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Chetwood JD, Ko Y, Pudipeddi A, Kariyawasam V, Paramsothy S, Leong RW. Biological Agents in the Treatment of Crohn's Disease: A Propensity Score-Matched Analysis From the Prospective Persistence Australian National IBD Cohort (PANIC3) Study. Am J Gastroenterol 2024:00000434-990000000-00991. [PMID: 38275272 DOI: 10.14309/ajg.0000000000002679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Comparative effectiveness research provides data on the relative benefits and risks between treatments. In Crohn's disease (CD), however, there are few head-to-head studies comparing advanced therapies and none with long-term follow-up. Real-world effectiveness, defined by treatment persistence, obtained from prospective population-based patient cohorts, may help determine the best sequencing and positioning of biological agents. METHODS We analyzed the prospectively collected population-based Australian national Pharmaceutical Benefits Scheme dispensing data registry (2005-2019) for CD. There is no mandated biological agent prescribing order, and all citizens and permanent residents are eligible for treatment irrespective of insurance status. Propensity score matching was performed to reduce selection bias. RESULTS There were 2,029 lines of therapy in 1,446 patients (median age 43 years, interquartile range 34-58, 44% male patients) over the 15-year period with 5,618 patient-years of follow-up. Per line of therapy, 915/2,029 (45.1%) patients used adalimumab, 722/2,029 (35.6%) used infliximab, 155/2,029 (7.6%) used vedolizumab, and 237/2,029 (11.7%) used ustekinumab. When used in biological agent-naive patients, there was no difference in persistence between any agent ( P > 0.05). Used after first line in biological agent-experienced CD, ustekinumab had significantly better persistence than non-ustekinumab biological agents ( P = 0.0018), vs anti-tumor necrosis factor (TNF) alpha therapy ( P = 0.006) or vedolizumab ( P < 0.001). Ustekinumab persistence was unaffected by prior biological agent exposure ( P = 0.51). After anti-TNF use, ustekinumab had superior persistence to an alternative anti-TNF agent ( P = 0.033) and to vedolizumab ( P = 0.026). Using a propensity score-matched analysis adjusted for age, immunomodulator use, and bio-exposed status, ustekinumab had superior persistence to anti-TNF ( P = 0.01). Multivariate predictors of worse persistence were the use of a non-ustekinumab biological agent (adjusted hazard ratio 2.10, P < 0.001), and bio-experienced status (adjusted hazard ratio 1.23, P < 0.001). DISCUSSION This large national prospective database with nonhierarchical prescribing of biological agents did not identify superior persistence of any agent in bio-naive CD. However, for patients with bio-experienced CD, persistence was greater with ustekinumab.
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Affiliation(s)
- John David Chetwood
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia
- Concord Clinical School, University of Sydney, Sydney, Australia
| | - Yanna Ko
- Canterbury Hospital, Sydney, Australia
| | - Aviv Pudipeddi
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia
- Concord Clinical School, University of Sydney, Sydney, Australia
| | - Viraj Kariyawasam
- Department of Gastroenterology and Hepatology, Blacktown and Mount Druitt Hospital, Sydney, Australia
- Blacktown Clinical School, Western Sydney University, Sydney, Australia
| | - Sudarshan Paramsothy
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia
- Concord Clinical School, University of Sydney, Sydney, Australia
- Department of Gastroenterology, Macquarie University Hospital, Sydney, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Rupert W Leong
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, Australia
- Concord Clinical School, University of Sydney, Sydney, Australia
- Department of Gastroenterology, Macquarie University Hospital, Sydney, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
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Yiu TH, Ko Y, Pudipeddi A, Natale P, Leong RW. Comparing persistence of new biologics to conventional anti-TNF alphas in adult patients with inflammatory bowel disease: a systematic review and meta-analysis protocol. BMJ Open 2023; 13:e073071. [PMID: 37788929 PMCID: PMC10551959 DOI: 10.1136/bmjopen-2023-073071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/13/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Biological therapy is a cornerstone of managing moderate-to-severe inflammatory bowel disease (IBD), ulcerative colitis (UC) and Crohn's disease (CD). New biologics have been evolving over the past 20 years and selection of an agent remains challenging.Drug persistence measures the duration of time from initiation to discontinuation of a therapy, which can be a surrogate marker of drug tolerance and efficacy. OBJECTIVES The study aimed to compare drug persistence of new generation biologics for the treatment of UC and CD (vedolizumab, ustekinumab, certolizumab, tofacitinib, natalizumab and golimumab) with conventional anti-tumor necroisis factor alphas (anti-TNF alphas) (adalimumab and infliximab) in adult patients with IBD. Results of the study may provide guidance on the preferred first and subsequent lines of biological treatments in patients with IBD. METHODS AND ANALYSIS Search via electronic databases including EMBASE, MEDLINE, PubMed and clinical trial databases will be conducted on 10 March 2023 with eligible studies included from inception of 2017 to 2023. The primary outcomes are 1-year persistence of individual biologics with comparison of new biologics versus conventional anti-TNF alphas. A meta-analysis will be conducted using Review Manager V.5 and outcome will be presented as relative risk. Heterogeneity will be assessed with forest plot, χ2 and I2, followed with sensitivity analysis and subgroup analysis. Finally, the Grading of Recommendations Assessment, Development and Evaluation system will be used to assess the quality of evidence. ETHICS AND DISSEMINATION Ethical approval is not required as no private information of participants will be used. Results of the present study will be disseminated in a peer-reviewed journal or conference presentation. PROSPERO REGISTRATION NUMBER CRD42023392236.
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Affiliation(s)
- Tsz Hong Yiu
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Yanna Ko
- Western Sydney University, Campbelltown and Camden Hospitals, Sydney, Canterbury Hospital
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Aviv Pudipeddi
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Patrizia Natale
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- Department of Precision and Regenerative Medicine and Ionian Area (DIMEPRE-J), University of Bari Aldo Moro, Bari, Italy
| | - Rupert W Leong
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
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Arzivian A, Wiseman E, Ko Y. Capsule endoscopy retention in the upper esophagus: A comprehensive literature review. Medicine (Baltimore) 2023; 102:e35113. [PMID: 37682178 PMCID: PMC10489204 DOI: 10.1097/md.0000000000035113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023] Open
Abstract
Capsule endoscopy is the first-line investigation for small bowel disorders. Capsule retention in the small bowel is the most common adverse event. Retention has also been reported in the upper esophagus; however, guidance for diagnosis and management is lacking. This review aims to summarize the diagnostic workup and management of this complication. We conducted a systematic literature review by searching 5 databases; relevant keywords and MeSH terms were used. Exclusion criteria included publications of non-adult patients in non-English languages. Data from eligible studies were analyzed using IBM SPSS 29. Twelve case reports were found (9 males, median age of 76 years); 10 capsule retentions in Zenker's diverticulum and 2 in the cricopharyngeus. Most patients were asymptomatic before capsule endoscopy. Capsule retention was symptomatic in half of the patients (6/12). A neck X-ray confirmed the diagnosis in all patients. Endoscopic capsule retrieval was achieved by different tools (9/12) (Roth's net was the most used tool, 6 patients); retrieval required rigid endoscopy in a few cases (3/12). Endoscopic capsule re-insertion was successful; using an overtube to bypass the upper esophagus was the safest method. In conclusion, capsule retention in the upper esophagus is uncommon yet exposes patients to the risk of unnecessary procedures. Symptoms of swallowing and medium-to-large size Zenker's diverticulum should be considered contra-indications for capsule endoscopy. Neck and chest X-rays are required for elderly patients who do not pass the capsule 2 weeks after ingestion. Endoscopic retrieval using Roth's net and re-insertion through an overtube should be considered first-line management.
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Affiliation(s)
- Arteen Arzivian
- Endoscopy Unit, Macquarie University Hospital, Macquarie Park, NSW
| | - Elke Wiseman
- Endoscopy Unit, Macquarie University Hospital, Macquarie Park, NSW
| | - Yanna Ko
- Endoscopy Unit, Macquarie University Hospital, Macquarie Park, NSW
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Cho KK, Ko Y, Nilsen K, Verdon C, Femia G. Ulcerative colitis and acute perimyocarditis. Med J Aust 2022; 216:559-561. [DOI: 10.5694/mja2.51554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022]
Affiliation(s)
| | - Yanna Ko
- Campbelltown Hospital Sydney NSW
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Watanabe O, Ko Y, Tsujii N, Takase Y, Ejiri A, Shinohara K, Peng Y, Iwasaki K, Yamada I, Yatomi G, Moeller C, Peng YK. Design of a finline antenna for current drive in TST-2. Fusion Engineering and Design 2022. [DOI: 10.1016/j.fusengdes.2022.113094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Park H, Ko Y. M127 Internal quality control procedure for urine test strip analyzer: Multi-rule based on sigma metric. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.226] [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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Nayak A, Hu Y, Patel K, Ko Y, Okoh A, Wang J, Mehta A, Liu C, Pennington J, Xie R, Kirklin J, Kormos R, Simon M, Cowger J, Morris A. Machine Learning Algorithms Identify Distinct Phenotypes of Right Heart Failure After Left Ventricular Assist Device Implant. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.089] [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: 10/18/2022] Open
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Pudipeddi A, Ko Y, Paramsothy S, Leong RW. Vedolizumab has longer persistence than infliximab as a first-line biological agent but not as a second-line biological agent in moderate-to-severe ulcerative colitis: real-world registry data from the Persistence Australian National IBD Cohort (PANIC) study. Therap Adv Gastroenterol 2022; 15:17562848221080793. [PMID: 35282607 PMCID: PMC8908405 DOI: 10.1177/17562848221080793] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/28/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The choice between infliximab (IFX) and vedolizumab (VED) as a first-line biological agent in moderate-to-severe ulcerative colitis (UC) can be difficult. Second-line vedolizumab (VED) efficacy may decline following prior infliximab (IFX) treatment failure in UC patients. However, it is not known whether second-line IFX efficacy declines after failure of first-line VED. AIMS We aimed to compare first-line and second-line persistence of IFX and VED, in particular whether second-line IFX persistence declines after failure of first-line VED. METHODS Persistence of IFX and VED was analysed from the Australian Pharmaceutical Benefits Scheme registry data as either first- or second-line treatment in UC. Propensity score matching (1:1) was conducted in the comparison of first-line treatments. Cox proportional hazard regression analysis was used to identify significant predictors and expressed as a hazard ratio (HR and 95% CI). RESULTS There were 420 subjects with moderate-to-severe UC who received either first-line IFX (n = 251) or VED (n = 169), with 774 patient-years of follow-up. First-line VED had significantly longer persistence than first-line IFX (>50.2 versus 22.2 months, p = 0.001). Fifty-three subjects failed first-line IFX and swapped to second-line VED (IFX→VED group). Twenty-two subjects failed first-line VED group and swapped to second-line IFX (VED→IFX group). First-line VED persistence was significantly longer than second-line VED (>50.2 versus 32.0 months, p = 0.03), but first-line IFX persistence was not statistically significantly different to second-line IFX (27.6 months versus > 38.6 months, p = 0.30). Immunomodulator co-therapy was significantly associated with a lower risk of nonpersistence of first-line VED (HR: 0.55, 95% CI: 0.33-0.89, p = 0.02) and IFX (HR: 0.63,95%CI: 0.33-0.92, p = 0.02). CONCLUSION VED had a significantly longer persistence than IFX as first-line biological agent but does not disadvantage second-line IFX use in moderate-to-severe UC. VED after IFX is associated with significantly poorer persistence. VED, therefore, should be considered as the first-line biological agent of choice in UC.
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Affiliation(s)
- Aviv Pudipeddi
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, NSW, Australia,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Yanna Ko
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, NSW, Australia,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Sudarshan Paramsothy
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, NSW, Australia,Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Sydney, NSW, Australia
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Choi H, Ko Y, Lee CY, Chung SJ, Kim HI, Kim JH, Park S, Hwang YI, Jang SH, Jung KS, Kim YK, Park JY. Impact of COVID-19 on TB epidemiology in South Korea. Int J Tuberc Lung Dis 2021; 25:854-860. [PMID: 34615583 DOI: 10.5588/ijtld.21.0255] [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: 11/10/2022] Open
Abstract
SETTING: Five referral hospitals, South Korea.OBJECTIVE: To assess epidemiological changes in TB before and during the COVID-19 pandemic.DESIGN: This was a multicentre cohort study of 3,969 patients diagnosed with TB.RESULTS: We analysed 3,453 patients diagnosed with TB prior to the COVID-19 pandemic (January 2016-February 2020) and 516 during the pandemic (March-November 2020). During the pandemic, the number of patients visits declined by 15% from the previous 4-year average, and the number of patients diagnosed with TB decreased by 17%. Patients diagnosed during the pandemic were older than those diagnosed before the pandemic (mean age, 60.2 vs. 56.6 years, P < 0.001). The proportion of patients to have primary TB at a younger age (births after 1980) among those diagnosed with TB was significantly lower during the pandemic than before (17.8% in 2020 vs. 23.5% in 2016, 24.0% in 2017, 22.5% in 2018, 23.5% in 2019; P = 0.005).CONCLUSIONS: The COVID-19 pandemic resulted in a reduction in the number of visits to respiratory departments, leading to fewer patients being diagnosed with TB. However, our results suggest that universal personal preventive measures help to suppress TB transmission in regions with intermediate TB burden.
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Affiliation(s)
- H Choi
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea, Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea
| | - Y Ko
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea, Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - C Y Lee
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea, Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - S J Chung
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea, Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Dongtan, Korea
| | - H I Kim
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea, Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - J-H Kim
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea, Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - S Park
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea, Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Y I Hwang
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea, Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - S H Jang
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea, Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - K-S Jung
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea, Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Y K Kim
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - J Y Park
- Lung Research Institute of Hallym University College of Medicine, Chuncheon, Korea, Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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Ko Y, Paramsothy S, Yau Y, Leong RW. Superior treatment persistence with ustekinumab in Crohn's disease and vedolizumab in ulcerative colitis compared with anti-TNF biological agents: real-world registry data from the Persistence Australian National IBD Cohort (PANIC) study. Aliment Pharmacol Ther 2021; 54:292-301. [PMID: 34151447 DOI: 10.1111/apt.16436] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/15/2021] [Accepted: 05/04/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Medication persistence contributes real-world evidence about treatment effectiveness, tolerability and prescriber and patient acceptability. AIMS To evaluate persistence of biological agents in Crohn's disease (CD) and ulcerative colitis (UC) and the effects of immunomodulator use and treatment lines. METHODS Retrospective national population-based data on treatment persistence for adalimumab, infliximab vedolizumab and ustekinumab for CD and UC were analysed from the Australian Pharmaceutical Benefits Scheme using Kaplan-Meier analysis and Cox proportional hazards models. RESULTS There were 2499 patients included with 8219 person-years of follow-up. In CD patients ustekinumab had increased persistence compared to anti-TNF agents (HR: 1.79, 95%CI: 1.32-2.38, P < 0.01). Twelve-month CD persistence rates were ustekinumab 80.0%, vedolizumab 73.5%, infliximab 68.1% and adalimumab 64.2% (P = 0.01). In moderate-severe UC vedolizumab had increased persistence compared to anti-TNF agents (HR: 1.67, 95% CI: 1.27-2.18 P < 0.001). Twelve-month UC persistence rates were vedolizumab 73.4%, infliximab 61.1% and adalimumab 45.5% (P < 0.001). Immunomodulator co-therapy did not significantly increase persistence in non-anti-TNF therapy (P > 0.05). Thiopurines increased persistence of anti-TNF agents in CD (P < 0.001) and UC (P = 0.03). Methotrexate co-therapy increased persistence of anti-TNF agents in CD (P = 0.001) only. First-line therapy was superior to non-first line in persistence (P < 0.001). In fistulising CD, the persistence of infliximab and adalimumab was not significantly different (P = 0.11). CONCLUSION Persistence was highest in ustekinumab in CD and vedolizumab in UC. Factors which increased the persistence of biological agents are first-line therapy, and immunomodulator co-therapy in anti-TNF agent use.
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Affiliation(s)
- Yanna Ko
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, NSW, Australia.,Concord Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Sudarshan Paramsothy
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, NSW, Australia.,Concord Clinical School, The University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Yunki Yau
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Rupert W Leong
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, NSW, Australia.,Concord Clinical School, The University of Sydney, Sydney, NSW, Australia.,Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
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Amenomori M, Bao YW, Bi XJ, Chen D, Chen TL, Chen WY, Chen X, Chen Y, Cui SW, Ding LK, Fang JH, Fang K, Feng CF, Feng Z, Feng ZY, Gao Q, Gou QB, Guo YQ, Guo YY, He HH, He ZT, Hibino K, Hotta N, Hu H, Hu HB, Huang J, Jia HY, Jiang L, Jin HB, Kasahara K, Katayose Y, Kato C, Kato S, Kawata K, Kihara W, Ko Y, Kozai M, Le GM, Li AF, Li HJ, Li WJ, Lin YH, Liu B, Liu C, Liu JS, Liu MY, Liu W, Lou YQ, Lu H, Meng XR, Munakata K, Nakada H, Nakamura Y, Nanjo H, Nishizawa M, Ohnishi M, Ohura T, Ozawa S, Qian XL, Qu XB, Saito T, Sakata M, Sako TK, Shao J, Shibata M, Shiomi A, Sugimoto H, Takano W, Takita M, Tan YH, Tateyama N, Torii S, Tsuchiya H, Udo S, Wang H, Wu HR, Xue L, Yamamoto Y, Yang Z, Yokoe Y, Yuan AF, Zhai LM, Zhang HM, Zhang JL, Zhang X, Zhang XY, Zhang Y, Zhang Y, Zhang Y, Zhao SP, Zhou XX. First Detection of sub-PeV Diffuse Gamma Rays from the Galactic Disk: Evidence for Ubiquitous Galactic Cosmic Rays beyond PeV Energies. Phys Rev Lett 2021; 126:141101. [PMID: 33891464 DOI: 10.1103/physrevlett.126.141101] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/05/2021] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
We report, for the first time, the long-awaited detection of diffuse gamma rays with energies between 100 TeV and 1 PeV in the Galactic disk. Particularly, all gamma rays above 398 TeV are observed apart from known TeV gamma-ray sources and compatible with expectations from the hadronic emission scenario in which gamma rays originate from the decay of π^{0}'s produced through the interaction of protons with the interstellar medium in the Galaxy. This is strong evidence that cosmic rays are accelerated beyond PeV energies in our Galaxy and spread over the Galactic disk.
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Affiliation(s)
- M Amenomori
- Department of Physics, Hirosaki University, Hirosaki 036-8561, Japan
| | - Y W Bao
- School of Astronomy and Space Science, Nanjing University, Nanjing 210093, China
| | - X J Bi
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - D Chen
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - T L Chen
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - W Y Chen
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Xu Chen
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Chen
- School of Astronomy and Space Science, Nanjing University, Nanjing 210093, China
| | - S W Cui
- Department of Physics, Hebei Normal University, Shijiazhuang 050016, China
| | - L K Ding
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J H Fang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - K Fang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - C F Feng
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - Zhaoyang Feng
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Z Y Feng
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
| | - Qi Gao
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - Q B Gou
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Q Guo
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Y Guo
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H H He
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Z T He
- Department of Physics, Hebei Normal University, Shijiazhuang 050016, China
| | - K Hibino
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - N Hotta
- Faculty of Education, Utsunomiya University, Utsunomiya 321-8505, Japan
| | - Haibing Hu
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - H B Hu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J Huang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H Y Jia
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
| | - L Jiang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H B Jin
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - K Kasahara
- Faculty of Systems Engineering, Shibaura Institute of Technology, Omiya 330-8570, Japan
| | - Y Katayose
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - C Kato
- Department of Physics, Shinshu University, Matsumoto 390-8621, Japan
| | - S Kato
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - K Kawata
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - W Kihara
- Department of Physics, Shinshu University, Matsumoto 390-8621, Japan
| | - Y Ko
- Department of Physics, Shinshu University, Matsumoto 390-8621, Japan
| | - M Kozai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara 252-5210, Japan
| | - G M Le
- National Center for Space Weather, China Meteorological Administration, Beijing 100081, China
| | - A F Li
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
- School of Information Science and Engineering, Shandong Agriculture University, Taian 271018, China
| | - H J Li
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - W J Li
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
| | - Y H Lin
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - B Liu
- Department of Astronomy, School of Physical Sciences, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - C Liu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J S Liu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - M Y Liu
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - W Liu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y-Q Lou
- Department of Physics and Tsinghua Centre for Astrophysics (THCA), Tsinghua University, Beijing 100084, China
- Tsinghua University-National Astronomical Observatories of China (NAOC) Joint Research Center for Astrophysics, Tsinghua University, Beijing 100084, China
- Department of Astronomy, Tsinghua University, Beijing 100084, China
| | - H Lu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - X R Meng
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - K Munakata
- Department of Physics, Shinshu University, Matsumoto 390-8621, Japan
| | - H Nakada
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - Y Nakamura
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H Nanjo
- Department of Physics, Hirosaki University, Hirosaki 036-8561, Japan
| | - M Nishizawa
- National Institute of Informatics, Tokyo 101-8430, Japan
| | - M Ohnishi
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - T Ohura
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - S Ozawa
- National Institute of Information and Communications Technology, Tokyo 184-8795, Japan
| | - X L Qian
- Department of Mechanical and Electrical Engineering, Shandong Management University, Jinan 250357, China
| | - X B Qu
- College of Science, China University of Petroleum, Qingdao, 266555, China
| | - T Saito
- Tokyo Metropolitan College of Industrial Technology, Tokyo 116-8523, Japan
| | - M Sakata
- Department of Physics, Konan University, Kobe 658-8501, Japan
| | - T K Sako
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - J Shao
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - M Shibata
- Faculty of Engineering, Yokohama National University, Yokohama 240-8501, Japan
| | - A Shiomi
- College of Industrial Technology, Nihon University, Narashino 275-8575, Japan
| | - H Sugimoto
- Shonan Institute of Technology, Fujisawa 251-8511, Japan
| | - W Takano
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - M Takita
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - Y H Tan
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - N Tateyama
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - S Torii
- Research Institute for Science and Engineering, Waseda University, Tokyo 169-8555, Japan
| | - H Tsuchiya
- Japan Atomic Energy Agency, Tokai-mura 319-1195, Japan
| | - S Udo
- Faculty of Engineering, Kanagawa University, Yokohama 221-8686, Japan
| | - H Wang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - H R Wu
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - L Xue
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - Y Yamamoto
- Department of Physics, Konan University, Kobe 658-8501, Japan
| | - Z Yang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Y Yokoe
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa 277-8582, Japan
| | - A F Yuan
- Physics Department of Science School, Tibet University, Lhasa 850000, China
| | - L M Zhai
- National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012, China
| | - H M Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - J L Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - X Zhang
- School of Astronomy and Space Science, Nanjing University, Nanjing 210093, China
| | - X Y Zhang
- Institute of Frontier and Interdisciplinary Science and Key Laboratory of Particle Physics and Particle Irradiation (MOE), Shandong University, Qingdao 266237, China
| | - Y Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - Yi Zhang
- Key Laboratory of Dark Matter and Space Astronomy, Purple Mountain Observatory, Chinese Academy of Sciences, Nanjing 210034, China
| | - Ying Zhang
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - S P Zhao
- Key Laboratory of Particle Astrophysics, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing 100049, China
| | - X X Zhou
- Institute of Modern Physics, SouthWest Jiaotong University, Chengdu 610031, China
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12
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Ko Y, Wu Y, Yang C, Jian L. PNS62 An Expert Survey on Talent Cultivation in Health Technology Assessment. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Hsu C, Ko Y, Chen Y. PRO6 Epidemiology and Treatment Patterns of Hemophilia a in Taiwan from 2013 to 2017. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.501] [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: 10/23/2022]
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14
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Ko Y, Lee G, Kim B, Park M, Jang Y, Lim W. Modification of the RANKL-RANK-binding site for the immunotherapeutic treatment of osteoporosis. Osteoporos Int 2020; 31:983-993. [PMID: 31863125 DOI: 10.1007/s00198-019-05200-6] [Citation(s) in RCA: 5] [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: 04/25/2019] [Accepted: 10/16/2019] [Indexed: 12/20/2022]
Abstract
UNLABELLED Here, we proposed the use of mutated RANKL as an immunogen for active immunization and to induce anti-cytokine antibodies for osteoporosis treatment. INTRODUCTION Osteoclasts are responsible for bone resorption in bone-related disorders. Anti-cytokine therapeutic antibodies such as denosumab are effective for the treatment of osteoporosis. However, problems with antibody manufacturing and the immunogenicity caused by multiple antibody doses have led to the use of auto-cytokines as immunogens to induce anti-cytokine antibodies. METHODS RANKL was point-mutated based on the crystal structure of the complex of RANKL and its receptor RANK. RESULTS As a proof of concept, immunization with RANKL produced high levels of specific antibodies and blocked osteoclast development in vitro and inhibited osteoporosis in RANKL-treated or ovariectomized mouse models. CONCLUSIONS The results demonstrate the successful use of mutated RANKL as an immunogen for the induction of anti-RANKL immune response. This strategy is useful in general anti-cytokine immunotherapy to avoid toxic side effects of osteoporosis treatment.
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Affiliation(s)
- Y Ko
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea
| | - G Lee
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea
| | - B Kim
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea
| | - M Park
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea
| | - Y Jang
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea
- Department of Premedical Program, School of Medicine, Chosun University, Gwangju, 61452, South Korea
| | - W Lim
- Department of Orthopaedic Surgery, Chosun University Hospital, Gwangju, 61453, South Korea.
- Laboratory of Orthopaedic Research, Chosun University Hospital, Gwangju, 61453, South Korea.
- Department of Premedical Program, School of Medicine, Chosun University, Gwangju, 61452, South Korea.
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15
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Nayak A, Hu Y, Ko Y, Mehta A, Liu C, Xie R, Cowger J, Kirklin J, Kormos R, Simon M, Morris A. Gender Differences in Early Mortality after LVAD: An IMACS Analysis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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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16
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Ghazzal BZ, Kelli HM, Mehta A, Tahhan AS, Kim JH, Dong TA, Dhindsa DS, Sandesara PB, Hayek SS, Alkhoder AA, Liu C, Ko Y, Vaccarino V, Sperling LS, Quyyumi AA. P5479Educational attainment is an independent predictor of adverse outcomes in patients with coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Educational attainment is an indicator of socioeconomic status and is inversely associated with cardiovascular risk factors and risk for incident coronary artery disease (CAD). Whether the level of educational attainment (EL) in patients with CAD influences outcomes remains understudied.
Purpose
To ascertain the relationship between EL and adverse outcomes in patients with CAD. We hypothesize that EL will be inversely associated with adverse outcomes in this high-risk patient population.
Methods
Subjects undergoing cardiac catheterization for known or suspected CAD were recruited in a cardiovascular biobank and had their highest level of educational attainment assessed using predefined options of elementary/middle school, high school, college, or graduate education. The primary outcome of interest was all-cause mortality and secondary outcomes included a composite of cardiovascular deaths and nonfatal myocardial infarction (MI) events, and nonfatal MI events during follow-up. Cox proportional hazards regression models were used to analyze the association between EL and adverse outcomes after adjustment for demographic characteristics, cardiovascular risk factors, cardiovascular medication use, and estimated zip code-based annual family income.
Results
Among the 6,318 subjects (mean age 64 years, 63% male, 23% black) enrolled, 998 (16%) had received graduate or a higher qualification, 2,689 (43%) had received a college education, 2,403 (38%) had received a high school education, and 228 (3%) had received elementary/middle school education. During a median follow-up of 3 years,there were 1,110 deaths from all causes, 851 cardiovascular deaths/nonfatal MI, and 286 nonfatal MI events. After adjusting for covariates and compared to patients with graduate education or higher, those with lower EL (elementary/middle school, high school, or college education) had a higher risk of all-cause mortality [hazard ratio 1.66, (95% CI 1.08, 2.54), 1.58 (95% CI 1.22, 2.04), and 1.45 (95% CI 1.13, 1.57), respectively]. Similar findings were observed for secondary outcomes. EL dichotomized at graduate education was associated with all-cause mortality (hazard ratio 1.48, 95% CI 1.16, 1.88), but this relationship was significantly modified by sex (p-interaction 0.023) and the association was attenuated among male patients (hazard ratio 1.23, 95% CI 0.94, 1.61) but not female patients (hazard ratio 2.70, 95% CI 1.53, 4.77).
Conclusions
Lower educational attainment is an independent predictor of adverse outcomes in patients with CAD. The causal link between low education level and increased CV risk needs further investigation.
Acknowledgement/Funding
Dr. Quyyumi is supported by NIH grants 5P01HL101398-02, 1P20HL113451-01, 1R56HL126558-01, 1RF1AG051633-01, R01 NS064162-01, R01 HL89650-01, HL095479-0
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Affiliation(s)
- B Z Ghazzal
- Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, United States of America
| | - H M Kelli
- Emory University School of Medicine, Division of Cardiology, Department of Medicine, Atlanta, United States of America
| | - A Mehta
- Emory University School of Medicine, Division of Cardiology, Department of Medicine, Atlanta, United States of America
| | - A S Tahhan
- Emory University School of Medicine, Division of Cardiology, Department of Medicine, Atlanta, United States of America
| | - J H Kim
- Emory University School of Medicine, Division of Cardiology, Department of Medicine, Atlanta, United States of America
| | - T A Dong
- Emory University School of Medicine, Department of Medicine, Atlanta, United States of America
| | - D S Dhindsa
- Emory University School of Medicine, Department of Medicine, Atlanta, United States of America
| | - P B Sandesara
- Emory University School of Medicine, Division of Cardiology, Department of Medicine, Atlanta, United States of America
| | - S S Hayek
- University of Michigan Medical School, Division of Cardiology, Department of Internal Medicine, Ann Arbor, United States of America
| | - A A Alkhoder
- Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, United States of America
| | - C Liu
- Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, United States of America
| | - Y Ko
- Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, United States of America
| | - V Vaccarino
- Emory University, Rollins School of Public Health, Atlanta, United States of America
| | - L S Sperling
- Emory University School of Medicine, Division of Cardiology, Department of Medicine, Atlanta, United States of America
| | - A A Quyyumi
- Emory University School of Medicine, Division of Cardiology, Department of Medicine, Atlanta, United States of America
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17
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Gambaro K, Marques M, McNamara S, du Tertre MC, Hoffert C, Srivastava A, Samson B, Lesperance B, Ko Y, Dalfen R, St-Hilaire E, Sideris L, Couture F, Burkes R, Harb M, Camlioglu E, Gologan A, Pelsser V, Tejpar S, Kavan P, Kleinman C, Batist G. Copy number variation in longitudinal liver metastases biopsies in colorectal cancer identifies biomarker candidates of resistance to standard chemotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.019] [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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18
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Lee D, Ko Y, Won H, Sun D. TREATMENT OUTCOMES OF INVOLVED-FIELD RADIOTHERAPY IN ELDERLY PATIENTS WITH HIGH-GRADE OR RECURRENT NON-HODGKIN LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.93_2631] [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: 11/08/2022]
Affiliation(s)
- D. Lee
- Radiation Oncology, Uijeongbu St. Mary's Hospital; College of Medicine, The Catholic University of Korea; Gyeonggi-do Republic of Korea
| | - Y. Ko
- Medical Oncology; Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Gyeonggi-do Republic of Korea
| | - H. Won
- Medical Oncology; Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Gyeonggi-do Republic of Korea
| | - D. Sun
- Medical Oncology; Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea; Gyeonggi-do Republic of Korea
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19
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Nayak A, Ko Y, Chesnut N, Pekarek A, Cole R, Bhatt K, Gupta D, Burke M, Laskar S, Attia T, Smith A, Vega J, Morris A. Validating Patient Prioritization in the 2018 Revised UNOS Heart Allocation System: A Single Center Experience. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.315] [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: 10/27/2022] Open
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20
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Lee J, Jeon D, Lee S, Kim S, Ko Y, Roh H, Kim S, Kim K. PSXIII-22 Changes of reproductive hormones and pregnancy rate with different estrus synchronization methods in Korean black goats. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.795] [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: 11/13/2022] Open
Affiliation(s)
- J Lee
- National Institute of Animal Science,Namwon, Republic of Korea
| | - D Jeon
- National Institute of Animal Science,Namwon, Republic of Korea
| | - S Lee
- National Institute of Animal Science,Namwon, Republic of Korea
| | - S Kim
- National Institute of Animal Science,Namwon, Republic of Korea
| | - Y Ko
- National Institute of Animal Science,Namwon, Republic of Korea
| | - H Roh
- National Institute of Animal Science,Namwon, Republic of Korea
| | - S Kim
- National Institute of Animal Science,Namwon, South Korea
| | - K Kim
- National Institute of Animal Science,Namwon, South Korea
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21
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van der Poorten DK, McLeod D, Ahlenstiel G, Read S, Kwok A, Santhakumar C, Bassan M, Culican S, Campbell D, Wong SWJ, Evans L, Jideh B, Kane A, Katelaris CH, Keat K, Ko Y, Lee JA, Limaye S, Lin MW, Murad A, Rafferty M, Suan D, Swaminathan S, Riminton SD, Toong C, Berglund LJ. Gastric Cancer Screening in Common Variable Immunodeficiency. J Clin Immunol 2018; 38:768-777. [PMID: 30219982 DOI: 10.1007/s10875-018-0546-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 06/07/2018] [Accepted: 09/06/2018] [Indexed: 12/22/2022]
Abstract
Individuals with common variable immunodeficiency (CVID) have an increased risk of gastric cancer, and gastrointestinal lymphoma, yet screening for premalignant gastric lesions is rarely offered routinely to these patients. Proposed screening protocols are not widely accepted and are based on gastric cancer risk factors that are not applicable to all CVID patients. Fifty-two CVID patients were recruited for screening gastroscopy irrespective of symptoms or blood results and were compared to 40 controls presenting for gastroscopy for other clinical indications. Overall, 34% of CVID patients had intestinal metaplasia (IM), atrophic gastritis or moderate to severe non-atrophic gastritis, which can increase the risk of gastric cancer, compared to 7.5% of controls (p < 0.01). Focal nodular lymphoid hyperplasia, a precursor lesion for gastrointestinal lymphoma, was seen in eight CVID patients (16%), one of whom was diagnosed with gastrointestinal lymphoma on the same endoscopy. High-risk gastric pathology was associated with increased time since diagnosis of CVID, smoking, Helicobacter pylori, a low-serum pepsinogen I concentration, and diarrhea, but not pepsinogen I/II ratio, iron studies, vitamin B12 levels or upper gastrointestinal symptoms. There was a lower rate of detection of IM when fewer biopsies were taken, and IM and gastric atrophy were rarely predicted by the endoscopist macroscopically, highlighting the need for standardized biopsy protocols. The prevalence of premalignant gastric lesions in patients with CVID highlights the need for routine gastric screening. We propose a novel gastric screening protocol to detect early premalignant lesions and reduce the risk of gastric cancer and gastric lymphoma in these patients.
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Affiliation(s)
- David K van der Poorten
- Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, NSW, Australia.,Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia
| | - Duncan McLeod
- Department of Anatomical Pathology, Westmead Hospital, Sydney, NSW, Australia.,NSW Health Pathology, Sydney, NSW, Australia
| | - Golo Ahlenstiel
- Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia.,Blacktown Clinical School, School of Medicine, Western Sydney University, Penrith, NSW, Australia.,Department of Gastroenterology and Hepatology, Blacktown Hospital, Blacktown, NSW, Australia.,Storr Liver Centre, Westmead Institute of Medical Research, Westmead, NSW, Australia
| | - Scott Read
- Storr Liver Centre, Westmead Institute of Medical Research, Westmead, NSW, Australia
| | - Avelyn Kwok
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Cositha Santhakumar
- Department of Gastroenterology and Hepatology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Milan Bassan
- Department of Gastroenterology and Hepatology, Liverpool hospital, Sydney, NSW, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, NSW, Australia
| | | | | | | | - Louise Evans
- Faculty of Medicine, The University of New South Wales, Sydney, NSW, Australia.,Department of Immunology, Liverpool Hospital, Sydney, NSW, Australia
| | - Bilel Jideh
- Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, NSW, Australia
| | - Alisa Kane
- Department of Immunology, Liverpool Hospital, Sydney, NSW, Australia
| | - Constance H Katelaris
- Department of Immunology, Campbelltown Hospital, Campbelltown, NSW, Australia.,Faculty of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Karuna Keat
- Department of Immunology, Campbelltown Hospital, Campbelltown, NSW, Australia.,Faculty of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Yanna Ko
- Department of Immunology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Jessie A Lee
- Department of Immunology, Liverpool Hospital, Sydney, NSW, Australia
| | - Sandhya Limaye
- Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia.,Department of Immunology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Ming Wei Lin
- Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia.,Departments of Immunology and Immunopathology, Westmead Hospital, Hawkesbury Rd, Westmead, Sydney, NSW, 2145, Australia
| | - Ari Murad
- Department of Immunology, Liverpool Hospital, Sydney, NSW, Australia
| | - Martina Rafferty
- Department of Immunology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Dan Suan
- Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia.,Departments of Immunology and Immunopathology, Westmead Hospital, Hawkesbury Rd, Westmead, Sydney, NSW, 2145, Australia.,Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Sanjay Swaminathan
- Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia.,Departments of Immunology and Immunopathology, Westmead Hospital, Hawkesbury Rd, Westmead, Sydney, NSW, 2145, Australia
| | - Sean D Riminton
- Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia.,Department of Immunology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Catherine Toong
- NSW Health Pathology, Sydney, NSW, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, NSW, Australia.,Department of Immunology, Liverpool Hospital, Sydney, NSW, Australia.,Department of Immunology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Lucinda J Berglund
- Faculty of Medicine, The University of Sydney, Sydney, NSW, Australia. .,NSW Health Pathology, Sydney, NSW, Australia. .,Departments of Immunology and Immunopathology, Westmead Hospital, Hawkesbury Rd, Westmead, Sydney, NSW, 2145, Australia.
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22
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Affiliation(s)
- Yanna Ko
- Concord Repatriation General Hospital, Sydney, New South Wales, Australia
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23
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Sanagapalli S, Ko Y, Kariyawasam V, Ng SC, Tang W, de Silva HJ, Chen M, Wu K, Aniwan S, Ng KK, Ong D, Ouyang Q, Hilmi I, Simadibrata M, Pisespongsa P, Gopikrishna S, Leong RW. The association between new generation oral contraceptive pill and the development of inflammatory bowel diseases. Intest Res 2018; 16:409-415. [PMID: 30090040 PMCID: PMC6077300 DOI: 10.5217/ir.2018.16.3.409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/22/2018] [Accepted: 02/28/2018] [Indexed: 02/06/2023] Open
Abstract
Background/Aims To examine the association between use of oral contraceptive pills (OCPs) and the risk of developing inflammatory bowel diseases (IBD), in a modern cohort. Methods A prospective nested case-control study across sites in the Asia-Pacific region was conducted; involving female IBD cases and asymptomatic controls. Subjects completed a questionnaire addressing questions related to OCP use. Primary outcome was the risk of development of IBD of those exposed to OCP versus non-exposure. Secondary outcomes were development of Crohn's disease (CD) versus ulcerative colitis (UC), and whether age of first use of OCP use may be associated with risk of IBD. Results Three hundred and forty-eight female IBD cases (41% CD, median age: 43 years) and 590 female age-matched controls were recruited. No significant association was found between OCP use and the risk of IBD (odds ratio [OR], 1.65; 95% confidence interval, 0.77-3.13; P=0.22), CD (OR, 1.55) or UC (OR, 1.01). The lack of association persisted when results were adjusted for age and smoking. IBD cases commenced OCP use at a younger age than controls (18 years vs. 20 years, P=0.049). Conclusions In this large cohort of subjects from the Asia-Pacific region, we found a modest but not significantly increased risk of developing IBD amongst OCP users.
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Affiliation(s)
- Santosh Sanagapalli
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Concord NSW, Australia
| | - Yanna Ko
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Concord NSW, Australia
| | - Viraj Kariyawasam
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Concord NSW, Australia
| | - Siew C Ng
- Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Hong Kong, China
| | - Whitney Tang
- Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Hong Kong, China
| | | | - Minhu Chen
- The First Affiliated Hospital of Sun Yat Sen University, Guangzhou, China
| | - Kaichun Wu
- Xijing Hospital, Fourth Military Medical University, Xian, China
| | | | - Ka Kei Ng
- Hospital Conde S Januario, Macau, China
| | - David Ong
- National University Hospital of Singapore, Singapore
| | - Qin Ouyang
- West China Hospital, Sichuan University, Chengdu, China
| | - Ida Hilmi
- University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | | | | | - Saranya Gopikrishna
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Concord NSW, Australia
| | - Rupert W Leong
- Gastroenterology and Liver Services, Concord Repatriation General Hospital, Concord NSW, Australia
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Marques M, Gambaro K, du Tertre MC, Witcher M, Samson B, Lesperance B, Ko Y, Dalfen R, St-Hilaire E, Sideris L, Couture F, Tejpar S, Burkes R, Harb M, Alcindor T, Camlioglu E, Gologan A, Pelsser V, McNamara S, Kavan P, Kleinman C, Batist G. Characterizations of DNA copy number variations and spatio-temporal intra tumor heterogeneity in liver metastasis from colorectal cancer patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.005] [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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Siaw MYL, Malone DC, Ko Y, Lee JYC. Cost-effectiveness of multidisciplinary collaborative care versus usual care in the management of high-risk patients with diabetes in Singapore: Short-term results from a randomized controlled trial. J Clin Pharm Ther 2018; 43:775-783. [DOI: 10.1111/jcpt.12700] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 03/28/2018] [Indexed: 01/21/2023]
Affiliation(s)
- M. Y. L. Siaw
- Department of Pharmacy; Faculty of Science; National University of Singapore; Singapore Singapore
| | - D. C. Malone
- College of Pharmacy; University of Arizona; Tucson AZ USA
| | - Y. Ko
- Department of Pharmacy; College of Pharmacy; Taipei Medical University; Taipei Taiwan
- Research Center of Pharmacoeconomics; College of Pharmacy; Taipei Medical University; Taipei Taiwan
| | - J. Y.-C. Lee
- Department of Pharmacy; Faculty of Science; National University of Singapore; Singapore Singapore
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Bui Q, Braun O, Brambatti M, Ko Y, Hernandez H, Wettersten N, Tran H, Pretorius V, Adler E. SIPAT May Predict Clinical Outcomes in Patients With Left Ventricular Assist Device (LVAD). J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Xu L, Lochhead P, Ko Y, Claggett B, Leong RW, Ananthakrishnan AN. Systematic review with meta-analysis: breastfeeding and the risk of Crohn's disease and ulcerative colitis. Aliment Pharmacol Ther 2017; 46:780-789. [PMID: 28892171 PMCID: PMC5688338 DOI: 10.1111/apt.14291] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 07/24/2017] [Accepted: 08/16/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Breastfeeding is a modifiable factor that may influence development of inflammatory bowel diseases. However, literature on this has been inconsistent and not accounted for heterogeneity in populations and exposure. AIM To conduct a meta-analysis to examine the association between breastfeeding in infancy and risk of Crohn's disease (CD) and ulcerative colitis (UC). METHODS A systematic search of Medline/PubMed and Embase was performed for full text, English-language literature through November 2016. Studies were included if they described breastfeeding in infancy in patients with CD or UC, and healthy controls. Data were pooled using a random effects model for analysis. RESULTS A total of 35 studies were included in the final analysis, comprising 7536 individuals with CD, 7353 with UC and 330 222 controls. Ever being breastfed was associated with a lower risk of CD (OR 0.71, 95% CI 0.59-0.85) and UC (OR 0.78, 95% CI 0.67-0.91). While this inverse association was observed in all ethnicity groups, the magnitude of protection was significantly greater among Asians (OR 0.31, 95% CI 0.20-0.48) compared to Caucasians (OR 0.78, 95% CI 0.66-0.93; P = .0001) in CD. Breastfeeding duration showed a dose-dependent association, with strongest decrease in risk when breastfed for at least 12 months for CD (OR 0.20, 95% CI 0.08-0.50) and UC (OR 0.21, 95% CI 0.10-0.43) as compared to 3 or 6 months. CONCLUSION Breastfeeding in infancy protects against the development of CD and ulcerative colitis.
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Affiliation(s)
- Luyi Xu
- Division of Gastroenterology, Massachusetts General Hospital, Boston, United States,Harvard Medical School, Boston, United States
| | - Paul Lochhead
- Division of Gastroenterology, Massachusetts General Hospital, Boston, United States
| | - Yanna Ko
- Concord Hospital, Gastroenterology and Liver Services, Sydney, Australia
| | - Brian Claggett
- Harvard Medical School, Boston, United States,Cardiac Imaging Core Laboratory and Clinical Trials Endpoints Center, Brigham and Women’s Hospital, Boston, United States
| | - Rupert W Leong
- Concord Hospital, Gastroenterology and Liver Services, Sydney, Australia
| | - Ashwin N Ananthakrishnan
- Division of Gastroenterology, Massachusetts General Hospital, Boston, United States,Harvard Medical School, Boston, United States
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Park B, Ko Y, Cheon D, Oh S, Ko J, Ro Y, Kim J. 172 Skin type analysis based on the new questionnaire in Korean women. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.482] [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: 10/18/2022]
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Sandesara P, Samman Tahhan A, Ko Y, Hayek S, Khambhati J, Lee S, Alkhoder A, Aida H, Sperling L, Quyyumi A. P1555Using a decision tree analysis to risk stratify patients with coronary artery disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Siaw MYL, Ko Y, Malone DC, Tsou KYK, Lew YJ, Foo D, Tan E, Chan SC, Chia A, Sinaram SS, Goh KC, Lee JYC. Impact of pharmacist-involved collaborative care on the clinical, humanistic and cost outcomes of high-risk patients with type 2 diabetes (IMPACT): a randomized controlled trial. J Clin Pharm Ther 2017; 42:475-482. [PMID: 28449205 DOI: 10.1111/jcpt.12536] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [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: 01/24/2017] [Accepted: 03/29/2017] [Indexed: 12/14/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE With the increasing prevalence of diabetes, the physician-centred model is challenged to deliver holistic care in Asia. Diabetes may be managed effectively within a multidisciplinary collaborative care model; however, evidence on its effectiveness in Asian patients is lacking. Therefore, the primary objective was to evaluate the clinical outcomes of multidisciplinary collaborative care vs physician-centred care in diabetes. The secondary objectives were to evaluate humanistic and economic outcomes among the two types of care. METHODS This 6-month prospective, open-label, parallel-arm, randomized, controlled study was conducted at four outpatient healthcare institutions. High-risk patients aged ≥21 years with uncontrolled type 2 diabetes, polypharmacy and comorbidities were included. Patients with type 1 diabetes or those who were unable to communicate independently were excluded. The control arm received usual care with referrals to nurses and dietitians as needed. The intervention arm (multidisciplinary collaborative care) was followed up with pharmacists regularly, in addition to receiving the usual care. The primary outcomes included HbA1c, systolic blood pressure, low-density lipoprotein and triglycerides. The secondary outcomes included scores from the Problem Areas in Diabetes (PAID) and the Diabetes Treatment Satisfaction Questionnaires (DTSQ), and diabetes-related health service utilization rates and costs. RESULTS AND DISCUSSION Of 411 eligible patients, 214 and 197 patients were randomized into the intervention and control arms, respectively. At 6 months, 141 patients in the intervention arm (65.9%) and 189 patients in the control arm (95.9%) completed the study. Mean HbA1c reduced from 8.6%±1.5% at baseline to 8.1%±1.3% at 6 months in the intervention arm (P=.04), with up to mean HbA1c improvement of 0.8% in patients with greater levels of uncontrolled glycemia. Whereas the mean HbA1c in the control arm remained unchanged (8.5%±1.4%) throughout the 6-month period. Improvements in PAID and DTSQ scores, reduction in physician workload and an average cost savings of US$91.01 per patient were observed in the intervention arm over 6 months. WHAT IS NEW AND CONCLUSIONS The positive clinical, humanistic and economic outcomes highlighted the value of multidisciplinary collaborative care for Asian diabetic patients, thereby supporting the effectiveness of this approach in managing chronic diseases.
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Affiliation(s)
- M Y L Siaw
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Y Ko
- Department of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Research Center for Pharmacoeconomics, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - D C Malone
- College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - K Y K Tsou
- National Healthcare Group, Singapore, Singapore
| | - Y-J Lew
- National Healthcare Group, Singapore, Singapore
| | - D Foo
- Tan Tock Seng Hospital, Singapore, Singapore
| | - E Tan
- National Healthcare Group, Singapore, Singapore
| | - S C Chan
- National Healthcare Group Pharmacy, Singapore, Singapore
| | - A Chia
- Tan Tock Seng Hospital, Singapore, Singapore
| | - S S Sinaram
- Agency of Integrated Care, Singapore, Singapore
| | - K C Goh
- National Healthcare Group, Singapore, Singapore
| | - J Y-C Lee
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
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Philipone E, Yoon A, Wang S, Shen J, Santella R, Ko Y, Rockafellow A, Shammay N. MICRO RNAS AS PREDICTIVE MARKERS OF ORAL LEUKOPLAKIA THAT PROGRESS TO CANCER. Oral Surg Oral Med Oral Pathol Oral Radiol 2016. [DOI: 10.1016/j.oooo.2016.06.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lee J, Chan Jeon W, Seo H, Ko Y, Kwak J, Park E. 285 New Chest Compression Method in Infant Resuscitations. Ann Emerg Med 2016. [DOI: 10.1016/j.annemergmed.2016.08.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ko Y, Lee HK, Lee YS, Kim MY, Shin JH, Shim EJ, Park SY, Mo EK, Park YB. Accuracy of Xpert(®) MTB/RIF assay compared with AdvanSure™ TB/NTM real-time PCR using bronchoscopy specimens. Int J Tuberc Lung Dis 2016; 20:115-20. [PMID: 26688537 DOI: 10.5588/ijtld.15.0227] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The performance of Xpert(®) MTB/RIF assay, an automated nucleic acid amplification test (NAAT) that was developed for the detection of tuberculosis (TB), has been evaluated in various clinical settings. However, few studies have compared Xpert with other NAATs, especially its performance using lower respiratory tract specimens (LRTS). OBJECTIVE To compare the practical diagnostic performance of the Xpert assay with that of the AdvanSure™ TB/NTM RT-PCR kit in the detection of pulmonary TB (PTB), using LRTS obtained through bronchoscopy. RESULTS Of 249 patients included, 105 had culture-confirmed PTB. Using culture as reference, the overall sensitivity of Xpert and AdvanSure was respectively 92.4% and 83.8%. When acid-fast bacilli smear results were taken into consideration, the sensitivity of Xpert for smear-positive and smear-negative LRTS was respectively 100% and 88.9%, while that of the AdvanSure was 100% and 76.4%. Xpert showed better results than AdvanSure in terms of sensitivity in smear-negative LRTS (P = 0.012), but no difference in smear-positive LRTS. CONCLUSIONS Xpert may be advantageous in the detection of PTB using LRTS, particularly in low microbiological burden settings.
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Affiliation(s)
- Y Ko
- Department of Pulmonary and Critical Care Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - H-K Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Y S Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea; Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - M-Y Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - J H Shin
- Department of Laboratory Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - E-J Shim
- Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Inje, Republic of Korea
| | - S Y Park
- Department of Pulmonary and Critical Care Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - E K Mo
- Department of Pulmonary and Critical Care Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Y B Park
- Department of Pulmonary and Critical Care Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
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Ko Y, Seo J, Lee M, Lee J. Humanizing the NOD/SCID/IL-2Rɤnull (NSG) mice using busulfan and retro-orbital injection of umbilical cord blood-derived CD34+ cells. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61646-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Choi JH, Choi WQ, Choi Y, Jang HI, Jang JS, Jeon EJ, Joo KK, Kim BR, Kim HS, Kim JY, Kim SB, Kim SY, Kim W, Kim YD, Ko Y, Lee DH, Lim IT, Pac MY, Park IG, Park JS, Park RG, Seo H, Seo SH, Seon YG, Shin CD, Siyeon K, Yang JH, Yeo IS, Yu I. Observation of Energy and Baseline Dependent Reactor Antineutrino Disappearance in the RENO Experiment. Phys Rev Lett 2016; 116:211801. [PMID: 27284648 DOI: 10.1103/physrevlett.116.211801] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Indexed: 06/06/2023]
Abstract
The RENO experiment has analyzed about 500 live days of data to observe an energy dependent disappearance of reactor ν[over ¯]_{e} by comparing their prompt signal spectra measured in two identical near and far detectors. In the period between August of 2011 and January of 2013, the far (near) detector observed 31 541 (290 775) electron antineutrino candidate events with a background fraction of 4.9% (2.8%). The measured prompt spectra show an excess of reactor ν[over ¯]_{e} around 5 MeV relative to the prediction from a most commonly used model. A clear energy and baseline dependent disappearance of reactor ν[over ¯]_{e} is observed in the deficit of the observed number of ν[over ¯]_{e}. Based on the measured far-to-near ratio of prompt spectra, we obtain sin^{2}2θ_{13}=0.082±0.009(stat)±0.006(syst) and |Δm_{ee}^{2}|=[2.62_{-0.23}^{+0.21}(stat)_{-0.13}^{+0.12}(syst)]×10^{-3} eV^{2}.
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Affiliation(s)
- J H Choi
- Department of Radiology, Dongshin University, Naju 58245, Korea
| | - W Q Choi
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - Y Choi
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - H I Jang
- Department of Fire Safety, Seoyeong University, Gwangju 61268, Korea
| | - J S Jang
- GIST College, Gwangju Institute of Science and Technology, Gwangju 61005, Korea
| | - E J Jeon
- Institute for Basic Science, Daejeon 34047, Korea
- Department of Physics and Astronomy, Sejong University, Seoul 05006, Korea
| | - K K Joo
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - B R Kim
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - H S Kim
- Department of Physics and Astronomy, Sejong University, Seoul 05006, Korea
| | - J Y Kim
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - S B Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - S Y Kim
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - W Kim
- Department of Physics, Kyungpook National University, Daegu 41566, Korea
| | - Y D Kim
- Institute for Basic Science, Daejeon 34047, Korea
- Department of Physics and Astronomy, Sejong University, Seoul 05006, Korea
| | - Y Ko
- Department of Physics, Chung Ang University, Seoul 06974, Korea
| | - D H Lee
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - I T Lim
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - M Y Pac
- Department of Radiology, Dongshin University, Naju 58245, Korea
| | - I G Park
- Department of Physics, Gyeongsang National University, Jinju 52828, Korea
| | - J S Park
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - R G Park
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - H Seo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - S H Seo
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - Y G Seon
- Department of Physics, Kyungpook National University, Daegu 41566, Korea
| | - C D Shin
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - K Siyeon
- Department of Physics, Chung Ang University, Seoul 06974, Korea
| | - J H Yang
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
| | - I S Yeo
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - I Yu
- Department of Physics, Sungkyunkwan University, Suwon 16419, Korea
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Abstract
AIM To review and evaluate the most recent literature on the economic outcomes of pharmacist-managed services in people with diabetes. BACKGROUND The global prevalence of diabetes is increasing. Although pharmacist-managed services have been shown to improve people's health outcomes, the economic impact of these programmes remains unclear. METHODS A systematic review was conducted of six databases. Study inclusion criteria were: (1) original research; (2) evaluation of pharmacist-managed services in people with diabetes; (3) an economic evaluation; (4) English-language publication; and (5) full-text, published between January 2006 and December 2014. The quality of the full economic evaluations reviewed was evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. RESULTS A total of 2204 articles were screened and 25 studies were selected. These studies were conducted in a community pharmacy (n = 10), a clinic- /hospital-based outpatient facility (n = 8), or others. Pharmacist-managed services included targeted education (n = 24), general pharmacotherapeutic monitoring (n = 21), health screening or laboratory testing services (n = 9), immunization services (n = 2) and pharmacokinetic monitoring (n = 1). Compared with usual care, pharmacist-managed services resulted in cost savings that varied from $7 to $65,000 ($8 to $85,000 in 2014 US dollars) per person per year, and generated higher quality-adjusted life years with lower costs. Benefit-to-cost ratios ranged from 1:1 to 8.5:1. Among the 25 studies reviewed, 11 were full economic evaluations of moderate quality. CONCLUSIONS Pharmacist-managed services had a positive return in terms of economic viability. With the expanding role of pharmacists in the healthcare sector, alongside increasing health expenditure, future economic studies of high quality are needed to investigate the cost-effectiveness of these services.
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Affiliation(s)
- Y Wang
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Q Q Yeo
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | - Y Ko
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taiwan
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Yin M, Schultz W, Ko Y, Cole R, Gupta D, Laskar S, Smith A, Vega D, Nguyen D, Pekarek A, Wittersheim K, Morris A. Predictors of Out-of-Therapeutic-Range INR during Support with Continuous-Flow Left Ventricular Assist Device. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Abstract
BACKGROUND The hygiene hypothesis refers to where modern living conditions are responsible for the increasing incidences of immune-related diseases including the development of inflammatory bowel diseases (IBD). Improved hygiene may result in decreased enteric microbiota diversity and dysbiosis, which may be responsible for the development of IBD. KEY MESSAGES The rising incidence of IBD is well documented in developing regions of the world, in accordance with the hygiene hypothesis. What is unknown, however, is whether the hygiene hypothesis is applicable all over the world. Hygiene cannot be easily measured and proxy markers need to be used. These include regional data such as a country's gross domestic product or an individual's affluence or exposure to infection risk factors. A comparative case-control study of Caucasian Australian IBD subjects versus migrants from the Middle East to Australia identified that environmental risk factors are different in the 2 populations. Among Australian Caucasians, hygiene-related environmental risk factors are no longer relevant in the development of IBD. Given the country's high affluence, there has been high hygienic standard for several generations. However, migrants from less affluent countries exposed to hygiene-related environmental factors are at increased risks of developing IBD, especially in the second generation migrants born in the affluent country. Divergent risk factors include the use of antibiotics in childhood increasing the risk of IBD in developed societies but being a risk factor for developing IBD in migrants. In India, risk factors associated with infections were found to be positively associated with the development of ulcerative colitis, rather than protective. CONCLUSIONS The hygiene hypothesis is not applicable to all populations worldwide, being most relevant in societies undergoing increasing affluence or following migration from less to more affluent countries. This review examines data from around the world that link the hygiene hypothesis with the development of IBD and in particular the divergent results arising from data from affluent countries versus less-affluent countries.
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Affiliation(s)
- Rupert W Leong
- Gastroenterology and Liver Services, Concord Hospital, Sydney, N.S.W., Australia
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Ko Y, Lee YM, Lee HY, Lee YS, Song JW, Hong GY, Kim MY, Lee HK, Choi SJ, Shim EJ. Changes in lung function according to disease extent before and after pulmonary tuberculosis. Int J Tuberc Lung Dis 2016; 19:589-95. [PMID: 25868029 DOI: 10.5588/ijtld.14.0454] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To evaluate changes in lung function in individuals before and after treatment for pulmonary tuberculosis (PTB) in relation to extent of disease. DESIGN Using a retrospective cohort design, changes in and predictors of lung function were evaluated. RESULTS A total of 41 patients were included in the final analysis. The median decline in annualised forced expiratory volume in 1 sec (FEV1) was 180.0 ml/year (95%CI 118.9-356.1) in advanced PTB and 94.7 ml/year (95%CI 33.4-147.3) in localised PTB (ΔFEV1% predicted/year 9.4%, 95%CI 4.4-14.0 vs. 3.8%, 95%CI 1.8-6.2). The median decline in annualised forced vital capacity (FVC) was 309.6 ml/year (95%CI 137.0-359.0) in advanced PTB and 101.1 ml/year (95%CI 30.3-219.6) in localised PTB (ΔFVC % predicted/year 7.3%, 95%CI 5.3-12.3 vs. 2.9%, 95%CI 0.9-6.5). CONCLUSIONS As the sample size of our study was small, the conclusions could be biased. Nevertheless, our findings show that PTB causes a significant decline in lung function even in localised PTB, whereas advanced PTB was associated with excessive or even higher decline. This study suggests that early diagnosis and treatment of PTB is needed to preserve lung function.
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Affiliation(s)
- Y Ko
- Department of Pulmonary and Critical Care Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Y-M Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - H-Y Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Y S Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - J-W Song
- Division of Pulmonary Medicine, CHA University School of Medicine, Gumi CHA Hospital, Gumi, Republic of Korea
| | - G-Y Hong
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Dankook University Hospital, Cheonan, Republic of Korea
| | - M-Y Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - H-K Lee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - S J Choi
- Department of Radiology, Inje University College of Medicine, Busan, Republic of Korea
| | - E-J Shim
- Department of Pharmacology and Pharmaco Genomics Research Center, Inje University College of Medicine, Busan, Republic of Korea
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Ko Y, Tang J, Sanagapalli S, Kim BSM, Leong RW. Safety of proton pump inhibitors and risk of gastric cancers: review of literature and pathophysiological mechanisms. Expert Opin Drug Saf 2015; 15:53-63. [PMID: 26560097 DOI: 10.1517/14740338.2016.1118050] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Despite being an overall safe drug, several long-term adverse effects are associated with proton pump inhibitors (PPIs). The link between PPI use and gastric neuroendocrine tumors (NETs), gastric adenocarcinomas and Barrett's esophagus progression gastric cancers has been investigated due to PPI-induced hypergastrinemia. AREAS COVERED The pathophysiological mechanisms underlying PPI exposure and gastric NETs, gastric adenocarcinomas and Barrett's esophagus progression are discussed. The quality of randomized control studies, cohort studies and case reports investigating the link between gastric cancers and PPIs are examined. Recommendations for clinicians are provided. EXPERT OPINION PPIs cause a hypergastrinemic state, increasing enterochromaffin-like cell dysplasia and risk of gastric NET development, increasing gastritis severity in the context of Helicobacter pylori infection, and progression of carcinogenesis in a certain predisposed subset of Barrett's esophagus patients. There are case reports of PPI-induced gastric NETs and adenocarcinomas as consequences of these effects. In pernicious anemia and chronic gastritis, clinicians should be aware of potential increased risk of gastric NET development with chronic PPI use in these patients. Eradication status of H. pylori prior to commencing long-term PPI therapy should be established to reduce the risk of severe atrophic gastritis and development of gastric dysplasia.
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Affiliation(s)
- Yanna Ko
- a Gastroenterology and Liver Service , Concord Hospital , Sydney , Australia
| | | | - Santosh Sanagapalli
- a Gastroenterology and Liver Service , Concord Hospital , Sydney , Australia
| | | | - Rupert W Leong
- a Gastroenterology and Liver Service , Concord Hospital , Sydney , Australia
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Ko Y, Kariyawasam V, Karnib M, Butcher R, Samuel D, Alrubaie A, Rahme N, McDonald C, Cowlishaw J, Katelaris P, Barr G, Jones B, Connor S, Paven G, Chapman G, Park G, Gearry R, Leong RW. Inflammatory Bowel Disease Environmental Risk Factors: A Population-Based Case-Control Study of Middle Eastern Migration to Australia. Clin Gastroenterol Hepatol 2015; 13:1453-63.e1. [PMID: 25771246 DOI: 10.1016/j.cgh.2015.02.045] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [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: 01/05/2015] [Revised: 02/13/2015] [Accepted: 02/20/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The incidences of the inflammatory bowel diseases (IBDs) Crohn's disease (CD) and ulcerative colitis (UC) are increasing, indicating gene-environment interactions. Migrants from low-IBD-prevalence countries to a high-prevalence country may help identify the relative contribution of environmental risk factors compared with native Caucasians. METHODS This prospective case-control study evaluated IBD environmental risk factors of Middle Eastern migrants (MEM) in Australia compared with matched Caucasian IBD subjects, MEM controls, Caucasian controls, and controls in the Middle East using adjusted odds ratios (aOR). RESULTS A total of 795 subjects were recruited: 154 MEM cases (75 CD; 79 UC), 153 MEM controls, 162 Caucasian cases (85 CD; 77 UC), 173 Caucasian controls, and 153 controls in Lebanon. Smoking increased CD risk in MEM and Caucasians and reduced UC risk in Caucasians (aOR, 0.77; 95% CI, 0.41-0.98) but not MEM (aOR, 1.45; 95% CI, 0.80-2.62). Antibiotic use reduced the risk of MEM CD (aOR, 0.27; 95% CI, 0.11-0.67) and UC (aOR, 0.38; 95% CI, 0.18-0.80), but increased the risk in Caucasians (CD: aOR, 5.24; 95% CI, 2.13-12.90; and UC: aOR, 6.82; 95% CI, 2.67-17.38). Most hygiene markers (rural dwelling, pet ownership, pet feeding, and farm animal contact) reduced CD and UC risk in MEM (P < .05). In contrast, in Caucasians these hygiene markers lacked significance. Other significant risk factors include IBD family history, appendectomy, tonsillectomy, and breastfeeding. CONCLUSIONS Differential IBD environmental risk factors exist between migrants and native Caucasians, indicating a dynamic interplay between environmental factors and IBD risk for immigrants that is distinct to those factors most relevant in native Caucasians.
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Affiliation(s)
- Yanna Ko
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia; Gastroenterology and Liver Services, Bankstown Hospital, Sydney, Australia; Faculty of Medicine, UNSW Australia
| | - Viraj Kariyawasam
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia; Gastroenterology and Liver Services, Bankstown Hospital, Sydney, Australia
| | - Mohamad Karnib
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Rhys Butcher
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia; Gastroenterology and Liver Services, Bankstown Hospital, Sydney, Australia
| | - Douglas Samuel
- Gastroenterology and Liver Services, Bankstown Hospital, Sydney, Australia; IBD Sydney Organisation, Sydney, Australia
| | - Ahmad Alrubaie
- Gastroenterology and Liver Services, Bankstown Hospital, Sydney, Australia; IBD Sydney Organisation, Sydney, Australia
| | - Nabil Rahme
- Gastroenterology and Liver Services, Bankstown Hospital, Sydney, Australia; IBD Sydney Organisation, Sydney, Australia
| | - Charles McDonald
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia; IBD Sydney Organisation, Sydney, Australia
| | - James Cowlishaw
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia; IBD Sydney Organisation, Sydney, Australia
| | - Peter Katelaris
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia; IBD Sydney Organisation, Sydney, Australia
| | - Gavin Barr
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia; IBD Sydney Organisation, Sydney, Australia
| | - Brian Jones
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia; IBD Sydney Organisation, Sydney, Australia
| | - Susan Connor
- Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney, New South Wales, Australia; IBD Sydney Organisation, Sydney, Australia
| | - Gokulan Paven
- Department of Gastroenterology and Hepatology, St George Hospital, Kogarah, New South Wales, Australia
| | - Grace Chapman
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia; Faculty of Medicine, UNSW Australia; IBD Sydney Organisation, Sydney, Australia
| | - Gordon Park
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia; Faculty of Medicine, UNSW Australia; IBD Sydney Organisation, Sydney, Australia
| | - Richard Gearry
- Faculty of Medicine, University of Otago, Christchurch, New Zealand
| | - Rupert W Leong
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia; Gastroenterology and Liver Services, Bankstown Hospital, Sydney, Australia; Faculty of Medicine, UNSW Australia; IBD Sydney Organisation, Sydney, Australia.
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Ng SC, Tang W, Leong RW, Chen M, Ko Y, Studd C, Niewiadomski O, Bell S, Kamm MA, de Silva HJ, Kasturiratne A, Senanayake YU, Ooi CJ, Ling KL, Ong D, Goh KL, Hilmi I, Ouyang Q, Wang YF, Hu P, Zhu Z, Zeng Z, Wu K, Wang X, Xia B, Li J, Pisespongsa P, Manatsathit S, Aniwan S, Simadibrata M, Abdullah M, Tsang SWC, Wong TC, Hui AJ, Chow CM, Yu HH, Li MF, Ng KK, Ching J, Wu JCY, Chan FKL, Sung JJY. Environmental risk factors in inflammatory bowel disease: a population-based case-control study in Asia-Pacific. Gut 2015; 64:1063-71. [PMID: 25217388 DOI: 10.1136/gutjnl-2014-307410] [Citation(s) in RCA: 243] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 08/25/2014] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The rising incidence of inflammatory bowel disease in Asia supports the importance of environmental risk factors in disease aetiology. This prospective population-based case-control study in Asia-Pacific examined risk factors prior to patients developing IBD. DESIGN 442 incident cases (186 Crohn's disease (CD); 256 UC; 374 Asians) diagnosed between 2011 and 2013 from eight countries in Asia and Australia and 940 controls (frequency-matched by sex, age and geographical location; 789 Asians) completed an environmental factor questionnaire at diagnosis. Unconditional logistic regression models were used to estimate adjusted ORs (aOR) and 95% CIs. RESULTS In multivariate model, being breast fed >12 months (aOR 0.10; 95% CI 0.04 to 0.30), antibiotic use (aOR 0.19; 0.07 to 0.52), having dogs (aOR 0.54; 0.35 to 0.83), daily tea consumption (aOR 0.62; 0.43 to 0.91) and daily physical activity (aOR 0.58; 0.35 to 0.96) decreased the odds for CD in Asians. In UC, being breast fed >12 months (aOR 0.16; 0.08 to 0.31), antibiotic use (aOR 0.48; 0.27 to 0.87), daily tea (aOR 0.63; 0.46 to 0.86) or coffee consumption (aOR 0.51; 0.36 to 0.72), presence of hot water tap (aOR 0.65; 0.46 to 0.91) and flush toilet in childhood (aOR 0.71; 0.51 to 0.98) were protective for UC development whereas ex-smoking (aOR 2.02; 1.22 to 3.35) increased the risk of UC. CONCLUSIONS This first population-based study of IBD risk factors in Asia-Pacific supports the importance of childhood immunological, hygiene and dietary factors in the development of IBD, suggesting that markers of altered intestinal microbiota may modulate risk of IBD later in life.
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Affiliation(s)
- Siew C Ng
- Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Hong Kong, China
| | - Whitney Tang
- Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Hong Kong, China
| | - Rupert W Leong
- Bankstown and Concord Hospitals, Sydney, New South Wales, Australia
| | - Minhu Chen
- The First Affiliated Hospital of San Yat Sen University, Guangzhou, China
| | - Yanna Ko
- Bankstown and Concord Hospitals, Sydney, New South Wales, Australia
| | - Corrie Studd
- St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Ola Niewiadomski
- St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Sally Bell
- St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Michael A Kamm
- St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia Imperial College London, London, UK
| | - H J de Silva
- Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | | | | | | | | | - David Ong
- National University Hospital of Singapore, Singapore, Singapore
| | - Khean Lee Goh
- University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Ida Hilmi
- University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Qin Ouyang
- West China Hospital, Sichuan University, Chengdu, China
| | - Yu-Fang Wang
- West China Hospital, Sichuan University, Chengdu, China
| | - PinJin Hu
- The First Affiliated Hospital of San Yat Sen University, Guangzhou, China
| | - Zhenhua Zhu
- The First Affiliated Hospital of San Yat Sen University, Guangzhou, China
| | - Zhirong Zeng
- The First Affiliated Hospital of San Yat Sen University, Guangzhou, China
| | - Kaichun Wu
- Xijing Hospital, Fourth Military Medical University, Xian, China
| | - Xin Wang
- Xijing Hospital, Fourth Military Medical University, Xian, China
| | - Bing Xia
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jin Li
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | | | | | | | | | | | | | | | - Aric J Hui
- Alice Ho Miu Ling Nethersole Hospital, Hong Kong, Hong Kong
| | - Chung Mo Chow
- Department of Pediatrics, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | | | | | - Ka Kei Ng
- Hospital Conde S Januario, Macau, China
| | - Jessica Ching
- Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Hong Kong, China
| | - Justin C Y Wu
- Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Hong Kong, China
| | - Francis K L Chan
- Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Hong Kong, China
| | - Joseph J Y Sung
- Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Li Ka Shing Institute of Health Science, Hong Kong, China
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Lee K, Kim M, Ha H, Ko Y, Lee H, Jeong J, Lee W. A comparison of lateral abdominal muscles thickness during bridging exercises with stable versus unstable support in healthy individuals. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1668] [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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Leong RWL, Huang T, Ko Y, Jeon A, Chang J, Kohler F, Kariyawasam V. Prospective validation study of the International Classification of Functioning, Disability and Health score in Crohn's disease and ulcerative colitis. J Crohns Colitis 2014; 8:1237-45. [PMID: 24662396 DOI: 10.1016/j.crohns.2014.02.028] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 02/23/2014] [Accepted: 02/25/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Inflammatory bowel diseases (IBD) may result in disability. We aim to validate a novel scoring system for the IBD disability index (IBD-DI), and identify predictors of disability and its correlation with work absenteeism. METHODS This prospective IBD ambulatory clinic cohort study measured IBD-DI, Crohn's Disease Activity Index (CDAI) for Crohn's disease (CD) or partial Mayo score (pMayo) for ulcerative colitis (UC), IBDQ quality-of-life, and Work Productivity and Activity Impairment. Negative IBD-DI represented greater disability. Validation tests were performed and predictors and extent of work absenteeism were determined. RESULTS 166 consecutive subjects were recruited (75 CD, 41 UC, 50 controls). IBD-DI correlated with CDAI (r=-0.77, P<0.001), pMayo (r=-0.82, P<0.001) and IBDQ (r=0.86, P<0.001). IBD-DI differentiated CD, and UC from controls (medians -7, -4, +10; P<0.001) with a score of >3.5 identifying controls with 94% sensitivity and 83% specificity (area-under-curve 0.92). Stable patients had unchanged IBD-DI (P=ns) but not in those who relapsed (P<0.001). Intraclass correlation was 0.89 and Cronbach's alpha of internal consistency was 0.94. Diagnosis age, sex, phenotype, perianal disease, prior surgery, steroid-use and disease duration did not influence the IBD-DI but active use of biological agents significantly reduced disability (P=0.03). 21.6% of IBD patients had moderate-severe disability equating to missing >25% of work hours in the previous week. Multivariate analysis identified that only IBD-DI to be predictive of unemployment status (OR: 0.94; 95% CI: 0.89-0.99). CONCLUSIONS The IBD-DI is a valid tool measuring disability in both CD and UC and correlates with workforce participation. It is a potential useful tool in the assessment of participation restriction and activity limitation. TRIAL REGISTRATION ACTRN12613000903785.
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Affiliation(s)
- Rupert W L Leong
- Gastroenterology and Liver Services, Concord Hospital, Hospital Rd, Sydney, New South Wales 2139, Australia; Faculty of Medicine, The University of New South Wales, Sydney, Australia.
| | - Tony Huang
- Gastroenterology and Liver Services, Concord Hospital, Hospital Rd, Sydney, New South Wales 2139, Australia; Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Yanna Ko
- Gastroenterology and Liver Services, Concord Hospital, Hospital Rd, Sydney, New South Wales 2139, Australia; Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Ari Jeon
- Gastroenterology and Liver Services, Concord Hospital, Hospital Rd, Sydney, New South Wales 2139, Australia
| | - Jeff Chang
- Gastroenterology and Liver Services, Concord Hospital, Hospital Rd, Sydney, New South Wales 2139, Australia; Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Friedbert Kohler
- Department of Rehabilitation Medicine, Braeside Hospital, Sydney, Australia; Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Viraj Kariyawasam
- Gastroenterology and Liver Services, Concord Hospital, Hospital Rd, Sydney, New South Wales 2139, Australia
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Jin SH, Lee JE, Yun JH, Kim I, Ko Y, Park JB. Isolation and characterization of human mesenchymal stem cells from gingival connective tissue. J Periodontal Res 2014; 50:461-7. [DOI: 10.1111/jre.12228] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2014] [Indexed: 12/16/2022]
Affiliation(s)
- S. H. Jin
- Department of Periodontics; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - J. E. Lee
- Department of Periodontics; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - J-H. Yun
- Division of Periodontology; Department of Dentistry; School of Medicine; Inha University; Incheon Korea
| | - I. Kim
- Division of Oral and Maxillofacial Surgery; Department of Dentistry; Uijeongbu St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Uijeongbu Korea
| | - Y. Ko
- Department of Periodontics; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - J. B. Park
- Department of Periodontics; College of Medicine; The Catholic University of Korea; Seoul Korea
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Byun S, Kim S, Ko Y, Kwon S, Cheon J, Shin D, Kim C, Yang S, Cho S, Na I. Family Caregivers’ Awareness of Illness and Attitude Toward Disclosure During Chemotherapy for Advanced Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu350.14] [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: 11/14/2022] Open
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Maroun J, Ko Y, Ghafoor A, Kavan P, Cripps M, Jonker D, Goel R, Asmis T, Goodwin R, Tsvetkova E, Marginean H. Standard Clinical Practice of Folfirinox (Ffx) in Advanced/Metastatic Pancreatic Cancer (Pc) Patients: a Canadian Retrospective Registry. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.87] [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: 11/13/2022] Open
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Sonpavde G, Bellmunt J, Rosenberg J, Bajorin D, Regazzi A, Choueiri T, Qu A, Niegisch G, Albers P, Necchi A, Di Lorenzo G, Fougeray R, Dreicer R, Wong Y, Sridhar S, Ko Y, Milowsky M, Galsky M, Pond G. The Significance of Complete Response (Cr) in Patients Receiving Salvage Therapy for Advanced Urothelial Carcinoma (Uc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu337.58] [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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50
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Frank R, Scheffler M, Michels S, König K, Merkelbach-Bruse S, Serke M, Ko Y, Gerigk U, Geist T, Heukamp L, Büttner R, Wolf J. Occurrence and Characteristics of Keap1-Mutations in Patients with Non-Small Cell Lung Cancer (Nsclc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.93] [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: 11/14/2022] Open
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