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Ram J, Awan KH, Freitas CMT, Bhandi S, Licari FW, Patil S. Clinical effects of Lactobacillus reuteri probiotic in chronic periodontitis - a systematic review. Eur Rev Med Pharmacol Sci 2024; 28:1695-1707. [PMID: 38497853 DOI: 10.26355/eurrev_202403_35584] [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: 03/19/2024]
Abstract
OBJECTIVE This systematic review examines the effectiveness of Lactobacillus reuteri as an adjunct to scaling and root planing in the treatment of chronic periodontitis. MATERIALS AND METHODS Scopus, PubMed, and Web of Science databases were searched according to specific inclusion and exclusion criteria in October 2022. Randomized control trials that evaluated the effects of Lactobacillus reuteri in patients with periodontitis were included. The primary outcome was pocket depth and clinical attachment levels, while the secondary outcome considered was bleeding on probing, microbial levels, and gingival index score. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions and the ROB2 tool. RESULTS A total of eleven studies that examined 369 subjects were included in the review. Adults in the age group of 18-70 years of age suffering from chronic periodontitis were evaluated. Eight out of the eleven studies reported statistically significant improvement in the intergroup pocket depths, whereas seven studies showed a statistically significant reduction in the clinical attachment levels in the probiotic group. Three studies showed no significant improvement in the pocket depth levels in the probiotic group as compared to the controls. Four studies showed no significant reduction in clinical attachment levels between the two groups. The overall risk of bias was high in four studies, while seven studies reported some concerns about the risk of bias. CONCLUSIONS Based on the limited evidence available, the adjunctive use of Lactobacillus reuteri to scaling and root planing may provide some additional benefit in improving periodontal parameters.
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Affiliation(s)
- J Ram
- College of Graduate Studies, Roseman University of Health Sciences, South Jordan, Utah, USA.
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Comen E, Budhu S, Elhanati Y, Page D, Rasalan-Ho T, Ritter E, Wong P, Plitas G, Patil S, Brogi E, Jochelson M, Bryce Y, Solomon SB, Norton L, Merghoub T, McArthur HL. Preoperative immune checkpoint inhibition and cryoablation in early-stage breast cancer. iScience 2024; 27:108880. [PMID: 38333710 PMCID: PMC10850740 DOI: 10.1016/j.isci.2024.108880] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/31/2023] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
Local cryoablation can engender systemic immune activation/anticancer responses in tumors otherwise resistant to immune checkpoint blockade (ICB). We evaluated the safety/tolerability of preoperative cryoablation plus ipilimumab and nivolumab in 5 early-stage/resectable breast cancers. The primary endpoint was met when all 5 patients underwent standard-of-care primary breast surgery undelayedly. Three patients developed transient hyperthyroidism; one developed grade 4 liver toxicity (resolved with supportive management). We compared this strategy with cryoablation and/or ipilimumab. Dual ICB plus cryoablation induced higher expression of T cell activation markers and serum Th1 cytokines and reduced immunosuppressive serum CD4+PD-1hi T cells, improving effector-to-suppressor T cell ratio. After dual ICB and before cryoablation, T cell receptor sequencing of 4 patients showed increased T cell clonality. In this small subset of patients, we provide preliminary evidence that preoperative cryoablation plus ipilimumab and nivolumab is feasible, inducing systemic adaptive immune activation potentially more robust than cryoablation with/without ipilimumab.
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Affiliation(s)
- Elizabeth Comen
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sadna Budhu
- Ludwig Collaborative and Swim Across America Laboratory, Department of Pharmacology and Mayer Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Yuval Elhanati
- Computational Oncology Service, Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David Page
- Earle A. Chiles Research Institute, Robert W. Franz Cancer Center, Providence Cancer Institute, Portland, OR, USA
| | - Teresa Rasalan-Ho
- Immune Monitoring Core Facility, Ludwig Center for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Erika Ritter
- Immune Monitoring Core Facility, Ludwig Center for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Phillip Wong
- Immune Monitoring Core Facility, Ludwig Center for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - George Plitas
- Breast Surgery, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sujata Patil
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Edi Brogi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maxine Jochelson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yolanda Bryce
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stephen B. Solomon
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Larry Norton
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Taha Merghoub
- Ludwig Collaborative and Swim Across America Laboratory, Department of Pharmacology and Mayer Cancer Center, Weill Cornell Medicine, New York, NY, USA
| | - Heather L. McArthur
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Division of Medical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Pascal M, Edelman SM, Nopp A, Möbs C, Geilenkeuser WJ, Knol EF, Ebo DG, Mertens C, Shamji MH, Santos AF, Patil S, Eberlein B, Mayorga C, Hoffmann HJ. EAACI task force report: A consensus protocol for the basophil activation test for collaboration and external quality assurance. Allergy 2024; 79:290-293. [PMID: 37795777 PMCID: PMC10843141 DOI: 10.1111/all.15907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/06/2023]
Affiliation(s)
- M Pascal
- Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
- RETICS Asma reacciones adversas y alérgicas (ARADYAL) and RICORS Red De Enfermedades Inflamatorias (REI), Madrid, Spain
| | - S M Edelman
- Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - A Nopp
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, and Sachs´ Children and Youth Hospital, Stockholm, Sweden
| | - C Möbs
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | | | - E F Knol
- Center of Translational Immunology and Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D G Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology-Allergology- Rheumatology, University of Antwerp, Antwerp, Belgium
| | - C Mertens
- Faculty of Medicine and Health Sciences, Department of Immunology-Allergology- Rheumatology, University of Antwerp, Antwerp, Belgium
| | - M H Shamji
- National Heart and Lung Institute, Imperial College London, London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
| | - A F Santos
- Department of Women and Children's Health (Pediatric Allergy) & Peter Gorer Department of Immunobiology, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom
| | - S Patil
- Division of Allergy and Immunology, Departments of Medicine and Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - B Eberlein
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University Munich, Munich, Germany
| | - C Mayorga
- RETICS Asma reacciones adversas y alérgicas (ARADYAL) and RICORS Red De Enfermedades Inflamatorias (REI), Madrid, Spain
- Allergy Clinical Unit, Hospital Regional Universitario de Málaga and Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA-BIONAND, Málaga, Spain
| | - H J Hoffmann
- Department of Clinical Medicine, Aarhus University, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
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Thompson HM, Omer DM, Lin S, Kim JK, Yuval JB, Veheij FS, Qin LX, Gollub MJ, Wu AJC, Lee M, Patil S, Hezel AF, Marcet JE, Cataldo PA, Polite BN, Herzig DO, Liska D, Oommen S, Friel CM, Ternent CA, Coveler AL, Hunt SR, Garcia-Aguilar J. Organ Preservation and Survival by Clinical Response Grade in Patients With Rectal Cancer Treated With Total Neoadjuvant Therapy: A Secondary Analysis of the OPRA Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2350903. [PMID: 38194231 PMCID: PMC10777257 DOI: 10.1001/jamanetworkopen.2023.50903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/20/2023] [Indexed: 01/10/2024] Open
Abstract
Importance Assessing clinical tumor response following completion of total neoadjuvant therapy (TNT) in patients with locally advanced rectal cancer is paramount to select patients for watch-and-wait treatment. Objective To assess organ preservation (OP) and oncologic outcomes according to clinical tumor response grade. Design, Setting, and Participants This was secondary analysis of the Organ Preservation in Patients with Rectal Adenocarcinoma trial, a phase 2, nonblinded, multicenter, randomized clinical trial. Randomization occurred between April 2014 and March 2020. Eligible participants included patients with stage II or III rectal adenocarcinoma. Data analysis occurred from March 2022 to July 2023. Intervention Patients were randomized to induction chemotherapy followed by chemoradiation or chemoradiation followed by consolidation chemotherapy. Tumor response was assessed 8 (±4) weeks after TNT by digital rectal examination and endoscopy and categorized by clinical tumor response grade. A 3-tier grading schema that stratifies clinical tumor response into clinical complete response (CCR), near complete response (NCR), and incomplete clinical response (ICR) was devised to maximize patient eligibility for OP. Main Outcomes and Measures OP and survival rates by clinical tumor response grade were analyzed using the Kaplan-Meier method and log-rank test. Results There were 304 eligible patients, including 125 patients with a CCR (median [IQR] age, 60.6 [50.4-68.0] years; 76 male [60.8%]), 114 with an NCR (median [IQR] age, 57.6 [49.1-67.9] years; 80 male [70.2%]), and 65 with an ICR (median [IQR] age, 55.5 [47.7-64.2] years; 41 male [63.1%]) based on endoscopic imaging. Age, sex, tumor distance from the anal verge, pathological tumor classification, and clinical nodal classification were similar among the clinical tumor response grades. Median (IQR) follow-up for patients with OP was 4.09 (2.99-4.93) years. The 3-year probability of OP was 77% (95% CI, 70%-85%) for patients with a CCR and 40% (95% CI, 32%-51%) for patients with an NCR (P < .001). Clinical tumor response grade was associated with disease-free survival, local recurrence-free survival, distant metastasis-free survival, and overall survival. Conclusions and Relevance In this secondary analysis of a randomized clinical trial, most patients with a CCR after TNT achieved OP, with few developing tumor regrowth. Although the probability of tumor regrowth was higher for patients with an NCR compared with patients with a CCR, a significant proportion of patients achieved OP. These findings suggest the 3-tier grading schema can be used to estimate recurrence and survival outcomes in patients with locally advanced rectal cancer who receive TNT. Trial Registration ClinicalTrials.gov Identifier: NCT02008656.
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Affiliation(s)
- Hannah M. Thompson
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Dana M. Omer
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sabrina Lin
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jin K. Kim
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jonathan B. Yuval
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Floris S. Veheij
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Li-Xuan Qin
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marc J. Gollub
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Abraham Jing-Ching Wu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Meghan Lee
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sujata Patil
- Department of Quantitative Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Aram F. Hezel
- James P. Wilmot Cancer Center, University of Rochester, Rochester, New York
| | | | | | - Blase N. Polite
- Department of Surgery, University of Chicago, Chicago, Illinois
| | - Daniel O. Herzig
- Department of Surgery, Oregon Health & Science University, Portland
| | - David Liska
- Department of Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Samuel Oommen
- Department of Surgery, John Muir Health, Walnut Creek, California
| | - Charles M. Friel
- Department of Surgery, University Hospital, University of Virginia Health System, Charlottesville
| | - Charles A. Ternent
- Department of Surgery, Creighton University Medical Center, Omaha, Nebraska
| | | | - Steven R. Hunt
- Department of Surgery, Washington University, St Louis, Missouri
| | - Julio Garcia-Aguilar
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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Lakshmi DM, Nandini VV, Raj SN, Albar NH, Alamoudi A, Bahammam SA, Zidane B, Bahammam HA, Patil S. A Comparative Evaluation of Three Methods of Disinfection of Gypsum Casts and the Changes in Surface Roughness and Dimensional Accuracy after Disinfection-An Ex Vivo Study. Niger J Clin Pract 2024; 27:47-53. [PMID: 38317034 DOI: 10.4103/njcp.njcp_303_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 12/12/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND One of the major problems of everyday dental practice is cross-contamination. It can place office personnel, dentists, and patients at risk of acquiring serious illness. Disinfection helps in controlling this cross-contamination to an extent. The evaluation was done to find the efficient disinfection method on gypsum casts. AIMS The aim of this study is to evaluate and compare the efficacy of three methods of disinfection of gypsum casts, namely, chemical disinfection by immersion, spray method, and microwave method, and also to evaluate and compare changes in surface roughness and dimensional accuracy between the three methods after disinfection. MATERIALS AND METHODS Ex vivo and experimental study. Thirty participants were selected, and impressions of the maxillary arch were made using polyvinyl siloxane impression material. Ninety type IV die stone gypsum casts were poured. It was divided into three groups and was subjected to chemical disinfection by immersion and spray methods, and microwave method. The disinfected casts were evaluated for microbial growth, surface roughness, and dimensional accuracy. It was performed by using the one-way analysis of variance test and paired t-test followed by the Kruskal - Wallis test and Wilcoxon signed rank test (α = 0.05). RESULTS Microwave disinfection was more effective than both immersion and spray chemical disinfection methods (P < 0.010 and <0.001). The surface roughness of the microwave-irradiated casts had significantly increased after disinfection. However, there were no significant dimensional changes by any of the methods of disinfection. CONCLUSION Within the limitations of the study, the microwave method of disinfection is more effective in eradicating microorganisms when compared to chemical methods of disinfection by immersion and spray methods.
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Affiliation(s)
- D M Lakshmi
- Department of Prosthodontics and Implantology, Private Practitioner (Aluminus of SRM Kattankulathur Dental College), SRM Nagar, Kattankulathur, Tamil Nadu, India
| | - V V Nandini
- Department of Prosthodontics and Implantology, SRM Dental College and Hospital, Kattankulathur, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Tamil Nadu, India
| | - S N Raj
- Department of Prosthodontics and Implantology, SRM Dental College and Hospital, Kattankulathur, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur, Tamil Nadu, India
| | - N H Albar
- Department of Restorative Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - A Alamoudi
- Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - S A Bahammam
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Medina, Kingdom of Saudi Arabia
| | - B Zidane
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - H A Bahammam
- Department of Pediatric Dentistry, College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - S Patil
- College of Dental Medicine, Roseman University of Health Science, South Jordan, UTAH, USA
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Funt SA, Knezevic A, Wilson K, Bromberg M, Budnick A, O'Connor KL, McHugh DJ, Larsen E, Bajorin DF, Motzer RJ, Tonorezos ES, Patil S, Feldman DR. Ototoxicity associated with high-dose carboplatin for patients with previously treated germ cell tumors. Cancer 2023; 129:3952-3961. [PMID: 37715631 DOI: 10.1002/cncr.34991] [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: 03/28/2023] [Revised: 06/26/2023] [Accepted: 07/18/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND High-dose carboplatin is an essential part of curative high-dose chemotherapy (HDCT) for patients with previously treated germ cell tumors (GCTs). Although hearing loss (HL) is a known side effect of HDCT, data on its severity and characteristics are limited. METHODS Eligible patients received HDCT for GCTs from 1993 to 2017 and had audiograms before and after HDCT. HL severity was classified by American Speech-Language-Hearing Association criteria, and mean change in hearing threshold at each frequency (0.25-8 kHz) was estimated from pre- to post-HDCT and between HDCT cycles. RESULTS Of 115 patients (median age, 32 years), 102 (89%) received three cycles of HDCT. Of 106 patients with normal hearing to mild HL in the speech frequencies (0.5-4 kHz) before HDCT, 70 (66%) developed moderate to profound HL in the speech frequencies after HDCT. Twenty-five patients (22%) were recommended for hearing aids after HDCT. Patients with moderate to profound HL isolated to the higher frequencies (6-8 kHz) before HDCT were more likely to develop moderate to profound HL in the speech frequencies after HDCT (94% vs. 61%; p = .01) and to be recommended for hearing aids (39% vs. 18%; p = .05). CONCLUSIONS HL was frequent after HDCT for GCTs, with most patients developing at least moderate HL in the speech frequencies and approximately one in five recommended for hearing aids. Moderate to profound HL isolated to high frequencies at baseline was predictive of more clinically significant hearing impairment after HDCT. PLAIN LANGUAGE SUMMARY Some patients with germ cell tumors, the most common malignancy in adolescent and young adult men, are not cured with standard-dose chemotherapy and require high-dose chemotherapy (HDCT). Using detailed hearing assessments of patients receiving HDCT, we found that most patients developed significant hearing loss and that one in five needed hearing aids. Thus, strategies to reduce this side effect are urgently needed, and all patients receiving HDCT should have a hearing test after therapy.
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Affiliation(s)
- Samuel A Funt
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | - Andrea Knezevic
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kaamilah Wilson
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Maria Bromberg
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Amy Budnick
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kerri L O'Connor
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Deaglan J McHugh
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | - Erik Larsen
- Formerly of Decibel Therapeutics, Boston, Massachusetts, USA
| | - Dean F Bajorin
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | - Robert J Motzer
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | | | - Sujata Patil
- Department of Biostatistics, Cleveland Clinic, Cleveland, Ohio, USA
| | - Darren R Feldman
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Weill Cornell Medical College, New York, New York, USA
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Nagarathinam AE, Dineshkumar T, Rajkumar K, Rameshkumar A, Shruthi TA, Alzahrani KJ, Alzahrani FM, Halawani IF, Patil S. Validation of Diagnostic Utility of Salivary Urea in Patients with Chronic Kidney Disease in Chennai: A Cross-Sectional Study. Niger J Clin Pract 2023; 26:1868-1875. [PMID: 38158355 DOI: 10.4103/njcp.njcp_421_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/09/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Serum urea levels are essential for the diagnosis of chronic kidney disease (CKD), as they are a measure of renal function. Salivary urea has been used as an alternative to serum urea in patients with CKD. AIM To estimate serum urea levels and their correlation with salivary urea levels in order to validate the use of saliva as an alternative diagnostic tool for renal dysfunction. PATIENTS AND METHODS Thirty healthy individuals and 150 patients with CKD (30 from each CKD stage) were recruited for the study. Serum and salivary samples were collected to estimate the urea levels, and statistical analyses were performed. RESULTS Statistically significant (P < 0.05) differences in the mean serum and salivary urea levels were observed between the healthy and each stage of the CKD group; significance at P < 0.05 was observed within the stages of CKD as well. Correlation analysis also showed significant differences between the serum and salivary urea levels at each stage of the disease. Receiver operating characteristic analysis revealed a higher area under the curve of 0.917 at a 95% confidence interval with a salivary urea cut-off of 28.25 mg/dl (sensitivity and specificity: 88% and 84%, respectively). CONCLUSION The variability in salivary urea levels in the early and late stages suggests the use of salivary urea in the late stages of CKD. It is suggested that salivary urea levels may be used as an alternative to serum to assess and monitor the progression of renal impairment along with other standard renal function markers.
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Affiliation(s)
- A E Nagarathinam
- Department of Oral Pathology and Microbiology, SRM Dental College, Ramapuram Campus, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India
| | - T Dineshkumar
- Department of Oral Pathology and Microbiology, SRM Dental College, Ramapuram Campus, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India
| | - K Rajkumar
- Department of Oral Pathology and Microbiology, SRM Dental College, Ramapuram Campus, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India
| | - A Rameshkumar
- Department of Oral Pathology and Microbiology, SRM Dental College, Ramapuram Campus, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India
| | - T A Shruthi
- Department of Oral Pathology and Microbiology, SRM Dental College, Ramapuram Campus, SRM Institute of Science and Technology, Chennai, Tamil Nadu, India
| | - K J Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - F M Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - I F Halawani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
- Department of Haematology and Immunology, Faculty of Medicine, Umm Al-Qura University, Al Abdeyah, Saudi Arabia
| | - S Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UTAH, USA
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Harikrishnan S, Dinesh S, Sivakumar A, Awadh W, Alshehri A, Albar NH, Alamoudi A, Bahammam SA, Zidane B, Bahammam HA, Albar DH, Bahammam MA, Alzahrani KJ, Kalra S, Patil S. Comparative Evaluation of Various Lens and Ring Flash Combination for Intraoral Photography. Niger J Clin Pract 2023; 26:1800-1807. [PMID: 38158345 DOI: 10.4103/njcp.njcp_120_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/28/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Extraoral and intraoral dental photographs serve as preoperative records and document the entire treatment. Correctly composed orthodontic photographs are crucial for remote diagnosis and may serve as a bulwark against medicolegal challenges. MATERIALS AND METHODS In this prospective study, intraoral frontal photographs of patients with ideal occlusion were taken using two types of lenses (EF-S 18-55 mm f/3.5-5.6 IS STM lens (Canon, Tokyo, JP), SP 90 mm F/2.8 MACRO VC lens (Model F017 Tamron, NY, USA)) and two different ring flash systems (Meike FC-100 Macro Ring LED Light (Meike, China), Macro Ring flash Lite YN-14EX (Yongnuo digital, China)). The combination of lens and flash used was grouped into four groups. Twenty-eight intraoral photographs of patients were taken. An image quality assessment survey was distributed among two groups - 50 orthodontists and 50 other dental specialists. RESULTS The participants were asked to assess all the intraoral images and subjectively score them on a scale of one to ten, with one being very poor and ten being excellent, considering the sharpness, color, brightness, contrast, and overall quality of the image. The general dentists rated the images taken with a 90-mm macro lens and ring flash as the best quality photographs. Images obtained using an 18-55 mm lens and ring LED received significantly lesser scores and were graded good by dentists. CONCLUSION This combination of lens and flash may prove a valuable investment in the long-term aiding in excellent dental images for diagnosis and treatment monitoring.
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Affiliation(s)
- S Harikrishnan
- Department of Orthodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Sps Dinesh
- Department of Orthodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - A Sivakumar
- Department of Orthodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - W Awadh
- Department of Preventive Dental Sciences, Division of Orthodontics, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - A Alshehri
- Department of Preventive Dental Sciences, Division of Orthodontics, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - N H Albar
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - A Alamoudi
- Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - S A Bahammam
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, Taibah University, Medina, Saudi Arabia
| | - B Zidane
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - H A Bahammam
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - D H Albar
- Department of Preventive Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - M A Bahammam
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Executive Presidency of Academic Affairs, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - K J Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - S Kalra
- Private Practice, New Delhi, India
| | - S Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UTAH-84095, USA
- Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Patel S, Awan KH, Freitas CMT, Bhandi S, Licari FW, Patil S. Diode laser targeting red-complex bacteria in periodontitis: a systematic review. Eur Rev Med Pharmacol Sci 2023; 27:11806-11816. [PMID: 38164844 DOI: 10.26355/eurrev_202312_34779] [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: 01/03/2024]
Abstract
OBJECTIVE This systematic review examines the effectiveness of diode laser irradiation in reducing the levels of red complex bacteria as well as periodontal parameters of pocket depth and clinical attachment level. MATERIALS AND METHODS We conducted electronic searches across databases such as Scopus, Embase, Medline, and Web of Science databases in July 2022. Randomized controlled trials that evaluated the reduction of red-complex bacteria in patients with periodontitis using diode lasers were included. The primary focus was the reduction in the microbial count of red complex bacteria, whereas probing depth and attachment level were considered secondary outcomes. Articles in languages other than English were excluded. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions and the ROB2 tool. RESULTS After searching the databases, eight independent studies were included, with a sample size of 210 subjects. The average age group of the study population was 30-60 years, and there was a lack of consensus on the antimicrobial effect of diode lasers. Out of the eight studies, four studies reported no significant difference in the levels of red complex bacteria before and after laser application. Three studies reported significantly lower levels of red complex bacteria in the intergroup comparison. One study reported that laser had no significant effect on intergroup bacterial levels. The combination of diode laser irradiation with scaling reduced the count of red complex bacteria and improved the clinical parameters, although not significantly. CONCLUSIONS Based on the limited evidence available, the adjunctive use of diode laser for scaling and root planning may provide some additional benefit in terms of reduction of red complex bacterial count and clinical parameters. Further well-designed trials and the use of objective measures are necessary before outlining universal guidelines for best practice. The adjunctive use of diode laser in non-surgical periodontal therapy may provide a reduction in the red complex microbial count and improvement in clinical parameters, decreasing the need for periodontal surgery.
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Affiliation(s)
- S Patel
- College of Graduate Studies, Roseman University of Health Sciences, South Jordan, Utah, USA.
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10
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Kraehenbuehl L, Kang D, Bang AS, Ketosugbo KF, Hay J, Patil S, Goldfarb S, Cho J, Lacouture ME. Validation and Responsiveness of the English version of the Chemotherapy-Induced Alopecia Distress Scale (CADS) in Breast Cancer Patients. medRxiv 2023:2023.11.05.23298093. [PMID: 37986836 PMCID: PMC10659502 DOI: 10.1101/2023.11.05.23298093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Purpose This study aimed to validate the chemotherapy-induced alopecia distress scale (CADS) in a diverse English-speaking population and patients with endocrine treatment- induced alopecia (EIA). Objective Chemotherapy and endocrine therapy commonly cause alopecia in breast cancer patients, leading to significant psychological and social challenges. The CADS was developed to assess the psychosocial impact of alopecia, but its generalizability beyond Korean patients requires further investigation. Methods Data from the CHANCE study ( NCT02530177 ), which focused on non-metastatic breast cancer, was used. The cohort included 256 patients, and CADS data were collected at baseline, six months after chemotherapy completion, or 12 months after initiating endocrine therapy. The CADS questionnaire comprised 17 items covering physical and emotional health, daily activities, and relationships. Reliability was assessed using Cronbach's alpha, and responsiveness was measured by effect size. Results The CADS exhibited good reliability, with a Cronbach's alpha of 0.91 for the overall score, indicating acceptable internal consistency in both chemotherapy (0.89) and endocrine therapy (0.86) groups. Longitudinal responsiveness was supported by an effect size of 0.49 between decreasing satisfaction with hair growth and increasing emotional distress. Cross-sectional validity was confirmed, with effect sizes of 0.91 and 0.92 for satisfaction with hair growth and emotional and activity domains, respectively. Conclusion The CADS is a valid and responsive tool for assessing the psychosocial impact of chemotherapy-induced alopecia and endocrine treatment-induced alopecia in a diverse Western patient population.
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Ramachandran L, Sathesh S, Prakash P, Parthasarathy H, Sudarsan A, Balaji TM, Halawani IF, Alzahrani FM, Alzahrani KJ, Patil S. Public Awareness on Perio-systemic Interplay: A Cross-Sectional Survey in South India. Niger J Clin Pract 2023; 26:1703-1708. [PMID: 38044776 DOI: 10.4103/njcp.njcp_324_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/24/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The oral cavity has been referred to as "the gateway to overall health." It is also said to be the meeting point of medicine and dentistry. AIMS Our study sought to determine the extent to which the public was aware of the connection between oral/periodontal conditions and general health. SETTINGS AND DESIGN The observational cross-sectional study's questionnaire was sectioned into oral health awareness, systemic influence on oral health, and personal oral health assessment. MATERIALS AND METHODS A total of 994 responses were recorded and a Chi-square test was performed to uncover the relationships using SPSS version 22.0. According to responses, 70% of the population on average comprehended the responses to the majority of the oral health awareness-related questions. RESULTS It has been noticed that only 30% of the general public was aware of the prevalent health issues like diabetes, hypertension, and malnutrition's impact on dental health. However, more than 60% had confidence in their oral health and gave a rating of at least 5. CONCLUSION The study indicates that a good number of the population was prioritizing their oral health. However, there exists a definitive need to improve oral health awareness thereby ameliorating the overall health of an individual.
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Affiliation(s)
- L Ramachandran
- Department of Periodontics, SRM Dental College, Ramapuram, Chennai, India
| | - S Sathesh
- Department of Periodontics, SRM Dental College, Ramapuram, Chennai, India
| | - Psg Prakash
- Department of Periodontics, SRM Dental College, Ramapuram, Chennai, India
| | - H Parthasarathy
- Department of Periodontics, SRM Dental College, Ramapuram, Chennai, India
| | - A Sudarsan
- Department of Periodontics, SRM Dental College, Ramapuram, Chennai, India
| | - T M Balaji
- Department of Dentistry, Bharathiraja Hospital, Chennai, India
| | - I F Halawani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - F M Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - K J Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - S Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UTAH, USA
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12
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Yuval JB, Thompson HM, Verheij FS, Fiasconaro M, Patil S, Widmar M, Wei IH, Pappou EP, Smith JJ, Nash GM, Weiser MR, Paty PB, Garcia-Aguilar J. Comparison of Robotic, Laparoscopic, and Open Resections of Nonmetastatic Colon Cancer. Dis Colon Rectum 2023; 66:1347-1358. [PMID: 36649145 PMCID: PMC10369538 DOI: 10.1097/dcr.0000000000002637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Laparoscopic resection for colon cancer has not been associated with improvements in oncological outcomes in comparison to open resection. Robotic resections are associated with increased lymph node yield and radicality of mesenteric resection in patients with right-sided tumors. It is unclear whether lymph node yield is higher in robotic resections in other parts of the colon and whether higher lymph node yield is associated with improved survival. OBJECTIVE To compare survival rates between robotic, laparoscopic, and open resections in a large cohort of patients with nonmetastatic colon cancer. DESIGN This is a retrospective observational study. SETTING A single comprehensive cancer center. PATIENTS Patients who underwent resection of nonmetastatic primary colon cancer between January 2006 and December 2018. MAIN OUTCOME MEASURES Univariable and multivariable models were used to identify predictors of disease-free and overall survival. Lymph node yield and perioperative outcomes were compared between operative approaches. RESULTS There were 2398 patients who met the inclusion criteria: 699 (29%) underwent open, 824 (34%) underwent laparoscopic, and 875 (36%) underwent robotic resection. The median follow-up was 3.8 years (45.4 months). Robotic surgery was associated with higher lymph node yield and radicality of mesenteric resection. On multivariable analysis, the surgical approach was not associated with a difference in disease-free or overall survival. Minimally invasive colectomy was associated with fewer complications and shorter length of stay in comparison to open surgery. In a direct comparison between the 2 minimally invasive approaches, robotic colectomy was associated with fewer complications, shorter length of stay, and lower conversion rate than laparoscopy. LIMITATIONS This was a single-center retrospective study. CONCLUSIONS Our data indicate that the 3 surgical approaches are similarly effective in treating primary resectable colon cancer and that differences in outcomes are observed primarily in the early postoperative period. See Video Abstract at http://links.lww.com/DCR/C115 . COMPARACIN DE RESECCIONES ROBTICAS, LAPAROSCPICAS Y ABIERTAS DE CNCER DE COLON NO METASTSICO ANTECEDENTES:La resección laparoscópica para el cáncer de colon no se ha asociado con mejoras en los resultados oncológicos en comparación con la resección abierta. Las resecciones robóticas se asocian con un mayor rendimiento de los ganglios linfáticos y la radicalidad de la resección mesentérica en pacientes con tumores del lado derecho. No está claro si la cosecha ganglionar es mayor en las resecciones robóticas en otras partes del colon y si un mayor rendimiento de los ganglios linfáticos se asocia con una mejor supervivencia.OBJETIVO:Comparar las tasas de supervivencia entre resecciones robóticas, laparoscópicas y abiertas en una gran cohorte de pacientes con cáncer de colon no metastásico.DISEÑO:Este es un estudio observacional retrospectivo.ESCENARIO:Este estudio se realizó en un único centro oncológico integral.PACIENTES:Pacientes que se sometieron a resección de cáncer de colon primario no metastásico entre enero de 2006 y diciembre de 2018.PRINCIPALES MEDIDAS DE RESULTADO:Se utilizaron modelos univariables y multivariables para identificar predictores de supervivencia libre de enfermedad y global. La cosecha ganglionar y los resultados perioperatorios se compararon entre los abordajes quirúrgicos.RESULTADOS:Hubo 2398 pacientes que cumplieron con los criterios de inclusión: 699 (29%) se sometieron a cirugía abierta, 824 (34%) se sometieron a resección laparoscópica y 875 (36%) se sometieron a resección robótica. La mediana de seguimiento fue de 3,8 años (45,4 meses). La cirugía robótica se asoció con una mayor cosecha ganglionar y la radicalidad de la resección mesentérica. En el análisis multivariable, el abordaje quirúrgico no se asoció con una diferencia en la supervivencia general o libre de enfermedad. La colectomía mínimamente invasiva se asoció con menos complicaciones y una estancia más corta en comparación con la cirugía abierta. En una comparación directa entre los dos enfoques mínimamente invasivos, la colectomía robótica se asoció con menos complicaciones, una estancia más corta y una tasa de conversión más baja que la laparoscopia.LIMITACIONES:Este fue un estudio retrospectivo de un solo centro.CONCLUSIONES:Nuestros datos indican que los tres enfoques quirúrgicos son igualmente efectivos en el tratamiento del cáncer de colon resecable primario y que las diferencias en los resultados se observan principalmente en el período posoperatorio temprano. Consulte Video Resumen en http://links.lww.com/DCR/C115 . (Traducción-Dr. Felipe Bellolio ).
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Affiliation(s)
- Jonathan B. Yuval
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hannah M. Thompson
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Floris S. Verheij
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Megan Fiasconaro
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sujata Patil
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Maria Widmar
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Iris H. Wei
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Emmanouil P. Pappou
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - J. Joshua Smith
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Garrett M. Nash
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martin R. Weiser
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Philip B. Paty
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Julio Garcia-Aguilar
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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Selvaraj A, Saravana Dinesh SP, Sivakumar A, Arvind TRP, Albar DH, Alshehri A, Awadh W, Alzahrani KJ, Halawani IF, Alshammeri S, Baeshen HA, Patil S. Evaluation of scanning accuracy for two commercially available intraoral scanners in reproducing orthodontic bracket dimensions. Eur Rev Med Pharmacol Sci 2023; 27:7898-7906. [PMID: 37750618 DOI: 10.26355/eurrev_202309_33548] [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: 09/27/2023]
Abstract
OBJECTIVE The aim of this study was to compare the scanning accuracy of two different intra-oral scanners- MEDIT i500 and TRIOS 3 shape in reproducing orthodontic bracket dimensions. MATERIALS AND METHODS This in vivo cross-sectional study comprised seven subjects with a full complement of permanent dentition without third molars. Complete arch scanning was carried out with two intraoral scanners, such as MEDIT i500, TRIOS 3 shape, after bonding with brackets. The control group consisted of bracket dimensions measured directly by using Vernier calipers before bonding. Bracket dimensions of three-dimensional (3D) images were measured by using OrthoAnalyzer software. The accuracy of intraoral scanning was investigated by comparing bracket dimensions among the three groups using One-way ANOVA and Post-Hoc Tukey HSD test, and by evaluating outcomes for each quadrant and an individual tooth in complete-arch scans. RESULTS When comparing bracket dimensions of 3D images with manual measurements using a traditional Vernier caliper, MEDIT i500 showed no significant difference when compared to the control group (p>0.05) in full arch scanning as well as the quadrant and single tooth scans in complete arch scanning. TRIOS 3 shape showed a significant difference when compared to the control and MEDIT i500 group (p<0.05) for all parameters. CONCLUSIONS MEDIT i500 showed higher accuracy and better reproduction of orthodontic bracket dimensions than TRIOS 3 shape.
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Affiliation(s)
- A Selvaraj
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
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Chaganti S, Kunthsam V, Velangini SY, Alzahrani KJ, Alzahrani FM, Halawani IF, Alshahrani M, Ashi H, Baeshen HA, Patil S. Comparison of bacterial colonization on absorbable non-coated suture with Triclosan- or Chlorhexidine-coated sutures: a randomized controlled study. Eur Rev Med Pharmacol Sci 2023; 27:8371-8383. [PMID: 37782154 DOI: 10.26355/eurrev_202309_33760] [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: 10/03/2023]
Abstract
OBJECTIVE The oral cavity is a colossal reservoir for the bacteria. The healing of tissues is compromised after flap surgery, particularly in the presence of sutures, as they can act as repositories for bacteria, ultimately leading to surgical site infections. Hence, antibacterial-coated sutures have been considered as an alternative to reduce the risk of these infections and further improve the wound healing of the tissues after flap surgery. Since minimal information is available on the effect of antibacterial-coated sutures on periodontal tissues, this study aims to clinically and microbiologically assess the antibacterial efficacy of Triclosan (TCS) and Chlorhexidine-coated sutures (CCS) on periodontal tissues compared to non-coated sutures (NCS). PATIENTS AND METHODS A total of 75 subjects with moderate to severe periodontitis were included in the study and randomly allocated to one of the three groups, (TCS, CCS, and NCS groups) equally. Suture removal was performed on postoperative day 8, and parameters such as wound healing and post-operative pain were evaluated. The retrieved suture samples were subjected to microbiological analysis and the bacteria were identified quantitatively and qualitatively. RESULTS Intragroup analysis of the wound healing index and post-operative pain for all the groups showed a significant improvement (p<0.01), from day 8 to day 30. Intergroup analysis of the wound healing index revealed significant wound healing (p<0.05) on day 15 and day 30. For post-operative pain, intergroup analyses showed significantly low pain scores (p<0.01) for the TCS group. Microbiologic analysis of aerobic colony counts in both anterior and posterior regions revealed significantly (p<0.01) least colony counts in TCS and highest colony counts in NCS groups, respectively. Although anaerobic colony counts were not statistically significant, relatively fewer colony counts were identified in the TCS group. Whereas, relatively higher anaerobic colony counts were seen in the CCS group in the anterior region and in the NCS group in the posterior region. Qualitative assessment revealed higher amounts of Streptococcus and Staphylococcus species in all the three groups (TCS, CCS, and NCS groups). CONCLUSIONS Antibacterial-coated sutures, particularly Triclosan-coated sutures, are effective in reducing bacterial accumulation compared to non-coated sutures. Therefore, these sutures can be effectively utilized in periodontal flap surgery.
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Affiliation(s)
- S Chaganti
- Department of Periodontology and Oral Implantology, Anil Neerukonda Institute of Dental Sciences, Bheemunipatnam, Andhra Pradesh, India.
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15
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Mugri MH, Sayed ME, Bhandi S, A Alaqi HA, B Alsubeaie NH, Alsubaie SH, Varadarajan S, Raj AT, Yadalam PK, Khurshid Z, Balaji TM, Patil S. Success rate of immediately loaded implants in the posterior zone. Niger J Clin Pract 2023; 26:1215-1225. [PMID: 37794532 DOI: 10.4103/njcp.njcp_884_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Dental implants are considered an ideal treatment for a missing single tooth. Immediate loading of implants can hasten the procedure, providing comfort to the patients. Recently, immediate loading of implants has gained much importance as it helps hasten the procedure and provides more comfort to patients. A previous systematic review published 5 years ago compared the success rates between immediate and conventional loading. There are several factors that influence the success rate of implants that were not discussed in detail in the previous review. Hence, the present systematic review is done to report differences in the outcomes from single implant restorations of missing teeth in the posterior region in patients who were subjected to immediate loading and conventional loading. A follow up for 1 year was done. Electronic databases of Medline, Scopus, and Web of Science were searched for publications in the English Language during May 2021. The search results yielded 306 articles, out of which 225 were excluded based on title and abstract screening. Screening of the remaining 81 full text articles yielded 14 original research articles that satisfied the predefined inclusion criteria. Meta analysis was not possible due to the heterogeneity of the data. The overall success rate of the immediate loading of a single implant is 94.31%. Implants in the maxillary region had a higher survival rate than those in the mandibular region. The age range between 18 and 80 years showed good prognosis and outcomes in older individuals. Good oral hygiene was emphasized for all patients to prevent any secondary conditions or delays in healing.
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Affiliation(s)
- M H Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - M E Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - S Bhandi
- College of Dental Medicine, Roseman University of Health Science, South Jordan, UTAH-84095, USA
| | - H A A Alaqi
- Private Practice, Jazan, Kingdom of Saudi Arabia
| | | | - S H Alsubaie
- Private Practice, Riyadh, Kingdom of Saudi Arabia
| | - S Varadarajan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
| | - A T Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
| | - P K Yadalam
- Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Z Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
| | - T M Balaji
- Department of Periodontology, Tagore Dental College and Hospital, Chennai, India
| | - S Patil
- College of Dental Medicine, Roseman University of Health Science, South Jordan, UTAH-84095, USA
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16
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Yuval JB, Patil S, Gangai N, Omer DM, Akselrod DG, Fung A, Harmath CB, Kampalath R, Krehbiel K, Lee S, Liu PS, Millet JD, O'Malley RB, Purysko AS, Veniero JC, Wasnik AP, Garcia-Aguilar J, Gollub MJ. MRI assessment of rectal cancer response to neoadjuvant therapy: a multireader study. Eur Radiol 2023; 33:5761-5768. [PMID: 36814032 PMCID: PMC10394731 DOI: 10.1007/s00330-023-09480-9] [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: 05/15/2022] [Revised: 12/05/2022] [Accepted: 01/27/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVES A watch and wait strategy with the goal of organ preservation is an emerging treatment paradigm for rectal cancer following neoadjuvant treatment. However, the selection of appropriate patients remains a challenge. Most previous efforts to measure the accuracy of MRI in assessing rectal cancer response used a small number of radiologists and did not report variability among them. METHODS Twelve radiologists from 8 institutions assessed baseline and restaging MRI scans of 39 patients. The participating radiologists were asked to assess MRI features and to categorize the overall response as complete or incomplete. The reference standard was pathological complete response or a sustained clinical response for > 2 years. RESULTS We measured the accuracy and described the interobserver variability of interpretation of rectal cancer response between radiologists at different medical centers. Overall accuracy was 64%, with a sensitivity of 65% for detecting complete response and specificity of 63% for detecting residual tumor. Interpretation of the overall response was more accurate than the interpretation of any individual feature. Variability of interpretation was dependent on the patient and imaging feature investigated. In general, variability and accuracy were inversely correlated. CONCLUSIONS MRI-based evaluation of response at restaging is insufficiently accurate and has substantial variability of interpretation. Although some patients' response to neoadjuvant treatment on MRI may be easily recognizable, as seen by high accuracy and low variability, that is not the case for most patients. KEY POINTS • The overall accuracy of MRI-based response assessment is low and radiologists differed in their interpretation of key imaging features. • Some patients' scans were interpreted with high accuracy and low variability, suggesting that these patients' pattern of response is easier to interpret. • The most accurate assessments were those of the overall response, which took into consideration both T2W and DWI sequences and the assessment of both the primary tumor and the lymph nodes.
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Affiliation(s)
- Jonathan B Yuval
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, NY, USA
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Sujata Patil
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, USA
| | - Natalie Gangai
- Department of Radiology, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Dana M Omer
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, NY, USA
| | | | - Alice Fung
- Department of Radiology, Oregon Health & Sciences University, Portland, USA
| | - Carla B Harmath
- Department of Radiology, University of Chicago, Chicago, USA
| | - Rony Kampalath
- Department of Radiology, University of California Irvine, Irvine, USA
| | - Kyle Krehbiel
- Department of Radiology, Creighton University Medical Center - Bergan Mercy, Omaha, USA
| | - Sonia Lee
- Department of Radiology, University of California Irvine, Irvine, USA
| | - Peter S Liu
- Department of Radiology, Cleveland Clinic, Cleveland, USA
| | - John D Millet
- Department of Radiology, University of Michigan, Ann Arbor, USA
| | - Ryan B O'Malley
- Department of Radiology, University of Washington, Seattle, USA
| | | | | | - Ashish P Wasnik
- Department of Radiology, University of Michigan, Ann Arbor, USA
| | - Julio Garcia-Aguilar
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Marc J Gollub
- Department of Radiology, Memorial Sloan Kettering Cancer Center, NY, USA.
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Reese SW, Khaleel S, Silagy A, Xie A, Eismann L, Vazquez-Rivera K, Oparanozie A, Patil S, Coleman J, Motzer R, Kotecha RR, Russo P, Voss MH, Hakimi AA. Prognostic Factors for Survival in Patients Undergoing Surveillance After Cytoreductive Nephrectomy. J Urol 2023; 210:273-279. [PMID: 37167628 PMCID: PMC10726735 DOI: 10.1097/ju.0000000000003549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/04/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE The clinical course of patients being placed on surveillance in a cohort of systemic therapy-naïve patients who undergo cytoreductive nephrectomy is not well documented. Thus, we evaluated the clinical course of patients placed on surveillance following cytoreductive nephrectomy and identified predictors of survival. MATERIALS AND METHODS In this large single-institution study, we retrospectively analyzed metastatic renal cell carcinoma patients who underwent cytoreductive nephrectomy followed by surveillance. Predictors of survival were evaluated using the Kaplan-Meier method with a log-rank test. Patients were risk stratified based on IMDC (International mRCC Database Consortium) and number of metastatic sites (Rini score), with IMDC score ≤1 and ≤2 metastatic organ sites considered favorable risk. Primary end point was systemic therapy-free survival. Secondary end points included intervention-free survival, cancer-specific survival, and overall survival. RESULTS Median systemic therapy-free survival was 23.6 months (95% CI: 15.1-40.6), intervention-free survival was 11.8 months (95% CI: 8.0-18.4), cancer-specific survival was 54.2 months (95% CI: 46.2-71.4), and overall survival 52.4 months (95% CI: 40.3-66.8). Favorable-risk patients compared to unfavorable-risk patients had longer systemic therapy-free survival (50.6 vs 11.1 months, P < .01), survival (25.2 vs 7.3, P < .01), and cancer-specific survival (71.4 vs 46.2 months, P = .02). CONCLUSIONS Using risk stratification based on IMDC and number of metastatic sites, surveillance in favorable-risk patients can be utilized for a period without the initiation of systemic therapy. This approach can delay patients' exposure to the side effects of systemic therapy.
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Affiliation(s)
- Stephen W Reese
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sari Khaleel
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrew Silagy
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Amy Xie
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lennert Eismann
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Katiana Vazquez-Rivera
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Arnold Oparanozie
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sujata Patil
- Department of Urology, Ludwig-Maximilians University, Munich, Germany
| | - Jonathan Coleman
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Robert Motzer
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ritesh R Kotecha
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Paul Russo
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martin H Voss
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - A Ari Hakimi
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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18
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Reese SW, Khaleel S, Silagy A, Xie A, Eismann L, Vazquez-Rivera K, Oparanozie A, Patil S, Coleman J, Motzer R, Kotecha RR, Russo P, Voss MH, Hakimi AA. Reply by Authors. J Urol 2023; 210:279-280. [PMID: 37416962 DOI: 10.1097/ju.0000000000003549.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Affiliation(s)
- Stephen W Reese
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sari Khaleel
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrew Silagy
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Amy Xie
- Computational Oncology, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lennert Eismann
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Katiana Vazquez-Rivera
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Arnold Oparanozie
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sujata Patil
- Department of Urology, Ludwig-Maximilians University, Munich, Germany
| | - Jonathan Coleman
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Robert Motzer
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ritesh R Kotecha
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Paul Russo
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Martin H Voss
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - A Ari Hakimi
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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19
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Nichols MM, Ondrejka SL, Patil S, Durkin L, Hill BT, Hsi ED. Ki67 proliferation index in follicular lymphoma is associated with favorable outcome in patients treated with R-CHOP. Leuk Lymphoma 2023; 64:1433-1441. [PMID: 37226602 DOI: 10.1080/10428194.2023.2214651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/09/2023] [Accepted: 05/12/2023] [Indexed: 05/26/2023]
Abstract
Follicular lymphoma (FL) is a common, indolent small B-cell lymphoma. While the Follicular Lymphoma International Prognostic Index is widely used, reliable prognostic and predictive biomarkers are needed. A recent study suggested that architectural patterns of CD10, BCL6, and Ki67 expression may correlate with progression-free survival (PFS) in FL patients treated with chemotherapy-free regimens. We examined the prognostic and predictive utility of architectural patterns of CD10, BCL6, Ki67, and FOXP1 in 90 patients treated with immunochemotherapy (bendamustine-rituximab [BR] and R-cyclophosphamide, doxorubicin, vincristine, prednisone [CHOP]). We found that high follicular Ki67 (≥30%) was associated with longer PFS in the subgroup of patients treated with R-CHOP but not among those treated with BR. Validation of this biomarker may support routine use of Ki67 as a predictive marker in FL.
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Affiliation(s)
- Meredith M Nichols
- Robert Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sarah L Ondrejka
- Robert Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sujata Patil
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
- Lerner Research Institute, Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Lisa Durkin
- Robert Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Brian T Hill
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Eric D Hsi
- Department of Pathology, Wake Forest University School of Medicine, Winston Salem, NC, USA
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20
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Patil S, Awan KH, Licari FW. Breaking barriers: immersive virtual reality for dental treatment in autism spectrum children. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00816-z. [PMID: 37329445 DOI: 10.1007/s40368-023-00816-z] [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] [Received: 05/22/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023]
Affiliation(s)
- S Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, USA.
| | - K H Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, USA
| | - F W Licari
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, USA
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21
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Chouksey P, Yadav NS, Hazari P, Saxena V, Mahajan H, Narwani S, Somkuwar K, Alzahrani AH, Alqahtani SM, Robaian A, Alamoudi A, Zidane B, Albar N, Baeshen HA, Patil S. In Vitro Evaluation of marginal adaptation of polyether ether ketone and zirconia copings. Niger J Clin Pract 2023; 26:701-708. [PMID: 37470642 DOI: 10.4103/njcp.njcp_701_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Background Polyether ether ketone (PEEK) has emerged as a new thermoplastic material with potential applications as a restorative material. Aim: This study aimed to evaluate the marginal adaptation of PEEK copings compared to zirconia copings using field emission scanning electron microscopy. Materials and Methods A freshly extracted maxillary central incisor was prepared for a full-coverage restoration following standard principles of tooth preparation. The tooth was sent to a laboratory for fabrication of samples using computer-aided design and manufacturing (CAD/CAM). Twenty samples of polyether ether ketone (PEEK) copings (group A) and 20 of zirconia copings were fabricated (group B). The copings were scanned under a field emission scanning electron microscope and measurements were taken at four distinct points. The marginal adaptation over the buccal, lingual, mesial, and distal margins for both groups was evaluated. One-way analysis of variance (ANOVA) and independent t test were applied. Results Our findings indicate that PEEK showed better marginal adaptation than zirconia at all measurement points. The mean marginal gap value of the PEEK group was 33.99 ± 8.81 μm and of the zirconia group was 56.21 ± 15.07 μm. On comparing marginal adaptation among the mesial, distal, buccal, and lingual aspects, PEEK showed better adaptation on all four margins, with the best adaptation on the buccal margin that had the lowest mean gap value of 29.27 ± 6.07 μm. The zirconia group adapted best at the distal margin, with a lowest mean gap value of 53.58 ± 15.25 μm (P ≤ 0.05). Conclusion PEEK copings had better marginal adaptation and fit compared to zirconia copings. It may have applications as a restorative material in fixed prostheses.
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Affiliation(s)
- P Chouksey
- Peoples Dental Academy, Bhopal, Madhya Pradesh, India
| | - N S Yadav
- Department of Prosthodontics Crown and Bridge and Implantology, Peoples Dental Academy, Peoples University, Bhopal, Madhya Pradesh, India
| | - P Hazari
- Department of Prosthodontics Crown and Bridge and Implantology, Peoples Dental Academy, Peoples University, Bhopal, Madhya Pradesh, India
| | - V Saxena
- Department of Public Health Dentistry, Government Dental College, Indore, Madhya Pradesh, India
| | - H Mahajan
- Department of Prosthodontics Crown and Bridge and Implantology, Peoples Dental Academy, Peoples University, Bhopal, Madhya Pradesh, India
| | - S Narwani
- Department of Prosthodontics Crown and Bridge and Implantology, Peoples Dental Academy, Peoples University, Bhopal, Madhya Pradesh, India
| | - K Somkuwar
- Department of Prosthodontics Crown and Bridge and Implantology, Peoples Dental Academy, Peoples University, Bhopal, Madhya Pradesh, India
| | - A H Alzahrani
- Department of Prosthodontics, Faculty of Dentistry, Taif University, Taif- 90813, Saudi Arabia
| | - S M Alqahtani
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia
| | - A Robaian
- Conservative Dental Sciences Department, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj- 11942, Saudi Arabia
| | - Ahmed Alamoudi
- Oral Biology Department, King Abdulaziz University, Jeddah- 22252, Saudi Arabia
| | - B Zidane
- Restorative Dentistry Department, King Abdulaziz University, Jeddah- 22252, Saudi Arabia
| | - N Albar
- Restorative Dentistry Department, Faculty of Dentistry Jazan University, Jazan- 45412, Saudi Arabia
| | - H A Baeshen
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - S Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UTAH-84095, USA; Centre of Molecular Medicine and Diagnostics (COMManD), Department of Biochemistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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22
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Wasti J, Ravishankar PL, Wasti A, Rajula MPB, Sunanda K, Alzahrani KJ, Alharif KF, Halawani IF, Alzahrani FM, Baeshen HA, Abulhamael AM, Patil S. Root surface changes following manual and ultrasonic instrumentation - a scanning electron microscopic study. Eur Rev Med Pharmacol Sci 2023; 27:5415-5420. [PMID: 37401276 DOI: 10.26355/eurrev_202306_32776] [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: 07/05/2023]
Abstract
OBJECTIVE The aim of this study is to assess the efficacy of hand and ultrasonic scaling and to evaluate the surface roughness on the root surface of periodontally involved teeth using a scanning electron microscope. PATIENTS AND METHODS A sample of 90 single-rooted teeth with a hopeless prognosis was selected for the study and divided into three separate groups. Group I consist of no treatment. In Group II, hand scaling was done using Gracey curettes, and in Group III, ultrasonic scaling was done. The teeth were then extracted and fixed in 10% formaldehyde solution for 24-48 hours and subjected to scanning electron microscopic (SEM) evaluation. RESULTS The SEM analysis revealed that the remaining calculus index was found to be similar in the ultrasonic group and the hand scaling group, whereas the surface roughness was found to be the least in the ultrasonic group. CONCLUSIONS Hand instrumentation has resulted in more surface roughness as compared to ultrasonic instruments.
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Affiliation(s)
- J Wasti
- Department of Periodontics, Government Dental College, Raipur, Chhattisgarh, India.
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23
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Gopalakrishnan U, Madasamy R, Mathew R, Alsulaimani FF, Sayed M, Mugri M, Baeshen HA, Bhandi S, Testarelli L, Mahendra L, Muruganandhan J, Raj AT, Patil S. A split-mouth randomized controlled trial to compare the rate of canine retraction after a soft tissue procedure compared against a corticotomy procedure for accelerated tooth movement. Niger J Clin Pract 2023; 26:666-673. [PMID: 37470637 DOI: 10.4103/njcp.njcp_209_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Background and Aim Various methods to accelerate the orthodontic tooth movement have been used, among which corticotomy is considered to be the most common one. The suggested reasoning for such acceleration was the regional acceleratory phenomenon (RAP). Since the RAP is a property of both the hard and soft tissues, we designed a soft tissue flap procedure to compare the effects with the conventional corticotomy procedure. A split-mouth study was conducted where the two procedures were assessed in a single participant. Patients and Methods The total sample size was calculated to be 40 with 20 participants in each group. The rate of tooth movement was the primary outcome measure, and the secondary outcomes were dentoalveolar changes, which were studied in both the conventional corticotomy and the flap-only procedure based on a cone-beam computed tomography (CBCT) wherein the alveolar bone density (BD) around canines, tipping, and rotational changes in canines, premolars, and molars were assessed. Results Corticotomy resulted in greater canine angulation, lesser canine rotation and premolar rotation, and greater molar rotation compared with flap elevation, but these differences were statistically insignificant. Conclusion Though the corticotomy resulted in higher BD, the differences were statistically insignificant. There was no significant difference in the rate of space closure assessed by the two techniques compared.
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Affiliation(s)
- U Gopalakrishnan
- Department of Orthodontics, Sri Venkateswara Dental College and Hospital, Chennai, India
| | - R Madasamy
- Department of Orthodontics, Sri Venkateswara Dental College and Hospital, Chennai, India
| | - R Mathew
- Department of Oral and Maxillofacial Radiology, College of Dental Medicine, Midwestern University, Illinois, USA
| | - F F Alsulaimani
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - M Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - M Mugri
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - H A Baeshen
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - S Bhandi
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UTAH, USA
| | - L Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, Rome, Italy
| | - L Mahendra
- Department of Orthodontics, Sri Venkateswara Dental College and Hospital, Chennai, India
| | - J Muruganandhan
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
| | - A T Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
| | - S Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, USA
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24
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Kumar G, Rajula MP, Rao KS, Ravishankar PL, Albar DH, Bahammam MA, Alamoudi A, Alzahrani KJ, Alsharif KF, Halawani IF, Alzahrani FM, Alnfiai MM, Baeshen HA, Patil S. Antimicrobial Efficacy of Blended Essential Oil and Chlorhexidine against Periodontal Pathogen ( P.gingivalis)-An In Vitro Study. Niger J Clin Pract 2023; 26:625-629. [PMID: 37357480 DOI: 10.4103/njcp.njcp_787_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Background Essential oils (EOs) have a considerable amount of therapeutic and preventive effect in treating dental diseases due to their wider potential as antibacterial and anti-inflammatory agents. EOs like virgin coconut oil, eucalyptus oil, peppermint oil thyme oil, and clove oil, when used in combination, may further have enhanced antimicrobial effects. However, limited information exists on the synergistic effect of these oils when used in combination, especially on the primary periodontal pathogen Porphyromonas gingivalis. Aim The current study aims to compare the antimicrobial efficacy of commercially available EO on the periodontal pathogen, P. gingivalis, in comparison to chlorhexidine (CHX). Materials and Methods Antimicrobial efficacy of EO and CHX was assessed at various concentrations against the periodontal pathogen P. gingivalis, by evaluating the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Results P. gingivalis was seen to be sensitive at a MIC of 100 μg/ml and 50 μg/ml concentration of the EO, which is regarded as the MIC of EO against P. gingivalis and CHX effectively inhibited microbial growth at 0.4 μg/ml. Conclusion A combination of EOs possesses a potent antibacterial activity against P. gingivalis, and the antibacterial efficacy increases with increasing concentration of EOs.
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Affiliation(s)
- G Kumar
- Department of Periodontology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur 603203, Kancheepuram, Tamil Nadu, India
| | - M P Rajula
- Department of Periodontology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur 603203, Kancheepuram, Tamil Nadu, India
| | - K S Rao
- Department of Periodontology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur 603203, Kancheepuram, Tamil Nadu, India
| | - P L Ravishankar
- Department of Periodontology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, SRM Nagar, Kattankulathur 603203, Kancheepuram, Tamil Nadu, India
| | - D H Albar
- Department of Preventive Dentistry, College of Dentistry, Jazan University, Saudi Arabia
| | - M A Bahammam
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University. Jeddah; Executive Presidency of Academic Affairs, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - A Alamoudi
- Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - K J Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - K F Alsharif
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - I F Halawani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - F M Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - M M Alnfiai
- Department of Information Technology, College of Computers and Information Technology, Taif University, Taif, Saudi Arabia
| | - H A Baeshen
- Department of Orthodontics, College of Dentistry, King Abdulziz University, Jeddah, Saudi Arabia
| | - S Patil
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UTAH, USA
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25
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Yehia L, Plitt G, Tushar AM, Joo J, Burke CA, Campbell SC, Heiden K, Jin J, Macaron C, Michener CM, Pederson HJ, Radhakrishnan K, Shin J, Tamburro J, Patil S, Eng C. Longitudinal Analysis of Cancer Risk in Children and Adults With Germline PTEN Variants. JAMA Netw Open 2023; 6:e239705. [PMID: 37093598 PMCID: PMC10126871 DOI: 10.1001/jamanetworkopen.2023.9705] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
Importance Identifying hereditary cancer predisposition facilitates high-risk organ-specific cancer surveillance and prevention. In PTEN hamartoma tumor syndrome (PHTS), longitudinal studies remain lacking, and there are insufficient data on cancers in children and young adults, as well as individuals with neurodevelopmental disorders (NDD). Objective To evaluate lifetime cancer risks, including second malignant neoplasms (SMN), among patients with PHTS. Design, Setting, and Participants Prospective longitudinal cohort study (September 1, 2005, through January 6, 2022). General population risks from the Surveillance, Epidemiology, and End Results database. Patients with PHTS, molecularly defined as carrying germline PTEN variants, were accrued from community and academic medical centers throughout North America, South America, Europe, Australia, and Asia. Data were analyzed from July 2022 to February 2023. Exposures Review of physical and electronic medical records, and follow-up through clinical visits or telephone interviews. Main Outcomes and Measures Lifetime cancer risks in PHTS relative to the general population. Results A total of 7302 patients were prospectively accrued, 701 of whom had germline PTEN variants (median [IQR] age at consent, 38 [12-52] years; 413 female patients [59%]). Longitudinal follow-up data could be obtained for 260 patients (37%), with a median (IQR) follow-up of 4 (2-8) years. Of the 701 patients, 341 (49%) received at least 1 cancer diagnosis, with 144 (42%) of those having SMN. The study found significantly elevated lifetime risks for breast (91%), endometrial (48%), thyroid (33%), kidney (30%), and colorectal cancers (17%), as well as melanoma (5%). Cancer diagnoses were also observed in children and young adults with PHTS (15%) and in patients with PHTS with neurodevelopmental disorders (11%). Elevated risks (P < .001) of thyroid (age-adjusted standardized incidence ratios [SIR], 32.1; 95% CI, 26.0-39.0), kidney (SIR, 26.5; 95% CI, 18.8-36.3), endometrial (SIR, 26.0; 95% CI, 19.5-34.1), breast (SIR, 20.3; 95% CI, 17.3-23.7), and colorectal (SIR, 7.9; 95% CI, 5.2-11.7) cancers, and melanoma (SIR, 6.3; 95% CI, 3.5-10.5) were observed. Of the 341 patients with PHTS with cancer, 51 (15%) had 1 or more cancers diagnosed at age 29 years or younger, and 16 (31.4%) of those developed SMN at final follow-up. Twenty-three patients with PHTS with NDD and cancer were identified, with 5 (22%) having developed SMN at final follow-up. Individuals with PHTS and NDD showed higher lifetime cancer risks compared with individuals with PHTS but without NDD (hazard ratio, 2.7; 95% CI, 1.7-4.2; P < .001). Conclusions and Relevance This cohort study found consistently elevated lifetime cancer risks in PHTS. Organ-specific surveillance should continue in patients with PHTS. Additional study is required to ascertain elevated cancer risks in patients with PHTS with NDD.
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Affiliation(s)
- Lamis Yehia
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Gilman Plitt
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Ann M Tushar
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Julia Joo
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Carol A Burke
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
- Sanford R. Weiss MD Center for Hereditary Colorectal Neoplasia, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
- PTEN Multidisciplinary Clinic and Center of Excellence, Cleveland Clinic, Cleveland, Ohio
| | - Steven C Campbell
- PTEN Multidisciplinary Clinic and Center of Excellence, Cleveland Clinic, Cleveland, Ohio
- Department of Urology, Cleveland Clinic, Cleveland, Ohio
| | - Katherine Heiden
- PTEN Multidisciplinary Clinic and Center of Excellence, Cleveland Clinic, Cleveland, Ohio
- Center for Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Judy Jin
- PTEN Multidisciplinary Clinic and Center of Excellence, Cleveland Clinic, Cleveland, Ohio
- Center for Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Carole Macaron
- Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
- Sanford R. Weiss MD Center for Hereditary Colorectal Neoplasia, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
- PTEN Multidisciplinary Clinic and Center of Excellence, Cleveland Clinic, Cleveland, Ohio
| | - Chad M Michener
- PTEN Multidisciplinary Clinic and Center of Excellence, Cleveland Clinic, Cleveland, Ohio
- Division of Gynecologic Oncology, Obstetrics, Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio
| | - Holly J Pederson
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio
- PTEN Multidisciplinary Clinic and Center of Excellence, Cleveland Clinic, Cleveland, Ohio
| | - Kadakkal Radhakrishnan
- PTEN Multidisciplinary Clinic and Center of Excellence, Cleveland Clinic, Cleveland, Ohio
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic, Cleveland, Ohio
| | - Joyce Shin
- PTEN Multidisciplinary Clinic and Center of Excellence, Cleveland Clinic, Cleveland, Ohio
- Center for Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Joan Tamburro
- PTEN Multidisciplinary Clinic and Center of Excellence, Cleveland Clinic, Cleveland, Ohio
- Department of Dermatology, Cleveland Clinic, Cleveland, Ohio
| | - Sujata Patil
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Charis Eng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University School of Medicine, Cleveland, Ohio
- PTEN Multidisciplinary Clinic and Center of Excellence, Cleveland Clinic, Cleveland, Ohio
- Center for Personalized Genetic Healthcare, Community Care, Cleveland Clinic, Cleveland, Ohio
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Genetics and Genome Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
- Germline High Risk Cancer Focus Group, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio
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Crown A, McCartan D, Curry MA, Patil S, Kamer S, Goldfarb S, Gemignani ML. Pregnancy-associated breast cancer: does timing of presentation affect outcome? Breast Cancer Res Treat 2023; 198:283-294. [PMID: 36662395 DOI: 10.1007/s10549-022-06833-8] [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: 09/28/2022] [Accepted: 12/01/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE Pregnancy-associated breast cancer (PABC) comprises breast cancer diagnosed during the gestational period or within 12 months postpartum. While the incidence of PABC appears to be increasing, data regarding prognosis remain limited. METHODS Here we evaluate clinicopathologic features, treatments, and clinical outcomes among women with stage 0-III PABC diagnosed between 1992 and 2020. Comparisons were made between women who were diagnosed with PABC during gestation and those who were diagnosed within 12 months postpartum. RESULTS A total of 341 women were identified, with a median age of 36 years (range 25-46). The pregnancy group comprised 119 (35%) women, while 222 (65%) women made up the postpartum group. Clinicopathologic features were similar between groups, with most patients being parous and presenting with stage I and II disease. Treatment delays were uncommon, with a median time from histologic diagnosis to treatment of 4 weeks for both groups. Recurrence-free survival was similar between groups: 67% at 10 years for both. While 10-year overall survival appeared higher in the postpartum group (83% versus 78%, p = 0.02), only the presence of nodal metastases was associated with an increased risk of death (hazard ratio 5.61, 95% CI 2.20-14.3, p < 0.001), whereas timing of diagnosis and receptor profile did not reach statistical significance. CONCLUSION Clinicopathologic features of women with PABC are similar regardless of timing of diagnosis. While 10-year recurrence-free survival is similar between groups, 10-year overall survival is higher among women diagnosed postpartum; however, timing of diagnosis may not be the driving factor in determining survival outcomes.
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Affiliation(s)
- Angelena Crown
- Department of Breast Surgery, True Family Women's Cancer Center, Swedish Cancer Institute, Seattle, WA, USA
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Damian McCartan
- Department of Breast Surgery, St Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - Michael A Curry
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sujata Patil
- Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sabrina Kamer
- Department of Obstetrics and Gynecology, Albany Medical Center, Albany, NY, USA
| | - Shari Goldfarb
- Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Mary L Gemignani
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Kumar S, Nguyen D, Graviss E, Patil S, Kim J, Suarez E, Hussain I, Yousefzai R, Ahsan S, Gorthi J, Kassi M, Bhimaraj A, Martin C, Guha A. Donor-Derived Cell-Free DNA in Heart Multiorgan Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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28
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Ghosh M, Shivakumar Y, Balaram G, Thomas R, Dharman B, Kowsik P, Ghorpade S, Nanjaiah T, Patil S, Naik R, Kanakasetty G, Thungappa S, Poppareddy S, Jayappa SB, Bhattacharjee S, Susheela SP, R MN, Sharma A, Gunari P, Ajaikumar B. 153P Molecular epidemiology of EGFR mutations in NSCLC: A single-center experience from India. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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29
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Kumar S, Nguyen D, Graviss E, Patil S, Kim J, Suarez E, Hussain I, Yousefzai R, Ahsan S, Gorthi J, Kassi M, Bhimaraj A, Martin C, Guha A. A Novel Simultaneous Heart-Kidney (sHK) Transplantation Risk Calculator Predicts Chronic Dialysis or Death at 1-Year: A UNOS Analysis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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30
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Patil S, Bhandi S, Awan KH, Licari F. AI-assisted dental care. Br Dent J 2023; 234:555-556. [PMID: 37117336 DOI: 10.1038/s41415-023-5813-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 04/30/2023]
Affiliation(s)
- S Patil
- Roseman University of Health Sciences, South Jordan, USA.
| | - S Bhandi
- Roseman University of Health Sciences, South Jordan, USA.
| | - K H Awan
- Roseman University of Health Sciences, South Jordan, USA.
| | - F Licari
- Roseman University of Health Sciences, South Jordan, USA.
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31
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LeVee A, Spector K, Larkin B, Dezem F, Plummer J, Dadmanesh F, Patil S, McArthur HL. Incidence and prognostic impact of
HER2
‐positivity loss after dual
HER2
‐directed neoadjuvant therapy for
HER2
+ breast cancer. Cancer Med 2023; 12:10647-10659. [DOI: 10.1002/cam4.5817] [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] [Received: 08/03/2022] [Revised: 02/05/2023] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
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32
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Jyothi AK, Thotakura B, Priyadarshini SC, Patil S, Poojari MS, Subramanian M. Paternal stress alters synaptic density and expression of GAP-43, GRIN1, M1 and SYP genes in the hippocampus and cortex of offspring of stress-induced male rats. Morphologie 2023; 107:67-79. [PMID: 35715368 DOI: 10.1016/j.morpho.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/16/2022] [Accepted: 05/03/2022] [Indexed: 02/07/2023]
Abstract
Adverse experiences during pregnancy have a negative impact on the neuronal structure and behavior of offspring, but the effects of a father's life events on the outcome of progeny are scarce. The present study is intended to investigate whether paternal stress affects the offspring brain structure, especially those regions concerned with learning and formation of memory, namely the hippocampus (HC) and prefrontal cortex (PFC), and also the expression of certain genes linked to learning and memory in the offspring. Induced stress to male rats by five stressors, one per day followed by allowing them to mate with the normal, unstressed female. Synaptophysin immunoreactivity was assessed in the tissue sections of the HC and PFC as well as expression of genes concerned with learning and memory was evaluated by RT-PCR in the progeny of stress-received males. The progeny of stressed rats had reduced antisynaptophysin immunoreactivity in the HC and PFC. The synaptic density in HC was less in the A-S (Offspring of male rats who received stress during adulthood) and PA-S (offspring of male rats who received stress during both adolescence and adulthood) than in P-S (offspring of male rats who received stress during adolescence) and C-C (offspring of control) groups. Similar results were observed even in the PFC. The results of post hoc tests proved that the HC and PFC of the progeny of stress-exposed rats exhibited considerably less synaptic density than control (P<0.05), and the levels of expression of GAP-43, GRIN1, M1, and SYP genes in HC and PFC were down-regulated. This study concludes that paternal adverse experiences can affect the offspring's synaptic plasticity and also the genes, which can regulate learning and formation of memory.
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Affiliation(s)
- A K Jyothi
- Department of Anatomy, Basaveshwara Medical College and Hospital, 577502 Chitradurga, Karnataka, India
| | - B Thotakura
- Department of Anatomy, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chettinad Health City, 603103 Kanchipuram, Tamil Nadu, India.
| | - S C Priyadarshini
- Department of Anatomy, Tagore Medical College & Hospital, 600127 Chennai, Tamil Nadu, India
| | - S Patil
- Department of Anatomy, Basaveshwara Medical College and Hospital, 577502 Chitradurga, Karnataka, India
| | - M S Poojari
- Department of Anatomy, Basaveshwara Medical College and Hospital, 577502 Chitradurga, Karnataka, India
| | - M Subramanian
- Department of Anatomy, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chettinad Health City, 603103 Kanchipuram, Tamil Nadu, India
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33
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Patil S, Wagh K, Lopes B, Liu S, Wen F. ESBL encoding third-generation cephalosporin resistance observed in bloodstream infection in India. J Hosp Infect 2023; 133:98-99. [PMID: 36657491 DOI: 10.1016/j.jhin.2022.12.019] [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] [Received: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023]
Affiliation(s)
- S Patil
- Paediatric Research Institute, Shenzhen Children's Hospital, Shenzhen, China; Department of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, China.
| | - K Wagh
- Department of Microbiology, Dr Ulhas Patil Medical College and Hospital, Jalgaon Khu, Jalgaon, Maharashtra, India
| | - B Lopes
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK; National Horizons Centre, Teesside University, Darlington, UK
| | - S Liu
- Department of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, China
| | - F Wen
- Paediatric Research Institute, Shenzhen Children's Hospital, Shenzhen, China; Department of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, China
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McArthur H, Comen E, Bryce Y, Solomon S, Leal JHS, Abaya CD, Martinez C, Basho R, Park D, McAndrew P, Larkin B, Mills W, Page DB, Mellinger S, Fredrich N, Moxon N, Reddy S, Carter M, Patil S, Norton L. Abstract OT1-19-01: A Single Arm Phase 2 Study of Peri-Operative Checkpoint-Mediated Immune Therapy and Cryoablation in Women with Hormone Receptor-Negative, HER2-Negative Early Stage/Resectable Breast Cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-ot1-19-01] [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: 03/06/2023]
Abstract
Abstract
Background: Local tumor destruction with cryoablation (cryo) induces inflammation and releases antigens that can activate tumor-specific immune responses. Pre-clinically, cryo with immune checkpoint inhibition (ICI)-augmented tumor-specific immune responses and prevented recurrence. Clinically, we established that peri-operative (peri-op) cryo with ipilimumab (ipi) +/- nivolumab (nivo) was not only safe in patients (pts) with operable, early stage breast cancer (ESBC) but also generated robust intra-tumoral and systemic immune responses. In this phase 2 study, we evaluate the disease specific impact of peri-op ICI in women with residual triple negative breast cancer (TNBC) after neoadjuvant chemotherapy (NAC), a subset at high risk of early relapse. Methods: Eligible pts are ≥18y, with ER < 10%, PR < 10%, HER2 negative (per ASCO/CAP definition), ≥ 1.0 cm, residual operable disease after taxane-based NAC. Approximately 80 pts will be enrolled and treated with ipi/nivo/cryo followed by breast surgery and adjuvant nivo across multiple institutions. Pts undergo percutaneous, image-guided cryo with concurrent research core biopsy 7-10 days prior to surgery and will receive ipi (1mg/kg IV) with nivo (240mg IV) 1 to 5 days prior to cryo. After surgery, pts will receive 3 additional doses of nivo at 240mg IV Q2 weeks. Adjuvant capecitabine is recommended for all patients per local standard-of-care. Patients will be stratified by NAC platinum administration, NAC anthracycline administration, and clinical nodal status (positive versus negative). The primary endpoint is 3-year Event Free Survival (EFS). Secondary endpoints include Invasive Disease-Free Survival (IDFS), Distant Disease-Free Survival (DDFS), overall survival (OS) and safety. Exploratory correlative studies will be performed on tumor and serum to characterize the immunologic impact of the intervention and to explore predictors of efficacy and toxicity. Funding sources: Susan G. Komen, ASCO Conquer Cancer Foundation, Breast Cancer Research Foundation, Bristol-Myers Squibb, BTG International Ltd. NCT03546686
Citation Format: Heather McArthur, Elizabeth Comen, Yolanda Bryce, Stephen Solomon, Jorge Henrique Santos Leal, Christina DiLauro Abaya, Cristal Martinez, Reva Basho, Dorothy Park, Philomena McAndrew, Brigid Larkin, William Mills, David B. Page, Staci Mellinger, Nicole Fredrich, Nicole Moxon, Sangeetha Reddy, Meredith Carter, Sujata Patil, Larry Norton. A Single Arm Phase 2 Study of Peri-Operative Checkpoint-Mediated Immune Therapy and Cryoablation in Women with Hormone Receptor-Negative, HER2-Negative Early Stage/Resectable Breast Cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT1-19-01.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - David B. Page
- 13Robert W. Franz Cancer Research Center and Alliance, Portland, Oregon
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35
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Gomes I, Garg T, Churchyard G, Gupta A, Hesseling AC, Swindells S, Gurupira W, Martel B, Mbata L, Patil S, Riviere C, Tonquin M, Dowdy D, Sohn H. The cascade of care for household contacts of people with drug-resistant TB. Int J Tuberc Lung Dis 2023; 27:154-156. [PMID: 36853100 PMCID: PMC10115168 DOI: 10.5588/ijtld.22.0473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- I Gomes
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - T Garg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - G Churchyard
- Aurum Institute, Johannesburg, South Africa, School of Public Health, University of Witwatersrand, Johannesburg, South Africa, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - A Gupta
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - A C Hesseling
- Desmond Tutu TB Centre, the Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa
| | - S Swindells
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NB, USA
| | - W Gurupira
- Clinical Trials Research Centre (UZ-CTRC), University of Zimbabwe, Harare, Zimbabwe
| | - B Martel
- Socios En Salud Sucursal Peru, Lima, Peru
| | - L Mbata
- Aurum Institute, Rustenburg, South Africa
| | - S Patil
- Byramjee Jeejeebhoy Government Medical College CRS, Johns Hopkins University Baltimore-Washington-India Clinical Trials Unit, Pune, India
| | - C Riviere
- Les Centres GHESKIO, Port-au-Prince, Haiti
| | - M Tonquin
- Research Division, De La Salle Medical and Health Sciences Institute, Dasmarinas City, Cavite, The Philippines
| | - D Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - H Sohn
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
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36
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Patil S, Kalashetti S, Kokane H, Somalaram V, Kaur A, Gupta V. Evaluation of cardiovascular risk scores after implementation of digital therapeutic intervention in patients with uncontrolled primary hypertension. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Terrals Technologies Private Limited
Background
Cardiovascular risk scores serve as a useful tool to reinforce the importance of lifestyle modifications and treatment compliance. Yet, there remains a gap between advice by the physician and its implementation by the patient. Digital therapeutics (DTx) as a technology based approach can help bridge this gap. In this context, knowing the quantum of change in disease outcomes and long term cardiovascular risk after DTx implementation can be helpful in persuading the patients for lifestyle interventions.
Purpose
To evaluate the change in cardiovascular risk scores in hypertensive patients after a digital therapeutic intervention.
Method
We conducted a prospective, single arm, 12-week intervention trial at two primary care sites in India. A total of 125 subjects within the age group of 30-65 years with primary hypertension (≥ 140/90 mmHg) were enrolled. They were provided DTx intervention which consisted of modification in diet, physical activities, self-monitoring and health education superimposed on behavior science theories. Atherosclerotic Cardiovascular Disease (ASCVD) risk scores from Pooled Cohort Equation were calculated for all subjects before & after the DTx intervention and the change in score was assessed.
Results
We received the data of 116 patients having a mean age of 47.66 ± 9.47 years and mean BMI of 27.20 ± 4.77 Kg/m². After DTx intervention, the change in mean systolic blood pressure, among other ASCVD equation parameters, was -26.38 mmHg (154.77 vs 128.39 mmHg, P<0.001). The corresponding post-intervention 10-year mean ASCVD risk score for the sample population decreased by 4.74% (11.86% vs 7.12%, P<0.001). The 10-year mean relative risk of ASCVD decreased by 39.95 %. Similarly ASCVD lifetime risk score decreased by 3.04% (49.54% vs 46.50%, P<0.001), amounting to mean relative risk reduction of 6%. Female subjects (n=60) showed higher 10-year mean ASCVD risk reduction of 5.70% (11.70% vs 6.00%, P<0.001), compared to male subjects (n=56) who showed 10-year mean ASCVD risk reduction of 3.76% (12.06% vs 8.30%, P<0.001). This amounted to a relative risk reduction of 48.69% and 30.71% for female & male subjects, respectively. Patients with stage 1 hypertension (n=82) showed a reduction in 10-year mean ASCVD risk of 2.86% (9.90% vs 7.04%, P<0.001). Patients with stage 2 (n=30) & stage 3 hypertension (n=4) achieved higher 10-year mean ASCVD risk reduction of 8.67% (16.07% vs 7.40%, P<0.001) & 13.6% (20.88% vs 7.20%, P=.006).
Conclusion
Digital therapeutics enabled intervention has caused a significant decrease in 10-year & lifetime ASCVD risks which can eventually lead to a decrease in cardiovascular complications, morbidity and mortality. Therefore, such intervention programs should be further explored and studied.
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Affiliation(s)
- S Patil
- Terrals Technologies , Bangalore , India
| | | | - H Kokane
- Healthy Heart Clinic , Pune , India
| | | | - A Kaur
- Phable Care , Bangalore , India
| | - V Gupta
- Phable Care , Bangalore , India
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37
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Patil S, Kalashetti S, Kokane H, Somalaram V, Kaur A, Gupta V. Prospective evaluation of digital therapeutic intervention on blood pressure control in Indian patients with uncontrolled primary hypertension. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Terrals Technologies Private Limited
Background
Digital therapeutics (DTx) has emerged as a new approach in recent years making use of connected devices, smartphone software and electronic communication tools to help manage chronic cardiovascular diseases such as hypertension. Considering its nascent stage, many questions still remain with respect to its applicability, effectiveness and limitations.
Purpose
Assess the effectiveness of digital therapeutic intervention in controlling blood pressure in Indian patients with primary hypertension
Methods
We conducted a prospective, 12 week, single arm, interventional study, including 125 subjects at multiple sites in India. Subjects with uncontrolled primary hypertension (≥140 mmHg systolic and/or ≥90 mmHg diastolic) in the age group of 30-65 years who were under routine antihypertensive treatment were enrolled. They were provided supplementary DTx intervention comprising of smartphone application based personalized management of diet, exercise, self monitoring and health education by nutritionists and health coaches. Efficacy endpoints such as blood pressure (BP), body mass index (BMI), lipids, etc. were measured before and after the intervention.
Results
A total of 122 subjects who completed the trial had mean age of 47.44 ± 9.43 years, comprising 58 (48%) male and 64 (52%) female patients and mean BMI of 27.21 ±4.7 kg/m². Post-intervention change in mean systolic BP (SBP) was -25.61 mmHg (95% CI 22.55 - 28.66, 154.98 mmHg vs 129.37 mmHg, P<.001). The post-intervention change in mean diastolic BP (DBP) was -18.62 mmHg (95% CI 16.29 - 20.96, 100.04 mmHg vs 81.42 mmHg, P<.001). Patients with stage 1 hypertension (69.6%) achieved mean systolic reduction of 20.87 ± 13.9 mmHg, (148.54 mmHg vs 127.67 mmHg, P<.001). The patients with stage 2 (27.04%) and stage 3 (3.27%) hypertension achieved a higher mean SBP reduction of 34.67 ± 15.19 mmHg (167.24 mmHg vs 132.58 mmHg, P<.001) and 51.5 ± 40.45 mmHg (190.75 mmHg vs 139.25 mmHg, P=.084), respectively. Male and female patients showed almost similar reduction in systolic BP of 25.47 ± 14.72 and 25.73 ± 19.39 mmHg, respectively. Also, the subjects with other chronic comorbidities (23.9%) achieved a mean systolic BP reduction of 29.51 ± 15.25 mmHg.
A total of 79.51% (n=97) patients achieved the SBP <140 mmHg, while 59.84% (n=73) patients achieved SBP <130 mmHg. Combining both the systolic and diastolic targets together, 65.57% (n=80) patients achieved the target of <140/90 mmHg, while ESC/ESH 2018 recommended BP target of <130/80 mmHg was achieved by 31.15% (n=38) patients.
Conclusion
The implementation of Digital therapeutic application integrated with primary healthcare resulted in significant reduction in blood pressure in participants with uncontrolled hypertension. Greater improvement was observed in participants with higher baseline blood pressure.
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Affiliation(s)
- S Patil
- Terrals Technologies , Bangalore , India
| | | | - H Kokane
- Healthy Heart Clinic , Pune , India
| | | | - A Kaur
- Phable Care , Bangalore , India
| | - V Gupta
- Phable Care , Bangalore , India
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38
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Rais MA, Awad AK, Veseli E, Patil S, Tovani-Palone MR. Correction to: Challenges and obstacles. Br Dent J 2023; 234:74. [PMID: 36707602 DOI: 10.1038/s41415-023-5452-2] [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: 01/29/2023]
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39
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Ged Y, Sanchez A, Patil S, Knezevic A, Stein E, Petruzella S, Weiss K, Duzgol C, Chaim J, Akin O, Mourtzakis M, Paris MT, Scott J, Kuo F, Kotecha R, Hakimi AA, Lee CH, Motzer RJ, Voss MH, Furberg H. Associations between Pretreatment Body Composition Features and Clinical Outcomes among Patients with Metastatic Clear Cell Renal Cell Carcinoma Treated with Immune Checkpoint Blockade. Clin Cancer Res 2022; 28:5180-5189. [PMID: 36190538 PMCID: PMC9793646 DOI: 10.1158/1078-0432.ccr-22-1389] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/24/2022] [Accepted: 09/29/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE High body mass index (BMI) may lead to improved immune-checkpoint blockade (ICB) outcomes in metastatic clear cell renal cell carcinoma (mccRCC). However, BMI is a crude body size measure. We investigated BMI and radiographically assessed body composition (BC) parameters association with mccRCC ICB outcomes. EXPERIMENTAL DESIGN Retrospective study of ICB-treated patients with mccRCC. BMI and BC variables [skeletal muscle index (SMI) and multiple adiposity indexes] were determined using pretreatment CT scans. We examined the associations between BMI and BC variables with ICB outcomes. Therapeutic responses per RECIST v1.1 were determined. We compared whole-transcriptomic patterns with BC variables in a separate cohort of 62 primary tumor samples. RESULTS 205 patients with mccRCC were included in the cohort (74% were male, 71% were overweight/obese, and 53% were classified as low SMI). High-BMI patients experienced longer overall survival (OS) than normal-weight patients [unadjusted HR, 0.66; 95% confidence interval (CI), 0.45-0.97; P = 0.035]. The only BC variable associated with OS was SMI [unadjusted HR comparing low vs. high SMI 1.65 (95% CI: 1.13-2.43); P = 0.009]. However, this OS association became nonsignificant after adjusting for International Metastatic Renal Cell Carcinoma Database Consortium score and line of therapy. No OS association was seen for adiposity and no BC variable was associated with progression-free survival or radiological responses. Tumors from patients with low SMI displayed increased angiogenic, inflammatory, and myeloid signals. CONCLUSIONS Our findings highlight the relevance of skeletal muscle in the BMI paradox. Future studies should investigate if addressing low skeletal muscle in metastatic patients treated with ICB can improve survival.
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Affiliation(s)
- Yasser Ged
- Department of Medicine, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY,Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - Alejandro Sanchez
- Department of Surgery, MSKCC, New York,Department of Surgery, Division of Urology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Sujata Patil
- Department of Biostatistics, Cleveland Clinic, Cleveland, OH,Department of Epidemiology and Biostatistics, MSKCC, New York, NY
| | - Andrea Knezevic
- Department of Epidemiology and Biostatistics, MSKCC, New York, NY
| | - Emily Stein
- Department of Epidemiology and Biostatistics, MSKCC, New York, NY
| | | | - Kate Weiss
- Department of Medicine, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY
| | | | | | - Oguz Akin
- Department of Radiology, MSKCC, New York, NY
| | | | - Michael T. Paris
- Department of Kinesiology, University of Waterloo, Waterloo Canada
| | - Jessica Scott
- Department of Medicine, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY
| | | | - Ritesh Kotecha
- Department of Medicine, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY
| | | | - Chung-Han Lee
- Department of Medicine, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY
| | - Robert J. Motzer
- Department of Medicine, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY
| | - Martin H. Voss
- Department of Medicine, Memorial Sloan Kettering Cancer Center (MSKCC), New York, NY
| | - Helena Furberg
- Department of Epidemiology and Biostatistics, MSKCC, New York, NY
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Yuval JB, Thompson HM, Fiasconaro M, Patil S, Wei IH, Pappou EP, Smith JJ, Guillem JG, Nash GM, Weiser MR, Paty PB, Garcia-Aguilar J, Widmar M. Predictors of operative difficulty in robotic low anterior resection for rectal cancer. Colorectal Dis 2022; 24:1318-1324. [PMID: 35656853 PMCID: PMC9701150 DOI: 10.1111/codi.16212] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/12/2022] [Accepted: 05/24/2022] [Indexed: 02/08/2023]
Abstract
AIM This study evaluates the relationship of tumour and anatomical features with operative difficulty in robotic low anterior resection performed by four experienced surgeons in a high-volume colorectal cancer practice. METHODS Data from 382 patients who underwent robotic low anterior resection by four expert surgeons between January 2016 and June 2019 were included in the analysis. Operating time was used as a measure of operative difficulty. Univariate and multivariate mixed models were used to identify associations between baseline characteristics and operating time, with surgeon as a random effect, thereby controlling for variability in surgeon speed and proficiency. In an exploratory analysis, operative difficulty was defined as conversion to laparotomy, a positive margin or an incomplete mesorectum. RESULTS Median operating time was 4.28 h (range 1.95-11.33 h) but varied by surgeon from 3.45 h (1.95-6.10 h) to 5.93 h (3.33-11.33 h) (P < 0.001). Predictors of longer operating time in multivariate analysis were male sex, higher body mass index, neoadjuvant radiotherapy, low tumour height, greater sacral height and larger mesorectal area at the S5 vertebral level. Conversion occurred in two cases (0.5%), and incomplete mesorectum and positive margins were found in nine (2.4%) and 19 (5.0%) patients, respectively. Neoadjuvant radiotherapy and larger pelvic outlet were the only characteristics associated with the exploratory measure of difficulty. CONCLUSION Predicting operative difficulty based on easy to identify, preoperative radiological and clinical variables is feasible in robotic anterior resection.
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Affiliation(s)
- Jonathan B. Yuval
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hannah M. Thompson
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Megan Fiasconaro
- Departments of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sujata Patil
- Departments of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Iris H. Wei
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Emmanouil P. Pappou
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J. Joshua Smith
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jose G. Guillem
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Garrett M. Nash
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Martin R. Weiser
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Philip B. Paty
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Julio Garcia-Aguilar
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Maria Widmar
- Colorectal Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Lohith G, Krithikaa S, Kallur K, Swamy S, Ramaswamy V, Bj S, Pichandi A, Tungappa S, Patil S, Amalraj J, Ghosh R, Dasgupta R, Naik R, Rahul M, Naseer M, Kumar BA. Flagging the Merited Lesions-Fibroblast 1 and 4 Imaging to Map the Key Avid Domains for Spiked Antigenicity Using SBRT In Situ Vaccination and Metronomic Radiation with Anti PDL-1 Therapy for Augmented Abscopal-Radscopal Responses in Disseminated Cancers. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pappou EP, Temple LK, Patil S, Smith JJ, Wei IH, Nash GM, Guillem JG, Widmar M, Weiser MR, Paty PB, Schrag D, Garcia-Aguilar J. Quality of life and function after rectal cancer surgery with and without sphincter preservation. Front Oncol 2022; 12:944843. [PMID: 36353560 PMCID: PMC9639454 DOI: 10.3389/fonc.2022.944843] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/23/2022] [Indexed: 01/12/2023] Open
Abstract
Despite improvements in surgical techniques, functional outcomes and quality of life after therapy for rectal cancer remain suboptimal. We sought to prospectively evaluate the effect of bowel, bladder, and sexual functional outcomes on health-related quality of life (QOL) in patients with restorative versus non-restorative resections after rectal cancer surgery. A cohort of 211 patients with clinical stage I-III rectal cancer who underwent open surgery between 2006 and 2009 at Memorial Sloan Kettering were included. Subjects were asked to complete surveys preoperatively and at 6, 12, and 24 months after surgery. Validated instruments were used to measure QOL, bowel, bladder, and sexual function. Univariable and multivariable regression analyses evaluated predictors of 24- month QOL. In addition, longitudinal trends over the study period were evaluated using repeated measures models. In total, 180 patients (85%) completed at least 1 survey, and response rates at each time point were high (>70%). QOL was most impaired at 6 and 12 months and returned to baseline levels at 24 months. Among patients who underwent sphincter-preserving surgery (SPS; n=153 [85%]), overall bowel function at 24 months was significantly impaired and never returned to baseline. There were no differences in QOL at 24 months between patients who underwent SPS and those who did not (p=.29). Bowel function was correlated with QOL at 24 months (Pearson correlation,.41; p<.001). QOL among patients who have undergone SPS for rectal cancer is good despite poor function. Patients with ostomies are able to adjust to the functional changes and, overall, have good global QOL. Patients with low anastomoses had lower global QOL at 24 months than patients with permanent stomas. Our findings can help patients set expectations about function and quality of life after surgery for rectal cancer with and without a permanent stoma.
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Affiliation(s)
- Emmanouil P. Pappou
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States,*Correspondence: Emmanouil P. Pappou,
| | - Larissa K. Temple
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, United States
| | - Sujata Patil
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States
| | - J. Joshua Smith
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Iris H. Wei
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Garrett M. Nash
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - José G. Guillem
- Department of Surgery, UNC School of Medicine, Chapel Hill, NC, United States
| | - Maria Widmar
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Martin R. Weiser
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Philip B. Paty
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Deborah Schrag
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Julio Garcia-Aguilar
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States
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Blinder VS, Patil S, Finik J, Makower D, Muppidi M, Lichtenthal WG, Parker PA, Claros M, Suarez J, Narang B, Gany F. An interactive mobile application versus an educational booklet to promote job retention in women undergoing adjuvant chemotherapy for breast cancer: a randomized controlled trial. Trials 2022; 23:840. [PMID: 36192754 PMCID: PMC9527379 DOI: 10.1186/s13063-022-06580-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/15/2022] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Job loss after a cancer diagnosis can lead to long-term financial toxicity and its attendant adverse clinical consequences, including decreased treatment adherence. Among women undergoing (neo)adjuvant chemotherapy for breast cancer, access to work accommodations (e.g., sick leave) is associated with higher job retention after treatment completion. However, low-income and/or minority women are less likely to have access to work accommodations and, therefore, are at higher risk of job loss. Given the time and transportation barriers that low-income working patients commonly face, it is crucial to develop an intervention that is convenient and easy to use. METHODS We designed an intervention to promote job retention during and after (neo)adjuvant chemotherapy for breast cancer by improving access to relevant accommodations. Talking to Employers And Medical staff about Work (TEAMWork) is an English/Spanish mobile application (app) that provides (1) suggestions for work accommodations tailored to specific job demands, (2) coaching/strategies for negotiating with an employer, (3) advice for symptom self-management, and (4) tools to improve communication with the medical oncology team. This study is a randomized controlled trial to evaluate the app as a job-retention tool compared to a control condition that provides the app content in an informational paper booklet. The primary outcome of the study is work status after treatment completion. Secondary outcomes include work status 1 and 2 years later, participant self-efficacy to ask an employer for accommodations, receipt of workplace accommodations during and following adjuvant therapy, patient self-efficacy to communicate with the oncology provider, self-reported symptom burden during and following adjuvant therapy, and cancer treatment adherence. DISCUSSION This study will assess the use of mobile technology to improve vulnerable breast cancer patients' ability to communicate with their employers and oncology providers, work during treatment and retain their jobs in the long term, thereby diminishing the potential consequences of job loss, including decreased treatment adherence, debt, and bankruptcy. TRIAL REGISTRATION ClincalTrials.gov NCT03572374 . Registered on 08 June 2018.
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Affiliation(s)
- Victoria S. Blinder
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center (MSK), New York, USA
| | - Sujata Patil
- grid.239578.20000 0001 0675 4725Cleveland Clinic, Cleveland, USA
| | - Jackie Finik
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center (MSK), New York, USA
| | - Della Makower
- grid.240283.f0000 0001 2152 0791Montefiore Medical Center, New York, USA
| | - Monica Muppidi
- grid.415933.90000 0004 0381 1087Lincoln Medical and Mental Health Center, New York, USA
| | - Wendy G. Lichtenthal
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center (MSK), New York, USA
| | - Patricia A. Parker
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center (MSK), New York, USA
| | - Maria Claros
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center (MSK), New York, USA
| | - Jennifer Suarez
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center (MSK), New York, USA
| | - Bharat Narang
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center (MSK), New York, USA
| | - Francesca Gany
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center (MSK), New York, USA
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Kuehn D, Zeisel SH, Orenstein DF, German JB, Field CJ, Teerdhala S, Knezevic A, Patil S, Donovan SM, Lönnerdal B. Effects of a Novel High-Quality Protein Infant Formula on Energetic Efficiency and Tolerance: A Randomized Trial. J Pediatr Gastroenterol Nutr 2022; 75:521-528. [PMID: 35666855 PMCID: PMC9470040 DOI: 10.1097/mpg.0000000000003490] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/24/2022] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Protein overfeeding in infants can have negative effects, such as diabetes and childhood obesity; key to reducing protein intake from formula is improving protein quality. The impact of a new infant formula [study formula (SF)] containing alpha-lactalbumin, lactoferrin, partially hydrolyzed whey, and whole milk on growth and tolerance compared to a commercial formula (CF) and a human milk reference arm was evaluated. METHODS This randomized, double-blind trial included healthy, singleton, term infants, enrollment age ≤14 days. Primary outcome was mean daily weight gain. Secondary outcomes were anthropometrics, formula intake, serum amino acids, adverse events, gastrointestinal characteristics, and general disposition. RESULTS Non-inferiority was demonstrated. There were no differences between the formula groups for z scores over time. Formula intake [-0.33 oz/kg/day, 95% confidence interval (CI): -0.66 to -0.01, P = 0.05] and mean protein intake (-0.13 g/kg/day, 95% CI: -0.26 to 0.00, P = 0.05) were lower in the SF infants, with higher serum essential amino acid concentrations (including tryptophan) compared to the CF infants. Energetic efficiency was 14.0% (95% CI: 8.3%, 19.7%), 13.0% (95% CI: 6.0%, 20.0%), and 18.1% (95% CI: 9.4%, 26.8%) higher for weight, length, and head circumference, respectively, in SF infants compared to the CF infants. SF infants had significantly fewer spit-ups and softer stool consistency than CF infants. CONCLUSIONS The SF resulted in improved parent-reported gastrointestinal tolerance and more efficient growth with less daily formula and protein intake supporting that this novel formula may potentially reduce the metabolic burden of protein overfeeding associated with infant formula.
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Affiliation(s)
| | - Steven H. Zeisel
- the University of North Carolina at Chapel Hill, Chapel Hill, NC
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Walsh EM, Gucalp A, Patil S, Edelweiss M, Ross DS, Razavi P, Modi S, Iyengar NM, Sanford R, Troso-Sandoval T, Gorsky M, Bromberg J, Drullinsky P, Lake D, Wong S, DeFusco PA, Lamparella N, Gupta R, Tabassum T, Boyle LA, Arumov A, Traina TA. Adjuvant enzalutamide for the treatment of early-stage androgen-receptor positive, triple-negative breast cancer: a feasibility study. Breast Cancer Res Treat 2022; 195:341-351. [PMID: 35986801 PMCID: PMC10506398 DOI: 10.1007/s10549-022-06669-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/29/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE Chemotherapy with or without immunotherapy remains the mainstay of treatment for triple-negative breast cancer (TNBC). A subset of TNBCs express the androgen receptor (AR), representing a potential new therapeutic target. This study assessed the feasibility of adjuvant enzalutamide, an AR antagonist, in early-stage, AR-positive (AR +) TNBC. METHODS This study was a single-arm, open-label, multicenter trial in which patients with stage I-III, AR ≥ 1% TNBC who had completed standard-of-care therapy were treated with enzalutamide 160 mg/day orally for 1 year. The primary objective of this study was to evaluate the feasibility of 1 year of adjuvant enzalutamide, defined as the treatment discontinuation rate of enzalutamide due to toxicity, withdrawal of consent, or other events related to tolerability. Secondary endpoints included disease-free survival (DFS), overall survival (OS), safety, and genomic features of recurrent tumors. RESULTS Fifty patients were enrolled in this study. Thirty-five patients completed 1 year of therapy, thereby meeting the prespecified trial endpoint for feasibility. Thirty-two patients elected to continue with an optional second year of treatment. Grade ≥ 3 treatment-related adverse events were uncommon. The 1-year, 2-year, and 3-year DFS were 94%, 92% , and 80%, respectively. Median OS has not been reached. CONCLUSION This clinical trial demonstrates that adjuvant enzalutamide is a feasible and well-tolerated regimen in patients with an early-stage AR + TNBC. Randomized trials in the metastatic setting may inform patient selection through biomarker development; longer follow-up is needed to determine the effect of anti-androgens on DFS and OS in this patient population.
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Affiliation(s)
- Elaine M Walsh
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA.
| | - Ayca Gucalp
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Sujata Patil
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marcia Edelweiss
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dara S Ross
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Pedram Razavi
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Shanu Modi
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Neil M Iyengar
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Rachel Sanford
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Tiffany Troso-Sandoval
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Mila Gorsky
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Jacqueline Bromberg
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Pamela Drullinsky
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Diana Lake
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Serena Wong
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | | | | | - Ranja Gupta
- Lehigh Valley Health Network Cancer Institute, Allentown, PA, USA
| | - Tasmila Tabassum
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Leigh Ann Boyle
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Artavazd Arumov
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
| | - Tiffany A Traina
- Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, 300 East 66thStreet, New York, NY, USA
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Lakshmanan L, Jeevanandan G, Vishwanathaiah S, Maganur PC, Alzahrani KJ, Alkahtani A, Boreak N, Testarelli L, Baeshen HA, Patil S. Anti-microbial efficacy of root canal preparation in deciduous teeth with manual and rotary files: A randomized clinical trial. Niger J Clin Pract 2022; 25:1681-1686. [PMID: 36308239 DOI: 10.4103/njcp.njcp_71_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND In a pulpectomy, the eradication of microbes from the primary root canal is accomplished through biomechanical preparation, which could be carried out with either manual or rotary instruments. AIMS The objective of this clinical trial was to evaluate the efficiency of manual K-files, H-files, and Kedo-S Square rotary files in reducing microbial flora after canal preparation in primary molars. MATERIALS AND METHODS This randomized clinical trial consisted of 45 primary molars requiring pulpectomy. The teeth were randomly allocated to one of the three groups: Group I: Manual K-files, Group II: Manual H-files, and Group III: Kedo-S Square rotary files, based on the type of instrumentation. Pre-and Post-instrumentation sampling was performed using clean absorbent paper points and kept in a clean Eppendorf tube having thioglycolate broth as the transport medium. Culturing was performed on agar media from which both aerobic and anaerobic microbial counts were estimated. Collected data were statistically analyzed using one-way analysis of variance (ANOVA) and Wilcoxon signed-rank test. Following root canal preparation, 87-89% reduction of the aerobic and anaerobic microbial load was noted in group I, whereas it was an 89-92% reduction in group II and a 93-95% reduction in group III. RESULTS Biomechanical preparation with Kedo-S Square rotary file showed higher efficacy in microbial reduction compared to manual instrumentation. CONCLUSION Manual and rotary files were equally effective in removing root canal microbes. Biomechanical preparation with a KedoS Square rotary file resulted in greater microbial efficacy. Hence In children, effective root canal cleaning in a short period of time is a major consideration.
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Affiliation(s)
- L Lakshmanan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College, Chennai, Tamil Nadu, India
| | - G Jeevanandan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College, Chennai, Tamil Nadu, India
| | - S Vishwanathaiah
- Department of Preventive Dental Sciences, Division of Pediatric Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Prabhadevi C Maganur
- Department of Preventive Dental Sciences, Division of Pediatric Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - K J Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - A Alkahtani
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - N Boreak
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - L Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, Rome, Italy
| | - H A Baeshen
- Department of Orthodontics, College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - S Patil
- College of Dental Medicine, Roseman University of Health Science, South Jordan, UTAH-84095, USA; College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Patil S, Patil A, Jamale T, Hase N. POS-079 RISK FACTORS AND OUTCOMES OF TUBERCULOSIS IN INDIAN KIDNEY TRANSPLANT RECIPIENTS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.07.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Garcia-Aguilar J, Patil S, Gollub MJ, Kim JK, Yuval JB, Thompson HM, Verheij FS, Omer DM, Lee M, Dunne RF, Marcet J, Cataldo P, Polite B, Herzig DO, Liska D, Oommen S, Friel CM, Ternent C, Coveler AL, Hunt S, Gregory A, Varma MG, Bello BL, Carmichael JC, Krauss J, Gleisner A, Paty PB, Weiser MR, Nash GM, Pappou E, Guillem JG, Temple L, Wei IH, Widmar M, Lin S, Segal NH, Cercek A, Yaeger R, Smith JJ, Goodman KA, Wu AJ, Saltz LB. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy. J Clin Oncol 2022; 40:2546-2556. [PMID: 35483010 PMCID: PMC9362876 DOI: 10.1200/jco.22.00032] [Citation(s) in RCA: 228] [Impact Index Per Article: 114.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/01/2022] [Accepted: 03/17/2022] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Prospective data on the efficacy of a watch-and-wait strategy to achieve organ preservation in patients with locally advanced rectal cancer treated with total neoadjuvant therapy are limited. METHODS In this prospective, randomized phase II trial, we assessed the outcomes of 324 patients with stage II or III rectal adenocarcinoma treated with induction chemotherapy followed by chemoradiotherapy (INCT-CRT) or chemoradiotherapy followed by consolidation chemotherapy (CRT-CNCT) and either total mesorectal excision (TME) or watch-and-wait on the basis of tumor response. Patients in both groups received 4 months of infusional fluorouracil-leucovorin-oxaliplatin or capecitabine-oxaliplatin and 5,000 to 5,600 cGy of radiation combined with either continuous infusion fluorouracil or capecitabine during radiotherapy. The trial was designed as two stand-alone studies with disease-free survival (DFS) as the primary end point for both groups, with a comparison to a null hypothesis on the basis of historical data. The secondary end point was TME-free survival. RESULTS Median follow-up was 3 years. Three-year DFS was 76% (95% CI, 69 to 84) for the INCT-CRT group and 76% (95% CI, 69 to 83) for the CRT-CNCT group, in line with the 3-year DFS rate (75%) observed historically. Three-year TME-free survival was 41% (95% CI, 33 to 50) in the INCT-CRT group and 53% (95% CI, 45 to 62) in the CRT-CNCT group. No differences were found between groups in local recurrence-free survival, distant metastasis-free survival, or overall survival. Patients who underwent TME after restaging and patients who underwent TME after regrowth had similar DFS rates. CONCLUSION Organ preservation is achievable in half of the patients with rectal cancer treated with total neoadjuvant therapy, without an apparent detriment in survival, compared with historical controls treated with chemoradiotherapy, TME, and postoperative chemotherapy.
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Affiliation(s)
- Julio Garcia-Aguilar
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sujata Patil
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Marc J. Gollub
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jin K. Kim
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jonathan B. Yuval
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Hannah M. Thompson
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Floris S. Verheij
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Dana M. Omer
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Meghan Lee
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Richard F. Dunne
- Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
| | - Jorge Marcet
- Division of Colon and Rectal Surgery, Department of Surgery, University of South Florida, Tampa, FL
| | - Peter Cataldo
- Division of General Surgery, Department of Surgery, University of Vermont, Burlington, VT
| | - Blase Polite
- Department of Medicine, Comprehensive Cancer Center, University of Chicago, Chicago, IL
| | - Daniel O. Herzig
- Division of Gastrointestinal and General Surgery, Oregon Health and Science University, Portland, OR
| | - David Liska
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH
| | - Samuel Oommen
- Division of Gastrointestinal Oncology, John Muir Cancer Institute, John Muir Health, Walnut Creek, CA
| | - Charles M. Friel
- Division of General Surgery, Department of Surgery, University of Virginia, Charlottesville, VA
| | - Charles Ternent
- Department of Surgery, Colorectal Service at Bergan Mercy Medical Center, Omaha, NE
| | - Andrew L. Coveler
- Department of Medicine, Fred Hutch Cancer Center, University of Washington, Seattle, WA
| | - Steven Hunt
- Department of Surgery, Washington University School of Medicine, St Louis, MO
| | - Anita Gregory
- Department of Surgery, St Joseph Hospital Orange County, Orange, CA
| | - Madhulika G. Varma
- Section of Colon and Rectal Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Brian L. Bello
- Division of Colorectal Surgery, Department of Surgery, Medstar Washington Hospital Center, Washington, DC
| | - Joseph C. Carmichael
- Division of Colon and Rectal Surgery, Department of Surgery, University of California, Irvine, Irvine, CA
| | - John Krauss
- Department of Medicine, Rogel Cancer Center at the University of Michigan, Ann Arbor, MI
| | - Ana Gleisner
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Denver, CO
| | - Philip B. Paty
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Martin R. Weiser
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Garrett M. Nash
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Emmanouil Pappou
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - José G. Guillem
- Division of Gastrointestinal Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC
| | - Larissa Temple
- Division of Colorectal Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Iris H. Wei
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Maria Widmar
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sabrina Lin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Neil H. Segal
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andrea Cercek
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rona Yaeger
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - J. Joshua Smith
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Karyn A. Goodman
- Department of Radiation Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Abraham J. Wu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Leonard B. Saltz
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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Garcia-Aguilar J, Patil S, Gollub MJ, Kim JK, Yuval JB, Thompson HM, Verheij FS, Omer DM, Lee M, Dunne RF, Marcet J, Cataldo P, Polite B, Herzig DO, Liska D, Oommen S, Friel CM, Ternent C, Coveler AL, Hunt S, Gregory A, Varma MG, Bello BL, Carmichael JC, Krauss J, Gleisner A, Paty PB, Weiser MR, Nash GM, Pappou E, Guillem JG, Temple L, Wei IH, Widmar M, Lin S, Segal NH, Cercek A, Yaeger R, Smith JJ, Goodman KA, Wu AJ, Saltz LB. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy. J Clin Oncol 2022. [PMID: 35483010 DOI: 10.1200/jco.22.00032:jco2200032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
PURPOSE Prospective data on the efficacy of a watch-and-wait strategy to achieve organ preservation in patients with locally advanced rectal cancer treated with total neoadjuvant therapy are limited. METHODS In this prospective, randomized phase II trial, we assessed the outcomes of 324 patients with stage II or III rectal adenocarcinoma treated with induction chemotherapy followed by chemoradiotherapy (INCT-CRT) or chemoradiotherapy followed by consolidation chemotherapy (CRT-CNCT) and either total mesorectal excision (TME) or watch-and-wait on the basis of tumor response. Patients in both groups received 4 months of infusional fluorouracil-leucovorin-oxaliplatin or capecitabine-oxaliplatin and 5,000 to 5,600 cGy of radiation combined with either continuous infusion fluorouracil or capecitabine during radiotherapy. The trial was designed as two stand-alone studies with disease-free survival (DFS) as the primary end point for both groups, with a comparison to a null hypothesis on the basis of historical data. The secondary end point was TME-free survival. RESULTS Median follow-up was 3 years. Three-year DFS was 76% (95% CI, 69 to 84) for the INCT-CRT group and 76% (95% CI, 69 to 83) for the CRT-CNCT group, in line with the 3-year DFS rate (75%) observed historically. Three-year TME-free survival was 41% (95% CI, 33 to 50) in the INCT-CRT group and 53% (95% CI, 45 to 62) in the CRT-CNCT group. No differences were found between groups in local recurrence-free survival, distant metastasis-free survival, or overall survival. Patients who underwent TME after restaging and patients who underwent TME after regrowth had similar DFS rates. CONCLUSION Organ preservation is achievable in half of the patients with rectal cancer treated with total neoadjuvant therapy, without an apparent detriment in survival, compared with historical controls treated with chemoradiotherapy, TME, and postoperative chemotherapy.
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Affiliation(s)
- Julio Garcia-Aguilar
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sujata Patil
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Marc J Gollub
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jin K Kim
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jonathan B Yuval
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Hannah M Thompson
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Floris S Verheij
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Dana M Omer
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Meghan Lee
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Richard F Dunne
- Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
| | - Jorge Marcet
- Division of Colon and Rectal Surgery, Department of Surgery, University of South Florida, Tampa, FL
| | - Peter Cataldo
- Division of General Surgery, Department of Surgery, University of Vermont, Burlington, VT
| | - Blase Polite
- Department of Medicine, Comprehensive Cancer Center, University of Chicago, Chicago, IL
| | - Daniel O Herzig
- Division of Gastrointestinal and General Surgery, Oregon Health and Science University, Portland, OR
| | - David Liska
- Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH
| | - Samuel Oommen
- Division of Gastrointestinal Oncology, John Muir Cancer Institute, John Muir Health, Walnut Creek, CA
| | - Charles M Friel
- Division of General Surgery, Department of Surgery, University of Virginia, Charlottesville, VA
| | - Charles Ternent
- Department of Surgery, Colorectal Service at Bergan Mercy Medical Center, Omaha, NE
| | - Andrew L Coveler
- Department of Medicine, Fred Hutch Cancer Center, University of Washington, Seattle, WA
| | - Steven Hunt
- Department of Surgery, Washington University School of Medicine, St Louis, MO
| | - Anita Gregory
- Department of Surgery, St Joseph Hospital Orange County, Orange, CA
| | - Madhulika G Varma
- Section of Colon and Rectal Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Brian L Bello
- Division of Colorectal Surgery, Department of Surgery, Medstar Washington Hospital Center, Washington, DC
| | - Joseph C Carmichael
- Division of Colon and Rectal Surgery, Department of Surgery, University of California, Irvine, Irvine, CA
| | - John Krauss
- Department of Medicine, Rogel Cancer Center at the University of Michigan, Ann Arbor, MI
| | - Ana Gleisner
- Division of Surgical Oncology, Department of Surgery, University of Colorado, Denver, CO
| | - Philip B Paty
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Martin R Weiser
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Garrett M Nash
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Emmanouil Pappou
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - José G Guillem
- Division of Gastrointestinal Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC
| | - Larissa Temple
- Division of Colorectal Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Iris H Wei
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Maria Widmar
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sabrina Lin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Neil H Segal
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andrea Cercek
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rona Yaeger
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Joshua Smith
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Karyn A Goodman
- Department of Radiation Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Abraham J Wu
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Leonard B Saltz
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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50
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Carlo MI, Attalla K, Mazaheri Y, Gupta S, Yildirim O, Murray SJ, Coskey DT, Kotecha R, Lee CH, Feldman DR, Russo P, Patil S, Motzer RJ, Coleman JA, Durack JC, Chen YB, Akin O, Ari Hakimi A, Voss MH. Phase II Study of Neoadjuvant Nivolumab in Patients with Locally Advanced Clear Cell Renal Cell Carcinoma Undergoing Nephrectomy. Eur Urol 2022; 81:570-573. [PMID: 35183395 PMCID: PMC9156541 DOI: 10.1016/j.eururo.2022.01.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/10/2022] [Accepted: 01/24/2022] [Indexed: 01/22/2023]
Abstract
Immune checkpoint inhibitor therapy improves survival in patients with metastatic renal cell carcinoma (RCC) but has not been studied well preoperatively in patients with localized disease undergoing nephrectomy. We conducted a single-center study to evaluate the safety and feasibility of neoadjuvant nivolumab in patients undergoing nephrectomy for localized RCC. Eligible patients had a >20% risk of recurrence, as estimated by a preoperative nomogram. Patients received nivolumab every 2 wk for four treatments prior to surgery. The primary endpoints were feasibility, defined as completing at least three treatments without significant surgical delay, and safety, defined as the rate of surgical complications. Treatment effects were assessed by radiomics and immunohistochemistry. A total of 18 patients (11 men; median age 60 yr) with clear cell RCC were enrolled. All received at least one dose of nivolumab and proceeded to nephrectomy without delay; 16/18 patients completed all four doses. Two patients discontinued nivolumab for immune-related adverse events, and four had surgical complications as per the Clavien-Dindo classification. Integrated pathology plus radiomic analysis demonstrated an association between post-treatment immune infiltration and low entropy apparent diffusion coefficient on magnetic resonance imaging. Nivolumab prior to nephrectomy was safe and feasible, without significant surgical delays and with an expected rate of immune-related adverse events. PATIENT SUMMARY: We evaluated the outcomes for patients with localized kidney cancer who received immunotherapy prior to surgery to remove their kidney tumor. In a small group of patients who had cancer confined to the kidney, this approach appeared safe and feasible.
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Affiliation(s)
- Maria I Carlo
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kyrollis Attalla
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yousef Mazaheri
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sounak Gupta
- Department of Pathology, Mayo Clinic, Rochester, MN, USA
| | - Onur Yildirim
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Samuel J Murray
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Devyn T Coskey
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ritesh Kotecha
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chung-Han Lee
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Darren R Feldman
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paul Russo
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sujata Patil
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Robert J Motzer
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jonathan A Coleman
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeremy C Durack
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ying-Bei Chen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Oguz Akin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A Ari Hakimi
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Martin H Voss
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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