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Baltzopoulos V. Inverse dynamics, joint reaction forces and loading in the musculoskeletal system: guidelines for correct mechanical terms and recommendations for accurate reporting of results. Sports Biomech 2024; 23:287-300. [PMID: 33433300 DOI: 10.1080/14763141.2020.1841826] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 04/16/2020] [Accepted: 10/21/2020] [Indexed: 10/22/2022]
Abstract
Inverse Dynamics is routinely used in biomechanics for the estimation of loading in the musculoskeletal system but there are problems with the terms and definitions and even official recommendations introduce artificial and incorrect mechanical constructs to justify arbitrary and inappropriate terms. These terminology problems lead to further confusion and misinterpretations rather than to standardisation of mechanically correct nomenclature and accurate interpretation of joint loading. The perspective in this paper exposes some of the flawed foundational premises of these constructs and makes recommendations for accurate reporting of inverse dynamics outcomes and musculoskeletal loading. The inverse dynamics approach is based on free body diagrams that include the actual forces as applied ('Actual Forces' approach) or the replacement of actual forces with an equivalent resultant force and moment ('Resultant Moments' approach). Irrespective of the approach used to model the muscle and other forces, the inverse dynamics outputs always include the joint reaction forces representing the interactions with adjacent segments. The different terms suggested to distinguish the calculated joint reaction forces from the two approaches such as 'net joint force', 'resultant force', 'intersegmental force' and 'bone-on-bone force' are inappropriate, misleading and confusing. It is recommended to refer to joint reaction forces as Total or Partial when using an Actual Forces or a Resultant Moments approach, respectively.
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Affiliation(s)
- Vasilios Baltzopoulos
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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2
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Silva MM, Canha M, Salazar D, Neves JS, Ferreira G, Carvalho D, Duarte H. Efficacy, Toxicity, and Prognostic Factors of Re-treatment With [177Lu]Lu-DOTA-TATE in Patients With Progressing Neuroendocrine Tumors: The Experience of a Single Center. Cureus 2023; 15:e47506. [PMID: 38021538 PMCID: PMC10663964 DOI: 10.7759/cureus.47506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
PURPOSE Peptide receptor radionuclide therapy (PRRT) is an effective and safe treatment of unresectable or metastatic, progressive neuroendocrine tumours (NETs). However, if progression occurs after the initial PRRT, treatment options remain limited. Our aim was to evaluate the efficacy and safety of a repeat 177Lutetium-[DOTA°,Tyr3]octreotate ([177Lu]Lu-DOTA-TATE) PRRT course in patients with progressive NET after the first [177Lu]Lu-DOTA-TATE PRRT (peptide receptor radionuclide therapy first treatment (PRRT1)). METHODS This is a nine-year retrospective observational study of 20 patients who were re-treated with PRRT (peptide receptor radionuclide therapy retreatment (PRRTR)) after PRRT1. RESULTS The median progression-free survival (PFS) following PRRT1 was 32 months (interquartile range (IQR): 16.5-44.5). After PRRT1, all 20 patients progressed. Of the 20 patients included, two were lost during follow-up. The median PFS after PRRTR was 17.5 months (IQR: 7-39). At the time of analysis, 15/18 patients progressed, and 3/18 had stable disease after PRRTR. Among those patients who progressed, the median time to progression was nine months (IQR: 0-17). The median overall survival from the time of the first cycle of PRRT1 was 66 months (IQR: 65-90). No significant renal or liver toxicity was reported, nor was there a drop in haemoglobin. The decrease in platelet count after PRRTR was statistically significant (p=0.03). Two cycles at PRRTR (vs. 1) were associated with a longer PFS (p=0.014) and the presence of metastases pre-PRRTR was associated with a shorter time to progression following PRRTR (p=0.04). Conclusion: Patients who progressed after PRRT1 can achieve good PFS and minor toxicity. Our study reinforces the efficacy and safety of PRRTR and provides an analysis of factors associated with better outcomes, which can aid clinicians in clinical decision-making.
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Affiliation(s)
- Maria Manuel Silva
- Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Marta Canha
- Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Daniela Salazar
- Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, PRT
| | - João Sergio Neves
- Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Gonçalo Ferreira
- Nuclear Medicine, Instituto Português de Oncologia Porto, Porto, PRT
| | - Davide Carvalho
- Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Hugo Duarte
- Nuclear Medicine, Instituto Português de Oncologia Porto, Porto, PRT
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Zhang V, Taparra K, Fisher G, Aparici C, Soltys SG. Definitive Treatment of Brain Metastases From a Neuroendocrine Tumor With Peptide Receptor Radionuclide Therapy With 177Lutetium DOTATATE: A Case Report. Cureus 2023; 15:e45327. [PMID: 37849592 PMCID: PMC10577096 DOI: 10.7759/cureus.45327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/19/2023] Open
Abstract
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are rare malignancies that arise from secretory endocrine cells of the gastroenteropancreatic system. Clinical outcomes have improved for patients with GEP-NETs due to the development and recent FDA approval of 177Lutetium DOTATATE. However, the response of brain metastases from GEP-NETs from 177Lutetium DOTATATE is unreported. We present the case of an 81-year-old man with low-grade small bowel GEP-NET with liver and brain metastases treated with a total of six cycles of 177Lutetium DOTATATE. With over three years of follow-up from his initial treatment, his brain metastases have had complete or partial responses, with no need for brain radiotherapy or radiosurgery.
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Affiliation(s)
- Vivian Zhang
- Department of Radiation Oncology, Stanford University, Stanford, USA
| | - Kekoa Taparra
- Department of Radiation Oncology, Stanford University, Stanford, USA
| | - George Fisher
- Department of Medicine and Medical Oncology, Stanford University, Stanford, USA
| | - Carina Aparici
- Department of Nuclear Medicine and Molecular Imaging, Stanford University, Stanford, USA
| | - Scott G Soltys
- Department of Radiation Oncology, Stanford University, Stanford, USA
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4
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Kosmala A, Serfling SE, Schlötelburg W, Lindner T, Michalski K, Schirbel A, Higuchi T, Hartrampf PE, Buck AK, Weich A, Werner RA. Impact of 68 Ga-FAPI-04 PET/CT on Staging and Therapeutic Management in Patients With Digestive System Tumors. Clin Nucl Med 2023; 48:35-42. [PMID: 36354691 PMCID: PMC9762711 DOI: 10.1097/rlu.0000000000004480] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/30/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE We aimed to determine the impact of fibroblast activation protein inhibitor (FAPI)-directed molecular imaging on staging and therapeutic management in patients affected with digestive system tumors when compared with guideline-compatible imaging (GCI). PATIENTS AND METHODS Thirty-two patients with tumors of the digestive system were included: colon adenocarcinoma, 2/32 (6.3%); hepatocellular carcinoma (HCC), 6/32 (18.8%); pancreatic duct adenocarcinoma (PDAC), 6/32 (18.8%), and gastroenteropancreatic neuroendocrine neoplasms, 18/32 (56.3%). All patients underwent GCI and 68 Ga-FAPI-04 PET/CT within median 4 days. Staging outcomes and subsequent treatment decisions were compared between GCI and 68 Ga-FAPI-04 PET/CT. RESULTS Compared with GCI, 68 Ga-FAPI-04 PET/CT led to staging changes in 15/32 patients (46.9%). Among those, downstaging was recorded in 3/15 cases (20.0%) and upstaging in the remaining 12/15 patients (HCC, 4/12 [33.3%]; PDAC, 4/12 [33.3%]; neuroendocrine neoplasms, 3/12 [25%]; colon adenocarcinoma, 1/12 [8.3%]). Therapeutic management was impacted in 8/32 patients (25.0%), including 4 instances of major and 4 instances of minor therapeutic changes. The highest proportion of treatment modifications was observed in patients diagnosed with PDAC and HCC in 6/8 (75%). CONCLUSIONS In patients affected with digestive system tumors, 68 Ga-FAPI-04 PET/CT resulted in staging changes in more than 46% and therapeutic modifications in 25% of the cases, in particular in patients with HCC and PDAC. In clinical routine, such findings may favor a more widespread adoption of FAP-directed imaging in those tumor types.
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Affiliation(s)
- Aleksander Kosmala
- From the Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Sebastian E. Serfling
- From the Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Wiebke Schlötelburg
- From the Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Thomas Lindner
- From the Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Kerstin Michalski
- From the Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Andreas Schirbel
- From the Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Takahiro Higuchi
- From the Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
- Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Philipp E. Hartrampf
- From the Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Andreas K. Buck
- From the Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Alexander Weich
- Department of Internal Medicine II, Gastroenterology
- Würzburg NET Zentrum, European Neuroendocrine Tumor Society–Center of Excellence, University Hospital Würzburg, Würzburg, Germany
| | - Rudolf A. Werner
- From the Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
- Würzburg NET Zentrum, European Neuroendocrine Tumor Society–Center of Excellence, University Hospital Würzburg, Würzburg, Germany
- Johns Hopkins School of Medicine, The Russell H. Morgan Department of Radiology and Radiological Sciences, Baltimore, MD
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Loosen SH, Kostev K, Eschrich J, Krieg S, Krieg A, Luedde T, Jann H, Roderburg C. Clinical characteristics of 662 patients with pancreatic neuroendocrine tumors receiving antitumoral therapy. Medicine (Baltimore) 2022; 101:e32044. [PMID: 36550801 PMCID: PMC9771158 DOI: 10.1097/md.0000000000032044] [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] [Indexed: 12/24/2022] Open
Abstract
Pancreatic neuroendocrine neoplasia constitute an important subentity of the gastroenteropancreatic neuroendocrine neoplasms accounting for up to 15% of all neuroendocrine neoplasm. Prognosis and oncological behavior of pancreatic neuroendocrine tumors (pNETs) is extremely heterogenous and dependent on the specific tumor stage and differentiation. However, systematic data on the specific epidemiology of pNET are scarce. We identified 662 patients with pNET within the Oncology Dynamics database (IQVIA). Patients were derived from 4 European countries (Germany, France, UK, Spain), 3 Asian countries (Japan, China, South Korea) and 2 South American countries (Mexico and Brazil) and with regard to major patient and tumor related characteristics including patients' age, sex, tumor stage, tumor grading, and differentiation. The mean age of the study cohort was 62 years (SD 12 years) with 53.9.1% of all patients being male. The majority of patients had an Eastern co-operative of Oncology Group 1 performance status (63.3%). The most common Union international contre le cancer tumor stage was stage IV (85%) with liver metastases (89.0%) representing the most common site of extra-pancreatic tumor manifestation. The majority of all patients displayed well or moderate tumor differentiation (9.6% of patients had a Ki-67 expression below 2%. 67.6% of pNET patients had a Ki-67 expression between 2 and 20% and 22.8% of patients showed an expression above 20%). At time point of diagnoses, 93.1% of patients were classified as inoperable. Of note, 93.9 % of patients received systemic anti-tumoral therapy in palliative intention, while treatment was administered in 1.4 % of cases in neoadjuvant and in 4.7% of cases in in an adjuvant setting. Biological therapy was applied to 39.4% of patients, followed by targeted therapies (31.4%) and chemotherapy. Pancreatic neuroendocrine neoplasia are diagnosed in advanced tumor stages, globally. Systemic treatment was the most commonly used treatment modality. Such data may help to better understand the specific epidemiology of pNET worldwide.
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Affiliation(s)
- Sven H. Loosen
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | | | - Johannes Eschrich
- Department of Hepatology and Gastroenterology, Charité University Medicine Berlin, Berlin, Germany
| | - Sarah Krieg
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Andreas Krieg
- Department of Surgery (A), University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Tom Luedde
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Henning Jann
- Department of Hepatology and Gastroenterology, Charité University Medicine Berlin, Berlin, Germany
| | - Christoph Roderburg
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- *Correspondence: Christoph Roderburg, Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, GermanySven H. Loosen, Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany (e-mail: ; )
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6
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Muacevic A, Adler JR. Unresectable Mesenteric Mass Causing Small Bowel Obstruction. Cureus 2022; 14:e29871. [PMID: 36348891 PMCID: PMC9629657 DOI: 10.7759/cureus.29871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2022] [Indexed: 01/24/2023] Open
Abstract
Small bowel obstruction (SBO) has a variety of etiologies, including but not limited to adhesions, malignancy, hernia, and inflammatory bowel diseases. Treatment for SBO may be nonoperative or operative, depending on the underlying condition and clinical symptoms. Clinical judgment and radiological findings cooperate in formulating an appropriate assessment and treatment plan. Mass effect due to malignancy is an indication for surgical intervention, as tumor resection is a mainstay of treatment. However, patient safety and chances of vascular compromise must be considered when determining if the tumor is resectable. Reported is a case of a 65-year-old female with severe abdominal pain, nausea, vomiting, and obstipation due to a malignant neuroendocrine tumor within the mesentery adjacent to the aortic bifurcation. Management included surgical intervention to alleviate bowel obstruction and biopsy of the tumor.
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Minakawa N, Kawada H, Kongere JO, Sonye GO, Lutiali PA, Awuor B, Isozumi R, Futami K. Effectiveness of screened ceilings over the current best practice in reducing malaria prevalence in western Kenya: a cluster randomised controlled trial. Parasitology 2022; 149:1-39. [PMID: 35437129 PMCID: PMC10090608 DOI: 10.1017/s0031182022000415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 03/13/2022] [Accepted: 03/17/2022] [Indexed: 11/06/2022]
Abstract
Increases in bed net coverage and antimalarial treatment have reduced the risk of malaria in sub-Saharan Africa. However, the pace of reduction has slowed, and new tools are needed to reverse this trend. We evaluated houses screened with insecticide-treated ceiling nets using a cluster randomized-controlled trial in western Kenya. The primary endpoints were Plasmodium falciparum PCR-positive prevalence (PCRPf PR) of children from 7 months to 10 years old and anopheline density. Ceiling nets and bed nets were provided to 1073 houses, and 1162 houses were provided with bed nets only. The treatment and control arms each had four clusters. We conducted three epidemiological and entomological post-intervention surveys over the course of a year and a half. Each epidemiological survey targeted 150 children per cluster, and entomological surveys targeted 25 houses. When the three surveys were combined, the median PCRPf PRs were 23% (IQR 8%) in the intervention arm and 42% (IQR 12%) in the control arm. The adjusted risk ratio (RR) was 0.53 [95% confidence interval (CI) 0.41–0.71; P = 0.029]. The median anopheline densities were 0.4 (IQR 0.4) and 2.0 (IQR 1.4), respectively. The adjusted RR was 0.41 (95% CI 0.29–0.90; P = 0.029). The present study indicates additional protection from insecticide-screened ceilings over the current best practice.
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Affiliation(s)
- Noboru Minakawa
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki 852-8523, Japan
| | - Hitoshi Kawada
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki 852-8523, Japan
| | - James O. Kongere
- Kenya Medical Research Institute, Nairobi, Kenya
- Center for Research in Tropical Medicine and Community Development (CRTMCD), Nairobi, Kenya
| | | | - Peter A. Lutiali
- Kenya Medical Research Institute, Nairobi, Kenya
- Center for Research in Tropical Medicine and Community Development (CRTMCD), Nairobi, Kenya
| | | | - Rie Isozumi
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki 852-8523, Japan
| | - Kyoko Futami
- Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki 852-8523, Japan
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Ohmiya N, Oka S, Nakayama Y, Iwama I, Nakamura M, Shimizu H, Sumioka A, Abe N, Kudo T, Osawa S, Honma H, Okuhira T, Mtsufuji S, Imaeda H, Ota K, Matsuoka R, Hotta N, Inoue M, Nakaji K, Takamaru H, Ozeki K, Kobayashi T, Hosoe N, Tajiri H, Tanaka S. Safety and efficacy of the endoscopic delivery of capsule endoscopes in adult and pediatric patients: Multicenter Japanese study (AdvanCE-J study). Dig Endosc 2022; 34:543-552. [PMID: 34379849 DOI: 10.1111/den.14104] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/10/2021] [Accepted: 08/10/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIM We retrospectively determined the safety and efficacy of the endoscopic delivery (ED) of capsule endoscopes. METHODS We enrolled 10,156 patients who underwent small bowel capsule endoscopy (SBCE), 3182 who underwent patency capsule (PC), and 1367 who underwent colon capsule endoscopy (CCE), at 11 gastroenterological and nine pediatric centers. RESULTS Small bowel capsule endoscopies, PCs, and CCEs were endoscopically delivered to 546 (5.4%), 214 (6.7%), and 14 (1.0%) patients, respectively. Only mild complications occurred for 21.6% (167/774), including uneventful mucosal damage, bleeding, and abdominal pain. Successful ED of SBCE to the duodenum or jejunum occurred in 91.8% and 90.7% of patients aged <16 years and ≥16 years, respectively (P = 0.6661), but the total enteroscopy rate was higher in the first group (91.7%) than in the second (76.2%, P < 0.0001), for whom impossible ingestion (87.3%) was significantly more common than prolonged lodging in the stomach (64.2%, P = 0.0010). Successful PC and CCE delivery to the duodenum occurred in 84.1% and 28.6%, thereafter the patency confirmation rate and total colonoscopy rate was 100% and 61.5%, respectively. The height, weight, and age cutoff points in predicting spontaneous ingestion were 132 cm, 24.8 kg, and 9 years 2 months, respectively, in patients aged <16 years. Patients aged ≥16 years could not swallow the SBCEs mainly due to dysphagia (75.0%); those who retained it in the esophagus due to cardiac disease (28.6%), etc. and in the stomach due to diabetes mellitus (15.7%), etc. CONCLUSIONS: This large-scale study supports the safety and efficacy of ED in adult and pediatric patients. UMIN000042020.
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Affiliation(s)
- Naoki Ohmiya
- Departments of Gastroenterology and Advanced Endoscopy, Fujita Health University School of Medicine, Aichi, Japan
| | - Shiro Oka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Yoshiko Nakayama
- Department of Pediatrics, Shinshu University School of Medicine, Nagano, Japan
| | - Itaru Iwama
- Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan
| | - Masanao Nakamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hirotaka Shimizu
- Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiko Sumioka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Naoki Abe
- Division of Infectious Diseases and Immunology, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Takahiro Kudo
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Osawa
- Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hitoshi Honma
- Department of Gastroenterology and Endocrinology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Takeru Okuhira
- Department of Pediatrics, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Shoji Mtsufuji
- Department of Gastroenterology, Kyoto Kujo Hospital, Kyoto, Japan
| | - Hiroyuki Imaeda
- Department of Gastroenterology, Saitama Medical University, Saitama, Japan
| | - Kazuhiro Ota
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Ryo Matsuoka
- Department of Pediatrics, Fuji City General Hospital, Shizuoka, Japan
| | - Naoki Hotta
- Department of Internal Medicine, Masuko Memorial Hospital, Aichi, Japan
| | - Mikihiro Inoue
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | | | | | - Keiji Ozeki
- Departments of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Taku Kobayashi
- Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Naoki Hosoe
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinji Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
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Pratò S, Didonna V, Garletti F, Marfia G, Barbaresi A, Palumbo F, Garzia E, Ciniglio Appiani G, Riboldi L, Vigna L. Loss of consciousness in a helicopter pilot as plausible first sign of insulinoma: a case report. Med Lav 2022; 113:e2022007. [PMID: 35226655 PMCID: PMC8902744 DOI: 10.23749/mdl.v113i1.12037] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/31/2021] [Indexed: 11/04/2022]
Abstract
A 50-year-old man who worked as a helicopter rescue pilot transiently lost consciousness while piloting a helicopter rescue. In the diagnostic process, all tests for the main possible differential diagnoses of loss of consciousness (cardiological and neurological) were performed and yielded normal results. Blood chemistry tests revealed recurrent fasting hypoglycemia and Chromogranin A was at the upper limit of normal. Fine needle aspiration guided by endoscopic ultrasonography was used to diagnose insulinoma-type neuroendocrine tumor of the pancreas. According to the Italian policies, the occupational physician aims to maintain professional skills without neglecting flight safety. A careful analysis of the relationship between the characteristics of the state of health of the aviator and his specific work needs was carried out, and he was given the opportunity to continue working as a rescue pilot thanks to medical therapies associated with organizational interventions in the workplace.
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Affiliation(s)
- Simone Pratò
- UO Medicina del Lavoro – Clinica del Lavoro L. Devoto- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy,Postgraduate School of Occupational Medicine, University of Milan, Italy
| | - Vittoria Didonna
- UO Medicina del Lavoro – Clinica del Lavoro L. Devoto- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy,Postgraduate School of Occupational Medicine, University of Milan, Italy,Istituto di Medicina Aerospaziale “A.Mosso”, Aeronautica Militare Italiana, Milan, Italy
| | - Francesca Garletti
- UO Medicina del Lavoro – Clinica del Lavoro L. Devoto- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy,Postgraduate School of Occupational Medicine, University of Milan, Italy
| | - Giovanni Marfia
- Istituto di Medicina Aerospaziale “A.Mosso”, Aeronautica Militare Italiana, Milan, Italy
| | - Adriano Barbaresi
- Istituto di Medicina Aerospaziale “A.Mosso”, Aeronautica Militare Italiana, Milan, Italy
| | - Fabrizio Palumbo
- Istituto di Medicina Aerospaziale “A.Mosso”, Aeronautica Militare Italiana, Milan, Italy
| | - Emanuele Garzia
- Istituto di Medicina Aerospaziale “A.Mosso”, Aeronautica Militare Italiana, Milan, Italy
| | | | - Luciano Riboldi
- UO Medicina del Lavoro – Clinica del Lavoro L. Devoto- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luisella Vigna
- UO Medicina del Lavoro – Clinica del Lavoro L. Devoto- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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10
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Weir HK, Bryant H, Turner D, Coleman MP, Mariotto AB, Spika D, Matz M, Harewood R, Tucker TC, Allemani C. Population-Based Cancer Survival in Canada and the United States by Socioeconomic Status: Findings from the CONCORD-2 Study. J Registry Manag 2022; 49:23-33. [PMID: 37260622 PMCID: PMC10198415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Background Population-based cancer survival provides insight into the effectiveness of health systems to care for all residents with cancer, including those in marginalized groups. Methods Using CONCORD-2 data, we estimated 5-year net survival among patients diagnosed 2004-2009 with one of 10 common cancers, and children diagnosed with acute lymphoblastic leukemia (ALL), by socioeconomic status (SES) quintile, age (0-14, 15-64, ≥65 years), and country (Canada or United States). Results In the lowest SES quintile, survival was higher among younger Canadian adults diagnosed with liver (23% vs 15%) and cervical (78% vs 68%) cancers and with leukemia (62% vs 56%), including children diagnosed with ALL (92% vs 86%); and higher among older Americans diagnosed with colon (62% vs 56%), female breast (87% vs 80%), and prostate (97% vs 85%) cancers. In the highest SES quintile, survival was higher among younger Americans diagnosed with stomach cancer (33% vs 27%) and younger Canadians diagnosed with liver cancer (31% vs 23%); and higher among older Americans diagnosed with stomach (27% vs 22%) and prostate (99% vs 92%) cancers. Conclusions Among younger Canadian cancer patients in the lowest SES group, greater access to health care may have resulted in higher cancer survival, while higher screening prevalence and access to health insurance (Medicare) among older Americans during the period of this study may have resulted in higher survival for some screen-detected cancers. Higher survival in the highest SES group for stomach and liver may relate to treatment differences. Survival differences by age and SES between Canada and the United States may help inform cancer control strategies.
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Affiliation(s)
- Hannah K Weir
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Devon Spika
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rhea Harewood
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
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11
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Stuck L, Chacky F, Festo C, Lutambi A, Abdul R, Greer G, Mandike R, Nathan R, Elisaria E, Yukich J. Evaluation of Long-Lasting Insecticidal Net Distribution Through Schools in Southern Tanzania. Health Policy Plan 2021; 37:243-254. [PMID: 34918055 DOI: 10.1093/heapol/czab140] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/14/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Universal coverage with effective vector control remains the mainstay of malaria vector control in sub-Saharan Africa Tanzania has utilized a number of mechanisms for the maintenance of long-lasting insecticidal net (LLIN) coverage over time. Schools have been identified as one potential channel for continuous distribution of LLIN. This research aims to evaluate an annual school based LLIN distribution programme in Tanzania which began in 2013, called the School Net Programme (SNP). Following each of the first four rounds of SNP distribution, a household survey was conducted in intervention and comparison districts in Southern and Lake zones of Tanzania (N = 5083 households). Measures of ownership, access, and use were compared between intervention and comparison districts. Determinants of reach were assessed in intervention districts. Population access to an LLIN increased from 63.1% (95% CI: 58.8, 67.5) to 76.5% (95% CI: 72.9, 80.0) in the intervention districts between the first and last surveys. Access also rose in the comparison districts from 51.4% (95% CI: 46.9, 55.9) to 79.8% (95% CI: 77.3, 82.0) following a mass distribution and implementation of school-based distribution during the study period. LLIN use increased in intervention districts from 44.9% (95% CI: 40.5, 49.3) to 65.6% (95% CI: 59.4, 71.8) and from 57.2% (95% CI: 49.7, 64.7) to 77.4% (95% CI: 69.3, 85.5) specifically amongst primary school-aged children. Households reached by the SNP were wealthier households with children enrolled in school. The SNP in Tanzania was able to maintain population level LLIN ownership, use, and access in the absence of a mass distribution. The SNP successfully reached households which housed school-aged children. Alternative delivery strategies may need to be considered to reach households without children enrolled in school which experienced less benefit from the program.
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Affiliation(s)
- Logan Stuck
- Department of Tropical Medicine, Centre for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Frank Chacky
- National Malaria Control Programme, Dar es Salaam, Tanzania
| | | | | | | | - George Greer
- U. S. President's Malaria Initiative, United States Agency for Development, Dar es Salaam, Tanzania
| | | | - Rose Nathan
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | | | - Joshua Yukich
- Department of Tropical Medicine, Centre for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
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12
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Asemota IR, Ajiboye O, Nwaichi C, Mbachi C, Mba B. Cushing's Syndrome Due to a Functional Thymic Neuroendocrine Tumor in Multiple Endocrine Neoplasia Type 1 Syndrome. Cureus 2021; 13:e18590. [PMID: 34760427 PMCID: PMC8572323 DOI: 10.7759/cureus.18590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/07/2021] [Indexed: 11/05/2022] Open
Abstract
Multiple endocrine neoplasia type 1 (MEN 1) syndrome is characterized by endocrinopathies and could be associated with thymic neuroendocrine tumors (NET). On rare occasions, they can be functional adrenocorticotropic hormone-secreting thymic carcinoid leading to Cushing's syndrome. In this report, we describe a case of adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome due to a thymic NET associated with MEN type 1 syndrome. We highlight its aggressive clinical course, the premise for a high index of suspicion for an ectopic ACTH secretion, and the need for early surgical resection combined with medical therapy and alternative treatments.
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Affiliation(s)
| | - Oyintayo Ajiboye
- Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | - Chineme Nwaichi
- Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | - Chimezie Mbachi
- Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | - Benjamin Mba
- Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
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13
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Basendowah MH, Ashour MA, Hassan AY, Alshaynawi S, Alyazidi LK. Multiple Small Intestinal Neuroendocrine Tumors With Findings of Intestinal Obstruction. Cureus 2021; 13:e17629. [PMID: 34646678 PMCID: PMC8485364 DOI: 10.7759/cureus.17629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 12/04/2022] Open
Abstract
Carcinoid tumors are one of the most common types of small intestinal neuroendocrine tumors (SI-NETs). However, SI-NETs that manifest as subacute intestinal obstruction are extremely rare. The annual occurrence rate of jejuno-ileal NETs is 0.28-0.8 per 100,000 people. In this report, we describe a case of subacute intestinal obstruction due to a mid-ileal stricture. The patient underwent laparotomy after evaluation and investigation. Mid-ileal growth was noted, and small bowel resection was performed with primary end-to-end anastomosis. Postoperative histopathology revealed the growth to be a well-differentiated NET.
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Affiliation(s)
| | - Mohammed A Ashour
- Medicine, College of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Ammar Y Hassan
- Medical Physics, College of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Shahad Alshaynawi
- Surgery, College of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Lujain K Alyazidi
- Medicine, College of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
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14
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Watkins L, Sullivan PJ, Walter MT. What You Net Depends on if You Grab: A Meta-analysis of Sampling Method's Impact on Measured Aquatic Microplastic Concentration. Environ Sci Technol 2021; 55:12930-12942. [PMID: 34550691 DOI: 10.1021/acs.est.1c03019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Microplastic pollution is measured with a variety of sampling methods. Field experiments indicate that commonly used sampling methods, including net, pump, and grab samples, do not always result in equivalent measured concentration. We investigate the comparability of these methods through a meta-analysis of 121 surface water microplastic studies. We find systematic relationships between measured concentration and sampled volume, method of collection, mesh size used for filtration, and waterbody sampled. Most significantly, a strong log-linear relationship exists between sample volume and measured concentration, with small-volume grab samples measuring up to 104 particles/L higher concentrations than larger volume net samples, even when sampled concurrently. Potential biasing factors explored included filtration size (±102 particles/L), net volume overestimation (±101 particles/L), fiber loss through net mesh (unknown magnitude), intersample variability (±101 particles/L), and contamination, the potential factor with an effect large enough (±103 particles/L) to explain the observed differences. On the basis of these results, we caution against comparing concentrations across multiple studies or combining multiple study results to identify regional patterns. Additionally, we emphasize the importance of contamination reduction and quantification strategies, namely that blank samples from all stages of field sampling be collected and reported as a matter of course for all studies.
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Affiliation(s)
- Lisa Watkins
- Department of Biological and Environmental Engineering, Cornell University, Ithaca, New York 14853, United States
| | - Patrick J Sullivan
- Department of Natural Resources and the Environment, Cornell University, Ithaca, New York 14853, United States
| | - M Todd Walter
- Department of Biological and Environmental Engineering, Cornell University, Ithaca, New York 14853, United States
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15
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Kripalani S, Patel V, Joneja U, Talwar S, Parikh M, Barshay V, Chaaya A. Intrapancreatic Accessory Spleen Diagnosed As Neuroendocrine Tumor: The Dangers of False Positives and Their Implications in Subsequent Management. Cureus 2021; 13:e15891. [PMID: 34336412 PMCID: PMC8312822 DOI: 10.7759/cureus.15891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2021] [Indexed: 11/20/2022] Open
Abstract
This case serves as a reminder to consider ectopic splenic tissue in the differential diagnosis of pancreatic masses. The literature shows a lack of awareness and overtreatment of this condition due to clinical and radiologic concern for malignancy, namely neuroendocrine tumors (NETs) identified on positron emission tomography (PET)-CT NETSPOT. Given the vast difference in management and prognosis of ectopic splenic anomalies and malignant neoplasms involving the pancreas, accurate diagnosis is imperative to avoid unnecessary invasive procedures such as Whipple or distal pancreatectomy and splenectomy, which are associated with increased morbidity and mortality.
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Affiliation(s)
- Simran Kripalani
- Department of Gastroenterology, Cooper Medical School of Rowan University, Camden, USA
| | - Vikram Patel
- Department of Gastroenterology, Cooper University Hospital, Camden, USA
| | - Upasana Joneja
- Department of Pathology, Cooper University Hospital, Camden, USA
| | - Shikha Talwar
- Department of Medicine, Cooper University Hospital, Camden, USA
| | - Meet Parikh
- Department of Gastroenterology, Cooper University Hospital, Camden, USA
| | - Veniamin Barshay
- Department of Radiology, Cooper University Hospital, Camden, USA
| | - Adib Chaaya
- Department of Gastroenterology, Cooper University Hospital, Camden, USA
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16
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Bannister J, Sievers M, Bush F, Bloecher N. Biofouling in marine aquaculture: a review of recent research and developments. Biofouling 2019; 35:631-648. [PMID: 31339358 DOI: 10.1080/08927014.2019.1640214] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/02/2019] [Accepted: 07/02/2019] [Indexed: 06/10/2023]
Abstract
Biofouling in marine aquaculture is one of the main barriers to efficient and sustainable production. Owing to the growth of aquaculture globally, it is pertinent to update previous reviews to inform management and guide future research. Here, the authors highlight recent research and developments on the impacts, prevention and control of biofouling in shellfish, finfish and seaweed aquaculture, and the significant gaps that still exist in aquaculturalists' capacity to manage it. Antifouling methods are being explored and developed; these are centred on harnessing naturally occurring antifouling properties, culturing fouling-resistant genotypes, and improving farming strategies by adopting more sensitive and informative monitoring and modelling capabilities together with novel cleaning equipment. While no simple, quick-fix solutions to biofouling management in existing aquaculture industry situations have been developed, the expectation is that effective methods are likely to evolve as aquaculture develops into emerging culture scenarios, which will undoubtedly influence the path for future solutions.
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Affiliation(s)
- Jana Bannister
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, Tasmania, Australia
| | - Michael Sievers
- Australian Rivers Institute - Coast and Estuaries, Griffith University, Gold Coast, Queensland, Australia
| | - Flora Bush
- Institute for Marine and Antarctic Studies, University of Tasmania, Hobart, Tasmania, Australia
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17
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Calcagno P, Lotti M, Campanati L, Greco S, Trezzi R, Assolari A, Vaterlini E, Bertani C, Allievi N, Giulii Capponi M. Emergency Presentation of Gastric Ectopic Pancreas. Cureus 2018; 10:e3565. [PMID: 30648097 PMCID: PMC6325026 DOI: 10.7759/cureus.3565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Ectopic pancreas is a rare embryological abnormality apparently not in association with others. Stomach and duodenum are the most common organs involved. Symptoms are nonspecific. Patients may complain of dyspepsia, abdominal pain or intestinal obstruction. Malignant evolution of ectopic pancreatic cells has been reported. Diagnosis can be very challenging due to the rarity of the disease and the absence of specific symptoms and radiological findings. We report two cases of young-adult men admitted to the emergency department due to acute upper gastro-intestinal and pancreatic symptoms. In both cases, during upper gastrointestinal endoscopy no mucosal vegetations were found. Endoscopic ultrasonography revealed gastric lesions originating from the muscularis propria, with a pattern suspected but not conclusive for malignancy. Fine needle aspiration was inconclusive in both cases. The patients underwent abdominal computed tomography, that showed gastric masses originating from the antrum and the lesser curvature of the stomach, with enlarged locoregional lymph nodes. According to the patients’ symptoms, family history, radiological and cytological findings, the patients were scheduled for an explorative laparoscopy. In both cases, gastric ectopic pancreas was found. Clinical presentation of ectopic pancreas is heterogeneous and the diagnosis can be challenging, especially in an emergency setting. Endoscopic ultrasonography and fine needle aspiration can be useful for the diagnosis and clinical staging, but they can be unspecific. Diagnostic-therapeutic laparoscopy should be considered in symptomatic patients.
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Affiliation(s)
| | - Marco Lotti
- Surgery, Papa Giovanni Xxiii Hospital, Bergamo, ITA
| | | | - Salvatore Greco
- Internal Medicine, Papa Giovanni Xxiii Hospital, Bergamo, ITA
| | | | - Andrea Assolari
- Internal Medicine, Papa Giovanni Xxiii Hospital, Bergamo, ITA
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18
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Stuck L, Lutambi A, Chacky F, Schaettle P, Kramer K, Mandike R, Nathan R, Yukich J. Can school-based distribution be used to maintain coverage of long-lasting insecticide treated bed nets: evidence from a large scale programme in southern Tanzania? Health Policy Plan 2018; 32:980-989. [PMID: 28444184 DOI: 10.1093/heapol/czx028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 11/13/2022] Open
Abstract
Many sub-Saharan African countries have achieved substantial gains in insecticide treated bednet coverage since 2005. The Tanzania National Malaria Control Programme identified school-based net distribution as one potential 'keep-up' strategy for the purpose of maintaining long-lasting insecticidal net (LLIN) coverage after a nationwide mass campaign in 2011. The School Net Programme (SNP) was implemented in three regions of southern Tanzania and distributed one LLIN to each enrolled child attending schools in primary grades (standards) 1, 3, 5 and 7, and secondary grades (forms) 2 and 4 in 2013 and again with slightly modified eligibility criteria in 2014 and 2015. Household surveys in the programme area as well as in a control area were conducted after each of the SNP distributions to measure ownership and use of long-lasting insecticide treated nets. Ownership of at least one LLIN after the first distribution was 76.1% (95% CI 70.8-80.7) in the intervention area and 78.6% (95% CI 74.4-82.3) in the control area. After the second distribution, ownership of at least one LLIN had dropped significantly in the control area to 65.4% (95% CI 59.5-71.0) in 2015 (P < 0.001), while coverage in the intervention area was maintained at 79.3% (95% CI 75.4 × 82.6). Ownership of at least one LLIN in intervention area remained stable following the second round of net distribution. During the same period LLIN ownership, especially of enough nets to ensure all household member access, fell significantly in the control area. These results demonstrate that the SNP may be sufficient to maintain stable LLIN coverage following a mass distribution of LLINs.
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Affiliation(s)
- Logan Stuck
- Department of Tropical Medicine, Centre for Applied Malaria Research and Evaluation, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | | | - Frank Chacky
- National Malaria Control Programme, Dar es Salaam, Tanzania
| | - Paul Schaettle
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Karen Kramer
- National Malaria Control Programme and Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Renata Mandike
- National Malaria Control Programme, Dar es Salaam, Tanzania
| | - Rose Nathan
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Joshua Yukich
- Department of Tropical Medicine, center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
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19
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Toussaint M, Jackson DJ, Swieboda D, Guedán A, Tsourouktsoglou TD, Ching YM, Radermecker C, Makrinioti H, Aniscenko J, Bartlett NW, Edwards MR, Solari R, Farnir F, Papayannopoulos V, Bureau F, Marichal T, Johnston SL. Host DNA released by NETosis promotes rhinovirus-induced type-2 allergic asthma exacerbation. Nat Med 2017; 23:681-691. [PMID: 28459437 PMCID: PMC5821220 DOI: 10.1038/nm.4332] [Citation(s) in RCA: 216] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 04/04/2017] [Indexed: 02/06/2023]
Abstract
Respiratory viral infections represent the most common cause of allergic asthma exacerbations. Amplification of the type-2 immune response is strongly implicated in asthma exacerbation, but how virus infection boosts type-2 responses is poorly understood. We report a significant correlation between the release of host double-stranded DNA (dsDNA) following rhinovirus infection and the exacerbation of type-2 allergic inflammation in humans. In a mouse model of allergic airway hypersensitivity, we show that rhinovirus infection triggers dsDNA release associated with the formation of neutrophil extracellular traps (NETs), known as NETosis. We further demonstrate that inhibiting NETosis by blocking neutrophil elastase or by degrading NETs with DNase protects mice from type-2 immunopathology. Furthermore, the injection of mouse genomic DNA alone is sufficient to recapitulate many features of rhinovirus-induced type-2 immune responses and asthma pathology. Thus, NETosis and its associated extracellular dsDNA contribute to the pathogenesis and may represent potential therapeutic targets of rhinovirus-induced asthma exacerbations.
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Affiliation(s)
- Marie Toussaint
- Airway Disease Infection Section, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Medical Research Council (MRC) and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - David J Jackson
- Airway Disease Infection Section, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Medical Research Council (MRC) and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
- Imperial College Healthcare NHS Trust, London, UK
- Guy's and St Thomas' NHS Trust, London, UK
| | - Dawid Swieboda
- Airway Disease Infection Section, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Medical Research Council (MRC) and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Anabel Guedán
- Airway Disease Infection Section, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Medical Research Council (MRC) and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | | | - Yee Man Ching
- Airway Disease Infection Section, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Medical Research Council (MRC) and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Coraline Radermecker
- Laboratory of Cellular and Molecular Immunology, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA), University of Liège, Liège, Belgium
- Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Heidi Makrinioti
- Airway Disease Infection Section, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Medical Research Council (MRC) and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Julia Aniscenko
- Airway Disease Infection Section, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Medical Research Council (MRC) and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Nathan W Bartlett
- Airway Disease Infection Section, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Medical Research Council (MRC) and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Michael R Edwards
- Airway Disease Infection Section, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Medical Research Council (MRC) and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Roberto Solari
- Airway Disease Infection Section, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Medical Research Council (MRC) and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Frédéric Farnir
- Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
- Fundamental and Applied Research for Animals &Health, University of Liège, Liège, Belgium
| | | | - Fabrice Bureau
- Laboratory of Cellular and Molecular Immunology, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA), University of Liège, Liège, Belgium
- Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
- WELBIO, Walloon Excellence in Life Sciences and Biotechnology, Wallonia, Belgium
| | - Thomas Marichal
- Laboratory of Cellular and Molecular Immunology, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA), University of Liège, Liège, Belgium
- Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Sebastian L Johnston
- Airway Disease Infection Section, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Medical Research Council (MRC) and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
- Imperial College Healthcare NHS Trust, London, UK
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20
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Nikou GC, Pazaitou-Panayiotou K, Dimitroulopoulos D, Alexandrakis G, Papakostas P, Vaslamatzis M, Kaldrymidis P, Markussis V, Koumarianou A. Results of a prospective multicenter neuroendocrine tumor registry reporting on clinicopathologic characteristics of Greek patients. BMC Endocr Disord 2016; 16:8. [PMID: 26872616 PMCID: PMC4752769 DOI: 10.1186/s12902-016-0089-7] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 02/05/2016] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The rare incidence of neuroendocrine neoplasms (NENs) has contributed to a paucity of large epidemiologic studies of patients with this condition. We investigated the occurrence and clinicopathologic features of NENs in Greece. METHODS Between October 2010 and November 2012 we collected data on 246 newly diagnosed patients from a broad-based multi-institutional registry that comprises eight academic and hospital sites in Greece. The WHO 2010 pathologic classification and the 7th AJCC Staging system was applied in all cases. RESULTS Of all patients 94 % had a sporadic and 6 % a multiple endocrine neoplasia tumor; 63.4 % were gastroenteropancreatic-(GEP)-NENs, 17.9 % Head & Neck NENs, 9.8 % NENs of Unknown Primary, 6.5 % Lung NENs and 2.4 % Pheochromocytomas. Gastric and pancreatic NENs were the most common primary sites. Poorly differentiated neuroendocrine carcinomas (NEC) were 9.3 %, all sporadic. Fifteen percent of patients were asymptomatic at presentation, 24 % had a first symptom of the disease related to endocrine syndrome and 61 % had symptoms related to locally advanced or metastatic disease. Metastatic disease was established in 25 % of tumors most frequently in the GEP NEN group. Findings are presented according to Ki-67 distribution. MRI had a higher diagnostic positive yield than Octreoscan. Somatostatin analogs, lanreotide and octreotide acetate, were prescribed at 38.5 & 61.5 % of NEN patients respectively and were found to be equally effective at providing symptomatic relief. CONCLUSIONS This is to our knowledge the first study of a Greek tumor registry and one of the few European Registries providing information regarding clinicopathologic characteristics and therapies in patients with neuroendocrine tumors of various origin sites, beyond GEP NENs.
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Affiliation(s)
- George C. Nikou
- />Neuroendocrinology Section, 1st Department of Propaedeutic Internal Medicine, Laiko University Hospital, Athens, Greece
| | | | | | | | | | | | | | | | - Anna Koumarianou
- />Hematology-Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodestrian University of Athens, Rimini 1, 12462, Haidari, Athens, Greece
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Kangaslampi S, Garoff F, Peltonen K. Narrative exposure therapy for immigrant children traumatized by war: study protocol for a randomized controlled trial of effectiveness and mechanisms of change. BMC Psychiatry 2015; 15:127. [PMID: 26081580 PMCID: PMC4469253 DOI: 10.1186/s12888-015-0520-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 06/05/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Millions of children worldwide suffer from posttraumatic stress disorder (PTSD) symptoms and other mental health problems due to repeated exposure to war or organized violence. Forms of cognitive-behavioral therapy (CBT) are the most commonly used treatment for PTSD and appear to be effective for children as well, but little is known about the mechanisms of change through which they achieve their effectiveness. Here we present the study protocol of a randomized controlled trial (RCT) studying the effectiveness and mechanisms of change of Narrative Exposure Therapy (NET), a CBT-based, manualized, short-term intervention for PTSD symptoms resulting from repeated traumatization, in immigrant children traumatized by war. METHODS/DESIGN We are conducting a multicentre, pragmatic RCT in a usual care setting. Up to 80 9-17-year-old immigrant children who have experienced war and suffer from PTSD symptoms will be randomized into intervention (NET) and control (treatment as usual, TAU) groups of equal sizes. The effectiveness of NET treatment will be compared to both a waiting list and the parallel TAU positive control group, on the primary outcomes of PTSD and depressive symptoms, psychological distress, resilience, and level of cognitive performance. The effects of the intervention on traumatic memories and posttraumatic cognitions will be studied as potential mechanisms of change mediating overall treatment effectiveness. The possible moderating effects of peritraumatic dissociation, level of cognitive performance, and gender on treatment effectiveness will also be considered. We hypothesize that NET will be more effective than a waitlist condition or TAU in reducing PTSD and other symptoms and improving resilience, and that these effects will be mediated by changes in traumatic memories and posttraumatic cognitions. DISCUSSION The results of this trial will provide evidence for the effectiveness of NET in treating trauma-related symptoms in immigrant children affected by war. The trial will also generate insights into the complex relationships between PTSD, memory functions, posttraumatic cognitions and cognitive performance in children, and help guide the future development and implementation of therapeutic interventions for PTSD in children. TRIAL REGISTRATION ClinicalTrials.gov NCT02425280 . Registered 15 April 2015.
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Affiliation(s)
- Samuli Kangaslampi
- School of Social Sciences and Humanities/Psychology, FI-33014, University of Tampere, Tampere, Finland.
| | - Ferdinand Garoff
- Institute of Behavioural Sciences/Psychology, FI-00014, University of Helsinki, Helsinki, Finland.
| | - Kirsi Peltonen
- School of Social Sciences and Humanities/Psychology, FI-33014, University of Tampere, Tampere, Finland.
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Abstract
Background Isopoda are the most diverse Crustacea. In order to encourage the study of isopod crustaceans and their use in biodiversity studies, systematics, ecology, physiology and more, one needs to know who the isopods are and where to find them. New information This is a short “how to” guide focusing on the free-living marine and freshwater isopods: where they live and how to collect and preserve them. The tools and techniques described here are simple, but invaluable in accessing the natural history of these remarkable creatures.
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Affiliation(s)
- Regina Wetzer
- Natural History Museum of Los Angeles County, Los Angeles, United States of America
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García-Malinis AJ, Santamarina-Albertos A, Martin-Martin G, Carrera-Aguado N, Miranda-Romero A. Allergic contact dermatitis caused by undisclosed thiurams in a patch test tubular net. Contact Dermatitis 2014; 72:116-7. [PMID: 25441105 DOI: 10.1111/cod.12316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 09/12/2014] [Accepted: 10/13/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Ana Julia García-Malinis
- Servicio de Dermatología, Hospital Clinico Universitario de Valladolid, Avenida Ramón y Cajal, 13, 47005, Valladolid, Spain
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Abstract
BACKGROUND Information technology can play a vital role in meeting patient needs and reinforcing the relationship among patients and their pain physicians. However, strong resistance remains on the medical side to this type of non-frontal care. OBJECTIVES The primary objective of this study was to assess the effectiveness of an E-mail intervention on customers' satisfaction. The secondary goals were to analyze the messages from patients to their clinician (not only the volume but also the content) and the impact on client, professional and health services outcomes. STUDY DESIGN A prospective, non-randomized evaluation of patients undergoing treatment for chronic pain from September 2011 to May 2012. SETTING A private, specialty referral center in Spain. MATERIALS AND METHODS Participants were users visiting the Pain Management Unit evaluated by one physician. The E-mail address of the facility was written in every medical report provided. Patient satisfaction at the end of the 8-month trial period was assessed and outcomes recorded. RESULTS Patients reported better communication with their therapist and greater satisfaction with overall care. 780 E-mails were read. Specialists received an average of 5 messages per day (standard deviation 0,3). None of them was unsuitable. LIMITATIONS This is a prospective, single center evaluation performed by one doctor. There was no control group due to ethical considerations. CONCLUSIONS Electronic communication is a cheap, easy and feasible way to address a wide range of concerns, thus enhancing patients' satisfaction. More efforts are needed to implement routinely usage of this tool. If used appropriately, E-mail can facilitate physician-dependent interactions, promote access to care, save time and reduce costs. Concerns about billing, improper utilization, privacy and confidentiality might complicate its introduction and acceptance. Internet access remains a significant barrier to online patient-provider transference.
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Affiliation(s)
- Irene Solera Ruiz
- Consultant, Department of Anesthesia and Pain Treatment, León Hospital, León, Spain
| | | | - Irene Riquelme
- Consultant, Department of Anesthesia and Pain Treatment, Torrejón Hospital, Torrejón, Spain
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Grimaldi F, Fazio N, Attanasio R, Frasoldati A, Papini E, Angelini F, Baldelli R, Berretti D, Bianchetti S, Bizzarri G, Caputo M, Castello R, Cremonini N, Crescenzi A, Davì MV, D’Elia AV, Faggiano A, Pizzolitto S, Versari A, Zini M, Rindi G, Öberg K. Italian Association of Clinical Endocrinologists (AME) position statement: a stepwise clinical approach to the diagnosis of gastroenteropancreatic neuroendocrine neoplasms. J Endocrinol Invest 2014; 37:875-909. [PMID: 25038902 PMCID: PMC4159596 DOI: 10.1007/s40618-014-0119-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 03/29/2014] [Indexed: 02/07/2023]
Affiliation(s)
- Franco Grimaldi
- Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia”, P.le S.M. della Misericordia, 15-33100, Udine, Italy
| | - Nicola Fazio
- Unit of Gastrointestinal and Neuroendocrine Tumors, European Institute of Oncology, Milan, Italy
| | | | - Andrea Frasoldati
- Endocrinology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Enrico Papini
- Endocrinology Unit, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - Francesco Angelini
- Oncology and Hematology Unit, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - Roberto Baldelli
- Endocrinology Section, Regina Elena National Cancer Institute, Rome, Italy
| | - Debora Berretti
- Gastroenterology Unit, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia”, Udine, Italy
| | - Sara Bianchetti
- Oncology and Hematology Unit, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - Giancarlo Bizzarri
- Diagnostic Imaging Unit, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - Marco Caputo
- Dipartimento Servizi di Diagnosi e Cura, AUSL 22 Regione Veneto, Bussolengo, VR Italy
| | - Roberto Castello
- Medicina Interna ad indirizzo Endocrinologico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Nadia Cremonini
- Endocrinology Unit, Maggiore and Bellaria Hospital, Bologna, Italy
| | - Anna Crescenzi
- Pathology Unit, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - Maria Vittoria Davì
- Medicina Interna D, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Angela Valentina D’Elia
- Genetic Service, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia”, Udine, Italy
| | - Antongiulio Faggiano
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Stefano Pizzolitto
- Pathology Unit, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia”, Udine, Italy
| | - Annibale Versari
- Nuclear Medicine Service, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Michele Zini
- Endocrinology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Guido Rindi
- Institute of Pathology, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Kjell Öberg
- Department of Endocrine Oncology, University Hospital, Uppsala, Sweden
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Park S, Maxwell AD, Owens GE, Gurm HS, Cain CA, Xu Z. Non-invasive embolus trap using histotripsy-an acoustic parameter study. Ultrasound Med Biol 2013; 39:611-9. [PMID: 23415285 PMCID: PMC3631564 DOI: 10.1016/j.ultrasmedbio.2012.11.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 11/17/2012] [Accepted: 11/28/2012] [Indexed: 05/06/2023]
Abstract
Free-flowing particles in a blood vessel were observed to be attracted, trapped and eroded by a histotripsy bubble cloud. This phenomenon may be used to develop a non-invasive embolus trap (NET) to prevent embolization. This study investigates the effect of acoustic parameters on the trapping ability of the NET generated by a focused 1.063 MHz transducer. The maximum trapping velocity, defined by the maximum mean fluid velocity at which a 3-4 mm particle trapped in a 6 mm diameter vessel phantom, increased linearly with peak negative pressure (P-) and increased as the square root of pulse length and pulse repetition frequency (PRF). At 19.9 MPa P-, 1000 Hz PRF and 10 cycle pulse length, a 3 mm clot-mimicking particle could remain trapped under a background velocity of 9.7 cm/s. Clot fragments treated by NET resulted in debris particles <75 μm. These results will guide the appropriate selection of NET parameters.
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Affiliation(s)
- Simone Park
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109
| | - Adam D. Maxwell
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109
| | - Gabe E. Owens
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109
- Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109
| | - Hitinder S. Gurm
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109
| | - Charles A. Cain
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109
- Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109
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NWANERI D, ADELEYE O, ANDE A. Asymptomatic malaria parasitaemia using rapid diagnostic test in unbooked pregnant women in rural Ondo-south district, Nigeria. J Prev Med Hyg 2013; 54:49-52. [PMID: 24397006 PMCID: PMC4718361] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Malaria is a major contributor of maternal and peri-natal morbidity and mortality. The disease may be asymptomatic despite sequestration of parasitized red blood cells in the placental micro-circulation with antecedent complications. In such condition, it may also be difficult to identify the malaria parasite by the peripheral blood film microscopy, thus the need for use of simple but reliable tool for malaria parasite diagnosis. OBJECTIVE AND METHOD To determine the prevalence of asymptomatic malaria parasitaemia using the Rapid Diagnostic Test in pregnant unbooked women seen in a primary health centre during a malaria control campaign programme in rural Ondo-south, District Nigeria. RESULTS Prevalence of asymptomatic malaria parasitaemia was 25.9%. Only 3 (3.5%) of the 85 women had the long lasting insecticide-treated nets. There was no significant association between malaria parasitaemia, and the age group, parity and gestation age. CONCLUSION Given the high prevalence of asymptomatic malaria in pregnancy, routine screening for malaria at booking and scaling-up of other malaria control strategies such as the use of long lasting insecticidal-treated nets and intermittent preventive therapy for pregnant women are recommended.
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Affiliation(s)
- D.U. NWANERI
- Correspondence: D.U. Nwaneri, Institute of Child Health, University of Benin, PMB 1154, Benin City, Edo State, Nigeria - Tel. +23 48056321577 +23 480139172309 - E-mail:
| | | | - A.B. ANDE
- Department of Obstetrics and Gynaecology, University of Benin, Benin City, Edo State, Nigeria
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Green MD, Mayxay M, Beach R, Pongvongsa T, Phompida S, Hongvanthong B, Vanisaveth V, Newton PN, Vizcaino L, Swamidoss I. Evaluation of a rapid colorimetric field test to assess the effective life of long-lasting insecticide-treated mosquito nets in the Lao PDR. Malar J 2013; 12:57. [PMID: 23391349 PMCID: PMC3623780 DOI: 10.1186/1475-2875-12-57] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 01/05/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Malaria morbidity and mortality have been significantly reduced through the proper use of insecticide-treated mosquito nets, but the extra protection afforded by the insecticide diminishes over time. The insecticide depletion rates vary according to location where wash frequency and wear are influenced by cultural habits as well as the availability of water. Monitoring of available insecticides on the net surface is essential for determining the effective life of the net. Therefore, a rapid and inexpensive colorimetric field test for cyanopyrethroids (Cyanopyrethroid Field Test or CFT) was used to measure surface levels of deltamethrin on insecticide-coated polyester nets (PowerNets™) in rural Lao PDR over a two-year period. METHODS Net surface levels of deltamethrin were measured by wiping the net with filter paper and measuring the adsorbed deltamethrin using the CFT. A relationship between surface levels of deltamethrin and whole net levels was established by comparing results of the CFT with whole levels assayed by high-performance liquid chromatography (HPLC). An effective deltamethrin surface concentration (EC80) was determined by comparing mosquito mortality (WHO Cone Test) with CFT and HPLC results. Five positions (roof to bottom) on each of 23 matched nets were assayed for deltamethrin surface levels at 6, 12, and 24 months. Mosquito mortality assays (WHO Cone Tests) were performed on a subset of eleven 24-month old nets and compared with the proportion of failed nets as predicted by the CFT. RESULTS At six months, the nets retained about 80% of the baseline (new net) levels of deltamethrin with no significant differences between net positions. At 12 months, ~15-40%, and at 24 months <10% of deltamethrin was retained on the nets, with significant differences appearing between positions. Results from the CFT show that 93% of the nets failed (deltamethrin surface levels = EC80) at 24 months. This value is in agreement with 91% failure as determined by the WHO Cone Test on a subset of 11 nets. The CFT results show that 50% of the nets from Laos failed at 12 months of normal use. CONCLUSION The CFT is a useful and accurate indicator of net efficacy and may be substituted for mosquito bioassays.
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Affiliation(s)
- Michael D Green
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mayfong Mayxay
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR, Laos
- Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao PDR, Laos
- Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Ray Beach
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Samlane Phompida
- Centre of Malariology, Parasitology and Entomology, Ministry of Health, Vientiane, Lao PDR, Laos
| | - Bouasy Hongvanthong
- Centre of Malariology, Parasitology and Entomology, Ministry of Health, Vientiane, Lao PDR, Laos
| | - Viengxay Vanisaveth
- Centre of Malariology, Parasitology and Entomology, Ministry of Health, Vientiane, Lao PDR, Laos
| | - Paul N Newton
- Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR, Laos
- Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Lucrecia Vizcaino
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Isabel Swamidoss
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Strosberg JR, Weber JM, Choi J, Campos TL, Valone TL, Han G, Schell MJ, Kvols LK. A phase II clinical trial of sunitinib following hepatic transarterial embolization for metastatic neuroendocrine tumors. Ann Oncol 2012; 23:2335-2341. [PMID: 22317769 PMCID: PMC4559904 DOI: 10.1093/annonc/mdr614] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 12/12/2011] [Accepted: 12/13/2011] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The liver is the predominant site of metastases among patients with advanced neuroendocrine tumors (NETs). Prior retrospective studies have reported high response rates in patients treated with transarterial embolization (TAE). NETs are highly vascular and are known to express vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor (VEGFR). We hypothesized that administration of sunitinib, a VEGFR inhibitor, following TAE would extend progression-free survival (PFS). PATIENTS AND METHODS Patients with metastatic NETs to the liver underwent a series of selective TAEs followed by sunitinib (until disease progression or maximum of 12 months). Radiographic response (by RECIST), survival, and safety parameters were monitored. RESULTS Thirty-nine patients were enrolled. The overall response rate was 72% [95% confidence interval (CI), 0.58-0.86]. Median PFS was 15.2 months. Rates of overall survival (OS) at 1 and 4 years were 95% (95% CI, 0.88-1.00) and 59% (95% CI, 0.38-0.80), respectively. A significant 34% rise in serum VEGF was observed following the initial TAE (P = 0.03). CONCLUSIONS Hepatic TAE is a highly active treatment option for patients with metastatic NETs to the liver. Embolization stimulates release of VEGF into the circulation. Sunitinib, an oral VEGFR inhibitor, can be safely administered following embolization. The high rates of PFS and OS associated with this sequence of therapies are encouraging.
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Affiliation(s)
| | - J M Weber
- Departments of Gastrointestinal Oncology
| | - J Choi
- Departments of Interventional Radiology
| | - T L Campos
- Departments of Gastrointestinal Oncology
| | - T L Valone
- Departments of Gastrointestinal Oncology
| | - G Han
- Departments of Biostatistics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - M J Schell
- Departments of Biostatistics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - L K Kvols
- Departments of Gastrointestinal Oncology
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Paczesny J, Sozański K, Dzięcielewski I, Żywociński A, Hołyst R. Formation of net-like patterns of gold nanoparticles in liquid crystal matrix at the air-water interface. J Nanopart Res 2012; 14:826. [PMID: 22798726 PMCID: PMC3394235 DOI: 10.1007/s11051-012-0826-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 03/09/2012] [Indexed: 06/01/2023]
Abstract
Controlled patterning and formation of nanostructures on surfaces based on self-assembly is a promising area in the field of "bottom-up" nanomaterial engineering. We report formation of net-like structures of gold nanoparticles (Au NPs) in a matrix of liquid crystalline amphiphile 4'-n-octyl-4-cyanobiphenyl at the air-water interface. After initial compression to at least 18 mN m(-1), decompression of a Langmuir film of a mixture containing both components results in formation of net-like structures. The average size of a unit cell of the net is easily adjustable by changing the surface pressure during the decompression of the film. The net-like patterns of different, desired average unit cell areas were transferred onto solid substrates (Langmuir-Blodgett method) and investigated with scanning electron microscopy and X-ray reflectivity (XRR). Uniform coverage over large areas was proved. XRR data revealed lifting of the Au NPs from the surface during the formation of the film. A molecular mechanism of formation of the net-like structures is discussed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11051-012-0826-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jan Paczesny
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland
| | - Krzysztof Sozański
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland
| | - Igor Dzięcielewski
- Institute of High Pressure Physics Unipress, Polish Academy of Sciences, Sokołowska 29/37, 01-142 Warsaw, Poland
| | - Andrzej Żywociński
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland
| | - Robert Hołyst
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland
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Klibanski A, Melmed S, Clemmons DR, Colao A, Cunningham RS, Molitch ME, Vinik AI, Adelman DT, Liebert KJP. The endocrine tumor summit 2008: appraising therapeutic approaches for acromegaly and carcinoid syndrome. Pituitary 2010; 13:266-86. [PMID: 20012914 PMCID: PMC2913001 DOI: 10.1007/s11102-009-0210-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The Endocrine Tumor Summit convened in December 2008 to address 6 statements prepared by panel members that reflect important questions in the treatment of acromegaly and carcinoid syndrome. Data pertinent to each of the statements were identified through review of pertinent literature by one of the 9-member panel, enabling a critical evaluation of the statements and the evidence supporting or refuting them. Three statements addressed the validity of serum growth hormone (GH) and insulin-like growth factor-I (IGF-I) concentrations as indicators or predictors of disease in acromegaly. Statements regarding the effects of preoperative somatostatin analog use on pituitary surgical outcomes, their effects on hormone and symptom control in carcinoid syndrome, and the efficacy of extended dosing intervals were reviewed. Panel opinions, based on the level of available scientific evidence, were polled. Finally, their views were compared with those of surveyed community-based endocrinologists and neurosurgeons.
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Affiliation(s)
- Anne Klibanski
- Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114 USA
| | - Shlomo Melmed
- Cedars-Sinai Medical Center, Academic Affairs, Room #2015, 8700 Beverly Boulevard, Los Angles, CA 90048 USA
| | - David R. Clemmons
- University of North Carolina School of Medicine, 8024 Burnette Womack, CB 7170, Bowles Building, Chapel Hill, NC 27599-7170 USA
| | - Annamaria Colao
- Department of Molecular and Clinical Endocrinology and Oncology, University Federico II of Naples, Via S. Pansini 5, Naples, 80131 Italy
| | - Regina S. Cunningham
- The Cancer Institute of New Jersey, Robert Wood Johnson Medical Center, 195 Little Albany Street, New Brunswick, NJ 08903-2681 USA
| | - Mark E. Molitch
- Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue Suite 530, Chicago, IL 60611 USA
| | - Aaron I. Vinik
- Department of Internal Medicine, Eastern Virginia Medical School, Strelitz Diabetes Center, 855 West Brambleton Ave., Norfolk, VA 23510 USA
| | - Daphne T. Adelman
- Northwestern University Feinberg School of Medicine, 645 N. Michigan Avenue Suite 530, Chicago, IL 60611 USA
| | - Karen J. P. Liebert
- Neuroendocrine Unit, Massachusetts General Hospital, Bulfinch 457 B, 55 Fruit Street, Boston, MA 02114 USA
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Abstract
Compliance with the Health Insurance Portability and Accountability Act (HIPAA) requires gathering audit information from picture archiving and communications systems (PACS) regarding evidence trails of human interactions. Until recently, most PACS users have had limited access to auditing information. Access required resources to handle manual inspection of audit logs, and access to proprietary databases was not always available. Some vendors now produce eXtensible Markup Language (XML) audit logs based on certain events occurring in PACS. However, it is up to the user to convert this information into an easily mined data repository supporting compliance and quality control. This process can be handled in multiple ways, which could mean different audit mechanisms depending on the PACS (or other hospital system) used. It is apparent that an organized method of dealing with audit information is needed. This help may be provided within the Integrating the Healthcare Environment (IHE) framework. The IHE initiative defines a set of profiles, actors, and transactions that create common scenarios for particular workflow processes. The Integration Profiles depict security as a fundamental requirement of the framework. Specifically, the Audit Trail and Node Authentication (ATNA) profile defines standards based mechanisms for securely transmitting and storing audit records in a central repository. The data structure defined by the profile provides a number of record types that capture different audit events. A general feasibility study for storing currently available PACS audit information following the profile is defined, and steps to an automated solution are discussed.
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Affiliation(s)
- Bill Gregg
- Department of Radiology, LSU Health Sciences Center, Shreveport, LA, USA.
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Norbeck AD, Monroe ME, Adkins JN, Smith RD. The utility of accurate mass and LC elution time information in the analysis of complex proteomes. J Am Soc Mass Spectrom 2005; 16:1239-49. [PMID: 15979333 PMCID: PMC1769320 DOI: 10.1016/j.jasms.2005.05.009] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2005] [Revised: 05/20/2005] [Accepted: 05/23/2005] [Indexed: 05/03/2023]
Abstract
The combination of mass and normalized elution time (NET) of a peptide identified by liquid chromatography-mass spectrometry (LC-MS) measurements can serve as a unique signature for that peptide. However, the specificity of an LC-MS measurement depends upon the complexity of the proteome (i.e., the number of possible peptides) and the accuracy of the LC-MS measurements. In this work, theoretical tryptic digests of all predicted proteins from the genomes of three organisms of varying complexity were evaluated for specificity. Accuracy of the LC-MS measurement of mass-NET pairs (on a 0 to 1.0 NET scale) was described by bivariate normal sampling distributions centered on the peptide signatures. Measurement accuracy (i.e., mass and NET standard deviations of +/-0.1, 1, 5, and 10 ppm, and +/-0.01 and 0.05, respectively) was varied to evaluate improvements in process quality. The spatially localized confidence score, a conditional probability of peptide uniqueness, formed the basis for the peptide identification. Application of this approach to organisms with comparatively small proteomes, such as Deinococcus radiodurans, shows that modest mass and elution time accuracies are generally adequate for confidently identifying most peptides. For more complex proteomes, more accurate measurements are required. However, the study suggests that the majority of proteins for even the human proteome should be identifiable with reasonable confidence by using LC-MS measurements with mass accuracies within +/-1 ppm and high efficiency separations having elution time measurements within +/-0.01 NET.
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Affiliation(s)
| | | | | | - Richard D. Smith
- Address reprint requests to: Richard D. Smith, Pacific Northwest National Laboratories, P.O. Box 999, MSIN: K8-98, Richland, Washington 99352, Phone: 509-376-0723, Fax: 509-376-7722,
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