flexible sigmoidoscopy mitigated the gender gap and may allow flexible sigmoidoscopy to be considered as a viable colorectal cancer screening test in women.
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Affiliation(s)
- Hemant K Roy
- Department of Medicine, Northshore University Health System, Evanston, IL 60201, USA.
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12
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Gomes AJ, Roy HK, Turzhitsky V, Kim Y, Rogers JD, Ruderman S, Stoyneva V, Goldberg MJ, Bianchi LK, Yen E, Kromine A, Jameel M, Backman V. Rectal mucosal microvascular blood supply increase is associated with colonic neoplasia. Clin Cancer Res 2009; 15:3110-7. [PMID: 19383816 DOI: 10.1158/1078-0432.ccr-08-2880] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Endoscopic examination has proven effective in both detecting and preventing colorectal cancer; however, only about a quarter of eligible patients undergo screening. Even if the compliance rate increased, limited endoscopic capacity and cost would be prohibitive. There is a need for an accurate method to target colonoscopy to those most at risk of harboring colonic neoplasia. Exploiting field carcinogenesis seems to be a promising avenue. Our group recently reported that an early increase in blood supply (EIBS) is a reliable marker of field carcinogenesis in experimental models. We now investigate whether in situ detection of EIBS in the rectum can predict neoplasia elsewhere in the colon. EXPERIMENTAL DESIGN We developed a novel polarization-gated spectroscopy fiber-optic probe that allows depth-selective interrogation of microvascular blood content. Using the probe, we examined the blood content in vivo from the rectal mucosa of 216 patients undergoing screening colonoscopy. RESULTS Microvascular blood content was increased by approximately 50% in the endoscopically normal rectal mucosa of patients harboring advanced adenomas when compared with neoplasia-free patients irrespective of lesion location. Demographic factors and nonneoplastic lesions did not confound this observation. Logistic regression using mucosal oxyhemoglobin concentration and patient age resulted in a sensitivity of 83%, a specificity of 82%, and an area under the receiver operating characteristic curve of 0.88 for the detection of advanced adenomas. CONCLUSIONS Increased microvascular blood supply in the normal rectal mucosa is associated with the presence of clinically significant neoplasia elsewhere in the colon, supporting the development of rectal EIBS as a colon cancer risk-stratification tool.
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Affiliation(s)
- Andrew J Gomes
- Biomedical Engineering Department, Northwestern University, IL, USA.
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Roy HK, Gomes A, Turzhitsky V, Goldberg MJ, Rogers J, Ruderman S, L YK, Kromine A, Brand RE, Jameel M, Vakil P, Hasabou N, Backman V. Spectroscopic microvascular blood detection from the endoscopically normal colonic mucosa: biomarker for neoplasia risk. Gastroenterology 2008; 135:1069-78. [PMID: 18722372 PMCID: PMC3405534 DOI: 10.1053/j.gastro.2008.06.046] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [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] [Received: 04/12/2008] [Revised: 06/11/2008] [Accepted: 06/19/2008] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS We previously used a novel biomedical optics technology, 4-dimensional elastically scattered light fingerprinting, to show that in experimental colon carcinogenesis the predysplastic epithelial microvascular blood content is increased markedly. To assess the potential clinical translatability of this putative field effect marker, we characterized the early increase in blood supply (EIBS) in human beings in vivo. METHODS We developed a novel, endoscopically compatible, polarization-gated, spectroscopic probe that was capable of measuring oxygenated and deoxygenated (Dhb) hemoglobin specifically in the mucosal microcirculation through polarization gating. Microvascular blood content was measured in 222 patients from the endoscopically normal cecum, midtransverse colon, and rectum. If a polyp was present, readings were taken from the polyp tissue along with the normal mucosa 10-cm and 30-cm proximal and distal to the lesion. RESULTS Tissue phantom studies showed that the probe had outstanding accuracy for hemoglobin determination (r(2) = 0.99). Augmentation of microvasculature blood content was most pronounced within the most superficial ( approximately 100 microm) layer and dissipated in deeper layers (ie, submucosa). EIBS was detectable within 30 cm from the lesion and the magnitude mirrored adenoma proximity. This occurred for both oxygenated hemoglobin and DHb, with the effect size being slightly greater for DHb. EIBS correlated with adenoma size and was not engendered by nonneoplastic (hyperplastic) polyps. CONCLUSIONS We show, herein, that in vivo microvascular blood content can be measured and provides an accurate marker of field carcinogenesis. This technological/biological advance has numerous potential applications in colorectal cancer screening such as improved polyp detection and risk stratification.
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Affiliation(s)
- Hemant K. Roy
- Dept of Internal Medicine, Evanston-Northwestern Healthcare, Evanston IL
| | - Andrew Gomes
- Biomedical Engineering Department, Northwestern University, Evanston IL
| | | | - Michael J Goldberg
- Dept of Internal Medicine, Evanston-Northwestern Healthcare, Evanston IL
| | - Jeremy Rogers
- Biomedical Engineering Department, Northwestern University, Evanston IL
| | - Sarah Ruderman
- Biomedical Engineering Department, Northwestern University, Evanston IL
| | - Young Kim L
- Dept of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh PA
| | - Alex Kromine
- Biomedical Engineering Department, Northwestern University, Evanston IL
| | - Randall E. Brand
- Dept of Biomedical Engineering, Purdue University, West Lafayette IN
| | - Mohammed Jameel
- Dept of Internal Medicine, Evanston-Northwestern Healthcare, Evanston IL
| | - Parmede Vakil
- Biomedical Engineering Department, Northwestern University, Evanston IL
| | - Nahla Hasabou
- Dept of Internal Medicine, Evanston-Northwestern Healthcare, Evanston IL
| | - Vadim Backman
- Biomedical Engineering Department, Northwestern University, Evanston IL
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Rich BW, Hart B, Barrett A, Marks G, Ruderman S. Peer consultation: a look at process. CLIN NURSE SPEC 1995; 9:181-5. [PMID: 7606686 DOI: 10.1097/00002800-199505000-00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
After attending graduate nursing school, and being exposed to the concepts of peer supervision and consultation, six women formed a peer consultation group. A peer consultation group, simply stated, is a professional support group. In this article, evolution of the group process is described from personal experience and personal perspectives. The aim is to inspire other CNSs and nursing personnel involved in advanced practice to consider involvement in such a group to enhance their own professional growth and well-being. Although the format, group size, individual composition, and beneficial aspects of the group have varied throughout the 5-year tenure, group members unanimously agree that such a forum has been invaluable for their professional growth and development.
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Ruderman S. Bicycle injuries in a suburban community. N J Med 1987; 84:629-31. [PMID: 3478611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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