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Chang W, Cohen J, Wang DQ, Abdulla S, Mahende MK, Gavana T, Scott V, Msuya HM, Mwanyika-Sando M, Njau RJA, Lu SN, Temu S, Masanja H, Anthony W, Aregawi W M, Sunder N, Kun T, Bruxvoort K, Kitau J, Kihwele F, Chila G, Michael M, Castro M, Menzies NA, Kim S, Ning X, Zhou XN, Chaki P, Mlacha YP. Impact of 1,7-malaria reactive community-based testing and response (1,7-mRCTR) approach on malaria prevalence in Tanzania. Infect Dis Poverty 2023; 12:116. [PMID: 38105258 PMCID: PMC10726614 DOI: 10.1186/s40249-023-01166-0] [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: 09/11/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Progress in malaria control has stalled in recent years and innovative surveillance and response approaches are needed to accelerate malaria control and elimination efforts in endemic areas of Africa. Building on a previous China-UK-Tanzania pilot study on malaria control, this study aimed to assess the impact of the 1,7-malaria Reactive Community-Based Testing and Response (1,7-mRCTR) approach implemented over two years in three districts of Tanzania. METHODS The 1,7-mRCTR approach provides community-based malaria testing via rapid diagnostic tests and treatment in villages with the highest burden of malaria incidence based on surveillance data from health facilities. We used a difference-in-differences quasi-experimental design with linear probability models and two waves of cross-sectional household surveys to assess the impact of 1,7-mRCTR on malaria prevalence. We conducted sensitivity analyses to assess the robustness of our results, examined how intervention effects varied in subgroups, and explored alternative explanations for the observed results. RESULTS Between October 2019 and September 2021, 244,771 community-based malaria rapid tests were completed in intervention areas, and each intervention village received an average of 3.85 rounds of 1-7mRCTR. Malaria prevalence declined from 27.4% at baseline to 11.7% at endline in the intervention areas and from 26.0% to 16.0% in the control areas. 1,7-mRCTR was associated with a 4.5-percentage-point decrease in malaria prevalence (95% confidence interval: - 0.067, - 0.023), equivalent to a 17% reduction from the baseline. In Rufiji, a district characterized by lower prevalence and where larviciding was additionally provided, 1,7-mRCTR was associated with a 63.9% decline in malaria prevalence. CONCLUSIONS The 1,7-mRCTR approach reduced malaria prevalence. Despite implementation interruptions due to the COVID-19 pandemic and supply chain challenges, the study provided novel evidence on the effectiveness of community-based reactive approaches in moderate- to high-endemicity areas and demonstrated the potential of South-South cooperation in tackling global health challenges.
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Affiliation(s)
- Wei Chang
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jessica Cohen
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Duo-Quan Wang
- Chinese Center for Disease Control and Prevention, National Institute of Parasitic Diseases, Shanghai, People's Republic of China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China
- National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China
| | - Salim Abdulla
- Ifakara Health Institute, #5 Ifakara Street, Plot 463 Mikocheni, P.O. Box 78 373, Dar es Salaam, United Republic of Tanzania
| | - Muhidin Kassim Mahende
- Ifakara Health Institute, #5 Ifakara Street, Plot 463 Mikocheni, P.O. Box 78 373, Dar es Salaam, United Republic of Tanzania
| | - Tegemeo Gavana
- Ifakara Health Institute, #5 Ifakara Street, Plot 463 Mikocheni, P.O. Box 78 373, Dar es Salaam, United Republic of Tanzania
| | - Valerie Scott
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Hajirani M Msuya
- Ifakara Health Institute, #5 Ifakara Street, Plot 463 Mikocheni, P.O. Box 78 373, Dar es Salaam, United Republic of Tanzania
| | | | - Ritha John A Njau
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Shen-Ning Lu
- Chinese Center for Disease Control and Prevention, National Institute of Parasitic Diseases, Shanghai, People's Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China
- National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China
| | - Silas Temu
- Ifakara Health Institute, #5 Ifakara Street, Plot 463 Mikocheni, P.O. Box 78 373, Dar es Salaam, United Republic of Tanzania
| | - Honorati Masanja
- Ifakara Health Institute, #5 Ifakara Street, Plot 463 Mikocheni, P.O. Box 78 373, Dar es Salaam, United Republic of Tanzania
| | | | - Maru Aregawi W
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | | | - Tang Kun
- Vanke School of Public Health, Tsinghua University, Beijing, People's Republic of China
| | - Katia Bruxvoort
- School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jovin Kitau
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Fadhila Kihwele
- Ifakara Health Institute, #5 Ifakara Street, Plot 463 Mikocheni, P.O. Box 78 373, Dar es Salaam, United Republic of Tanzania
| | - Godlove Chila
- Ifakara Health Institute, #5 Ifakara Street, Plot 463 Mikocheni, P.O. Box 78 373, Dar es Salaam, United Republic of Tanzania
| | - Mihayo Michael
- Ifakara Health Institute, #5 Ifakara Street, Plot 463 Mikocheni, P.O. Box 78 373, Dar es Salaam, United Republic of Tanzania
| | - Marcia Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Nicolas A Menzies
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sein Kim
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Xiao Ning
- Chinese Center for Disease Control and Prevention, National Institute of Parasitic Diseases, Shanghai, People's Republic of China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China
- National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China
| | - Xiao-Nong Zhou
- Chinese Center for Disease Control and Prevention, National Institute of Parasitic Diseases, Shanghai, People's Republic of China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People's Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China
- National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, People's Republic of China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, People's Republic of China
| | - Prosper Chaki
- Ifakara Health Institute, #5 Ifakara Street, Plot 463 Mikocheni, P.O. Box 78 373, Dar es Salaam, United Republic of Tanzania
- The Pan-African Mosquito Control Association (PAMCA), KEMRI Headquarters, Mbagathi Road, Nairobi, 54840-00200, Kenya
| | - Yeromin P Mlacha
- Ifakara Health Institute, #5 Ifakara Street, Plot 463 Mikocheni, P.O. Box 78 373, Dar es Salaam, United Republic of Tanzania.
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McLean CP, Foa EB, Malek N, Young-McCaughan S, Peterson AL, Hanson BS, Lillard IJ, Patterson TJ, Rosado J, Scott V, Rosenfield D. A multistep mediation model examining how consultation in prolonged exposure therapy affects PTSD treatment outcomes. Psychol Serv 2023:2023-69937-001. [PMID: 37155269 PMCID: PMC10630526 DOI: 10.1037/ser0000769] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Prolonged exposure therapy (PE) is an evidence-based psychotherapy (EBP) for posttraumatic stress disorder (PTSD) that is underutilized in the military health system. Previous research suggests that postworkshop consultation is important for successful implementation. However, little is known about how consultation may relate to EBP adoption or patient outcomes. The present study addressed these gaps by examining associations between consultation, provider self-efficacy, use of PE, and patient outcomes using a multistep mediation model. This study used data from Foa et al. (2020), a two-armed randomized implementation trial comparing two PE training models: standard training (workshop only) and extended training (workshop + 6-8 months of postworkshop expert consultation) at three U.S. Army sites. Participants were patients with PTSD (N = 242) receiving care from the participating providers (N = 103). Providers who received extended training reported greater PE self-efficacy compared to standard training providers, but self-efficacy was unrelated to their use of PE components or to patient outcomes. Extended training providers used more PE components and had superior patient outcomes than standard training providers, and patient outcomes were mediated by the use of PE components. To our knowledge, this is the first study to demonstrate that EBP consultation leads to improved clinical outcomes for patients through increased use of the EBP. PE adoption (i.e., use of PE components in therapy) was not explained by increases in self-efficacy among providers who received extended training. Therefore, future research should assess how other factors may influence provider behavior in implementing EBPs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Carmen P. McLean
- Dissemination and Training Division, National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California, United States
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University
| | - Edna B. Foa
- Department of Psychiatry, School of Medicine, University of Pennsylvania
| | - Nadia Malek
- Dissemination and Training Division, National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California, United States
| | - Stacey Young-McCaughan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Texas Health Science Center at San Antonio
- Research and Development Service, South Texas Veterans Health Care System, San Antonio, Texas, United States
| | - Alan L. Peterson
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Texas Health Science Center at San Antonio
- Research and Development Service, South Texas Veterans Health Care System, San Antonio, Texas, United States
- Department of Psychology, University of Texas at San Antonio
| | - Brenda S. Hanson
- William Beaumont Army Medical Center, Fort Bliss, Texas, United States
| | - Ivett J. Lillard
- Blanchfield Army Community Hospital, Fort Campbell, Kentucky, United States
| | | | - Julio Rosado
- William Beaumont Army Medical Center, Fort Bliss, Texas, United States
| | - Valerie Scott
- Blanchfield Army Community Hospital, Fort Campbell, Kentucky, United States
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Scott V, Dey D, Kuwik J, Hinkelman K, Waldman M, Islam K. Allele-Specific Chemical Rescue of Histone Demethylases Using Abiotic Cofactors. ACS Chem Biol 2022; 17:3321-3330. [PMID: 34496208 DOI: 10.1021/acschembio.1c00335] [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: 01/20/2023]
Abstract
Closely related protein families evolved from common ancestral genes present a significant hurdle in developing member- and isoform-specific chemical probes, owing to their similarity in fold and function. In this piece of work, we explore an allele-specific chemical rescue strategy to activate a "dead" variant of a wildtype protein using synthetic cofactors and demonstrate its successful application to the members of the alpha-ketoglutarate (αKG)-dependent histone demethylase 4 (KDM4) family. We show that a mutation at a specific residue in the catalytic site renders the variant inactive toward the natural cosubstrate. In contrast, αKG derivatives bearing appropriate stereoelectronic features endowed the mutant with native-like demethylase activity while remaining refractory to a set of wild type dioxygenases. The orthogonal enzyme-cofactor pairs demonstrated site- and degree-specific lysine demethylation on a full-length chromosomal histone in the cellular milieu. Our work offers a strategy to modulate a specific histone demethylase by identifying and engineering a conserved phenylalanine residue, which acts as a gatekeeper in the KDM4 subfamily, to sensitize the enzyme toward a novel set of αKG derivatives. The orthogonal pairs developed herein will serve as probes to study the role of degree-specific lysine demethylation in mammalian gene expression. Furthermore, this approach to overcome active site degeneracy is expected to have general application among all human αKG-dependent dioxygenases.
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Affiliation(s)
- Valerie Scott
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, Pennsylvania 15260, United States
| | - Debasis Dey
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, Pennsylvania 15260, United States
| | - Jordan Kuwik
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, Pennsylvania 15260, United States
| | - Kathryn Hinkelman
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, Pennsylvania 15260, United States
| | - Megan Waldman
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, Pennsylvania 15260, United States
| | - Kabirul Islam
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, Pennsylvania 15260, United States
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Cerbone L, Tran D, Tran Dien A, Verret B, Droin N, Scott V, Garberis I, Savaudet A, Maella F, Leite B, Scoazec JY, Ayadi C, Machavoine C, Camara-Clayette V, André F. 138P Dissecting intra-tumoral heterogeneity in localized HR+/Her2− breast cancer using single cell DNA sequencing. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Dubinskaya A, Heard J, Choi E, Cohen T, Anger J, Eilber K, Scott V. Female Sexual Dysfunction Resources: Women and Healthcare Providers Need More Options. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.05.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Dubinskaya A, Horwitz R, Shoureshi P, Anger J, Scott V, Eilber K. Is it Time for FPMRS to Prescribe Vibrators? J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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7
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Dubinskaya A, Dallas K, Eilber K, Scott V, Anger J. Female Genitalia in Pornography: The Source of Labiaplasty Trends? J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.05.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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8
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Ntuku H, Smith-Gueye C, Scott V, Njau J, Whittemore B, Zelman B, Tambo M, Prach LM, Wu L, Schrubbe L, Kang Dufour MS, Mwilima A, Uusiku P, Sturrock H, Bennett A, Smith J, Kleinschmidt I, Mumbengegwi D, Gosling R, Hsiang M. Cost and cost effectiveness of reactive case detection (RACD), reactive focal mass drug administration (rfMDA) and reactive focal vector control (RAVC) to reduce malaria in the low endemic setting of Namibia: an analysis alongside a 2×2 factorial design cluster randomised controlled trial. BMJ Open 2022; 12:e049050. [PMID: 35738650 PMCID: PMC9226870 DOI: 10.1136/bmjopen-2021-049050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To estimate the cost and cost effectiveness of reactive case detection (RACD), reactive focal mass drug administration (rfMDA) and reactive focal vector control (RAVC) to reduce malaria in a low endemic setting. SETTING The study was part of a 2×2 factorial design cluster randomised controlled trial within the catchment area of 11 primary health facilities in Zambezi, Namibia. PARTICIPANTS Cost and outcome data were collected from the trial, which included 8948 community members that received interventions due to their residence within 500 m of malaria index cases. OUTCOME MEASURES The primary outcome was incremental cost effectiveness ratio (ICER) per in incident case averted. ICER per prevalent case and per disability-adjusted life years (DALY) averted were secondary outcomes, as were per unit interventions costs and personnel time. Outcomes were compared as: (1) rfMDA versus RACD, (2) RAVC versus no RAVC and (3) rfMDA+RAVC versus RACD only. RESULTS rfMDA cost 1.1× more than RACD, and RAVC cost 1.7× more than no RAVC. Relative to RACD only, the cost of rfMDA+RAVC was double ($3082 vs $1553 per event). The ICERs for rfMDA versus RACD, RAVC versus no RAVC and rfMDA+RAVC versus RACD only were $114, $1472 and $842, per incident case averted, respectively. Using prevalent infections and DALYs as outcomes, trends were similar. The median personnel time to implement rfMDA was 20% lower than for RACD (30 vs 38 min per person). The median personnel time for RAVC was 34 min per structure sprayed. CONCLUSION Implemented alone or in combination, rfMDA and RAVC were cost effective in reducing malaria incidence and prevalence despite higher implementation costs in the intervention compared with control arms. Compared with RACD, rfMDA was time saving. Cost and time requirements for the combined intervention could be decreased by implementing rfMDA and RAVC simultaneously by a single team. TRIAL REGISTRATION NUMBER NCT02610400; Post-results.
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Affiliation(s)
- Henry Ntuku
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Cara Smith-Gueye
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Valerie Scott
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Joseph Njau
- JoDon Consulting Group LLC, Atlanta, Georgia, USA
| | - Brooke Whittemore
- Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Brittany Zelman
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Munyaradzi Tambo
- Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia
| | - Lisa M Prach
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Lindsey Wu
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Leah Schrubbe
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Mi-Suk Kang Dufour
- Division of Prevention Science, University of California San Francisco, San Francisco, California, USA
| | - Agnes Mwilima
- Ministry of Health and Social Services, Zambezi Region, Katima Mulilo, Namibia
| | - Petrina Uusiku
- Ministry of Health and Social Services, Windhoek, Namibia
| | - Hugh Sturrock
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Jennifer Smith
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Immo Kleinschmidt
- Faculty of Health Sciences, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Davis Mumbengegwi
- Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia
| | - Roly Gosling
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
| | - Michelle Hsiang
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California, USA
- Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Memani B, Beko B, Dumile N, Mohr-Holland E, Daniels J, Sibanda B, Damse Z, Scott V, von der Heyden E, Pfaff C, Reuter A, Furin J. Causes of loss to follow-up from drug-resistant TB treatment in Khayelitsha, South Africa. Public Health Action 2022; 12:55-57. [PMID: 35734003 PMCID: PMC9176197 DOI: 10.5588/pha.21.0083] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/22/2022] [Indexed: 01/24/2023] Open
Abstract
Patients initiated on drug-resistant TB(DR-TB) treatment in 2019 in Khayelitsha, South Africa, with a loss to follow-up outcome were evaluated to better understand reasons for loss to follow-up and to determine if any had returned to care. Of a total of 187 patients, 28 (15%) were lost to follow-up (LTFU), 24 (86%) of whom were traced: 20/24 (83%) were found when they re-presented to facilities and 8/28 (29%) were linked back to DR-TB care. People with DR-TB continue to seek care even after being LTFU; thus better coordination between different components of the healthcare system are required to re-engage with these patients. Interventions to mitigate the socio-economic challenges of people on DR-TB treatment are needed. Many people who were LTFU and symptomatic were willing to re-engage with DR-TB care, which highlights the importance of for compassionate interventions to welcome them back.
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Affiliation(s)
- B. Memani
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - B. Beko
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - N. Dumile
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - E. Mohr-Holland
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
, MSF Southern Africa Medical Unit, Cape Town, South Africa
| | - J. Daniels
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - B. Sibanda
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - Z. Damse
- City of Cape Town Department of Health, Eastern Area, Cape Town, South Africa
| | - V. Scott
- City of Cape Town Department of Health, Eastern Area, Cape Town, South Africa
| | | | - C. Pfaff
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - A. Reuter
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - J. Furin
- Harvard Medical School, Boston, MA, USA
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Rassy E, Garberis I, Tran Dien A, Scott V, Bouakka I, Bassil J, Lacroix-Triki M, Zanconati F, Giudici F, Generali D, Rouleau E, Lacroix L, André F, Pistilli B. 18P Comparative genomic profiling of primary and locally recurrent luminal breast cancers (BC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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11
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Dubinskaya A, Dallas K, Eilber K, Scott V, Anger J. Female Genitalia in Pornography: The Source of Labiaplasty Trends? J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Wu L, Hsiang MS, Prach LM, Schrubbe L, Ntuku H, Dufour MSK, Whittemore B, Scott V, Yala J, Roberts KW, Patterson C, Biggs J, Hall T, Tetteh KK, Gueye CS, Greenhouse B, Bennett A, Smith JL, Katokele S, Uusiku P, Mumbengegwi D, Gosling R, Drakeley C, Kleinschmidt I. Serological evaluation of the effectiveness of reactive focal mass drug administration and reactive vector control to reduce malaria transmission in Zambezi Region, Namibia: Results from a secondary analysis of a cluster randomised trial. EClinicalMedicine 2022; 44:101272. [PMID: 35198913 PMCID: PMC8851292 DOI: 10.1016/j.eclinm.2022.101272] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/20/2021] [Accepted: 01/06/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Due to challenges in measuring changes in malaria at low transmission, serology is increasingly being used to complement clinical and parasitological surveillance. Longitudinal studies have shown that serological markers, such as Etramp5.Ag1, can reflect spatio-temporal differences in malaria transmission. However, these markers have yet to be used as endpoints in intervention trials. METHODS Based on data from a 2017 cluster randomised trial conducted in Zambezi Region, Namibia, evaluating the effectiveness of reactive focal mass drug administration (rfMDA) and reactive vector control (RAVC), this study conducted a secondary analysis comparing antibody responses between intervention arms as trial endpoints. Antibody responses were measured on a multiplex immunoassay, using a panel of eight serological markers of Plasmodium falciparum infection - Etramp5.Ag1, GEXP18, HSP40.Ag1, Rh2.2030, EBA175, PfMSP119, PfAMA1, and PfGLURP.R2. FINDINGS Reductions in sero-prevalence to antigens Etramp.Ag1, PfMSP119, Rh2.2030, and PfAMA1 were observed in study arms combining rfMDA and RAVC, but only effects for Etramp5.Ag1 were statistically significant. Etramp5.Ag1 sero-prevalence was significantly lower in all intervention arms. Compared to the reference arms, adjusted prevalence ratio (aPR) for Etramp5.Ag1 was 0.78 (95%CI 0.65 - 0.91, p = 0.0007) in the rfMDA arms and 0.79 (95%CI 0.67 - 0.92, p = 0.001) in the RAVC arms. For the combined rfMDA plus RAVC intervention, aPR was 0.59 (95%CI 0.46 - 0.76, p < 0.0001). Significant reductions were also observed based on continuous antibody responses. Sero-prevalence as an endpoint was found to achieve higher study power (99.9% power to detect a 50% reduction in prevalence) compared to quantitative polymerase chain reaction (qPCR) prevalence (72.9% power to detect a 50% reduction in prevalence). INTERPRETATION While the observed relative reduction in qPCR prevalence in the study was greater than serology, the use of serological endpoints to evaluate trial outcomes measured effect size with improved precision and study power. Serology has clear application in cluster randomised trials, particularly in settings where measuring clinical incidence or infection is less reliable due to seasonal fluctuations, limitations in health care seeking, or incomplete testing and reporting. FUNDING This study was supported by Novartis Foundation (A122666), the Bill & Melinda Gates Foundation (OPP1160129), and the Horchow Family Fund (5,300,375,400).
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Affiliation(s)
- Lindsey Wu
- London School of Hygiene and Tropical Medicine, Faculty of Infectious Tropical Diseases, Department of Infection Biology, London, United Kingdom of Great Britain
- Corresponding author.
| | - Michelle S. Hsiang
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Lisa M. Prach
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Leah Schrubbe
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Henry Ntuku
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Mi-Suk Kang Dufour
- Division of Prevention Science, University of California San Francisco, San Francisco, CA, USA
| | - Brooke Whittemore
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Valerie Scott
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Joy Yala
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Kathryn W. Roberts
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Catriona Patterson
- London School of Hygiene and Tropical Medicine, Faculty of Infectious Tropical Diseases, Department of Infection Biology, London, United Kingdom of Great Britain
| | - Joseph Biggs
- London School of Hygiene and Tropical Medicine, Faculty of Infectious Tropical Diseases, Department of Infection Biology, London, United Kingdom of Great Britain
| | - Tom Hall
- St. George's University of London, London, UK
| | - Kevin K.A. Tetteh
- London School of Hygiene and Tropical Medicine, Faculty of Infectious Tropical Diseases, Department of Infection Biology, London, United Kingdom of Great Britain
| | - Cara Smith Gueye
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Bryan Greenhouse
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Jennifer L. Smith
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Stark Katokele
- National Vector-Borne Diseases Control Programme, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Petrina Uusiku
- National Vector-Borne Diseases Control Programme, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Davis Mumbengegwi
- Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia
| | - Roly Gosling
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, United States of America
| | - Chris Drakeley
- London School of Hygiene and Tropical Medicine, Faculty of Infectious Tropical Diseases, Department of Infection Biology, London, United Kingdom of Great Britain
| | - Immo Kleinschmidt
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London, UK
- Research Council Collaborating Centre for Multi-Disciplinary Research on Malaria, School of Pathology, Wits Institute for Malaria Research, Faculty of Health Science, University of Witwatersrand, Johannesburg, South Africa
- Southern African Development Community Malaria Elimination Eight Secretariat, Windhoek, Namibia
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13
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Yee LM, McGee P, Bailit JL, Wapner RJ, Varner MW, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Mallett G, Grobman W, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Leveno K, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, Zhao Y, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Differences in obstetrical care and outcomes associated with the proportion of the obstetrician's shift completed. Am J Obstet Gynecol 2021; 225:430.e1-430.e11. [PMID: 33812810 DOI: 10.1016/j.ajog.2021.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding and improving obstetrical quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been implemented to improve the quality of care provided to obstetrical patients. Although many factors contribute to delivery decisions, a reduced workload has addressed how provider issues such as fatigue or behaviors surrounding impending shift changes may influence the delivery mode and outcomes. OBJECTIVE The objective was to assess whether intrapartum obstetrical interventions and adverse outcomes differ based on the temporal proximity of the delivery to the attending's shift change. STUDY DESIGN This was a secondary analysis from a multicenter obstetrical cohort in which all patients with cephalic, singleton gestations who attempted vaginal birth were eligible for inclusion. The primary exposure used to quantify the relationship between the proximity of the provider to their shift change and a delivery intervention was the ratio of time from the most recent attending shift change to vaginal delivery or decision for cesarean delivery to the total length of the shift. Ratios were used to represent the proportion of time completed in the shift by normalizing for varying shift lengths. A sensitivity analysis restricted to patients who were delivered by physicians working 12-hour shifts was performed. Outcomes chosen included cesarean delivery, episiotomy, third- or fourth-degree perineal laceration, 5-minute Apgar score of <4, and neonatal intensive care unit admission. Chi-squared tests were used to evaluate outcomes based on the proportion of the attending's shift completed. Adjusted and unadjusted logistic models fitting a cubic spline (when indicated) were used to determine whether the frequency of outcomes throughout the shift occurred in a statistically significant, nonlinear pattern RESULTS: Of the 82,851 patients eligible for inclusion, 47,262 (57%) had ratio data available and constituted the analyzable sample. Deliveries were evenly distributed throughout shifts, with 50.6% taking place in the first half of shifts. There were no statistically significant differences in the frequency of cesarean delivery, episiotomy, third- or fourth-degree perineal lacerations, or 5-minute Apgar scores of <4 based on the proportion of the shift completed. The findings were unchanged when evaluated with a cubic spline in unadjusted and adjusted logistic models. Sensitivity analyses performed on the 22.2% of patients who were delivered by a physician completing a 12-hour shift showed similar findings. There was a small increase in the frequency of neonatal intensive care unit admissions with a greater proportion of the shift completed (adjusted P=.009), but the findings did not persist in the sensitivity analysis. CONCLUSION Clinically significant differences in obstetrical interventions and outcomes do not seem to exist based on the temporal proximity to the attending physician's shift change. Future work should attempt to directly study unit culture and provider fatigue to further investigate opportunities to improve obstetrical quality of care, and additional studies are needed to corroborate these findings in community settings.
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14
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Mohr-Holland E, Hacking D, Daniels J, Scott V, Mudaly V, Furin J, Pfaff C, Reuter A. Diagnosis patterns for rifampicin-resistant TB after onset of COVID-19. Int J Tuberc Lung Dis 2021; 25:772-775. [PMID: 34802503 PMCID: PMC8412107 DOI: 10.5588/ijtld.21.0340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/11/2021] [Indexed: 12/14/2022] Open
Affiliation(s)
- E Mohr-Holland
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa, MSF Southern Africa Medical Unit, Cape Town, South Africa
| | - D Hacking
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - J Daniels
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - V Scott
- City of Cape Town Department of Health, Eastern Area, Cape Town, South Africa
| | - V Mudaly
- Provincial Government of the Western Cape, Cape Town, South Africa
| | - J Furin
- Harvard Medical School, Boston, MA, USA
| | - C Pfaff
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
| | - A Reuter
- Médecins Sans Frontières (MSF), Khayelitsha, South Africa
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15
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Douglas-Jones B, Mohr-Holland E, Mema N, Mathee S, Mathews G, Hurribance S, Scott V, Reuter A, Furin J, Pfaff C. A home-based care programme for rifampicin-resistant TB. Int J Tuberc Lung Dis 2021; 25:587-589. [PMID: 34183106 DOI: 10.5588/ijtld.21.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- B Douglas-Jones
- Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa
| | - E Mohr-Holland
- Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa, MSF Southern Africa Medical Unit, Observatory, Cape Town, South Africa
| | - N Mema
- Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa
| | - S Mathee
- Provinical Government of the Western Cape Department of Health, Cape Town, South Africa
| | - G Mathews
- City of Cape Town Health Department, Khayelitsha, Cape Town, South Africa
| | - S Hurribance
- City of Cape Town Health Department, Khayelitsha, Cape Town, South Africa
| | - V Scott
- City of Cape Town Health Department, Khayelitsha, Cape Town, South Africa
| | - A Reuter
- Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa
| | - J Furin
- Harvard Medical School, Boston, MA, USA
| | - C Pfaff
- Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa
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16
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Zokufa N, Lebelo K, Hacking D, Tabo L, Runeyi P, Malabi N, Sibanda SB, Cassidy T, Makanda G, Norman B, Khuzani S, Furin J, Jonker C, Nkasana B, Scott V, Pfaff C. Community-based TB testing as an essential part of TB recovery plans in the COVID-19 era. Int J Tuberc Lung Dis 2021; 25:406-408. [PMID: 33977911 PMCID: PMC8091909 DOI: 10.5588/ijtld.21.0077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- N Zokufa
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - K Lebelo
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - D Hacking
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - L Tabo
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - P Runeyi
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - N Malabi
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - S B Sibanda
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - T Cassidy
- Médecins Sans Frontières, Khayelitsha, South Africa, Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - G Makanda
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - B Norman
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - S Khuzani
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - J Furin
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - C Jonker
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - B Nkasana
- City of Cape Town, Department of Health, Cape Town, South Africa
| | - V Scott
- City of Cape Town, Department of Health, Cape Town, South Africa
| | - C Pfaff
- Médecins Sans Frontières, Khayelitsha, South Africa
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17
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Mohr-Holland E, Daniels J, Douglas-Jones B, Mema N, Scott V, Trivino-Duran L, Pfaff C, Furin J, Isaakidis P. A positive COVID-19 test is associated with high mortality in RR-TB-HIV patients. Int J Tuberc Lung Dis 2021; 25:409-412. [PMID: 33977912 PMCID: PMC8091908 DOI: 10.5588/ijtld.21.0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- E Mohr-Holland
- Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa, MSF Southern Africa Medical Unit, Observatory, Cape Town, South Africa
| | - J Daniels
- Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa
| | - B Douglas-Jones
- Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa
| | - N Mema
- Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa
| | - V Scott
- City of Cape Town Health Department, Khayelitsha, Cape Town, South Africa
| | - L Trivino-Duran
- Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa
| | - C Pfaff
- Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa
| | - J Furin
- Harvard Medical School, Boston, MA, USA
| | - P Isaakidis
- MSF Southern Africa Medical Unit, Observatory, Cape Town, South Africa
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Lindsey L, Purvis M, Miles D, Lintner A, Scott V, McGinn K, Bright A, Kahn S. An Adjusted Ideal Body Weight Index Formula With Fresh Frozen Plasma (FFP) Rescue Decreases Fluid Creep During Burn Resuscitation. Ann Burns Fire Disasters 2020; 33:216-223. [PMID: 33304212 PMCID: PMC7680196] [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] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/24/2020] [Indexed: 06/12/2023]
Abstract
Severe burn injury requires significant volume resuscitation, but over-resuscitation can be deadly. Accurate resuscitation of obese patients is challenging due to the decreased vascularity of adipose tissue. This study compares an adjusted ideal body weight index formula with fresh frozen plasma rescue to historical controls resuscitated with Parkland-based resuscitation. A retrospective review was conducted of adult patients admitted to our regional burn center with ≥ 20% total body surface area (TBSA) burns from 2010 to 2017 who survived more than 48 hours. Historical controls were resuscitated with Parkland-based resuscitation with occasional albumin. The adjusted ideal body weight (AIBW) patients were resuscitated with 2-4 mL/kg/%TBSA using an adjusted ideal body weight with fresh frozen plasma (FFP) rescue. Outcomes were compared with nonparametric statistics. A total of 161 patients met inclusion criteria: 40 patients received AIBW resuscitation and 121 patients were included as controls. The AIBW group received less fluid (3.30 vs. 4.15 mL/kg/%TBSA, p<0.001). A significant reduction in acute kidney injury requiring dialysis in the AIBW group was appreciated (5% vs. 19%, p=0.03) with improved mortality in AIBW patients as well (5% vs. 20%, p=0.03). Using an adjusted ideal body weight with FFP rescue to resuscitate patients with severe burn injury leads to a significant reduction in fluid administration without increase in acute kidney injury requiring dialysis and with improved mortality.
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Affiliation(s)
- L. Lindsey
- School of Medicine, University of South Alabama, Mobile, AL, USA
| | - M.V. Purvis
- Department of Surgery, Division of Acute Care Surgery & Burns, The University of South Alabama Medical Center, Mobile, AL, USA
| | - D. Miles
- School of Medicine, University of Mississippi, Jackson, MS, USA
| | - A. Lintner
- Department of Surgery, Division of Acute Care Surgery & Burns, The University of South Alabama Medical Center, Mobile, AL, USA
| | - V. Scott
- Department of Surgery, Division of Acute Care Surgery & Burns, The University of South Alabama Medical Center, Mobile, AL, USA
| | - K. McGinn
- Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, Mobile, AL, USA
| | - A. Bright
- Department of Surgery, Division of Acute Care Surgery & Burns, The University of South Alabama Medical Center, Mobile, AL, USA
| | - S.A. Kahn
- Department of Surgery, Medical University of South Carolina, Charleston, SC, USA
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Speed V, Green B, Roberts LN, Woolcombe S, Bartoli-Abdou J, Barsam S, Byrne R, Gee E, Czuprynska J, Brown A, Duffy S, Vadher B, Patel R, Scott V, Gazes A, Patel RK, Arya R, Patel JP. Fixed dose rivaroxaban can be used in extremes of bodyweight: A population pharmacokinetic analysis. J Thromb Haemost 2020; 18:2296-2307. [PMID: 32511863 DOI: 10.1111/jth.14948] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 02/21/2020] [Revised: 04/28/2020] [Accepted: 05/26/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Emerging safety and efficacy data for rivaroxaban suggest traditional therapy and rivaroxaban are comparable in the morbidly obese. However, real-world data that indicate pharmacokinetic (PK) parameters are comparable at the extremes of body size are lacking. The International Society of Thrombosis and Haemostasis Scientific and Standardisation Committee (ISTH SSC) suggests avoiding the use of direct oral anticoagulants (DOACs) in patients weighing >120 kg or with a body mass index >40 kg/m2 and gives no recommendation on the use of DOACs in those <50 kg. OBJECTIVES To generate a population PK model to understand the influence of bodyweight on rivaroxaban exposure from clinical practice data. METHOD Rivaroxaban plasma concentrations and patient characteristics were collated between 2013 and 2018 at King's College Hospital anticoagulation clinic. A population PK model was developed using a nonlinear mixed effects approach and then used to simulate rivaroxaban concentrations at the extremes of bodyweight. RESULTS A robust population PK model derived from 913 patients weighing between 39 kg and 172 kg was developed. The model included data from n = 86 >120 kg, n = 74 BMI >40 kg/m2 , and n = 30 <50 kg. A one-compartment model with between-subject variability on clearance and a proportional error model best described the data. Creatinine clearance calculated by Cockcroft-Gault, with lean bodyweight as the weight descriptor in this equation, was the most significant covariate influencing rivaroxaban exposure. CONCLUSIONS Our work demonstrates rivaroxaban can be used at extremes of bodyweight provided renal function is satisfactory. We recommend that the ISTH SSC revises the current guidance with respect to rivaroxaban at extremes of body size.
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Affiliation(s)
- Victoria Speed
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
- Institute of Pharmaceutical Science, King's College London, London, UK
| | | | - Lara N Roberts
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Sarah Woolcombe
- Department of Oral Surgery, King's College Hospital NHS Foundation Trust, London, UK
| | - John Bartoli-Abdou
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Sarah Barsam
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Rosalind Byrne
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Emma Gee
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Julia Czuprynska
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Alison Brown
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Sinead Duffy
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Bipin Vadher
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Rachna Patel
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Valerie Scott
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Anna Gazes
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Raj K Patel
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Roopen Arya
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Jignesh P Patel
- King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
- Institute of Pharmaceutical Science, King's College London, London, UK
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20
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Hsiang MS, Ntuku H, Roberts KW, Dufour MSK, Whittemore B, Tambo M, McCreesh P, Medzihradsky OF, Prach LM, Siloka G, Siame N, Gueye CS, Schrubbe L, Wu L, Scott V, Tessema S, Greenhouse B, Erlank E, Koekemoer LL, Sturrock HJW, Mwilima A, Katokele S, Uusiku P, Bennett A, Smith JL, Kleinschmidt I, Mumbengegwi D, Gosling R. Effectiveness of reactive focal mass drug administration and reactive focal vector control to reduce malaria transmission in the low malaria-endemic setting of Namibia: a cluster-randomised controlled, open-label, two-by-two factorial design trial. Lancet 2020; 395:1361-1373. [PMID: 32334702 PMCID: PMC7184675 DOI: 10.1016/s0140-6736(20)30470-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/23/2020] [Accepted: 02/25/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND In low malaria-endemic settings, screening and treatment of individuals in close proximity to index cases, also known as reactive case detection (RACD), is practised for surveillance and response. However, other approaches could be more effective for reducing transmission. We aimed to evaluate the effectiveness of reactive focal mass drug administration (rfMDA) and reactive focal vector control (RAVC) in the low malaria-endemic setting of Zambezi (Namibia). METHODS We did a cluster-randomised controlled, open-label trial using a two-by-two factorial design of 56 enumeration area clusters in the low malaria-endemic setting of Zambezi (Namibia). We randomly assigned these clusters using restricted randomisation to four groups: RACD only, rfMDA only, RAVC plus RACD, or rfMDA plus RAVC. RACD involved rapid diagnostic testing and treatment with artemether-lumefantrine and single-dose primaquine, rfMDA involved presumptive treatment with artemether-lumefantrine, and RAVC involved indoor residual spraying with pirimiphos-methyl. Interventions were administered within 500 m of index cases. To evaluate the effectiveness of interventions targeting the parasite reservoir in humans (rfMDA vs RACD), in mosquitoes (RAVC vs no RAVC), and in both humans and mosquitoes (rfMDA plus RAVC vs RACD only), an intention-to-treat analysis was done. For each of the three comparisons, the primary outcome was the cumulative incidence of locally acquired malaria cases. This trial is registered with ClinicalTrials.gov, number NCT02610400. FINDINGS Between Jan 1, 2017, and Dec 31, 2017, 55 enumeration area clusters had 1118 eligible index cases that led to 342 interventions covering 8948 individuals. The cumulative incidence of locally acquired malaria was 30·8 per 1000 person-years (95% CI 12·8-48·7) in the clusters that received rfMDA versus 38·3 per 1000 person-years (23·0-53·6) in the clusters that received RACD; 30·2 per 1000 person-years (15·0-45·5) in the clusters that received RAVC versus 38·9 per 1000 person-years (20·7-57·1) in the clusters that did not receive RAVC; and 25·0 per 1000 person-years (5·2-44·7) in the clusters that received rfMDA plus RAVC versus 41·4 per 1000 person-years (21·5-61·2) in the clusters that received RACD only. After adjusting for imbalances in baseline and implementation factors, the incidence of malaria was lower in clusters receiving rfMDA than in those receiving RACD (adjusted incidence rate ratio 0·52 [95% CI 0·16-0·88], p=0·009), lower in clusters receiving RAVC than in those that did not (0·48 [0·16-0·80], p=0·002), and lower in clusters that received rfMDA plus RAVC than in those receiving RACD only (0·26 [0·10-0·68], p=0·006). No serious adverse events were reported. INTERPRETATION In a low malaria-endemic setting, rfMDA and RAVC, implemented alone and in combination, reduced malaria transmission and should be considered as alternatives to RACD for elimination of malaria. FUNDING Novartis Foundation, Bill & Melinda Gates Foundation, and Horchow Family Fund.
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Affiliation(s)
- Michelle S Hsiang
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA; Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA.
| | - Henry Ntuku
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Kathryn W Roberts
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Mi-Suk Kang Dufour
- Division of Prevention Science, University of California San Francisco, San Francisco, CA, USA
| | - Brooke Whittemore
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Munyaradzi Tambo
- Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia
| | - Patrick McCreesh
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA; Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Oliver F Medzihradsky
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Lisa M Prach
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Griffith Siloka
- Zambezi Ministry of Health and Social Services, Katima, Namibia
| | - Noel Siame
- Zambezi Ministry of Health and Social Services, Katima, Namibia
| | - Cara Smith Gueye
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Leah Schrubbe
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Lindsey Wu
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Valerie Scott
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Sofonias Tessema
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Bryan Greenhouse
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Erica Erlank
- Wits Research Institute for Malaria, South African Medical Research Council Collaborating Centre for Multi-Disciplinary Research on Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lizette L Koekemoer
- Wits Research Institute for Malaria, South African Medical Research Council Collaborating Centre for Multi-Disciplinary Research on Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Hugh J W Sturrock
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Agnes Mwilima
- Zambezi Ministry of Health and Social Services, Katima, Namibia
| | - Stark Katokele
- National Vector-Borne Diseases Control Programme, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Petrina Uusiku
- National Vector-Borne Diseases Control Programme, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Adam Bennett
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Jennifer L Smith
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA
| | - Immo Kleinschmidt
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Wits Research Institute for Malaria, South African Medical Research Council Collaborating Centre for Multi-Disciplinary Research on Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Southern African Development Community, Malaria Elimination Eight Secretariat, Windhoek, Namibia
| | - Davis Mumbengegwi
- Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia
| | - Roly Gosling
- Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA; Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia
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Arnedos M, Bayar MA, Cheaib B, Scott V, Bouakka I, Valent A, Adam J, Leroux-Kozal V, Marty V, Rapinat A, Mazouni C, Sarfati B, Bieche I, Balleyguier C, Gentien D, Delaloge S, Lacroix-Triki M, Michiels S, Andre F. Modulation of Rb phosphorylation and antiproliferative response to palbociclib: the preoperative-palbociclib (POP) randomized clinical trial. Ann Oncol 2019; 29:1755-1762. [PMID: 29893769 DOI: 10.1093/annonc/mdy202] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background The cyclin-dependent kinase 4 (CDK4)/6 inhibitor Palbociclib is a new standard treatment in hormone-receptor positive breast cancer patients. No predictive biomarkers have been identified and no pharmacodynamics has properly been described so far. Patients and methods Patients with early-breast cancer were randomized 3 : 1 to oral palbociclib 125 mg daily for 14 days until the day before the surgery versus no treatment. Primary objective was antiproliferative response defined as a natural logarithm of Ki67 expression at day 15 below 1. Secondary end points were subgroups analyses and safety. Exploratory analyses included search for predictive biomarkers. Immunostainings (Ki67, RB, pRB, p16, pAKT, pER, pCDK2, CyclinD1), FISH (CCND1) and gene expression (GE) arrays were carried out at baseline and at surgery. In addition, activating PIK3CA and AKT1 mutations were assessed at baseline. Results 74 patients were allocated to palbociclib and 26 to control. Most patients (93%) were hormone-receptor (HR)-positive, whereas 8% were HER2-positive. Palbociclib led to significantly more antiproliferative responses when compared with control (58% versus 12%, P < 0.001), and to a significantly higher Ki67 decrease (P < 0.001). In the HR-positive/HER2-negative subgroup, this antiproliferative effect was even more marked in the palbociclib arm when compared with control (70% versus 9%, P < 0.001). Palbociclib treatment led also to a significantly higher decrease from baseline in phospho-Rb when compared with control (P < 0.001). Among treated patients, changes in Ki67 correlated with changes in phospho-Rb (Spearman rank r = 0.41, P < 0.0001). GE analyses confirmed a major effect on proliferation and cell cycle genes. Among treated patients, CCNE2 expression was significantly more decreased in antiproliferative responders versus nonresponders (P = 0.006). Conclusion Short-term preoperative palbociclib decreases Ki67 in early-breast cancer patients. Early decrease of Rb phosphorylation correlates with drug's effect on cell proliferation and could potentially identify patients with primary resistance. Clinical trial registration NCT02008734.
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Affiliation(s)
- M Arnedos
- Department of Cancer Medicine, Breast Cancer Committee, Gustave Roussy, Villejuif, France; INSERM Unit 981, Gustave Roussy, Villejuif, France.
| | - M A Bayar
- Statistics and Epidemiology Unit, Gustave Roussy, Villejuif, France; CESP, Medical School, INSERM, Université Paris Saclay, Villejuif, France
| | - B Cheaib
- Department of Cancer Medicine, Breast Cancer Committee, Gustave Roussy, Villejuif, France
| | - V Scott
- INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - I Bouakka
- INSERM Unit 981, Gustave Roussy, Villejuif, France
| | - A Valent
- Department of Biology and Pathology, Gustave Roussy, Villejuif, France
| | - J Adam
- INSERM Unit 981, Gustave Roussy, Villejuif, France; Department of Biology and Pathology, Gustave Roussy, Villejuif, France
| | - V Leroux-Kozal
- Department of Biology and Pathology, Gustave Roussy, Villejuif, France
| | - V Marty
- Hystopathology and Translational Research Department, Gustave Roussy, Villejuif, France
| | - A Rapinat
- Translational Research Department, Genomics Platform, Institut Curie, PSL Research University, Paris, France
| | - C Mazouni
- Department of Surgery, Gustave Roussy, Villejuif, France
| | - B Sarfati
- Department of Surgery, Gustave Roussy, Villejuif, France
| | - I Bieche
- Department of Genetics, Institut Curie, Paris, France
| | - C Balleyguier
- Department of Radiology, Gustave Roussy, Villejuif, France
| | - D Gentien
- Translational Research Department, Genomics Platform, Institut Curie, PSL Research University, Paris, France
| | - S Delaloge
- Department of Cancer Medicine, Breast Cancer Committee, Gustave Roussy, Villejuif, France
| | - M Lacroix-Triki
- Department of Biology and Pathology, Gustave Roussy, Villejuif, France
| | - S Michiels
- Statistics and Epidemiology Unit, Gustave Roussy, Villejuif, France; CESP, Medical School, INSERM, Université Paris Saclay, Villejuif, France
| | - F Andre
- Department of Cancer Medicine, Breast Cancer Committee, Gustave Roussy, Villejuif, France; INSERM Unit 981, Gustave Roussy, Villejuif, France
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Abstract
Histone demethylases play a critical role in mammalian gene expression by removing methyl groups from lysine residues in degree- and site-specific manner. To specifically interrogate members and isoforms of this class of enzymes, we have developed demethylase variants with an expanded active site. The mutant enzymes are capable of performing lysine demethylation with wild-type proficiency, but are sensitive to inhibition by cofactor-competitive molecules embellished with a complementary steric "bump". The selected inhibitors show more than 20-fold selectivity over the wild-type demethylase, thus overcoming issues typical to pharmacological and genetic approaches. The mutant-inhibitor pairs are shown to act on a physiologically relevant full-length substrate. By engineering a conserved amino acid to achieve member-specific perturbation, this study provides a general approach for studying histone demethylases in diverse cellular processes.
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Affiliation(s)
- Shana Wagner
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, PA, 15260, USA
| | - Megan Waldman
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, PA, 15260, USA
| | - Simran Arora
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, PA, 15260, USA
| | - Sinan Wang
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, PA, 15260, USA
| | - Valerie Scott
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, PA, 15260, USA
| | - Kabirul Islam
- Department of Chemistry, University of Pittsburgh, 219 Parkman Avenue, Pittsburgh, PA, 15260, USA
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Tita AT, Jablonski KA, Bailit JL, Grobman WA, Wapner RJ, Reddy UM, Varner MW, Thorp JM, Leveno KJ, Caritis SN, Iams JD, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Wallace M, Northen A, Grant J, Colquitt C, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Shubert P, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Neonatal outcomes of elective early-term births after demonstrated fetal lung maturity. Am J Obstet Gynecol 2018; 219:296.e1-296.e8. [PMID: 29800541 DOI: 10.1016/j.ajog.2018.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 11/09/2016] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Studies of early-term birth after demonstrated fetal lung maturity show that respiratory and other outcomes are worse with early-term birth (370-386 weeks) even after demonstrated fetal lung maturity when compared with full-term birth (390-406 weeks). However, these studies included medically indicated births and are therefore potentially limited by confounding by the indication for delivery. Thus, the increase in adverse outcomes might be due to the indication for early-term birth rather than the early-term birth itself. OBJECTIVE We examined the prevalence and risks of adverse neonatal outcomes associated with early-term birth after confirmed fetal lung maturity as compared with full-term birth in the absence of indications for early delivery. STUDY DESIGN This is a secondary analysis of an observational study of births to 115,502 women in 25 hospitals in the United States from 2008 through 2011. Singleton nonanomalous births at 37-40 weeks with no identifiable indication for delivery were included; early-term births after positive fetal lung maturity testing were compared with full-term births. The primary outcome was a composite of death, ventilator for ≥2 days, continuous positive airway pressure, proven sepsis, pneumonia or meningitis, treated hypoglycemia, hyperbilirubinemia (phototherapy), and 5-minute Apgar <7. Logistic regression and propensity score matching (both 1:1 and 1:2) were used. RESULTS In all, 48,137 births met inclusion criteria; the prevalence of fetal lung maturity testing in the absence of medical or obstetric indications for early delivery was 0.52% (n = 249). There were 180 (0.37%) early-term births after confirmed pulmonary maturity and 47,957 full-term births. Women in the former group were more likely to be non-Hispanic white, smoke, have received antenatal steroids, have induction, and have a cesarean. Risks of the composite (16.1% vs 5.4%; adjusted odds ratio, 3.2; 95% confidence interval, 2.1-4.8 from logistic regression) were more frequent with elective early-term birth. Propensity scores matching confirmed the increased primary composite in elective early-term births: adjusted odds ratios, 4.3 (95% confidence interval, 1.8-10.5) for 1:1 and 3.5 (95% confidence interval, 1.8-6.5) for 1:2 matching. Among components of the primary outcome, CPAP use and hyperbilirubinemia requiring phototherapy were significantly increased. Transient tachypnea of the newborn, neonatal intensive care unit admission, and prolonged neonatal intensive care unit stay (>2 days) were also increased with early-term birth. CONCLUSION Even with confirmed pulmonary maturity, early-term birth in the absence of medical or obstetric indications is associated with worse neonatal respiratory and hepatic outcomes compared with full-term birth, suggesting relative immaturity of these organ systems in early-term births.
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Stefanovska B, Vicier C, Scott V, Bouakka I, Rocca A, André F, Fromigué O. TRIB3: A new transcriptional target gene of rapalogs, modulating their effects on splicing. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy314.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kannan A, Olson L, Huang S, Su Z, Wetter J, Salte K, Edelmayer R, Todorovic V, Wang Y, McGaraughty S, Honore P, Scott V. 038 IL-36 mediated keratinocyte-myeloid cell crosstalk drives skin inflammation. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Purvis MV, Lindsey LJ, Leonard C, Lintner AC, Scott V, Brevard SB, Kahn SE. 3 An Adjusted Ideal Body Weight Index Formula with FFP Rescue Decreases Fluid Creep During Burn Resuscitation. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- M V Purvis
- The University of South Alabama Medical Center, Mobile, AL
| | - L J Lindsey
- The University of South Alabama Medical Center, Mobile, AL
| | - C Leonard
- The University of South Alabama Medical Center, Mobile, AL
| | - A C Lintner
- The University of South Alabama Medical Center, Mobile, AL
| | - V Scott
- The University of South Alabama Medical Center, Mobile, AL
| | - S B Brevard
- The University of South Alabama Medical Center, Mobile, AL
| | - S E Kahn
- The University of South Alabama Medical Center, Mobile, AL
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Condorelli R, Spring L, O’Shaughnessy J, Lacroix L, Bailleux C, Scott V, Dubois J, Nagy R, Lanman R, Iafrate A, Andre F, Bardia A. Polyclonal RB1 mutations and acquired resistance to CDK 4/6 inhibitors in patients with metastatic breast cancer. Ann Oncol 2018; 29:640-645. [DOI: 10.1093/annonc/mdx784] [Citation(s) in RCA: 188] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Andre F, Penault Llorca F, Carene D, Roche H, Delaloge S, Lacroix L, Scott V, Richon C, Lacroix-Ticrit M, Lemonnier J, Michiels S. Abstract PD4-10: FGFR1 / ZNF217 copy numbers and outcome in patients with node positive, HR+/Her2- early breast cancer: A genomic analysis of PACS04 trial. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd4-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: There is a need to identify which patients present a high risk of relapse after optimal adjuvant therapies, in order to better define which population of early breast cancer patients is eligible to new drugs. Previous studies have shown that gene copy numbers drive breast cancer progression. In the BIG1-98 trial, FGFR1 (8p11) and ZNF217 (20q13) amplifications were associated with poor outcome in patients with HR+/Her2- early breast cancers. In the present study, we aim to validate these findings using retrospective analysis of samples prospectively collected in a randomized trial (PACS04).
Patients and methods: Tumor DNA was extracted from FFPE samples obtained from patients included in PACS04 trial. This trial compared FEC to ED75 in patients with node positive, early breast cancer and included 3000 patients between 2001 and 2004. The biomarker study focuses on HR+/Her2- breast cancer. 500 samples were collected and hybridization was performed on 390. DNA copy numbers were assessed on 900 genes using Oncoscan FFPE assay kit. Prognostic value of FGFR1 (8p11) and ZNF217 (20q13) copy numbers was assessed in a Cox model that included prognostic parameters. Prognostic value was assessed using CNA as continuous variable, and with a predefined cut-off (CN>=3). Metastases-free survival (MFS) was chosen as endpoint for this biomarker study.
Results: Tumor copy numbers alterations were obtained in 390 patients with HR+/Her2-, node positive, early breast cancer. 31% of the patients presented more than 3 lymph node involved, and 25% a poorly differenciated tumor. The median tumor size was 20 mm. 120 (30%) and 112 (28%) patients presented FGFR1 and/or ZNF217 gene gain with a cut-off for amplification predefined at 3 copies. When assessed as continuous variable, FGFR1 (HR: 1.02, 95%CI:1.007-1.04, p=0.0045) and ZNF217 (HR: 1.011, 95%CI:1.003-1.01, p=0.006) copy numbers were associated with MFS. The 10 years MFS rates were 68% (95%CI: 59-78%) and 85% (95%CI: 81-91%) in patients with FGFR1-gained and FGFR1-normal tumors respectively (HR: 2.51, 95%CI:1.56-4.01, p=0.0001). The 10 years MFS rates were 72% (95%CI:65%-83%) and 83% (95%CI: 77-87%) in patients with ZNF217-gained and ZNF217-normal tumors (HR: 1.79, 95%CI:1.12-2.86, p=0.013). In a multivariate analysis, FGFR1-gain (HR: 2.45, 95%CI:1.42-4.22, p=0.0012) and ZNF217-gain (HR:1.78, 95%CI:1.00-3.17, p=0.049) were associated with a higher likelihood of metastases and/or death. The 10 MFS rate was 88% (95%CI: 83-94%) for patients who presented FGFR1- and ZNF217-normal tumor (n=191), and 71% (95%CI: 66-76%) in patients presenting FGFR1 and/or ZNF217 gene gain.
Conclusion: Using samples prospectively collected in a randomized trial, this study validates the prognostic value of FGFR1- and ZNF217- copy numbers in patients who present HR+/Her2- early breast cancer. Exploratory analyses on copy number alterations, together with targeted sequencing are ongoing and will be presented.
Citation Format: Andre F, Penault Llorca F, Carene D, Roche H, Delaloge S, Lacroix L, Scott V, Richon C, Lacroix-Ticrit M, Lemonnier J, Michiels S. FGFR1 / ZNF217 copy numbers and outcome in patients with node positive, HR+/Her2- early breast cancer: A genomic analysis of PACS04 trial [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD4-10.
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Affiliation(s)
- F Andre
- Institut Gustave Roussy; Centre Jean Perrin; Institut Claudias Regault; unicancer
| | - F Penault Llorca
- Institut Gustave Roussy; Centre Jean Perrin; Institut Claudias Regault; unicancer
| | - D Carene
- Institut Gustave Roussy; Centre Jean Perrin; Institut Claudias Regault; unicancer
| | - H Roche
- Institut Gustave Roussy; Centre Jean Perrin; Institut Claudias Regault; unicancer
| | - S Delaloge
- Institut Gustave Roussy; Centre Jean Perrin; Institut Claudias Regault; unicancer
| | - L Lacroix
- Institut Gustave Roussy; Centre Jean Perrin; Institut Claudias Regault; unicancer
| | - V Scott
- Institut Gustave Roussy; Centre Jean Perrin; Institut Claudias Regault; unicancer
| | - C Richon
- Institut Gustave Roussy; Centre Jean Perrin; Institut Claudias Regault; unicancer
| | - M Lacroix-Ticrit
- Institut Gustave Roussy; Centre Jean Perrin; Institut Claudias Regault; unicancer
| | - J Lemonnier
- Institut Gustave Roussy; Centre Jean Perrin; Institut Claudias Regault; unicancer
| | - S Michiels
- Institut Gustave Roussy; Centre Jean Perrin; Institut Claudias Regault; unicancer
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Todorovic V, Su Z, Lippert S, Leys L, Gerstein C, Seagal J, Mathew S, Horowitz A, Olson L, Sielaff B, Medina L, Wang L, Sadhukan R, Salte K, Scott V. 399 IL-36 receptor antagonistic antibodies inhibit inflammatory response in IL-23 model of psoriasiform dermatitis. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Vicier C, Lefebvre C, Mathieu M, Scott V, Drusch F, André F, Jaulin F. Intratumor heterogeneity in chemo-naïve localized invasive ductal carcinomas. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx507.001] [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: 11/12/2022] Open
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Spiekerkoetter E, Sung YK, Sudheendra D, Scott V, Del Rosario P, Bill M, Haddad F, Long-Boyle J, Hedlin H, Zamanian RT. Randomised placebo-controlled safety and tolerability trial of FK506 (tacrolimus) for pulmonary arterial hypertension. Eur Respir J 2017; 50:50/3/1602449. [DOI: 10.1183/13993003.02449-2016] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 06/07/2017] [Indexed: 11/05/2022]
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Edelmayer R, Wetter J, Salte K, Dunstan R, Leys L, Lippert S, Gauvin D, Su Z, McDonald H, Gauld S, Scott V, Honore P, McGaraughty S. 668 Digital dermatopathology for discovery: Turning qualitative into quantitative. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hamy AS, Bieche I, Lehmann-Che J, Scott V, Bertheau P, Guinebretière JM, Matthieu MC, Sigal-Zafrani B, Tembo O, Marty M, Asselain B, Spyratos F, de Cremoux P. BIRC5 (survivin): a pejorative prognostic marker in stage II/III breast cancer with no response to neoadjuvant chemotherapy. Breast Cancer Res Treat 2016; 159:499-511. [PMID: 27592112 DOI: 10.1007/s10549-016-3961-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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: 06/13/2016] [Accepted: 08/25/2016] [Indexed: 12/18/2022]
Abstract
PURPOSE Neoadjuvant systemic therapy (NAC) is currently used in the treatment of stage II/III breast cancer. Pathological complete response as a surrogate endpoint for clinical outcomes is not completely validated for all subgroups of breast cancers. Therefore, there is a need for reliable predictive tests of the most effective treatment. METHODS We used a combination of predictive clinical, pathological, and gene expression-based markers of response to NAC in a prospective phase II multicentre randomized clinical trial in breast cancer patients, with a long follow-up (8 years). This study concerned the subpopulation of 188 patients with similar levels of pathological response rates to sequential epirubicin/cyclophosphamide and docetaxel to determine predictive marker of pCR and DFS. We used a set of 45 genes selected from high throughput analysis and a standardized RT-qPCR. We analyzed the predictive markers of pathological complete response (pCR) and DFS in the overall population and DFS the subpopulation of 159 patients with no pCR. RESULTS In the overall population, combining both clinical and genomic variables, large tumor size, low TFF1, and MYBL2 overexpression were significantly associated with pCR. T4 Stage, lymphovascular invasion, negative PR status, histological type, and high values of CCNB1 were associated with DFS. In the no pCR population, only lymphovascular invasion and high values of BIRC5 were associated with DFS. CONCLUSIONS We confirm the importance of ER-related and proliferation genes in the prediction of pCR in NAC-treated breast cancer patients. Furthermore, we identified BIRC5 (survivin) as a main pejorative prognostic factor in patients with breast cancers with no pCR. These results also open perspective for predictive markers of new targeted therapies.
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Affiliation(s)
- A S Hamy
- Department of Biostatistics, Institut Curie, Paris, France
| | - I Bieche
- Pharmacogenomics Unit, Department of Genetics, Institut Curie, Paris, France
| | - J Lehmann-Che
- APHP Molecular Oncology Unit, Hôpital Saint Louis, Paris Diderot University, 1 Avenue Claude Vellefaux, 75010, Paris, France
| | - V Scott
- Biology Department, Institut Gustave Roussy, Villejuif, France
| | - Ph Bertheau
- APHP Pathology Department, Hôpital Saint Louis, Paris Diderot University, Paris, France
| | - J M Guinebretière
- Pathology Department, Hôpital René-Huguenin, Institut Curie, Saint-Cloud, France
| | - M C Matthieu
- Pathology Department, Institut Gustave Roussy, Villejuif, France
| | | | - O Tembo
- APHP, Centre for Therapeutic Innovation, Saint-Louis Hospital, Paris, France
| | - M Marty
- APHP, Centre for Therapeutic Innovation, Saint-Louis Hospital, Paris, France
| | - B Asselain
- Department of Biostatistics, Institut Curie, Paris, France
| | - F Spyratos
- Pharmacogenomics Unit, Department of Genetics, Institut Curie, Paris, France
| | - P de Cremoux
- APHP Molecular Oncology Unit, Hôpital Saint Louis, Paris Diderot University, 1 Avenue Claude Vellefaux, 75010, Paris, France.
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Manuck TA, Rice MM, Bailit JL, Grobman WA, Reddy UM, Wapner RJ, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Varner M, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Leveno K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Williams T, Spangler T, Lozitska A, Spong C, Tolivaisa S, VanDorsten J. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obstet Gynecol 2016; 215:103.e1-103.e14. [PMID: 26772790 DOI: 10.1016/j.ajog.2016.01.004] [Citation(s) in RCA: 290] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/28/2015] [Accepted: 01/02/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although preterm birth <37 weeks' gestation is the leading cause of neonatal morbidity and mortality in the United States, the majority of data regarding preterm neonatal outcomes come from older studies, and many reports have been limited to only very preterm neonates. Delineation of neonatal outcomes by delivery gestational age is needed to further clarify the continuum of mortality and morbidity frequencies among preterm neonates. OBJECTIVE We sought to describe the contemporary frequencies of neonatal death, neonatal morbidities, and neonatal length of stay across the spectrum of preterm gestational ages. STUDY DESIGN This was a secondary analysis of an obstetric cohort of 115,502 women and their neonates who were born in 25 hospitals nationwide, 2008 through 2011. All liveborn nonanomalous singleton preterm (23.0-36.9 weeks of gestation) neonates were included in this analysis. The frequency of neonatal death, major neonatal morbidity (intraventricular hemorrhage grade III/IV, seizures, hypoxic-ischemic encephalopathy, necrotizing enterocolitis stage II/III, bronchopulmonary dysplasia, persistent pulmonary hypertension), and minor neonatal morbidity (hypotension requiring treatment, intraventricular hemorrhage grade I/II, necrotizing enterocolitis stage I, respiratory distress syndrome, hyperbilirubinemia requiring treatment) were calculated by delivery gestational age; each neonate was classified once by the worst outcome for which criteria was met. RESULTS In all, 8334 deliveries met inclusion criteria. There were 119 (1.4%) neonatal deaths. In all, 657 (7.9%) neonates had major morbidity, 3136 (37.6%) had minor morbidity, and 4422 (53.1%) survived without any of the studied morbidities. Deaths declined rapidly with each advancing week of gestation. This decline in death was accompanied by an increase in major neonatal morbidity, which peaked at 54.8% at 25 weeks of gestation. As frequencies of death and major neonatal morbidity fell, minor neonatal morbidity increased, peaking at 81.7% at 31 weeks of gestation. The frequency of all morbidities fell >32 weeks. After 25 weeks, neonatal length of hospital stay decreased significantly with each additional completed week of pregnancy; among babies delivered from 26-32 weeks of gestation, each additional week in utero reduced the subsequent length of neonatal hospitalization by a minimum of 8 days. The median postmenstrual age at discharge nadired around 36 weeks' postmenstrual age for babies born at 31-35 weeks of gestation. CONCLUSION Our data show that there is a continuum of outcomes, with each additional week of gestation conferring survival benefit while reducing the length of initial hospitalization. These contemporary data can be useful for patient counseling regarding preterm outcomes.
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Pardy C, Pumphrey J, Hallows R, Scott V, Fidler K. Beware of the persistent abscess: Chronic granulomatous disease presenting with suppurative lymphadenitis. Journal of Pediatric Surgery Case Reports 2016. [DOI: 10.1016/j.epsc.2016.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Su Z, Gauvin D, Wetter J, Salte K, Gerstein C, Leys L, Huang S, Shaughn B, Waegell W, Edlmayer R, Scott V, Honore P, McGaraughty S, Gauld S. 530 Comparison of IL-23 models of psoriasiform dermatitis in mice. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kendall CG, Stockton AM, Leicht S, McCaig H, Chung S, Scott V, Zhong F, Lin Y. Amine Analysis Using AlexaFluor 488 Succinimidyl Ester and Capillary Electrophoresis with Laser-Induced Fluorescence. J Anal Methods Chem 2015; 2015:368362. [PMID: 26090268 PMCID: PMC4452322 DOI: 10.1155/2015/368362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 02/23/2015] [Accepted: 02/24/2015] [Indexed: 06/04/2023]
Abstract
Fluorescent probes enable detection of otherwise nonfluorescent species via highly sensitive laser-induced fluorescence. Organic amines are predominantly nonfluorescent and are of analytical interest in agricultural and food science, biomedical applications, and biowarfare detection. Alexa Fluor 488 N-hydroxysuccinimidyl ester (AF488 NHS-ester) is an amine-specific fluorescent probe. Here, we demonstrate low limit of detection of long-chain (C9 to C18) primary amines and optimize AF488 derivatization of long-chain primary amines. The reaction was found to be equally efficient in all solvents studied (dimethylsulfoxide, ethanol, and N,N-dimethylformamide). While an organic base (N,N-diisopropylethylamine) is required to achieve efficient reaction between AF488 NHS-ester and organic amines with longer hydrophobic chains, high concentrations (>5 mM) result in increased levels of ethylamine and propylamine in the blank. Optimal incubation times were found to be >12 hrs at room temperature. We present an initial capillary electrophoresis separation for analysis using a simple micellar electrokinetic chromatography (MEKC) buffer consisting of 12 mM sodium dodecylsulfate (SDS) and 5 mM carbonate, pH 10. Limits of detection using the optimized labeling conditions and these separation conditions were 5-17 nM. The method presented here represents a novel addition to the arsenal of fluorescent probes available for highly sensitive analysis of small organic molecules.
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Affiliation(s)
- Christian G. Kendall
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
- Weill Cornell Graduate School of Medical Science, New York, NY 10065, USA
| | - Amanda M. Stockton
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
- Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Stephen Leicht
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
- University of California, Los Angeles, CA 90095, USA
| | - Heather McCaig
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - Shirley Chung
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - Valerie Scott
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - Fang Zhong
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
| | - Ying Lin
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109, USA
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Scott V, O'Brien K, Boeneke C, Stewart L, Forney L, Henagan T. Exercise‐ and Kefir‐induced Internalization of the Anti‐inflammatory Melanocortin 3 Receptor in Monocytes. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.677.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Valerie Scott
- Nutrition SciencePurdue UniversityWest LafayetteIndianaUnited States
| | - Keely O'Brien
- School of Animal SciencesLouisiana Agricultural Experiment Station Louisiana State University Agricultural CenterBaton RougeLAUnited States
| | - Charles Boeneke
- School of Animal SciencesLouisiana Agricultural Experiment Station Louisiana State University Agricultural CenterBaton RougeLAUnited States
| | - Laura Stewart
- Rocky Mountain Cancer Rehabilitation Institute University of Northern ColoradoGreeleyCOUnited States
| | - Laura Forney
- School of Kinesiology Louisiana State UniversityBaton RougeLAUnited States
| | - Tara Henagan
- Nutrition SciencePurdue UniversityWest LafayetteIndianaUnited States
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Fontes P, Lopez R, van der Plaats A, Vodovotz Y, Minervini M, Scott V, Soltys K, Shiva S, Paranjpe S, Sadowsky D, Barclay D, Zamora R, Stolz D, Demetris A, Michalopoulos G, Marsh JW. Liver preservation with machine perfusion and a newly developed cell-free oxygen carrier solution under subnormothermic conditions. Am J Transplant 2015; 15:381-94. [PMID: 25612645 PMCID: PMC5024042 DOI: 10.1111/ajt.12991] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/28/2014] [Accepted: 08/23/2014] [Indexed: 01/25/2023]
Abstract
We describe a new preservation modality combining machine perfusion (MP) at subnormothermic conditions(21 °C) with a new hemoglobin-based oxygen carrier (HBOC) solution. MP (n=6) was compared to cold static preservation (CSP; n=6) in porcine orthotopic liver transplants after 9 h of cold ischemia and 5-day follow-up. Recipients' peripheral blood, serial liver biopsies, preservation solutions and bile specimens were collected before, during and after liver preservation. Clinical laboratorial and histological analyses were performed in addition to mitochondrial functional assays, transcriptomic, metabolomic and inflammatory inflammatory mediator analyses. Compared with CSP, MP animals had: (1) significantly higher survival (100%vs. 33%; p<0.05); (2) superior graft function (p<0.05);(3) eight times higher hepatic O2 delivery than O2 consumption (0.78 mL O2/g/h vs. 0.096 mL O2/g/h) during MP; and (4) significantly greater bile production (MP=378.5 ± 179.7; CS=151.6 ± 116.85). MP downregulated interferon (IFN)-α and IFN-γ in liver tissue. MP allografts cleared lactate, produced urea, sustained gluconeogenesis and produced hydrophilic bile after reperfusion. Enhanced oxygenation under subnormothermic conditions triggers regenerative and cell protective responses resulting in improved allograft function. MP at 21 °C with the HBOC solution significantly improves liver preservation compared to CSP.
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Affiliation(s)
- P. Fontes
- Department of SurgeryUniversity of Pittsburgh Medical CenterPittsburghPA,Department of SurgeryThomas E. Starzl Transplantation InstitutePittsburghPA,McGowan Institute of Regenerative MedicineUniversity of PittsburghPittsburghPA,Department of SurgeryUniversity of PittsburghPittsburghPA
| | - R. Lopez
- Department of SurgeryUniversity of Pittsburgh Medical CenterPittsburghPA,Department of SurgeryThomas E. Starzl Transplantation InstitutePittsburghPA
| | | | - Y. Vodovotz
- Department of SurgeryUniversity of PittsburghPittsburghPA
| | - M. Minervini
- Department of PathologyUniversity of Pittsburgh Medical CenterPittsburghPA
| | - V. Scott
- Department of AnesthesiaUniversity of PittsburghPittsburghPA
| | - K. Soltys
- Department of SurgeryUniversity of Pittsburgh Medical CenterPittsburghPA,Department of SurgeryThomas E. Starzl Transplantation InstitutePittsburghPA
| | - S. Shiva
- Vascular Medicine InstituteDepartment of Cardiothoracic SurgeryUniversity of PittsburghPittsburghPA
| | - S. Paranjpe
- Department of PathologyUniversity of PittsburghPittsburghPA
| | - D. Sadowsky
- Department of SurgeryUniversity of PittsburghPittsburghPA
| | - D. Barclay
- Department of SurgeryUniversity of PittsburghPittsburghPA
| | - R. Zamora
- Department of SurgeryUniversity of PittsburghPittsburghPA
| | - D. Stolz
- Department of PathologyUniversity of PittsburghPittsburghPA
| | - A. Demetris
- Department of PathologyUniversity of Pittsburgh Medical CenterPittsburghPA,Thomas E. Starzl Transplantation InstitutePittsburghPA
| | - G. Michalopoulos
- Department of PathologyUniversity of Pittsburgh Medical CenterPittsburghPA
| | - J. W. Marsh
- Department of SurgeryUniversity of Pittsburgh Medical CenterPittsburghPA,Department of SurgeryThomas E. Starzl Transplantation InstitutePittsburghPA
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Bailit JL, Grobman W, Zhao Y, Wapner RJ, Reddy UM, Varner MW, Leveno KJ, Caritis SN, Iams JD, Tita AT, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, VanDorsten JP, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Thorp J, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Shubert P, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Williams T, Spong C, Tolivaisa S. Nonmedically indicated induction vs expectant treatment in term nulliparous women. Am J Obstet Gynecol 2015; 212:103.e1-7. [PMID: 24983681 DOI: 10.1016/j.ajog.2014.06.054] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/27/2014] [Accepted: 06/23/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to compare maternal and neonatal outcomes in nulliparous women with nonmedically indicated inductions at term vs those expectantly treated. STUDY DESIGN Data were obtained from maternal and neonatal charts for all deliveries on randomly selected days across 25 US hospitals over a 3-year period. A low-risk subset of nulliparous women with vertex nonanomalous singleton gestations who delivered 38 0/7 to 41 6/7 weeks were selected. Maternal and neonatal outcomes for nonmedically indicated induction within each week were compared with women who did not undergo nonmedically indicated induction during that week. Multivariable analysis was used to adjust for hospital, maternal age, race/ethnicity, body mass index, cigarette use, and insurance status. RESULTS We found 31,169 women who met our criteria. Neonatal complications were either less frequent with nonmedically indicated induction or no different between groups. Nonmedically indicated induction was associated with less frequent peripartum infections (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.16-0.98) at 38 weeks of gestation and less frequent third- and fourth-degree lacerations (OR, 0.60; 95% CI, 0.42-0.86) and less frequent peripartum infections (OR, 0.66; 95% CI, 0.49-0.90) at 39 weeks of gestation. Nonmedically indicated induction was associated with a longer admission-to-delivery time by approximately 3-4 hours and increased odds of cesarean delivery at 38 (OR, 1.50; 95% CI, 1.08-2.08) and 40 weeks (OR, 1.30; 95% CI, 1.15-1.46) of gestation. CONCLUSION At 39 weeks of gestation, nonmedically indicated induction is associated with lower maternal and neonatal morbidity than women who are expectantly treated.
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Scott V, Mohammadi S, Tzias D, Wale A, Heller S. PB.37. Does conventional imaging accurately predict the extent of disease in women with dense breasts? If so, does this have a significant impact on patient surgical outcome? Breast Cancer Res 2014. [PMCID: PMC4243389 DOI: 10.1186/bcr3721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Clark CEF, Horadagoda A, Kerrisk KL, Scott V, Islam MR, Kaur R, Garcia SC. Grazing Soybean to Increase Voluntary Cow Traffic in a Pasture-based Automatic Milking System. Asian-Australas J Anim Sci 2014; 27:422-30. [PMID: 25049970 PMCID: PMC4093256 DOI: 10.5713/ajas.2013.13433] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 11/23/2013] [Accepted: 09/16/2013] [Indexed: 11/27/2022]
Abstract
Pasture-based automatic milking systems (AMS) require cow traffic to enable cows to be milked. The interval between milkings can be manipulated by strategically allocating pasture. The current experiment investigated the effect of replacing an allocation of grazed pasture with grazed soybean (Glycine max) with the hypothesis that incorporating soybean would increase voluntary cow traffic and milk production. One hundred and eighty mixed age, primiparous and multiparous Holstein-Friesian/Illawarra cows were randomly assigned to two treatment groups (n = 90/group) with a 2×2 Latin square design. Each group was either offered treatments of kikuyu grass (Pennisetum clandestinum Hoach ex Chiov.) pasture (pasture) or soybean from 0900 h to 1500 h during the experimental period which consisted of 2 periods of 3 days following 5 days of training and adaptation in each period with groups crossing over treatments after the first period. The number of cows trafficking to each treatment was similar together with milk yield (mean ≈18 L/cow/d) in this experiment. For the cows that arrived at soybean or pasture there were significant differences in their behaviour and consequently the number of cows exiting each treatment paddock. There was greater cow traffic (more cows and sooner) exiting pasture allocations. Cows that arrived at soybean stayed on the allocation for 25% more time and ate more forage (8.5 kg/cow/d/allocation) relative to pasture (4.7 kg/cow/d/allocation). Pasture cows predominantly replaced eating time with rumination. These findings suggest that replacing pasture with alternative grazeable forages provides no additional incentive to increase voluntary cow traffic to an allocation of feed in AMS. This work highlights the opportunity to increase forage intakes in AMS through the incorporation of alternative forages.
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Joe N, Scott V, Brown CH. Glial regulation of extrasynaptic NMDA receptor-mediated excitation of supraoptic nucleus neurones during dehydration. J Neuroendocrinol 2014; 26:35-42. [PMID: 24267175 DOI: 10.1111/jne.12121] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 11/12/2013] [Accepted: 11/18/2013] [Indexed: 11/29/2022]
Abstract
Magnocellular neurosecretory cells (MNCs) of the supraoptic nucleus (SON) project to the posterior pituitary gland where they release the hormones, vasopressin and oxytocin into the circulation to maintain plasma osmolality. Hormone release is proportionate to SON MNC action potential (spike) firing rate. When activated by ambient extracellular glutamate, extrasynaptic NMDA receptors (eNMDARs) mediate a tonic (persistent) depolarisation to increase the probability of action potential firing. In the present study, in vivo single-unit electrophysiological recordings were made from urethane-anaesthetised female Sprague-Dawley rats to investigate the impact of tonic eNMDAR activation on MNC activity. Water deprivation (for up to 48 h) caused an increase in the firing rate of SON MNCs that was associated with a general increase in post-spike excitability. To determine whether eNMDAR activation contributes to the increased MNC excitability during water deprivation, memantine, which preferentially blocks eNMDARs, was administered locally into the SON by microdialysis. Memantine significantly decreased the firing rate of MNCs recorded from 48-h water-deprived rats but had no effect on MNCs recorded from euhydrated rats. In the presence of the glial glutamate transporter-1 (GLT-1) blocker, dihydrokainate, memantine also reduced the MNC firing rate in euhydrated rats. Taken together, these observations suggest that GLT-1 clears extracellular glutamate to prevent the activation of eNDMARs under basal conditions and that, during dehydration, eNMDAR activation contributes to the increased firing rate of MNCs.
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Affiliation(s)
- N Joe
- Centre for Neuroendocrinology, Department of Physiology, University of Otago, Dunedin, New Zealand
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Dieci MV, Lefebvre C, Viehl P, Mathieu MC, Laporte M, Scott V, Marty V, Drusch F, Guarneri V, Conte P, Lacroix L, Delaloge S, André F. Abstract PD4-4: Whole exome sequencing of aggressive rare breast cancers histologic subtypes reveals novel pathway for breast cancer progression. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-pd4-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Rare cancers sometimes present clonal evolution. Genomic characterisation of these rare entities could lead to identify new genes involved in the progression of more frequent cancers. In the present study, we have performed whole exome sequencing of three rare and aggressive histological subtypes in order to identify new targets that could subsequently be validated in common breast cancers.
Methods: Whole exome sequencing was applied in ten pleiomorphic lobular carcinoma, seven micropapillary BC and eight metaplastic BC. Each cancer sample was matched with normal DNA from the same patient. Overall 50 samples were therefore sequenced. Tumor samples were selected to present >30% cancer cells. Histological diagnosis was confirmed by a BC pathologist. Whole exome sequencing (WES) was performed by BGI (Bejing Genomic Institute, Hong-Kong, China) using the Illumina Hiseq2000 platform (90bp paired-end reads, depth ≥80x). Genes recurrently mutated (with somatic mutations in >2 cases) were selected for validation. The validation by IonTorrent target sequencing was performed on additional formalin-fixed paraffin-embedded (FFPE) tumor samples (>30% of tumor cells).
Results: Complete results of both WES and targeted resequencing validation are available for pleiomorphic lobular carcinoma. Nine of the 10 DNA pairs were eligible for WES. Genes already implicated in BC were significantly mutated: PIK3CA (3/9), TP53 (3/9) and CDH1 (3/9). Novel significantly mutated genes were identified: PYGM (2/9), EMR1 (2/9), ALDH1A2 (2/9), and DCLK1 (2/9). The validation using target gene sequencing was performed on the same 9 cases and on 19 additional confirmed pleiomorphic lobular BC cases (n = 28). For 8 out of the 9 cases with WES data, the results were reproducible on FFPE samples. Validation set confirmed recurrent mutations on PYGM genes (25%). PYGM is involved in glycogen metabolism. Further analyses on gene expression array revealed that PYGM is downregulated in most of the common BC samples, as compared to normal tissue, suggesting a role for this gene in the metabolism of common BC.
WES data are available for micropapillary and metaplastic BC. HSPA8 (coding for a Heat shock protein) was found mutated in 3/7 of micropapillary samples. Validation on additional FFPE samples is ongoing and will be presented. WES of metaplastic BC revealed a high frequency of TP53 and PIK3CA mutations (50% in both cases).
Conclusions: A novel mutated gene was identified in PLBC. PYGM is a gene involved in glycogen metabolism and was found downregulated in most of the common breast cancer. WES of micropapillary cancers suggests mutations on HSPA8, a gene encoding for a chaperon protein. Validation is ongoing. Deeper sequencing is ongoing for metaplastic BC that may help identifying new mutated genes in this multiclonal disease. Results will be presented.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr PD4-4.
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Affiliation(s)
- MV Dieci
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - C Lefebvre
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - P Viehl
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - M-C Mathieu
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - M Laporte
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - V Scott
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - V Marty
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - F Drusch
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - V Guarneri
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - P Conte
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - L Lacroix
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - S Delaloge
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
| | - F André
- Institut Gustave Roussy, Villejuif, France; Istituto Oncologico Veneto, Padova, Italy
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Scott V, Mathews V, Gilson L. Constraints to implementing an equity-promoting staff allocation policy: understanding mid-level managers' and nurses' perspectives affecting implementation in South Africa. Health Policy Plan 2012. [DOI: 10.1093/heapol/czs080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Scott V, Fials B, Miller J. EVALUATION OF A CANADIAN PRIMARY CARE FALL PREVENTION TRAINING AND RESOURCE PACKAGE. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040580e.15] [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: 11/03/2022]
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Arnedos M, Scott V, Job B, De La Cruz J, Commo F, Mathieu M, Wolp-Diniz R, Richon C, Campone M, Bachelot T, Dalenc F, Dessen P, Lacroix L, Lazar V, Soria J, Delaloge S, Andre F. Array CGH and PIK3CA/AKT1 mutations to drive patients to specific targeted agents: A clinical experience in 108 patients with metastatic breast cancer. Eur J Cancer 2012; 48:2293-9. [DOI: 10.1016/j.ejca.2012.06.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Accepted: 06/17/2012] [Indexed: 11/25/2022]
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Scott V, Metcalfe S, Yassin Y. Fall and fall-related injury studies among older aboriginal people in Australia, Canada, New Zealand and the USA: a systematic review. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040590e.14] [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: 11/03/2022]
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Scott V, Feldman F, Wasdell M, Gillan R, Ross D, Thompson-Franson T, Leung M, Lin L, Korall A. BARRIERS AND FACILITATORS TO HIP PROTECTOR COMPLIANCE: A SYSTEMATIC REVIEW. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040590e.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mathieu MC, Mazouni C, Kesty NC, Zhang Y, Scott V, Passeron J, Arnedos M, Schnabel CA, Delaloge S, Erlander MG, André F. Breast Cancer Index predicts pathological complete response and eligibility for breast conserving surgery in breast cancer patients treated with neoadjuvant chemotherapy. Ann Oncol 2012; 23:2046-2052. [PMID: 22112967 DOI: 10.1093/annonc/mdr550] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The aim of neoadjuvant chemotherapy is to increase the likelihood of successful breast conservation surgery (BCS). Accurate identification of BCS candidates is a diagnostic challenge. Breast Cancer Index (BCI) predicts recurrence risk in estrogen receptor+lymph node-breast cancer. Performance of BCI to predict chemosensitivity based on pathological complete response (pCR) and BCS was assessed. METHODS Real-time RT-PCR BCI assay was conducted using tumor samples from 150 breast cancer patients treated with neoadjuvant chemotherapy. Logistical regression and c-index were used to assess predictive strength and additive accuracy of BCI beyond clinicopathologic factors. RESULTS BCI classified 42% of patients as low, 35% as intermediate and 23% as high risk. Low BCI risk group had 98.4% negative predictive value (NPV) for pCR and 86% NPV for BCS. High versus low BCI group had a 34 and 5.8 greater likelihood of achieving pCR and BCS, respectively (P=0.0055; P=0.0022). BCI increased c-index for pCR (0.875-0.924; P=0.017) and BCS prediction (0.788-0.843; P=0.027) beyond clinicopathologic factors. CONCLUSIONS BCI significantly predicted pCR and BCS beyond clinicopathologic factors. High NPVs indicate that BCI could be a useful tool to identify breast cancer patients who are not eligible for neoadjuvant chemotherapy. These results suggest that BCI could be used to assess both chemosensitivity and eligibility for BCS.
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Affiliation(s)
- M C Mathieu
- Breast Cancer Unit; INSERM Unit U981; Department of Pathology
| | - C Mazouni
- Breast Cancer Unit; Department of Surgery, Institut Gustave Roussy, Villejuif, France
| | - N C Kesty
- bioTheranostics, Inc., San Diego, USA
| | - Y Zhang
- bioTheranostics, Inc., San Diego, USA
| | | | | | - M Arnedos
- Breast Cancer Unit; INSERM Unit U981; Department of Medical Oncology; Institut Gustave Roussy, Villejuif, France
| | | | - S Delaloge
- Breast Cancer Unit; INSERM Unit U981; Department of Medical Oncology; Institut Gustave Roussy, Villejuif, France
| | | | - F André
- Breast Cancer Unit; INSERM Unit U981; Department of Medical Oncology; Institut Gustave Roussy, Villejuif, France.
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